# A prospective cohort study to determine the role of obesity in diverticulitis

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2022 · $475,046

## Abstract

PROJECT SUMMARY
Colonic diverticulitis is a common (209 cases per 100,000 person-years) disease that is responsible for $5.5
billion dollars in health care expenditures annually. Diverticulitis is a leading indication for operations, hospital
admissions, and ambulatory visits, with a greater burden of disease in women. Postmenopausal age women
are at highest risk of developing diverticulitis when compared to either similar age premenopausal women or
similar age men. The reason for this disparity is unknown but may be due to metabolic changes associated
with menopause. Menopause is associated with the development of all components of metabolic syndrome
including visceral fat accumulation, atherogenic dyslipidemia, insulin resistance, and hypertension. While there
is compelling evidence that obesity increases diverticulitis risk, the mechanism for this association is unclear.
We believe metabolic syndrome explains this association. Establishing a role for metabolic syndrome in
diverticulitis risk would radically redefine this disease and open new lines of research to utilizing existing
therapies that are currently used for the treatment of metabolic syndrome. Menopausal hormone therapy does
not prevent postmenopausal metabolic dysfunction and is associated with an increased risk of cardiovascular
events, particularly in women with preexisting metabolic syndrome. In limited work, menopausal hormone
therapy use has also been associated with increased diverticulitis risk. Building on existing, high-quality
evidence and our own preliminary data, the proposed application aims to demonstrate that metabolic
syndrome and preclinical obesity biomarkers play a role in diverticulitis. Our central hypothesis is that
diverticulitis is a metabolic disease. We plan to test this hypothesis using a large, ongoing, prospective cohort
study (Sister Study) conducted by the National Institute of Environmental Health Sciences. This mature cohort
of 50,884 women in the U.S. and Puerto Rico is well characterized with archived blood samples, sufficient
follow up to observe incident diverticulitis, standardized data collection, and detailed covariates including
reproductive characteristics. The aims of the proposed study are 1) to prospectively determine the association
between metabolic syndrome (hypertension, type 2 diabetes, dyslipidemia, and central obesity) and incident
diverticulitis, 2) to prospectively determine the association between menopausal hormone therapy and incident
diverticulitis in postmenopausal women, and 3) to prospectively determine the association between obesity-
related serum biomarkers in relation to incident diverticulitis. This is a novel approach to diverticulitis that
diverges from the current paradigm and creates the potential for multiple new medical and behavioral
strategies for diverticulitis treatment and prevention. Understanding the association between menopausal
hormone therapy and incident diverticulitis creates the possibility of imm...

## Key facts

- **NIH application ID:** 10416129
- **Project number:** 1R01DK132050-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** anne peery
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $475,046
- **Award type:** 1
- **Project period:** 2022-04-01 → 2027-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10416129

## Citation

> US National Institutes of Health, RePORTER application 10416129, A prospective cohort study to determine the role of obesity in diverticulitis (1R01DK132050-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10416129. Licensed CC0.

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