RT Journal Article
SR Electronic
T1 Influence of Obesity on Radiographic Changes in Patients With Diffuse Idiopathic Skeletal Hyperostosis
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1028
OP 1033
DO 10.3899/jrheum.2025-0243
VO 52
IS 10
A1 Kiefer, David
A1 Godolias, Michail
A1 Sewerin, Philipp
A1 Kiltz, Uta
A1 Tsiami, Styliani
A1 Andreica, Ioana
A1 Baraliakos, Xenofon
YR 2025
UL http://www.jrheum.org/content/52/10/1028.abstract
AB Objective Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by calcification and ossification, predominantly affecting the axial skeleton. DISH is associated with obesity, diabetes mellitus, and hypertension, all included in the metabolic syndrome (MetS). The aim of this study was to investigate the prevalence of DISH in patients with MetS and the influence of obesity on spinal radiographic changes related to DISH vs degenerative changes.Methods Patients diagnosed with MetS were categorized into 4 obesity classes (World Health Organization criteria). Based on Resnick criteria, patients were classified as DISH or non-DISH. Radiographs were assessed for degenerative (d)-spondylophytes and DISH-related chunky (Drc)-spondylophytes, and their association with obesity was analyzed.Results There were 124 patients were included, of whom 42 (33.9%) were identified as having DISH. The mean BMI was 39.8 (SD 6.3), with obesity classes distributed as follows: preobese (n = 7), obesity class I (n = 19), II (n = 38), and III (n = 60). Higher obesity classes (II and III) were significantly associated with an increased number of Drc-spondylophytes in all patients. In DISH, obesity class ≥ II was linked to a greater number of Drc-spondylophytes (14.8 [SD 10.3] vs 9.7 [SD 7.7]), whereas no association was found between obesity and d-spondylophytes. Overall, patients with DISH had fewer d-spondylophytes than those without DISH (2.7 [SD 2.7] vs 4.1 [SD 4.1]; P = 0.04).Conclusion One-third of patients with MetS were classified as having DISH. In contrast to degenerative spine disease, obese MetS classes II and III were significantly associated with radiographic spinal changes attributed to DISH.