Ukashi Offir, Pflantzer Barak, Barash Yiftach, Klang Eyal, Segev Shlomo, Ozeri David J, Veisman Ido, Lahat Adi, Laish Ido, Kopylov Uri, Oppenheim Amit
Department of Gastroenterology, Sheba Medical Center, Ha'ela 1, Ramat Gan, Israel.
Department of Internal Medicine A, Sheba Medical Center, Ha'ela 1, Ramat Gan, Israel.
Dig Dis Sci. 2023 Mar;68(3):902-912. doi: 10.1007/s10620-022-07572-y. Epub 2022 Jun 13.
The association between diverticular disease and atherosclerotic cardiovascular disease (ASCVD) has been demonstrated previously, mainly in symptomatic subjects.
To evaluate 10 years cardiovascular risk, exercise performance and association to ASCVD among subjects with asymptomatic diverticulosis.
A retrospective cross-sectional cohort of self-referred participants in a medical screening program, who underwent a screening colonoscopy. Demographics, clinical and laboratory variables, ASCVD score, and metabolic equivalents (METs) during treadmill stress test were compared between subjects with and without diverticulosis as diagnosed on screening colonoscopy.
4586 participants underwent screening colonoscopy; 799 (17.4%) had diverticulosis. Among 50-69 yo participants, diverticulosis subjects had a higher ASCVD score compared to non-diverticulosis subjects. Exercise performance was comparable between the groups, across all age groups. Using logistic regression analysis, advanced age group (50-59 yo Adjusted odds ratio (AOR) [95% confidence interval (CI)] 2.57 (1.52-4.34), p < 0.001; 60-69 yo, AOR 2.87 (2.09-3.95), p < 0.001; ≥ 70 yo AOR 4.81 (3.23-7.15), p < 0.001; compared to < 50 yo age group), smoking [AOR 1.27 (1.05-1.55), p = 0.016], HTN [AOR 1.27 (1.03-1.56), p = 0.022], obesity [AOR 1.36 (1.06-1.74), p = 0.014] and male sex [AOR 1.29 (1.02-1.64), p = 0.036] were associated with diverticular detection during screening colonoscopy. Among males, achieving METs score ≥ 10 was inversely associated with diverticular detection during screening colonoscopy [AOR 0.64 (0.43-0.95), p = 0.027].
Ten years probability for ASCVD estimated by the ASCVD score is higher among subjects with asymptomatic diverticulosis compared to subjects without diverticulosis. Improved exercise performance is demonstrated for the first time to correlate with decreased probability for diverticular disease in screening colonoscopy.
憩室病与动脉粥样硬化性心血管疾病（ASCVD）之间的关联此前已有报道，主要是在有症状的患者中。
评估无症状憩室病患者的10年心血管风险、运动能力以及与ASCVD的关联。
对一个医学筛查项目中自我推荐的参与者进行回顾性横断面队列研究，这些参与者接受了筛查结肠镜检查。比较了经筛查结肠镜检查诊断为有憩室病和无憩室病的受试者的人口统计学、临床和实验室变量、ASCVD评分以及跑步机压力测试期间的代谢当量（METs）。
4586名参与者接受了筛查结肠镜检查；799人（17.4%）有憩室病。在50 - 69岁的参与者中，有憩室病的受试者的ASCVD评分高于无憩室病的受试者。在所有年龄组中，两组之间的运动能力相当。使用逻辑回归分析，高龄组（50 - 59岁，调整比值比（AOR）[95%置信区间（CI）]为2.57（1.52 - 4.34），p < 0.001；60 - 69岁），AOR为2.87（2.09 - 3.95），p < 0.001；≥70岁，AOR为4.81（3.23 - 7.15），p < 0.001；与<50岁年龄组相比）、吸烟[AOR为1.27（1.05 - 1.55），p = 0.016]、高血压[AOR为1.27（1.03 - 1.56），p = 0.022]、肥胖[AOR为1.36（1.06 - 1.74），p = 0.014]和男性性别[AOR为1.29（1.02 - 1.64），p = 0.036]与筛查结肠镜检查时发现憩室有关。在男性中，METs评分≥10与筛查结肠镜检查时发现憩室呈负相关[AOR为0.64（0.43 - 0.95），p = 0.027]。
与无憩室病的受试者相比，无症状憩室病患者通过ASCVD评分估计的10年ASCVD发生概率更高。首次证明改善运动能力与筛查结肠镜检查中憩室病发生概率降低相关。
