title: Visceral Abdominal Obesity Measured by Computed Tomography is Associated With Increased Risk of Colonic Diverticulosis.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Departments 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.
authors.forename: Naoyoshi
authors.initials: N
authors.lastname: Nagata
authors.forename: Kayo
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Arai
authors.forename: Ryota
authors.initials: R
authors.lastname: Niikura
authors.forename: Takuro
authors.initials: T
authors.lastname: Shimbo
authors.forename: Masafumi
authors.initials: M
authors.lastname: Shinozaki
authors.forename: Tomonori
authors.initials: T
authors.lastname: Aoki
authors.forename: Katsunori
authors.initials: K
authors.lastname: Sekine
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Okubo
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sakurai
authors.forename: Chizu
authors.initials: C
authors.lastname: Yokoi
authors.forename: Junichi
authors.initials: J
authors.lastname: Akiyama
authors.forename: Mikio
authors.initials: M
authors.lastname: Yanase
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Noda
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Itoh
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizokami
authors.forename: Naomi
authors.initials: N
authors.lastname: Uemura
mesh_terms: D000328:Adult; D015992:Body Mass Index; D053704:Capsule Endoscopy; D003113:Colonoscopy; D043963:Diverticulosis, Colonic / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D056128:Obesity, Abdominal / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging / Q000473:pathology