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. 2025 Jun;16(3):e13864.
doi: 10.1002/jcsm.13864.

Parameters of Body Composition Predict Clinical Course in Acute Colonic Diverticulitis

Alexey Surov  1 , Mattes Hinnerichs  2 , Iram Shahzadi  1 , Nina P Haag  1 , Jan Robert Kröger  1 , Berthold Gerdes  3 , Saleem Elhabash  3 , Jan Borggrefe  1
Affiliations

Parameters of Body Composition Predict Clinical Course in Acute Colonic Diverticulitis

Alexey Surov et al. J Cachexia Sarcopenia Muscle. 2025 Jun.

Abstract

Background: Acute colonic diverticulitis (ACD) is the most common complication of colonic diverticulosis. Body composition, that is, proportion, distribution and quality of muscle and adipose tissues may play a relevant role in ACD. Previously, only few reports with small number of patients analysed the prognostic role of body composition in ACD. Our purpose was to analyse associations between the occurrence of complications and parameters of body composition in patients with ACD in a large sample.

Methods: This retrospective study included 646 patients with ACD. The duration of hospital stay (days) and occurrence of complications were recorded. Parameters of body composition were semiautomatically measured with the freely available ImageJ software. Skeletal muscle area (SMA), skeletal muscle density, visceral adipose tissue (VAT), subcutaneous adipose tissue and intramuscular adipose tissue were estimated. To assess the impact of body composition parameters on ACD complications, Cox regression model (adjusted for sex and age) was used.

Results: Low skeletal muscle area (sarcopenia) was found in 322 patients (49.8%). High VAT was observed in 525 patients (81.3%). Low skeletal muscle density or myosteatosis was identified in 322 patients (49.8%). Length of hospital stay was prolonged in patients with sarcopenia, myosteatosis and/or visceral adiposity. Sarcopenia was an independent predictor for occurrence of complicated ACD, OR = 1.48, 95% CI (1.03-2.13), p = 0.033. Myosteatosis predicted occurrence of free perforation, OR = 2.36, 95% CI (1.01-5.43), p = 0.033. Furthermore, visceral adiposity tended to be a strong predictor of free perforation, OR = 7.62, 95% CI (1.29-138.00), p = 0.05. Finally, sarcopenia predicted occurrence of macro abscesses, OR = 2.41, 95% CI (1.41-4.26), p = 0.002.

Conclusions: Patients with sarcopenia, myosteatosis and visceral adiposity have prolonged length of hospital stay. Macro abscesses occur more frequently in patients with sarcopenia. Myosteatosis and high VAT are associated with free perforation.

Keywords: acute colonic diverticulitis; myosteatosis; sarcopenia; visceral adiposity.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart diagram of patient acquisition.
FIGURE 2
FIGURE 2
Body composition in two representative patients of the study sample. Staging computer tomographic scans with segmented areas of body composition. Skeletal muscle area (red), intramuscular adipose tissue (yellow), subcutaneous adipose tissue (blue) and intramuscular adipose tissue (green). (a) Patient with normal muscle area and visceral adipose tissue. (b) Patient with low skeletal muscle area (sarcopenia) and high visceral, intramuscular and subcutaneous adipose tissues.
See this image and copyright information in PMC

References

    1. Williams S., Bjarnason I., Hayee B., and Haji A., “Diverticular Disease: Update on Pathophysiology, Classification and Management,” Frontline Gastroenterology 15, no. 1 (2023): 50–58. - PMC - PubMed
    1. Tiralongo F., Di Pietro S., Milazzo D., et al., “Acute Colonic Diverticulitis: CT Findings, Classifications, and a Proposal of a Structured Reporting Template,” Diagnostics (Basel) 13, no. 24 (2023): 3628. - PMC - PubMed
    1. Piscopo N. and Ellul P., “Diverticular Disease: A Review on Pathophysiology and Recent Evidence,” Ulster Medical Journal 89, no. 2 (2020. Sep): 83–88. - PMC - PubMed
    1. Bolkenstein H. E., van de Wall B. J. M., Consten E. C. J., Broeders I. A. M. J., and Draaisma W. A., “Risk Factors for Complicated Diverticulitis: Systematic Review and Meta‐Analysis,” International Journal of Colorectal Disease 32, no. 10 (2017): 1375–1383. - PMC - PubMed
    1. van Dijk S. T., Daniels L., Nio C. Y., Somers I., van Geloven A. A. W., and Boermeester M. A., “Predictive Factors on CT Imaging for Progression of Uncomplicated Into Complicated Acute Diverticulitis,” International Journal of Colorectal Disease 32, no. 12 (2017): 1693–1698. - PMC - PubMed