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Visceral fat accumulation affects risk of colonic diverticular hemorrhage

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purposes

Factors other than antithrombotic drugs associated with diverticular bleeding remain unknown. Visceral adiposity contributes to atherosclerosis and may affect arteriolar change at the diverticulum. We investigated whether visceral adipose tissue (VAT) measured by computed tomography (CT) is a risk factor for diverticular bleeding.

Methods

A cohort of 283 patients (184 with asymptomatic diverticulosis and 99 with diverticular bleeding) undergoing colonoscopy and CT was analyzed. Associations between body mass index (BMI), VAT, subcutaneous adipose tissue (SAT), and diverticular bleeding were assessed by logistic regression models adjusted for age, gender, alcohol, smoking, diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease, and antithrombotic drugs (nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin, and other antiplatelet drugs).

Results

In univariate analysis, hypertension, dyslipidemia, chronic kidney disease, and NSAIDs use, low-dose aspirin, non-aspirin antiplatelets, increasing BMI, and increasing VAT area were associated with diverticular bleeding. In multivariate analysis adjusted for confounding factors, VAT area (p = 0.021), but not BMI (p = 0.551) or SAT area (p = 0.635), was positively associated with diverticular bleeding. When BMI was considered simultaneously, VAT area remained positively associated with diverticular bleeding (p = 0.018). However, none of obesity indices including VAT area were associated with recurrence of diverticular bleeding or prolonged hospitalization.

Conclusions

This study presents new information on risk factors for diverticular bleeding. A large volume of visceral adipose tissue, but not BMI or SAT, appears to entail a risk for diverticular bleeding, after age, gender, metabolic factors, and antithrombotic drugs use adjustments.

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Acknowledgments

We wish to thank clinical research coordinators Hisae Kawashiro, Sawako Iijima, Yoko Tanigawa, Aiko Gotanda, and Yaeko Sawada for their help with data collection.

Conflict of interest

The authors declare that they have no competing interests.

Source of funding

This study was supported in part by a Grant-in-Aid from the Ministry of Health Labor and Welfare of Japan and a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (271000). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author contributions

Nagata N participated in the design of the study and mainly wrote the manuscript. Niikura R, Aoki T helped with data acquisition and performed endoscopy. Shimbo T participated in the design of the study and contributed to statistical analysis. Itoh T, Akiyama J, Mizokami M, and Uemura N advised on the design of the study and contributed to the writing of the manuscript. All authors have read and approved the final version of the article, including the authorship list.

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Authors and Affiliations

  1. Departments of Gastroenterology and Hepatology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Naoyoshi Nagata, Ryota Niikura, Tomonori Aoki, Katsunori Sekine, Hidetaka Okubo, Kazuhiro Watanabe, Toshiyuki Sakurai, Chizu Yokoi, Mikio Yanase & Junichi Akiyama

  2. Diagnostic Radiology, National Center for Global Health and Medicine, Tokyo, Japan

    Kayo Sakamoto, Tomohiro Arai & Masafumi Shinozaki

  3. Department of Internal Medicine, Ohta Nishinouchi Hospital, Fukushima, Japan

    Takuro Shimbo

  4. Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan

    Mitsuhiko Noda

  5. Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan

    Naomi Uemura

Authors
  1. Naoyoshi Nagata
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  2. Kayo Sakamoto
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  3. Tomohiro Arai
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  4. Ryota Niikura
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  6. Masafumi Shinozaki
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  7. Tomonori Aoki
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  8. Katsunori Sekine
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  9. Hidetaka Okubo
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  10. Kazuhiro Watanabe
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  12. Chizu Yokoi
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  13. Mikio Yanase
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  14. Junichi Akiyama
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  15. Mitsuhiko Noda
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  16. Naomi Uemura
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Corresponding author

Correspondence to Naoyoshi Nagata.

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Nagata, N., Sakamoto, K., Arai, T. et al. Visceral fat accumulation affects risk of colonic diverticular hemorrhage. Int J Colorectal Dis 30, 1399–1406 (2015). https://doi.org/10.1007/s00384-015-2295-6

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  • DOI: https://doi.org/10.1007/s00384-015-2295-6

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