Peery Anne F, Keil Alexander, Jicha Katherine, Galanko Joseph A, Sandler Robert S
Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Clin Gastroenterol Hepatol. 2020 Jan;18(1):107-114.e1. doi: 10.1016/j.cgh.2019.04.058. Epub 2019 May 8.
BACKGROUND & AIMS: Obesity has been associated with an increased risk of colonic diverticulosis. Evidence for this association is limited. We assessed whether anthropometric measures of obesity were associated with colonic diverticulosis.
We analyzed data from a prospective study of 623 patients undergoing screening colonoscopies from 2013 through 2015; colonoscopies included examinations for diverticulosis. Body measurements were made the day of the procedure. Multivariate analyses were performed using modified Poisson regression to estimate prevalence ratios (PRs) and 95% CIs while adjusting for confounding variables. All analyses were stratified by sex.
Among men, there was no association between any measure of obesity and diverticulosis. After adjustment, women with an obese body mass index (BMI ≥ 30) had an increased risk of any diverticulosis (PR, 1.48; 95% CI, 1.08-2.04) compared with women with a normal body mass index (BMI 18.5-24.9). The strength of this association was greater for more than 5 diverticula (PR, 2.05; 95% CI, 1.23-3.40). There was no significant association between measures of central obesity and diverticulosis in women. Stratified by sex, colonic diverticulosis was significantly less prevalent in women compared with men before the age of 51 years (29% vs 45%, P = .06). The prevalence of diverticulosis did not differ by sex in older age groups.
In an analysis of data from 623 patients undergoing screening colonoscopies, we found that obesity (BMI ≥30) significantly increased the risk of colonic diverticulosis in women but not men. Colonic diverticulosis was less prevalent in premenopausal-age women compared with similar-age men. These findings suggest that sex hormones may influence the development of diverticulosis.
肥胖与结肠憩室病风险增加有关。这种关联的证据有限。我们评估了肥胖的人体测量指标是否与结肠憩室病相关。
我们分析了2013年至2015年623例接受结肠镜筛查患者的前瞻性研究数据；结肠镜检查包括对憩室病的检查。在检查当天进行身体测量。使用修正的泊松回归进行多变量分析，以估计患病率比（PRs）和95%置信区间（CIs），同时对混杂变量进行调整。所有分析均按性别分层。
在男性中，任何肥胖指标与憩室病之间均无关联。调整后，与体重指数正常（BMI 18.5 - 24.9）的女性相比，肥胖体重指数（BMI≥30）的女性发生任何憩室病的风险增加（PR，1.48；95% CI，1.08 - 2.04）。这种关联强度在憩室超过5个时更大（PR，2.05；95% CI，1.23 - 3.40）。女性中心性肥胖指标与憩室病之间无显著关联。按性别分层，51岁之前女性结肠憩室病的患病率显著低于男性（29%对45%，P = 0.06）。在老年人群中，憩室病的患病率在性别上无差异。
在对623例接受结肠镜筛查患者的数据进行分析时，我们发现肥胖（BMI≥30）显著增加女性而非男性患结肠憩室病的风险。绝经前女性结肠憩室病的患病率低于同龄男性。这些发现表明性激素可能影响憩室病的发生发展。
