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

Abstract

Background: Diffuse idiopathic skeletal hyperostosis (DISH) is associated with both obesity and type 2 diabetes. Our objective was to investigate the relation between DISH and visceral adipose tissue (VAT) in particular, as this would support a causal role of insulin resistance and low grade inflammation in the development of DISH. Methods: In 4334 patients with manifest vascular disease, the relation between different adiposity measures and the presence of DISH was compared using z-scores via standard deviation logistic regression analyses. Analyses were stratified by sex and adjusted for age, systolic blood pressure, diabetes, non-HDL cholesterol, smoking status, and renal function. Results: DISH was present in 391 (9%) subjects. The presence of DISH was associated with markers of adiposity and had a strong relation with VAT in males (OR: 1.35; 95%CI: 1.20–1.54) and females (OR: 1.43; 95%CI: 1.06–1.93). In males with the most severe DISH (extensive ossification of seven or more vertebral bodies) the association between DISH and VAT was stronger (OR: 1.61; 95%CI: 1.31–1.98), while increased subcutaneous fat was negatively associated with DISH (OR: 0.65; 95%CI: 0.49–0.95). In females, increased subcutaneous fat was associated with the presence of DISH (OR: 1.43; 95%CI: 1.14–1.80). Conclusion: Markers of adiposity, including VAT, are strongly associated with the presence of DISH. Subcutaneous adipose tissue thickness was negatively associated with more severe cases of DISH in males, while in females, increased subcutaneous adipose tissue was associated with the presence of DISH.

Patients with diffuse idiopathic skeletal hyperostosis have an increased burden of thoracic aortic calcifications

“…DISH was diagnosed using the criteria from Resnick and Niwayama [ 18 ] following the presence of flowing bridging ossification of at least four contiguous vertebrae, (relative) preservation of the intervertebral disc height and the absence of apophyseal joint bony ankylosis. The severity of DISH was scored as described previously [ 19 ]: grade 1 DISH indicated flowing bridging osteophytes of four adjacent vertebral bodies, grade 2 DISH indicated flowing bridging osteophytes of five or six vertebral bodies and grade 3 DISH indicated flowing bridging osteophytes of seven or more vertebral bodies.…”

Cohort profile: the Utrecht Cardiovascular Cohort–Second Manifestations of Arterial Disease (UCC-SMART) Study–an ongoing prospective cohort study of patients at high cardiovascular risk in the Netherlands

“…The proportion of missing data is small, possibly explained by the protocolised screening programme taking place in 1 day. The substudies provide additional information on specific cardiovascular risk factors (eg, parental history of CVD, 48 characteristics related to left ventricle hypertrophia 31 and the presence of diffuse idiopathic skeletal hyperostosis 49 ), manifestations of atherosclerosis (eg, brain changes on MRI 25 and cognitive decline 26 ) and other important aspects in cardiovascular risk management (eg, the effect of a cardiovascular polypill 50 ).…”

Diffuse idiopathic skeletal hyperostosis of the cervical spine causing dysphagia and airway obstruction: an updated systematic review

“…DISH is most commonly diagnosed using the Resnick and Niwayama criteria which requires the presence of flowing calcification and/or ossification along the anterolateral aspect of at least four contiguous vertebral bodies; (relative) preservation of intervertebral disc height; and absence of apophyseal joint ankylosis and sacroiliac joint changes [4]. The exact pathophysiology of DISH remains unclear, but various genetic, metabolic and inflammatory factors have been hypothesized to be involved as DISH is associated with obesity, type 2 diabetes, and the metabolic syndrome [5]. Patients with DISH are also more at risk for spinal fractures and stroke [1,6].…”