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Visceral Abdominal Obesity Measured by Computed Tomography is Associated With Increased Risk of Colonic
Naoyoshi Nagata1, Kayo Sakamoto, Tomohiro Arai
1Departments of *Gastroenterology and Hepatology †Diagnostic Radiology ‡Clinical Research and Informatics, International Clinical Research Center Research Institute §Diabetes Research, Diabetes Research Center ∥Clinical Research Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo ¶Research Center for Hepatitis and Immunology #Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan.
Goals:
To investigate whether visceral obesity measured by computed tomography (CT) is a risk factor for colonic diverticulosis.
Background:
The association between colonoscopy-proven diverticulosis and visceral obesity has not been studied.
Study:
A cohort of 1445 participants (1117 nondiverticulosis and 328 diverticulosis) undergoing colonoscopy and CT was prospectively analyzed. Diverticulosis was diagnosed by high-resolution colonoscopy. The associations between body mass index (BMI), visceral adipose tissue (VAT) area, subcutaneous adipose tissue (SAT) area, and diverticulosis were estimated using odds ratios (ORs) adjusted for age, sex, alcohol, smoking, medications, and comorbidities.
Results:
In multivariate analysis, diverticulosis was significantly associated with VAT area and SAT area for both categorical data and trend (P for trend <0.001), but not BMI.Diverticulosis had a positive association with VAT area and SAT area for both categorical data and trend (P for trend <0.001) in men, but none of these associations were noted in women. In the subanalysis of normal-weight patients (BMI<25), diverticulosis was independently associated with VAT area and SAT area (P for trend <0.001). The adjusted ORs for VAT area ≥100 cm² was significantly increased in right-sided (OR, 1.8), left-sided (OR, 2.3), and bilateral (OR, 3.0) diverticula (P for trend <0.001).
Conclusions:
Abdominal obesity measured by CT, not BMI, is associated with colonic diverticulosis, even when body weight was normal. These findings suggest an important role for visceral fat accumulation in diverticulosis development. A high visceral fat was positively associated with the distribution of diverticula.
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