Risk Factors for Asymptomatic Diverticulosis

描述(由申请人提供)在美国，憩室病是一种常见且昂贵的疾病。2004年，有81.5万人因憩室病住院，330万次门诊护理，240万张处方。随着人口老龄化， 这些数字将会增加。尽管憩室病造成了相当大的经济和医疗负担，但由于无症状憩室病从未得到充分的研究，关于其病因的信息基本上是不存在的。这项拟议的研究建立在一项横断面研究的基础上，在这项研究中，与预期相反，研究人员发现，高纤维饮食与憩室病患病率的增加(而不是降低)相关，并具有显著的剂量反应，并且在憩室更频繁的个体中效果更强。这项研究将检验肠道微生物导致免疫反应改变和慢性炎症状态的假设，这种状态可能通过改变结肠壁的完整性或改变胃动素而导致憩室病的发展。本研究的目的是：(1)描述一组首次接受结肠镜检查的个体中无症状憩室病的患病率和人口学特征。(2)确定憩室病的饮食和生活方式危险因素。(3)探讨黏附微生物区系与憩室病的关系。(4)评估结肠粘膜的局部炎症和免疫激活，以支持憩室病的炎症病因学。为了进行这项研究，将收集900名研究对象的详细饮食和生活方式信息，这些受试者接受了全面的结肠镜检查，并仔细调查了憩室病。乙状结肠活检将用于通过焦磷酸测序来评估粘附性细菌生物体。组织的局部炎症和免疫激活将通过免疫组织化学进行检测。血液将被储存起来，用于未来对可能易患憩室病的基因的研究。这项研究旨在纠正之前对无症状憩室病研究的不足，并测试关于病因的生物学假说。这项拟议的研究是了解憩室病病因的第一步，希望能预防这种疾病及其并发症。

DESCRIPTION (provided by applicant) Diverticulosis is a common and expensive condition in the United States. In 2004 there were 815,000 hospitalizations for diverticular disease, 3.3 million ambulatory care visits, and 2.4 million prescriptions written. With an aging population all these figures will increase. Despite the considerable economic and medical burden from diverticular disease, information on the etiology is largely nonexistent because asymptomatic diverticulosis has never been adequately studied. The proposed study builds upon a cross sectional study in which, contrary to expectation, the investigators found that a high-fiber diet was associated with increased (rather than a decreased) prevalence odds of diverticulosis with a significant dose response and a stronger effect among individuals with more frequent diverticula. The study will test the hypothesis that gut microbes are responsible for an altered immune response and a state of chronic inflammation that could lead to the development of diverticulosis possibly through alterations in the integrity of the colonic wall or altered motilit. The aims of the study are: (1) To describe the prevalence and demographic characteristics of asymptomatic diverticulosis among a group of individuals undergoing first time screening colonoscopy. (2) To determine dietary and lifestyle risk factors for diverticulosis. (3) To evaluat the association between the adherent microbial flora and diverticulosis. (4) To assess local inflammation and immune activation in the colonic mucosa to support an inflammatory etiology for diverticulosis. To conduct the study, detailed dietary and lifestyle information will be colleced on 900 study subjects who undergo complete screening colonoscopy with careful investigation for diverticulosis. Sigmoid colon biopsies will be used to evaluate adherent bacterial organisms using pyrosequencing. Local inflammation and immune activation in tissue will be measured by immunohistochemistry. Blood will be stored for future studies of genes that might predispose to diverticular disease. The study is designed to correct the shortcomings of prior research on asymptomatic diverticulosis and test biological hypotheses about etiology. The proposed study is a first step in understanding the cause of diverticulosis with the hope of preventing the disease and its complications