Association between Cardiovascular Risk Assessment by SCORE2 and Diverticulosis: A Cross-Sectional Analysis

Background: The aim of this retrospective observational study was to examine the relationship between SCORE2 and the occurrence of colonic diverticula in a screening population without cardiovascular or gastrointestinal symptoms. SCORE2, recognized and supported by the European Society of Cardiology for cardiovascular risk assessment, served as the primary metric for the analysis in this investigation. Methods: We studied 3935 asymptomatic individuals undergoing screening colonoscopy. SCORE2 was calculated for each participant and categorized into three groups based on the following projected 10-year cardiovascular disease risk: SCORE2 0-4.9%, SCORE2 5-9.9%, and SCORE2 >= 10%. Logistic regression was used to assess the relationship between SCORE2 and diverticulosis. Results: SCORE2 was associated with the presence of diverticulosis (OR 1.09, 95%CI 1.07-1.10; p < 0.001) in univariable logistic regression, translating into an RR of 1.07 per unit increase. The association persisted after multivariable adjusting for metabolic syndrome (aOR 1.08; 95%CI 1.06-1.10; p < 0.001). Patients with high cardiovascular risk had higher rates of diverticulosis compared to those with lower risk: high risk (OR 2.00, 95%CI 1.71-2.33; p < 0.001); very high risk (OR 2.53, 95%CI 2.10-3.05; p < 0.001). This association remained after adjusting for metabolic syndrome: high risk (aOR 1.86, 95%CI 1.59-2.18; p < 0.001); very high risk (aOR 2.27, 95%CI 1.88-2.75; p < 0.001). Conclusions: A higher SCORE2 was found to be a suitable screening parameter for diverticular disease. This suggests a potential link between cardiovascular risk factors and colon diverticula development, warranting further research on whether optimizing cardiovascular risk factors could positively influence diverticular disease.