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18.03.2023 | ORIGINAL ARTICLE

Early stages of diffuse idiopathic skeletal hyperostosis (DISH) and chronic inflammation: the Camargo Cohort Study

verfasst von: Emilio Pariente, Stefanie F. Pini, José M. Olmos, Patricia Fierro, Rosa Landeras, Carmen Ramos, Víctor M. Martínez-Taboada, José L. Hernández

Erschienen in: Clinical Rheumatology | Ausgabe 7/2023

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Abstract

Introduction/objectives

DISH has traditionally been considered a non-inflammatory rheumatic disorder. Currently, an inflammatory component has been theorized in the early phases of this condition (EDISH). The study is aimed at investigating a possible relationship between EDISH and chronic inflammation.

Method

Analytical-observational study: participants from the Camargo Cohort Study were enrolled. We collected clinical, radiological, and laboratory data. C-reactive protein (CRP), albumin-to-globulin ratio (AGR), and triglyceride-glucose (TyG) index were assessed. EDISH was defined by Schlapbach’s scale grades I or II. A fuzzy matching with tolerance factor = 0.2 was performed. Subjects without ossification (NDISH), sex- and age-matched with cases (1:4), acted as controls. Definite DISH was an exclusion criterion. Multivariable analyses were performed.

Results

We evaluated 987 persons (mean age 64 ± 8 years; 191 cases with 63.9% women). EDISH subjects presented more frequently obesity, T2DM, MetS, and the lipid pattern [↑TG ↓TC]. TyG index and alkaline phosphatase (ALP) were higher. Trabecular bone score (TBS) was significantly lower (1.310 [0.2] vs. 1.342 [0.1]; p = 0.025). CRP and ALP showed the highest correlation (r = 0.510; p = 0.0001) at lowest TBS level. AGR was lower, and its correlations with ALP (r = − 0.219; p = 0.0001) and CTX (r = − 0.153; p = 0.022), were weaker or non-significant in NDISH. After adjustment for potential confounders, estimated CRP means for EDISH and NDISH were 0.52 (95% CI: 0.43–0.62) and 0.41 (95% CI: 0.36–0.46), respectively (p = 0.038).

Conclusions

EDISH was associated with chronic inflammation. Findings revealed an interplay between inflammation, trabecular impairment, and the onset of ossification. Lipid alterations were similar to those observed in chronic-inflammatory diseases.

Key Points

• An inflammatory component has been theorized in early stages of DISH (EDISH)

• In EDISH group compared to non-DISH, we observed significantly higher correlations between biomarkers and some relevant variables. In particular, with alkaline phosphatase (ALP) and with trabecular bone score (TBS)

• EDISH has shown to be associated with chronic inflammation

• The lipid alterations observed in the EDISH group were similar to those observed in chronic-inflammatory diseases

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Titel: Early stages of diffuse idiopathic skeletal hyperostosis (DISH) and chronic inflammation: the Camargo Cohort Study
verfasst von: Emilio Pariente
Stefanie F. Pini
José M. Olmos
Patricia Fierro
Rosa Landeras
Carmen Ramos
Víctor M. Martínez-Taboada
José L. Hernández
Publikationsdatum: 18.03.2023
Verlag: Springer International Publishing
Erschienen in: Clinical Rheumatology / Ausgabe 7/2023
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-023-06574-z

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Early stages of diffuse idiopathic skeletal hyperostosis (DISH) and chronic inflammation: the Camargo Cohort Study