Genetic and Lifestyle Risks Stratify Extreme Diverticulitis

Ueland TE, Shelley JP, Mosley JD, et al. Genetic Risk, Healthy Lifestyle, and Risk Stratification for Diverticulitis. J Am Coll Surg. January 2025.

This research used a polygenic danger rating plus a way of life rating (Life’s Essential 8) to look at long-term danger of extreme diverticulitis within the UK Biobank. Among 225,592 individuals adopted a median of 14 years, 2,584 developed extreme diverticulitis. Patients with mixed excessive genetic danger and unfavorable life-style had the very best danger, with a hazard ratio of 4.71 (95% CI 4.15–5.35) and a cumulative incidence of three.50% versus 0.75% within the the rest of the cohort. The mixed impact exceeded what could be anticipated from merely including genetic and life-style results (RERI 0.98, 95% CI 0.39–1.57).

From a surgeon’s standpoint, the principle worth is to not drive operative decision-making in isolation, however to enhance danger communication and deal with prevention counseling. If a affected person has excessive inherited susceptibility, life-style nonetheless seems to matter, and the highest-risk group is the place aggressive counseling round modifiable components could also be only. This is a population-level danger software fairly than a direct set off for elective colectomy, however it helps the idea that future diverticulitis counseling might develop into extra individualized utilizing mixed genetic and life-style profiles.