Cardiovascular Risk Factors and Physical Fitness Among Subjects with Asymptomatic Colonic Diverticulosis

Background The association between diverticular disease and atherosclerotic cardiovascular disease (ASCVD) has been demonstrated previously, mainly in symptomatic subjects. Aims To evaluate 10 years cardiovascular risk, exercise performance and association to ASCVD among subjects with asymptomatic diverticulosis. Methods A retrospective cross-sectional cohort of self-referred participants in a medical screening program, who underwent a screening colonoscopy. Demographics, clinical and laboratory variables, ASCVD score, and metabolic equivalents (METs) during treadmill stress test were compared between subjects with and without diverticulosis as diagnosed on screening colonoscopy. Results 4586 participants underwent screening colonoscopy; 799 (17.4%) had diverticulosis. Among 50–69 yo participants, diverticulosis subjects had a higher ASCVD score compared to non-diverticulosis subjects. Exercise performance was comparable between the groups, across all age groups. Using logistic regression analysis, advanced age group (50–59 yo Adjusted odds ratio (AOR) [95% confidence interval (CI)] 2.57 (1.52–4.34), p < 0.001; 60–69 yo, AOR 2.87 (2.09–3.95), p < 0.001; ≥ 70 yo AOR 4.81 (3.23–7.15), p < 0.001; compared to < 50 yo age group), smoking [AOR 1.27 (1.05–1.55), p = 0.016], HTN [AOR 1.27 (1.03–1.56), p = 0.022], obesity [AOR 1.36 (1.06–1.74), p = 0.014] and male sex [AOR 1.29 (1.02–1.64), p = 0.036] were associated with diverticular detection during screening colonoscopy. Among males, achieving METs score ≥ 10 was inversely associated with diverticular detection during screening colonoscopy [AOR 0.64 (0.43–0.95), p = 0.027]. Conclusions Ten years probability for ASCVD estimated by the ASCVD score is higher among subjects with asymptomatic diverticulosis compared to subjects without diverticulosis. Improved exercise performance is demonstrated for the first time to correlate with decreased probability for diverticular disease in screening colonoscopy.