Metabolic Syndrome is a Predisposing Factor for Diffuse Idiopathic Skeletal Hyperostosis

Abstract

Objective Diffuse idiopathic skeletal hyperostosis (DISH) causes spinal ankylosis, which can result in patients suffering specific spinal fractures that lead to a reduction in the activities of daily life in older patients. Currently, DISH is associated with diabetes mellitus and cardiovascular disease; however, the association between DISH and metabolic syndrome has not been established. The purpose of this study was to investigate a potential association between DISH and metabolic syndrome. Methods We retrospectively reviewed clinical data from consecutive subjects undergoing the musculoskeletal health medical checkups, and enrolled 327 subjects (174 men and 153 women; mean, 63.4 ± 13.7-years). Subjects who had spinal ankylosis at least 4 contiguous vertebral bodies were classified as the DISH group (n = 39) while the others were part of the non-DISH group (n = 288). The definition of the metabolic syndrome comes from diagnostic criteria used by the Japanese Society for Internal Medicine. Age, sex, body max index (BMI), hematological evaluation, blood pressure, presence of metabolic syndrome, the visceral fat area on abdominal computed tomography, and spinal epidural lipomatosis (SEL) on magnetic resonance imaging were evaluated. Results Compared to the non-DISH group, in the DISH group, mean age (DISH group, 74.3 years; non-DISH group, 1.9 years; p < 0.001), male prevalence were higher (DISH group, 82.1%; non-DISH group, 49.3%; p < 0.001), and BMI was greater (DISH group, 24.8; non-DISH group, 23.0; p = 0.006). the metabolic syndrome was more frequently observed in DISH group (28.9%) than in the non-DISH group (16.0%) (p = 0.045). The visceral fat area was significantly larger in the DISH group than in the non-DISH group (DISH group, 130.7 ± 58.2 cm 2 ; Non-DISH group, 89.0 ± 48.1 cm 2 ; p < 0.001). The prevalence of SEL was similar between the 2 groups (10.3% in the DISH group vs. 8.7% in the nonDISH group; p = 0.464). Poisson regression analysis revealed that the metabolic syndrome was significantly associated with DISH with odds ratio of 2.0 (95% confidence interval, 1.0–3.7; p = 0.004). Conclusion Metabolic syndrome was significantly associated with DISH. Our data showed metabolic syndrome is potentially related to DISH.

Visceral Adipose Tissue and Different Measures of Adiposity in Different Severities of Diffuse Idiopathic Skeletal Hyperostosis

“…Our results show that the presence of DISH is associated with VAT, which is in accordance with Lantsman et al [25] and Okada et al [26], who measured VAT in DISH patients using CT imaging. In the study by Okada and colleagues, the area of VAT was significantly increased in DISH patients (130.7 ± SD 58.2 cm 2 vs. 89.0 ± SD 48.1 cm 2 ).…”

Impact of Diffuse Idiopathic Skeletal Hyperostosis on Clinico-Radiological Profiles and Prognosis for Thoracic Ossification of Ligamentum Flavum-Myelopathy: A Propensity-Matched Monocentric Analysis

“…Multiple epidemiological studies have demonstrated that DISH patients were universally older and more likely to be males than non-DISH patients in different populations, whereas the differences between height, weight and BMI remain a matter of considerable debate [ 18 , 19 , 20 , 21 , 22 , 23 , 26 , 27 ]. Okada et al [ 26 ] reported that the mean BMI and weight instead of height were significantly higher in the DISH+ group than those in the DISH− group in 327 consecutive subjects undergoing the health checkups. Another survey for municipally registered Japanese residents showed comparable results in BMI of the DISH+ and DISH− group [ 18 ].…”

Association between diffuse idiopathic skeletal hyperostosis and thoracic kyphosis in patients with cervical myelopathy: a retrospective observational study

“…DISH has been recognized to be not only a systemic skeletal abnormality affecting the entire body but also a result of metabolic syndrome. Okada et al [32] reviewed 327 patients who attended for a routine wellness check and found that the prevalence of metabolic syndrome was significantly higher in patients with DISH than in those without DISH (28.9% vs 16.0%). Furthermore, in a study by Lantsman et al [33] the cross-sectional area of visceral fat on abdominal CT scans was greater in patients with DISH than in healthy control subjects.…”