St. Luke's University Health Network Bethlehem, PA
Farah Harmouch, MD1, Pooja Saraiya, DO2, Blessing Jerome, DO3, Hammad Liaquat, MD1, Parampreet Kaur, MD4, Kimberly J. Chaput, DO1; 1St. Luke's University Health Network, Bethlehem, PA; 2St. Luke’s University Health Network, Allentown, PA; 3St. Luke’s University Health Network, Macungie, PA; 4St. Luke's Hospital, Easton, PA
Introduction: Metabolic syndrome (MetS) is present in up to a third of the US adult population. Data is scarce about the association of MetS with development of colonic diverticulosis (CD) and internal hemorrhoids (IH) in the elderly. Our aim is to determine the association of metabolic syndrome and its components with incidence of CD and IH in the elderly aged ≥ 75 years. Methods: We conducted a retrospective chart review to identify patients who underwent a colonoscopy between 2012 and 2019 within our health network. We collected data on patient demographics, comorbidities, and colonoscopy findings. All statistical analyses were conducted in IBM SPSS Version 26 to compute means and frequencies of patient characteristics and rates of CD and IH diagnosed during colonoscopy as well as calculate odds ratios to test for associations between potential risk factors and presence of CD and IH. Results: A total of 590 patients were included with a median age of 79 years, 60.6% females and 91.0% Caucasian. The majority of patients had CD (68%) and a significant number had IH (30%). MetS was found in 33.1% patients. Subgroup analysis showed larger proportion of patients had MetS, most of its components and IH in the younger age group (75-84 years) while older patients (85 years and above) had more constipation, CD, and hypertriglyceridemia (HTG) (Table 1). MetS was significantly associated with CD (OR 1.4, CI 1.01-2.1) and IH (OR 1.5, CI 1.0-2.1, p-value 0.04), while male gender (OR 1.7, CI 1.2-2.4, p-value 0.005) and ASA ≥ 3 (OR 1.5, CI 1.04-2.3, p-value 0.03) had an association with IH (Table 2&3). There was a higher likelihood of HTN with CD (OR 1.6, CI 1.0-2.5, p-value 0.04), versus female gender (OR 1.7, CI 1.3-1.8, p-value 0.01) and ASA ≥ 3 (OR 1.7, CI 1.1-2.6, p-value 0.01) with IH in the younger age group. Obesity (OR 2.8, CI 0.5-13.1, p-value 0.23), HTN (OR 2.1, CI 0.7-5.6, p-value 0.14), and HTG (OR 5.6, CI 0.7-45.3, p-value 0.10) were associated with CD, while HTG (OR 2.3, CI 0.7-7.4, p-value 0.15) and fatty liver (OR 3.72, CI 2.6-5.3, p-value 0.27) were associated with IH in older patients. Discussion: Our data shows significant association of MetS with CD and IH in patients aged ≥ 75 years. Previous studies have mostly revealed an association of MetS and/or it components with CD and IH in the overall population. Increasing age and constipation did not impact CD or IH which supports emerging data that other factors might be contributing towards their pathophysiology which warrants further research.
Table 1: Demographics, risk factors, quality parameters of study patients.
Table 2. Risk factor analysis for diverticulosis.
Table 3. Risk factor analysis for internal hemorrhoids.
Disclosures: Farah Harmouch indicated no relevant financial relationships. Pooja Saraiya indicated no relevant financial relationships. Blessing Jerome indicated no relevant financial relationships. Hammad Liaquat indicated no relevant financial relationships. Parampreet Kaur indicated no relevant financial relationships. Kimberly Chaput indicated no relevant financial relationships.