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Kim, Kim, Kim, Kwon, Oh, Cha, Ok, Kwak, Kim, and Moon: A Prospective Study of Factors Influencing on the Clinical Characteristics of Colonic Diverticulosis
Original Article

Korean J Gastroenterol 2013;62(2):97-103.

Published online: 4 October 2013

DOI: https://doi.org/10.4166/kjg.2013.62.2.97

A Prospective Study of Factors Influencing on the Clinical Characteristics of Colonic Diverticulosis

Sun Young Kim, You Sun Kim, Hyun Tae Kim, Sun Ok Kwon, Myoung Ki Oh, In Hye Cha, Kyeong Sam Ok, Cheol Hun Kwak, Jin Nam Kim, Jeong Seop Moon

Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea

Correspondence to: You Sun Kim, Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, 9 Mareunnae-ro, Jung-gu, Seoul 100-032, Korea. Tel: +82-2-2270-0012, Fax: +82-2-2270-0257, E-mail: yousunk69@korea.com

Received 18 February 2013       Revised 4 June 2013       Accepted 19 June 2013

Copyright © 2013 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

The prevalence of colonic diverticulosis in Korea is increasing in conjunction with the adoption of western dietary pattern, extension of lifespan, and advances in diagnostic modalities. The clinical characteristics of colonic diverticulosis seem to be gradually becoming similar to those of Western societies. Therefore, factors associated with the clinical characteristics of colonic diverticulosis in Korea were investigated.

Methods

The data of 200 patients diagnosed with colonic diverticulosis using colonoscopy between May 2010 and April 2012 at Inje University Seoul Paik Hospital (Seoul, Korea) were prospectively collected. Clinical parameters acquired through a questionnaire include age, body mass index, waist circumference, exercise, diet, smoking, drinking habits, etc. Correlation between these factors and the clinical features of diverticulosis were analyzed.

Results

Mean age of the patients was 54.9±11.9 (range 17–79) years and male to female ratio was 2.2:1. Most diverticula were located on the right side of the colon (83%) and the mean number of diverticulum was 4.07±3.9. Factor associated with the location of diverticulum on the left side was age (p=0.001). There was a positive correlation between the waist circumference and the number of diverticulum (partial correlation coefficient r'=0.143, p=0.047). Diverticulitis occurred more frequently in younger patients than in older patients (p=0.002).

Conclusions

Colonic diverticulosis in older patients is found more frequently on the left colon, and the number of diverticulosis is associated with central obesity.

Keywords: Colonoscopy, Diverticulum, colon, Diverticulitis, colonic, Age factors, Obesity

