Visceral Abdominal Obesity Measured by Computed Tomography is Associated With Increased Risk of Colonic Diverticulosis

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 cm(2) 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.