Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Public Health Sciences, Washington University School of Medicine in St Louis, St Louis, Missouri.
Gastroenterology. 2018 Jul;155(1):58-66.e4. doi: 10.1053/j.gastro.2018.03.057. Epub 2018 Apr 1.
BACKGROUND & AIMS: There is little evidence that adiposity associates with diverticulitis, especially among women. We conducted a comprehensive evaluation of obesity, weight change, and incidence of diverticulitis in a large cohort of women.
We conducted a prospective cohort study of 46,079 women enrolled in the Nurses' Health Study who were 61-89 years old and free of diverticulitis, diverticular bleeding, cancers, or inflammatory bowel disease at baseline (in 2008). We used Cox proportional hazards models to examine the associations among risk of incident diverticulitis and body mass index (BMI), waist circumference, waist to hip ratio, and weight change from age 18 years to the present. The primary end point was first incident diverticulitis requiring antibiotic therapy or hospitalization.
We documented 1084 incident cases of diverticulitis over 6 years of follow-up, encompassing 248,001 person-years. After adjustment for other risk factors, women with a BMI ≥35.0 kg/m had a hazard ratio for diverticulitis of 1.42 (95% confidence interval [CI], 1.08-1.85) compared to women with a BMI <22.5 kg/m. Compared to women in the lowest quintile, the multivariable hazard ratios among women in the highest quintile were 1.35 (95% CI, 1.02-1.78) for waist circumference and 1.40 (95% CI, 1.07-1.84) for waist to hip ratio; these associations were attenuated with further adjustment for BMI. Compared to women maintaining weight from age 18 years to the present, those who gained ≥20 kg had a 73% increased risk of diverticulitis (95% CI, 27%-136%).
During a 6-year follow-up period, we observed an association between obesity and risk of diverticulitis among women. Weight gain during adulthood was also associated with increased risk.
肥胖与憩室炎之间的关联证据有限，特别是在女性中。我们对大量女性队列中肥胖、体重变化与憩室炎的发病率进行了综合评估。
我们对参加护士健康研究的 46079 名年龄在 61-89 岁、基线时（2008 年）无憩室炎、憩室出血、癌症或炎症性肠病的女性进行了前瞻性队列研究。我们使用 Cox 比例风险模型来研究从 18 岁到现在的体重指数（BMI）、腰围、腰围与臀围比值与憩室炎发病风险之间的关系。主要终点是首次需要抗生素治疗或住院的憩室炎事件。
在 6 年的随访期间，我们共记录了 1084 例憩室炎事件，涵盖了 248001 人年。在调整其他危险因素后，BMI≥35.0 kg/m²的女性患憩室炎的风险比为 1.42（95%可信区间[CI]，1.08-1.85），与 BMI<22.5 kg/m²的女性相比。与最低五分位组的女性相比，最高五分位组的女性的多变量风险比为腰围 1.35（95%CI，1.02-1.78）和腰围与臀围比值 1.40（95%CI，1.07-1.84）；这些关联在进一步调整 BMI 后减弱。与从 18 岁到现在体重保持不变的女性相比，体重增加≥20 kg 的女性患憩室炎的风险增加了 73%（95%CI，27%-136%）。
在 6 年的随访期间，我们观察到肥胖与女性憩室炎风险之间存在关联。成年期体重增加也与风险增加相关。