References

1. Parra-Blanco A. Colonic diverticular disease: pathophysiology and clinical picture. Digestion. 2006; 73(Suppl 1):47–57.
crossref
2. Martel J, Raskin JB. NDSG. History, incidence, and epidemiology of diverticulosis. J Clin Gastroenterol. 2008; 42:1125–1127.
crossref
3. Delvaux M. Diverticular disease of the colon in Europe: epidemiology, impact on citizen health and prevention. Aliment Pharmacol Ther. 2003; 18(Suppl 3):71–74.
crossref
4. Jun S, Stollman N. Epidemiology of diverticular disease. Best Pract Res Clin Gastroenterol. 2002; 16:529–542.
crossref
5. Kim HU, Kim YH, Choe WH, et al. Clinical characteristics of colonic diverticulitis in Koreans. Korean J Gastroenterol. 2003; 42:363–368.
6. Choi CS, Cho EY, Kweon JH, et al. The prevalence and clinical features of colonic diverticulosis diagnosed with colonscopy. Korean J Gastrointest Endosc. 2007; 35:146–151.
7. Petruzziello L, Iacopini F, Bulajic M, Shah S, Costamagna G. Review article: uncomplicated diverticular disease of the colon. Aliment Pharmacol Ther. 2006; 23:1379–1391.
crossref
8. Nakaji S, Danjo K, Munakata A, et al. Comparison of etiology of right-sided diverticula in Japan with that of left-sided diverticula in the West. Int J Colorectal Dis. 2002; 17:365–373.
crossref
9. Song JH, Huh JG, Kim YS, et al. Clinical characteristics of colonic diverticular disease diagnosed with colonoscopy. Intest Res. 2008; 6:110–115.
10. Song JH, Kim YS, Lee JH, et al. Clinical characteristics of colonic diverticulosis in Korea: a prospective study. Korean J Intern Med. 2010; 25:140–146.
crossref
11. Strate LL, Liu YL, Aldoori WH, Syngal S, Giovannucci EL. Obesity increases the risks of diverticulitis and diverticular bleeding. Gastroenterology. 2009; 136:115–122.
crossref
12. Tan KY, Seow-Choen F. Fiber and colorectal diseases: separating fact from fiction. World J Gastroenterol. 2007; 13:4161–4167.
crossref
13. Place RJ, Simmang CL. Diverticular disease. Best Pract Res Clin Gastroenterol. 2002; 16:135–148.
crossref
14. Kim WY, Cho MS, Lee HS. Development and validation of mini dietary assessment index for Koreans. Korean J Nutr. 2003; 36:83–92.
15. Choi SH, Kim DJ, Lee KE, et al. Cut-off value of waist circumference for metabolic syndrome patients in Korean adult population. J Korean Soc Study Obes. 2004; 13:53–60.
16. Kim KH, Kim YB, Kang JK, Kim SJ. A clinical study of diverticulosis of the colon. J Korean Med Assoc. 1986; 29:63–68.
17. Kim KS. Recent changes of colonic diverticulosis in Korea. J Korea Radiol Soc. 1984; 20:632–638.
crossref
18. Ko JK, Lee JK, Yun EJ, Moon HJ, Shin HJ. Colonic diverticulosis: evaluation wth double contrast barium enema. J Korean Radiol Soc. 1997; 36:285–289.
crossref
19. Kim JS, Cha SG, Kim YT, et al. The prevalence and clinical features of diverticular disease of the colon. Korean J Gastroenterol. 1993; 25:305–314.
20. Jacobs DO. Clinical practice. Diverticulitis. N Engl J Med. 2007; 357:2057–2066.
21. Gear JS, Ware A, Fursdon P, et al. Symptomless diverticular disease and intake of dietary fibre. Lancet. 1979; 1:511–514.
crossref
22. Aldoori WH, Giovannucci EL, Rimm EB, Wing AL, Trichopoulos DV, Willett WC. A prospective study of diet and the risk of symptomatic diverticular disease in men. Am J Clin Nutr. 1994; 60:757–764.
crossref
23. Law WL, Lo CY, Chu KW. Emergency surgery for colonic diverticulitis: differences between right-sided and left-sided lesions. Int J Colorectal Dis. 2001; 16:280–284.
crossref
24. Lim JS, Sohn CY, Bae OS, Park SD. A retrospective study comparing clinical characteristics between the right and left colonic diverticular disease. J Korean Soc Coloproctol. 1999; 15:219–226.
25. Kim JI, Yu BC, Jeon MJ, et al. Correlation of metabolic syndrome with waist circumference and waist-to-height ratio. Korean J Obes. 2009; 18:87–93.
26. Hwang KY, Yang HW, Kim SH, et al. Clinical characteristics of colonic diverticulitis in young patients. Korean J Med. 2008; 74:250–257.
27. Konvolinka CW. Acute diverticulitis under age forty. Am J Surg. 1994; 167:562–565.
crossref

Fig. 1.
Age distribution of the patients with colonic diverticulosis. The percentage of patients with colonic diverticulosis increases with advancing age and peaks in the 50–59 year age group.
kjg-62-97f1.tif
Fig. 2.
Number of colonic diverticulum. The most common number of colonic diverticulum ranges from 2 to 5.
kjg-62-97f2.tif
Table 1.
Scores on Corrected Mini Dietary Assessment Index
Index Almost always Occasionally Seldom
Fiber      
 1. Eat vegetables except Kimchi every meal 5 3 1
 2. Eat one serving size of fruit or fruit juice everyday 5 3 1
Fat      
 1. Eat more than one serving size of fried or stir-fried food every two days 1 3 5
 2. Eat more than one serving size of fatty meat every three days 1 3 5
 3. Eat more than one serving size of snack or dessert everyday 1 3 5
Table 2.
Univariate Analysis of the Variables Associated with the Location of Colonic Diverticulum
Variable Location of diverticulum p-value
Right Left
Gender     0.007
 Male 117 (94.4) 7 (5.6)  
 Female 49 (81.7) 11 (18.3)  
Age (yr) 53.4±11.84 65.3±8.01 0.000
Corrected MDA score 12.4±4.25 12.0±3.77 0.734
BMI (kg/m2) 24.0±2.96 23.7±3.11 0.702
Waist measurement (inch) 32.1±3.20 31.4±2.83 0.420
Smoking (pack-yr)     0.009
 Nonsmoker 71 (82.6) 15 (17.4)  
 1–5 8 (88.9) 1 (11.1)  
 6–10 15 (100) 0 (0)  
 ＞10 72 (97.3) 2 (2.7)  
Exercise (day/wk)     0.268
 None exercise 68 (94.4) 4 (5.6)  
 ＜3 41 (83.7) 5 (16.3)  
 ≥3 57 (86.4) 9 (13.6)  
Alcohol (g/mo)     0.047
 Nondrinker 52 (82.5) 11 (17.5)  
 ＜315 47 (90.4) 5 (9.6)  
 316–630 26 (96.3) 1 (3.7)  
 ≥630 41 (97.6) 1 (2.4)  

Values are expressed as n (%) or mean±SD.

