1 Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York2 Department of Internal Medicine, Norwalk Hospital, Yale University, Norwalk, Connecticut3 Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand4 Department of Internal Medicine, University of Hawaii, Honolulu, Hawaii5 Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota6 Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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BACKGROUND:The possible relationship between obesity and the risk of colonic diverticulosis has been suggested by recent epidemiologic studies, although the results were inconsistent.OBJECTIVE:This systematic review and meta-analysis was conducted to summarize all of the available data.DATA SOURCES:A comprehensive literature review was conducted using the MEDLINE and EMBASE databases through January 2017.STUDY SELECTION:Studies that compared the risk of colonic diverticulosis among subjects with obesity versus those without obesity were included.MAIN OUTCOME MEASURES:Effect estimates from each study were extracted and combined together using a random-effect, generic inverse variance method.RESULTS:Of 2989 potentially eligible articles, 10 studies (9 cross-sectional studies and 1 prospective cohort study) with 53,520 participants met the eligibility criteria and were included in the meta-analysis. The risk of colonic diverticulosis in obese subjects was significantly higher than in those without obesity, with a pooled OR of 1.41 (95% CI, 1.20–1.65). The statistical heterogeneity was high, with an I2 of 75%.LIMITATIONS:High statistical heterogeneity and publication bias in favor of positive studies may have been present in this meta-analysis.CONCLUSIONS:A significant association between colonic diverticulosis and obesity was shown in this study. However, additional studies are still required to determine the causality. See Video Abstract at http://links.lww.com/DCR/A500.