Cardiovascular Risk Factors and Physical Fitness Among Subjects with Asymptomatic Colonic Diverticulosis

Offir Ukashi; Barak Pflantzer; Yiftach Barash; Eyal Klang; Shlomo Segev; David J Ozeri; Ido Veisman; Adi Lahat; Ido Laish; Uri Kopylov; Amit Oppenheim

doi:10.1007/s10620-022-07572-y

Cardiovascular Risk Factors and Physical Fitness Among Subjects with Asymptomatic Colonic Diverticulosis

Dig Dis Sci. 2023 Mar;68(3):902-912. doi: 10.1007/s10620-022-07572-y. Epub 2022 Jun 13.

Authors

Offir Ukashi^{1

2

3}, Barak Pflantzer^{4

5}, Yiftach Barash^{6

7

8}, Eyal Klang^{6

7

8}, Shlomo Segev^{6

9}, David J Ozeri^{4

6

10}, Ido Veisman^{11

6}, Adi Lahat^{11

6}, Ido Laish^{11

6}, Uri Kopylov^{11

6}, Amit Oppenheim^{4

6}

Affiliations

¹ Department of Gastroenterology, Sheba Medical Center, Ha'ela 1, Ramat Gan, Israel. Offir.Ukashi@sheba.health.gov.il.
² Department of Internal Medicine A, Sheba Medical Center, Ha'ela 1, Ramat Gan, Israel. Offir.Ukashi@sheba.health.gov.il.
³ Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. Offir.Ukashi@sheba.health.gov.il.
⁴ Department of Internal Medicine A, Sheba Medical Center, Ha'ela 1, Ramat Gan, Israel.
⁵ Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
⁶ Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
⁷ Department of Diagnostic Imaging, Sheba Medical Center, Ramat-Gan, Israel.
⁸ DeepVision Lab, Sheba Medical Center, Ramat-Gan, Israel.
⁹ Institute of Medical Screening, Sheba Medical Center, Ramat-Gan, Israel.
¹⁰ Department of Rheumatology, Sheba Medical Center, Ramat-Gan, Israel.
¹¹ Department of Gastroenterology, Sheba Medical Center, Ha'ela 1, Ramat Gan, Israel.

PMID: 35695973
DOI: 10.1007/s10620-022-07572-y

Abstract

Background: The association between diverticular disease and atherosclerotic cardiovascular disease (ASCVD) has been demonstrated previously, mainly in symptomatic subjects.

Aims: To evaluate 10 years cardiovascular risk, exercise performance and association to ASCVD among subjects with asymptomatic diverticulosis.

Methods: A retrospective cross-sectional cohort of self-referred participants in a medical screening program, who underwent a screening colonoscopy. Demographics, clinical and laboratory variables, ASCVD score, and metabolic equivalents (METs) during treadmill stress test were compared between subjects with and without diverticulosis as diagnosed on screening colonoscopy.

Results: 4586 participants underwent screening colonoscopy; 799 (17.4%) had diverticulosis. Among 50-69 yo participants, diverticulosis subjects had a higher ASCVD score compared to non-diverticulosis subjects. Exercise performance was comparable between the groups, across all age groups. Using logistic regression analysis, advanced age group (50-59 yo Adjusted odds ratio (AOR) [95% confidence interval (CI)] 2.57 (1.52-4.34), p < 0.001; 60-69 yo, AOR 2.87 (2.09-3.95), p < 0.001; ≥ 70 yo AOR 4.81 (3.23-7.15), p < 0.001; compared to < 50 yo age group), smoking [AOR 1.27 (1.05-1.55), p = 0.016], HTN [AOR 1.27 (1.03-1.56), p = 0.022], obesity [AOR 1.36 (1.06-1.74), p = 0.014] and male sex [AOR 1.29 (1.02-1.64), p = 0.036] were associated with diverticular detection during screening colonoscopy. Among males, achieving METs score ≥ 10 was inversely associated with diverticular detection during screening colonoscopy [AOR 0.64 (0.43-0.95), p = 0.027].

Conclusions: Ten years probability for ASCVD estimated by the ASCVD score is higher among subjects with asymptomatic diverticulosis compared to subjects without diverticulosis. Improved exercise performance is demonstrated for the first time to correlate with decreased probability for diverticular disease in screening colonoscopy.

Keywords: ASCVD; Diverticulosis; Exercise performance; METs; Screening colonoscopy.

MeSH terms

Atherosclerosis* / complications
Cardiovascular Diseases* / complications
Cross-Sectional Studies
Diverticular Diseases* / complications
Diverticulosis, Colonic* / diagnosis
Diverticulosis, Colonic* / epidemiology
Diverticulum* / complications
Heart Disease Risk Factors
Humans
Male
Physical Fitness
Retrospective Studies
Risk Factors