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Siblings of patients with diverticular disease face increased risk
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The risk for developing diverticular disease is increased among the siblings of patients already diagnosed with the illness, according to recent results.
Researchers evaluated 142,123 patients in Denmark diagnosed with diverticular disease between 1977 and 2011. The cohort included 10,420 index siblings and 923 twins (330 monozygotic and 593 dizygotic) and was collected from the Danish National Registry of Patients.
Lisa L. Strate
“Little is known about the genetic basis of diverticular disease,” researcher Lisa L. Strate, MD, MPH, University of Washington, division of gastroenterology, told Healio.com. “A few case reports of diverticulitis in very young siblings and twins suggested that genetics could play a role. The robust Danish population-based databases made it possible to study both twins and siblings with regards to diverticular disease.”
Siblings of index cases were at significantly increased risk for diverticular disease compared with the general population (RR=2.92; 95% CI, 2.50-3.39). The sex of either sibling did not influence this association, but siblings of index patients who received surgery or were hospitalized (RR=5.37; 95% CI, 2.99-9.67) were at particularly increased risk.
Risk also was higher among siblings of those diagnosed when aged younger than 40 years (P<.001 compared with older index cases) and was highest among siblings of index cases diagnosed between 1977 and 1996 (RR=10.07; 95% CI, 2.51-40.52) vs. later time periods.
Both dizygotic (RR=5.5; 95% CI, 3.3-8.6) and monozygotic twins (RR=14.5; 95% CI, 8.9-23) were at significantly increased risk for diverticular disease. The association among monozygotic twins was stronger among females (tetrachoric correlation=0.60; 95% CI, 0.49-0.70 in females compared with 0.33; 95% CI, 0.13-0.51).
The investigators estimated that genetic factors accounted for more than half (53%; 95% CI, 45%-61%) of diverticular disease susceptibility.
“The results … suggest that genetic factors play an important role in the development of diverticular disease, including diverticulitis and diverticular bleeding,” Strate said. “These findings overturn the long-standing theory that diverticular disease is entirely environmental in nature. As effective preventive interventions become available, siblings of patients with diverticulitis or diverticular bleeding may be appropriate candidates.”
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