Brief Article
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World J Gastroenterol. Feb 28, 2011; 17(8): 1009-1017
Published online Feb 28, 2011. doi: 10.3748/wjg.v17.i8.1009
Demographic determinants of risk, colon distribution and density scores of diverticular disease
Mark Golder, Irina Chis Ster, Pratusha Babu, Amita Sharma, Muhammad Bayat, Abdulkadir Farah
Mark Golder, Centre for Academic Surgery, Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, Queen Mary University, London, E1 1BB, United Kingdom
Irina Chis Ster, MRC centre for Paediatric Epidemiology and Biostatistics, University College, London, WC1N 1EH, United Kingdom
Pratusha Babu, Amita Sharma, Muhammad Bayat, Abdulkadir Farah, Department of Radiology, University Hospital Lewisham, London, SE13 6LH, United Kingdom
Author contributions: Golder M was responsible for overall coordination of the study, for data analysis and for drafting the paper; Chis Ster I was responsible for the statistical analysis and its interpretation and contributed to the drafting of the paper; Babu P was responsible for collection of data and for its organisation prior to analysis; Farah A, Bayat M and Sharma A were responsible for analysis of barium enema examinations; all investigators revised the final report and agreed to its final form.
Supported by The University Hospital Lewisham
Correspondence to: Mark Golder, PhD, FRCS (Gen), Centre for Academic Surgery, Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, Queen Mary University, London, E1 1BB, United Kingdom. email@msgolder.co.uk
Telephone: +44-20-73777079  Fax: +44-20-73777283
Received: September 17, 2010
Revised: November 30, 2010
Accepted: December 7, 2010
Published online: February 28, 2011
Abstract

AIM: To investigate associations between ethnicity, age and sex and the risk, colon distribution and density scores of diverticular disease (DD).

METHODS: Barium enemas were examined in 1000 patients: 410 male, 590 female; 760 whites, 62 Asians, 44 black africans (BAs), and 134 other blacks (OBs). Risks and diverticula density of left-sided DD (LSDD) and right-sided-component DD (RSCDD = right-sided DD + right and left DD + Pan-DD) were compared using logistic regression.

RESULTS: Four hundred and forty-seven patients had DD (322 LSDD and 125 RSCDD). Adjusted risks: (1) LSDD: each year increase in age increased the odds by 6% (95% CI: 5-8, SE: 0.8%, P < 0.001); Asians: odds ratio (OR): 0.23 (95% CI: 0.10-0.53, SE: 0.1, P≤ 0.001) and OBs: OR: 0.25 (95% CI: 0.14-0.43, SE: 0.07, P≤ 0.001) appeared protected vs Whites; (2) RSCDD: each year increase in age increased the odds by 4% (95% CI: 2-6, SE: 1%, P < 0.001); females were 0.60 times (95% CI: 0.40-0.90, SE: 0.12, P = 0.01) less likely than males to have RSCDD; BAs were 3.51 times (95% CI: 1.70-7.24, SE: 1.30, P < 0.001) more likely than Whites to have RSCDD; and (3) DD density scores: each year increase in age increased the odds of high-density scores by 4% (95% CI: 1-6, SE: 1%, P < 0.001); RSCDD was 2.77 times (95% CI: 1.39-3.32, SE: 0.67, P < 0.001) more likely to be of high density than LSDD. No further significant differences were found in the adjusted models.

CONCLUSION: Right colonic DD might be more common and has higher diverticula density in the west than previously reported. BAs appear predisposed to DD, whereas other ethnic differences appear conserved following migration.

Keywords: Diverticular disease; Migration; Barium enema; Ethnicity; Colon distribution; Risk