Dear Editor,

I read with great interest the recent article by Wolf (2012). The article has very important data related to body mass index (BMI) and diverticulitis. In this study, there was no association between BMI and complication rate of diverticular disease. There is, however, another factor to also be considered. An increase of intra-abdominal fat (visceral adipose tissue) might lead to a proinflammatory state due to high interleukin 6, low adiponectin proactive molecules that are linked to intra-abdominal inflammatory events (Jeong et al., 2011; Mathieu, Poirier, Pibarot, Lemieux, & Despres, 2009). So an increase of visceral obesity rather than BMI could contribute to the development of complicated diverticulitis. That is why, an increase of visceral adipose tissue in the computed tomography of patients should also be considered.

Sincerely,

Levent Filik, MD

Associate Professor of Gastroenterology

Gastroenterology Clinic

Ankara Research Hospital

Ankara, Turkey

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