Predictors of colonic diverticulosis in non-elderly patients

Year 2022, Volume: 5 Issue: 3, 740 - 745, 30.05.2022

Abdurrahman Şahin Mustafa Cengiz Oktay Sarı

https://doi.org/10.32322/jhsm.1076167

Abstract

Aim: To investigate the clinical and laboratory features patients under aged 65 years with diverticulosis and to compare them to subjects with no diverticula.
Material and Method: This retrospective case-control study included subjects aged under 65 years who underwent a colonoscopy in the period from January 2016 to June 2018 for diverse indications. Patients with diverticulosis as detected by a colonoscopy were compared to patients without diverticulosis. The comparison parameters included demographic data, comorbidities, and laboratory parameters, including a complete blood count, blood biochemistry, erythrocyte sedimentation rate (ESR), and C-reactive protein.
Results: The study included 129 patients with diverticulosis and age and sex-matched 130 patients with no diverticula. Diverticula were predominantly left-sided in 64.3%, right-sided in 9.3%, and bilateral in 26.4%. Hypertension was more prevalent among patients with diverticulosis compared to control subjects (31% vs 17%, p<0.01). The median ESR was higher in diverticulosis group than in control group (13±1.6 mm/h vs 9±0.9 mm/h, p=0.01). The mean creatinine was higher (0.86±0.25mg/dL vs 0.76±0.19 mg/dL, p<0.01) and the mean albumin was lower (4.3±0.4 g/dL vs 4.5±0.3 g/dL, p<0.01) in diverticulosis group compared to control group. Hypertension, ESR, creatinine and albumin were independent predictors of the presence of diverticulosis in univariate and multivariate logistic regression analysis.
Conclusion: It is important to determine the characteristic features of asymptomatic patients with diverticulosis in earlier ages. The presence of hypertension, in conjunction with high creatinine and low albumin values increase the probability of the presence of asymptomatic colonic diverticula.

Keywords

Albumin, colonic diverticula, creatinine, hypertension, non-elderly

References

• Tursi A, Scarpignato C, Strate LL, et al. Colonic diverticular disease. Nat Rev Dis Primers 2020; 6: 20.
• Martel J, Raskin JB. History, incidence, and epidemiology of diverticulosis. J Clin Gastroenterol 2008; 42: 1125-7.
• Bohm SK. Risk Factors for Diverticulosis, diverticulitis, diverticular perforation, and bleeding: a plea for more subtle history taking. Viszeralmedizin 2015; 31: 84-94.
• Strate LL. Lifestyle factors and the course of diverticular disease. Dig Dis 2012; 30: 35-45.
• Tan JP, Barazanchi AW, Singh PP, Hill AG, Maccormick AD. Predictors of acute diverticulitis severity: a systematic review. Int J Surg 2016; 26: 43-52.
• Hong W, Geng W, Wang C, et al. Prevalence of colonic diverticulosis in mainland China from 2004 to 2014. Sci Rep 2016; 6: 26237.
• Sahin A, Tunc N, Demirel U, Kursat Poyrazoglu O, Yalniz M, Bahcecioglu IH. Relationship between diverticulosis and nonalcoholic fatty liver disease in elderly patients. J Int Med Res 2018; 46: 1545-54.
• Brown SR, Cleveland EM, Deeken CR, Huitron SS, Aluka KJ, Davis KG. Type I/type III collagen ratio associated with diverticulitis of the colon in young patients. J Surg Res 2017; 207: 229-34.
• Vather R, Broad JB, Jaung R, Robertson J, Bissett IP. Demographics and trends in the acute presentation of diverticular disease: a national study. ANZ J Surg 2015; 85: 744-8.
• Nguyen GC, Sam J, Anand N. Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States. World J Gastroenterol 2011; 17: 1600-5.
• Syed U, Companioni R, Bansal R, Alkhawam H, Walfish A. Diverticulitis in the young population: reconsidering conventional recommendations. Acta Gastroenterol Belg 2016; 79: 435-9.
• Strate LL, Morris AM. Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology 2019; 156: 1282-98 e1.
• Skoldberg F, Granlund J, Discacciati A, Hjern F, Schmidt PT, Olen O. Incidence and lifetime risk of hospitalization and surgery for diverticular disease. Br J Surg 2019; 106: 930-9.
• Yang F, Zheng Y, Jiang X, et al. Sex differences in risk factors of uncomplicated colonic diverticulosis in a metropolitan area from Northern China. Sci Rep 2018; 8: 138.
• Azzam N, Aljebreen AM, Alharbi O, Almadi MA. Prevalence and clinical features of colonic diverticulosis in a Middle Eastern population. World J Gastrointest Endosc 2013; 5: 391-7.
• Cassieri C, Pica R, Avallone EV, et al. Prevalence of colonic diverticulosis in patients affected by ulcerative colitis: a prospective study. J Clin Gastroenterol 2016; 50: S33-5.
• Sakuta H, Suzuki T. Prevalence rates of type 2 diabetes and hypertension are elevated among middle-aged Japanese men with colonic diverticulum. Environ Health Prev Med 2007; 12: 97-100.
• Kopylov U, Ben-Horin S, Lahat A, Segev S, Avidan B, Carter D. Obesity, metabolic syndrome and the risk of development of colonic diverticulosis. Digestion 2012; 86: 201-5.
• Tursi A. Diverticulosis today: unfashionable and still under-researched. Therap Adv Gastroenterol 2016; 9: 213-28.
• Pantaroto M, Lopes Filho Gde J, Pinto CA, Antico Filho A. Comparative study of collagen deposition in the colon wall of patients operated for sigmoid diverticular disease. Acta Cir Bras 2015; 30: 715-9.
• Whiteway J, Morson BC. Elastosis in diverticular disease of the sigmoid colon. Gut. 1985; 26: 258-66.
• Devocelle A, Lecru L, Ferlicot S, et al. IL-15 prevents renal fibrosis by inhibiting collagen synthesis: a new pathway in chronic kidney disease? Int J Mol Sci 2021; 22.