May 14, 2019
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Obesity increases risk for diverticulosis in women

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Women with obesity are at increased risk for developing diverticulosis while hormones seem to be at play as well, according to research published in Clinical Gastroenterology and Hepatology.

Anne F. Peery, MD, MSCR, of the division of gastroenterology and hepatology at the University of North Carolina School of Medicine, and colleagues wrote that although obesity and diverticulosis have been linked, evidence to support the association has been limited.

“Prior studies used body mass index but did not include measures of abdominal obesity, which is assessed by waist circumference, waist to hip ratio and waist to height ratio,” they wrote. “Furthermore, prior studies did not assess for heterogeneity of these associations by sex, even though obesity in men and women differs significantly.”

Researchers analyzed data from a prospective study comprising 623 patients (56% women) who underwent screening colonoscopies that included examinations for diverticulosis from 2013 to 2015.

Investigators found that women with a BMI of at least 30 kg/m2 had an increased risk for any diverticulosis (prevalence ratio [PR] = 1.48; 95% CI, 1.08–2.04) compared with women with a BMI between 18.5 kg/m2 and 24.9 kg/m2, which they defined as normal. The association grew stronger among women who had more than five diverticula (PR = 2.04; 95% CI, 1.23–3.4).

No other measures of central obesity were associated with diverticulosis in women and no measure of obesity was associated with diverticulosis among men.

Peery and colleagues wrote that diverticulosis was less prevalent among premenopausal women (age 50 years or less) than in men in the same age group (29% vs. 45%; P = .06).

“The lower prevalence of diverticulosis among women compared with men before the age of 51 is a novel finding and suggests that ovarian steroid hormones in premenopausal women may reduce the risk of diverticulosis,” they wrote. “The lower prevalence of diverticulosis in women is congruent with a population-based study that found that diverticulitis was more common in men compared with women before the age of 49. After the age of 60, diverticulitis was more common in women.” – by Alex Young

Disclosures: The authors report no relevant financial disclosures.