Changes in indicators of local and systemic inflammation in patients with uncomplicated diverticular disease in combination with obesity

Objective — to investigate the clinical features and expression of markers reflecting changes in local (fecal calprotectin levels) and systemic inflammation (C‑reactive protein and tumor necrosis factor‑alpha (TNF‑α) in blood serum) in patients with uncomplicated diverticular disease of the colon (DDC) in the context of obesity and normal body weight. Materials and methods. A total of 87 patients with uncomplicated diverticular disease of the colon were examined, of whom 39 (44.8%) had obesity (average body mass index — 33.9±0.4 kg/m2). The uncomplicated DDC diagnosis was established based on a detailed assessment of clinical symptoms, irrigoscopy or colonoscopy, and computed tomography. In addition to clinical blood analysis, all patients underwent investigation of calprotectin levels in feces, C‑reactive protein, and TNF‑α in blood serum using immunoenzymatic methods. Results. Diverticular disease of the large intestine in the context of obesity manifests at a younger age (44—60 years) in comparison with DDC against the background of normal weight and is significantly more prevalent in the lumbar colon. It presents with varying sizes, twice as many relapses, and markedly higher rates of local inflammation (fecal calprotectin levels were 1.47 times higher (p <0.05) than in patients with uncomplicated DDC with normal body weight). Among the indicators of systemic inflammation, levels of C‑reactive protein and TNF‑α were found to be significantly higher in obese patients with uncomplicated diverticular disease compared to those with normal body weight. Conclusions. Obesity, characterized by a slightly higher degree of local and systemic inflammation, along with elevated levels of calprotectin, C‑reactive protein, and pro‑inflammatory cytokine (TNF‑α), contributes additionally to the development and recurrent course of diverticular disease of the colon.