{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:23:29Z","timestamp":1774520609580,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Connective tissue changes due to ageing or diseases leading to changes in the colonic wall are one theory for the development of diverticula. Alpha\u20101\u2010antitrypsin (A1AT), a protease inhibitor that protects connective tissue, possibly plays a role in the aetiology of diverticulosis. The aim of this study was to explore associations between the development of diverticula and A1AT deficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a multicentre prospective case\u2013control study. A total of 221 patients aged \u2265\u00a060\u00a0years with acute abdominal pain undergoing abdominal CT were included and analysed. Patients with diverticula were defined as the research group, patients without diverticula as controls. Genotype analysis for A1AT deficiency was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010six of 221 (11.8%) patients were diagnosed with (being a carrier of) A1AT deficiency. A non\u2010significant difference in prevalence between patients with and without diverticula was found, 20 (13.9%) of 144 <jats:italic>vs<\/jats:italic> 6 (7.8%) of 77, respectively, with a crude OR of 1.9 (95% CI 0.7\u20135.0; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.186) and after adjustment for confounders an adjusted OR of 1.5 (95% CI 0.5\u20134.0; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.466). A non\u2010significant difference in 30\u2010day mortality rate from acute diverticulitis between A1AT deficient patients (or carriers) and those without was observed: two (22.2%) of nine patients with A1AT deficiency <jats:italic>vs<\/jats:italic> 1 (1.8%) of 55 without.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found no convincing evidence that A1AT deficiency plays a role in the aetiology of diverticulitis, although deficient patients and carriers had a higher mortality when experiencing diverticulitis. Diverticulitis is a multifactorial disease and larger numbers may be needed to explore the role of A1AT deficiency among other contributing factors.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15270","type":"journal-article","created":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T07:13:05Z","timestamp":1594797185000},"page":"2243-2251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Alpha\u20101\u2010antitrypsin deficiency (carrier) as possible risk factor for development of colonic diverticula. A multicentre prospective case\u2013control study: the ALADDIN study"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4996-8162","authenticated-orcid":false,"given":"S. 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A.","family":"Rottier","sequence":"additional","affiliation":[{"name":"Department of Surgery Northwest Clinics Alkmaar\/Den Helder The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"van Leeuwen","sequence":"additional","affiliation":[{"name":"Department of Molecular and Cellular Hemostasis Sanquin Blood Supply Division Research and Landsteiner Laboratory of the Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"de Boer","sequence":"additional","affiliation":[{"name":"Department of Molecular and Cellular Hemostasis Sanquin Blood Supply Division Research and Landsteiner Laboratory of the Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"van Mierlo","sequence":"additional","affiliation":[{"name":"Department of Immunopathology Sanquin Blood Supply Division Research and Landsteiner Laboratory of the Academic Medical Center University of Amsterdam, Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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