MDA, mini dietary assessment.

Pack yr=(packs smoked per day)×(years as a smoker).

Table 3.
Multivariate Analysis of the Variables That Associated with Left Side Location of Colonic Diverticulum by Logistic Regression Analysis
Variable OR CI p-value
Gender      
 Male 1    
 Female 3.494 0.659–18.519 0.141
Age (yr) 1.141 1.054–1.235 0.001
Corrected MDA score      
 5–9 1    
 10–15 1.391 0.316–6.119 0.662
 16–20 1.805 0.195–16.741 0.603
 ＞20 0.000 0.000 0.999
BMI (kg/m2)      
 ＜22 1    
 22–25 1.261 0.270–5.888 0.768
 ＞25 1.138 0.195–6.629 0.886
Waist measurement (inch)      
 ＜34 1    
 ≥34 0.793 0.139–4.543 0.795
Smoking (pack-yr)      
 Nonsmoker 1    
 1–5 2.108 0.129–34.496 0.601
 6–10 0.000 0.000 0.998
 ＞10 0.254 0.038–1.718 0.160
Exercise (day/wk)      
 None exercise 1    
 ＜3 2.739 0.511–14.672 0.239
 ≥3 2.483 0.508–12.130 0.261
Alcohol (g/mo)      
 Nondrinker 1    
 ＜315 0.890 0.191–4.137 0.881
 316–630 0.675 0.062–7.318 0.747
 ≥630 1.038 0.111–17.244 0.802

MDA, mini dietary assessment.

Pack yr=(packs smoked per day)×(years as a smoker).

Table 4.
Univariate Analysis after Adjustment for Other Variables That Can Be Associated with Number of Colonic Diverticulum
Variable Pearson's correlation coefficient (r) p-value Partial correlation coefficeient (r') p-value
Gender −0.095 0.183 0.028 0.694
Age (yr) 0.128 0.071 0.109 0.132
Corrected MDA score 0.089 0.209 0.049 0.502
BMI (kg/m2) 0.082 0.246 −0.052 0.476
Waist measurement 0.219 0.002 0.143 0.047
Smoking 0.097 0.172 −0.020 0.785
Exercise −0.011 0.874 −0.018 0.806
Alcohol 0.121 0.087 0.084 0.244

MDA, mini dietary assessment.

Table 5.
Multivariate Analysis of the Variables That Associated with Colonic Diverticulitis by Logistic Regression Analysis
Variable OR CI p-value
Gender      
 Male 1    
 Female 1.185 0.221–6.352 0.843
Age (yr)      
 ＜40 1    
 40–50 0.247 0.028–2.168 0.207
 50–60 0.114 0.017–0.766 0.025
 ≥60 0.014 0.001–0.201 0.002
Location of diverticulum      
 Both 1    
 Right 2.064 0.225–18.913 0.521
 Left 0.000 0.000 0.998
Number of diverticulum      
 1 1    
 2–5 1.428 0.294–6.936 0.659
 6–10 1.180 0.083–16.821 0.903
 ＞11 6.188 0.724–52.933 0.096
Corrected MDA score      
 5–9 1    
 10–15 2.748 0.576–13.122 0.205
 16–20 0.690 0.047–10.205 0.787
 ＞20 3.216 0.131–79.263 0.475
BMI (kg/m2)      
 ＜22 1    
 22–25 0.709 0.143–3.452 0.675
 ≥25 0.230 0.029–1.805 0.162
Waist measurement (inch)      
 ＜34 1    
 ≥34 1.511 0.207–11.030 0.684
Smoking (pack-yr)      
 Nonsmoker 1    
 1–5 0.352 0.023–5.420 0.454
 6–10 0.215 0.010–4.791 0.331
 ＞10 0.209 0.025–1726 0.146
Exercise (day/wk)      
 None exercise 1    
 ＜3 0.858 0.177–4160 0.849
 ≥3 0.983 0.200–4.824 0.983
Alcohol (g/mo)      
 Nondrinker 1    
 ＜315 0.454 0.078–2.644 0.380
 316–630 0.187 0.009–3.815 0.276
 ≥630 1.916 0.298–12.335 0.494

MDA, mini dietary assessment.

Pack-yr=(packs smoked per day)×(years as a smoker).

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You Sun Kim
https://orcid.org/http://orcid.org/0000-0002-5156-3458

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