Obesity Increases the Risks of Diverticulitis and Diverticular Bleeding
Received 15 February 2008; accepted 18 September 2008. published online 26 September 2008.
Background & Aims
Studies of obesity and diverticular complications are limited. We assessed the relationship between body mass index (BMI), waist circumference, and waist-to-hip ratio and diverticulitis and diverticular bleeding.
Methods
A prospective cohort study of 47,228 male health professionals (40–75 years old) who were free of diverticular disease in 1986 (baseline) was performed. Men reporting newly diagnosed diverticular disease on biennial follow-up questionnaires were sent supplemental questionnaires. Weight was recorded every 2 years, and data on waist and hip circumferences were collected in 1987.
Results
We documented 801 incident cases of diverticulitis and 383 incident cases of diverticular bleeding during 18 years of follow-up. After adjustment for other risk factors, men with a BMI ≥30 kg/m2 had a relative risk (RR) of 1.78 (95% confidence interval [CI], 1.08–2.94) for diverticulitis and 3.19 (95% CI, 1.45–7.00) for diverticular bleeding compared with men with a BMI of <21 kg/m2. Men in the highest quintile of waist circumference, compared with those in the lowest, had a multivariable RR of 1.56 (95% CI, 1.18–2.07) for diverticulitis and 1.96 (95% CI, 1.30–2.97) for diverticular bleeding. Waist-to-hip ratio was also associated with the risk of diverticular complications when the highest and lowest quintiles were compared, with a multivariable RR of 1.62 (95% CI, 1.23–2.14) for diverticulitis and 1.91 (95% CI, 1.26–2.90) for diverticular bleeding. Adjustment for BMI did not change the associations seen for waist-to-hip ratio.
Conclusions
In this large prospective cohort, BMI, waist circumference, and waist-to-hip ratio significantly increased the risks of diverticulitis and diverticular bleeding.
#Division of Population Sciences, Dana Farber Cancer Institute, Boston, Massachusetts
⁎⁎Division of Gastroenterology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
‡‡Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
Address requests for reprints to: Lisa L. Strate, MD, MPH, Harborview Medical Center, 325 Ninth Avenue, Box 359773, Seattle, Washington 98104. fax: (206) 744-8698
The authors disclose the following: Supported by grants from the Agency for Healthcare Research and Quality (K08 HS14062 to L.L.S.), the National Cancer Institute (PO1CA055075 to E.L.G. and K24 CA113433 to S.S.), and the National Heart, Lung, and Blood Institute (R01 HL035464 to E.L.G.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute, the National Institutes of Health, or the Agency for Healthcare Research and Quality. The funding sources had no role in the design, conduct, or reporting of this study.
ABSTRACT
Obesity Increases the Risks of Diverticulitis and Diverticular Bleeding