Characteristics and associated risk factors of diverticular disease assessed by magnetic resonance imaging in subjects from a Western general population
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Diverticular disease represents an increasing pathology and healthcare burden worldwide. Our aim was to study the prevalence, extent and distribution of asymptomatic diverticular disease assessed by magnetic resonance imaging (MRI) in a sample of a Western population.
Subjects from a population-based cohort study who underwent 3-T MRI were analyzed for the prevalence and extent of diverticula of the colon using an isotropic VIBE-Dixon gradient-echo sequence. The extent of diverticular disease was categorized according to the number of diverticula in each colonic segment. Univariate and adjusted analyses were performed to assess associated characteristics and risk factors.
Among 393 subjects included in the analysis (56.4 ± 9.2 years, 57.5% males), 164 (42%) had diverticular disease, with the highest prevalence in the left-sided colonic segments (93% diverticular disease in the descending and sigmoid segment). Subjects with advanced diverticular disease were older (62.1 vs. 54.4 years) and had a higher body mass index (BMI), LDL cholesterol levels and systolic blood pressure (30.2 ± 5.1 vs. 27.8 ± 4.9 kg/m2, 149.8 ± 29.3 vs. 135.2 ± 32.9 mg/dl and 128.2 ± 14.1 vs. 118.4 ± 16.1 mmHg, respectively; all p > 0.003) compared with subjects without diverticular disease. In contrast, no significant correlation could be found for gender, physical activity, smoking status and alcohol consumption (all p > 0.31). Intra-rater reliability was excellent for all colonic segments (intra-class correlation [ICC] = 0.99-1.00), and inter-rater reliability was excellent for left- and right-sided colonic segments (ICC = 0.84-0.97).
These findings provide insights into the disease mechanism of asymptomatic diverticular disease and may help to improve prevention of diverticulosis and its associated complications.
• Overall prevalence of asymptomatic diverticular disease assessed by MRI was 42%, affecting predominantly the left-sided colon.
• Asymptomatic diverticular disease was associated with age and cardiometabolic risk factors.
• Magnetic resonance imaging reveals insights into the pathophysiologic mechanism of asymptomatic diverticular disease.
KeywordsDiverticular disease Magnetic resonance imaging Colon Epidemiology
Body mass index
Computed tomography colonography
Intraclass correlation coefficient
Magnetic resonance imaging
Oral glucose tolerance test
This study was funded by the German Research Foundation (DFG, Bonn, Germany), the German Centre for Cardiovascular Disease Research (DZHK, Berlin, Germany) and the German Centre for Diabetes Research (DZD e.V., Neuherberg, Germany).
The KORA study was initiated and financed by the Helmholtz Zentrum München-German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria.
Compliance with ethical standards
The scientific guarantor of this publication is Fabian Bamberg, MD, MPH.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
Two of the authors (SR, RL) have significant statistical expertise.
Written informed consent was obtained from all subjects in this study.
Institutional Review Board approval was obtained.
• population based
• case-control study
• performed at one institution
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