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Insulin and new bone formation in diffuse idiopathic skeletal hyperostosis

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Summary

The tendency of patients with DISH towards obesity or an adult onset of diabetes has been reflected in marked hyperinsulinaemia following glucose challenge. It is hypothesized that insulin at prolonged and high physiologic levels promotes new bone growth, particularly in the entheseal regions. These areas are also subject to various mechanical forces. The resulting new bone produces the radiological changes which characterise DISH.

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References

  1. Resnick, D., Shapiro, R.F., Weisner, K.B., Niwayama, G., Utsinger, P.O., Shaul, S.R. Diffuse idiopathic skeletal hyperostosis (DISH) [Ankylosing hyperostosis of Forestier and Rotes-Querol]. Semin Arthritis Rheum, 1978, 7, 153–187.

    Article  PubMed  CAS  Google Scholar 

  2. Julkunen, H., Heinonen, O.P., Pyörälä, K. Hyperostosis of the spine in an adult population. Ann Rheum Dis, 1971, 30, 605–612.

    Article  PubMed  CAS  Google Scholar 

  3. Vernon-Roberts, B., Pirie, C.J. Trenwith, V. Pathology of the doral spine in ankylosing hyperostosis. Ann Rheum Dis, 1974, 33, 281–288.

    Article  PubMed  CAS  Google Scholar 

  4. Fornasier, V.L., Littlejohn, G.O., Urowitz, M.B., Keystone, E.C., Smythe, H.A. Spinal entheseal new bone formation: the early changes of spinal diffuse idiopathic skeletal hyperostosis. J Rheumatol 1983, 10, 939–947.

    PubMed  CAS  Google Scholar 

  5. Resnick, D., Niwayama, G. Diagnosis of bone and joint disorders. Philadelphia, Saunders, 1981, 1447–1448.

    Google Scholar 

  6. Schmorl, G., Junghanns, H. The human spine in health and disease, 2nd ed., E.F. Besemann (Tr). New York, Grune & Stratton, 1971, pp 141, 186, 354.

    Google Scholar 

  7. Bick, E.M. Vertebral osteophytosis. Pathologic basis of its roentgenology. Am J Roentgenol, 1955, 73, 979–983.

    CAS  Google Scholar 

  8. Littlejohn, G.O., Urowitz, M.B. Peripheral enthesopathy in diffuse idiopathic skeletal hyperostosis (DISH): a radiologic study. J Rheumatol, 1982, 9, 568–572.

    PubMed  CAS  Google Scholar 

  9. Harris, J., Carter, A.R., Glick, E.N. Ankylosing hyperostosis. 1. Clinical and radiological features. Ann Rheum Dis, 1974, 33, 210–215.

    Article  PubMed  CAS  Google Scholar 

  10. Forestier, J., Lagier, R. Ankylosing hyperostosis of the spine. Clin Orthop, 1971, 74, 65–83.

    PubMed  CAS  Google Scholar 

  11. Littlejohn, G.O., Urowitz, M.B., Smythe, H.A., Keystone, E.C. Radiographic features of the hand in diffuse idiopathic skeletal hyperostosis (DISH): comparison with normal subjects and acromegalic patients. Radiology, 1981, 140, 623–629.

    PubMed  CAS  Google Scholar 

  12. Jacqueline, F. Ossifications post-opératoires (prosthèse totale) des hanches de sujets atteints d'hyperostose vertébrale ankylosante. Rev Rhum Mal Osteoartic, 1979, 46, 45–52.

    PubMed  CAS  Google Scholar 

  13. Resnick D., Linovitz, R.J., Feingold, M.L. Postoperative heterotopic ossification in patients with ankylosing hyperostosis of the spine (Forestier's Disease). J Rheumatol, 1976, 313–320.

  14. Rubens-Duval, A., Villiaumey, J., Kaplan, G., Louis, R. Dysplasie vertébrale de croissance et hyperostose vertébrale engainante. Rev Rhum Mal Osteoartic, 1968, 35, 629–634.

    PubMed  CAS  Google Scholar 

  15. Smith, C.F., Pugh, D.G., Polley, H.F. Physiologic vertebral ligamentous calcification: an aging process. Am J Roentgenol, 1955, 74, 1049–1058.

    CAS  Google Scholar 

  16. Ott, V.R. Ueber die spondylosis hyperostotica. Schweiz Med Wochenschr, 1953, 83, 790–799.

    PubMed  CAS  Google Scholar 

  17. Vignon, G., Durant, J., Pansu, D., Bertrand, J.N., Truchot, R. La spondylorheostose ou H.A.V.D. Rev Rhum Mal Ostoartic, 1961, 28, 428–435.

    CAS  Google Scholar 

  18. Shapiro, R.F., Utsinger, P.D., Wiesner, K.B., Resnick, D., Bryan, B.L., Castles, J.L. The association of HLA-B27 with Forestier's disease (vertebral ankylosing hyperostosis). J Rheumatol, 1976, 3, 4–8.

    PubMed  CAS  Google Scholar 

  19. Shapiro, R.F., Wiesner, K.B., Bryan, B.L., Utsinger, P.D., Resnick, D., Castles, J.J. HLA-B27 and modified bone formation. Lancet, 1976, 1, 230–231.

    Article  PubMed  CAS  Google Scholar 

  20. Ercilla, M.G., Brancos, M.A., Breysse, Y., Alonso, G., Vives, J., Castillo, R., Rotes-Querol, J. HLA antigens in Forestier's disease, ankylosing spondylitis and polyarthrosis of the hands. J Rheumatol 1977, 4 (Suppl. 3): 89–93.

    Google Scholar 

  21. Rosenthal, M., Bahous, I., Muller, W. Increased frequency of HLA B8 in hyperostotic spondylosis. J Rheumatol, 1977, 4 (Suppl. 3) 1977, 94–96.

    Google Scholar 

  22. Spagnola, A.M., Bennett, P.M., Terasaki, P.I. Vertebral ankylosing hyperostosis (Forestier's Disease) and HLA antigens in Pima Indians. Arthritis Rheum, 1978, 21, 467–472.

    Article  PubMed  CAS  Google Scholar 

  23. Brigode, M., Francois, R.J. Histocompatibility antigens in vertebral ankylosing hyperostosis. J Rheumatol, 1977, 4, 429–434.

    PubMed  CAS  Google Scholar 

  24. Perry, J.D., Wolf, H., Festenstein, H., Storey, G.O. Ankylosing hyperostosis: a study of HLA A, B, and C antigens. Ann Rheum Dis, 1979, 38, 72–73.

    Article  PubMed  CAS  Google Scholar 

  25. Seawright, A.A., English, P.B., Gartner, R.J.W. Hypervitaminosis A and hyperostosis of the cat. Nature, 1965 206, 1171–1172.

    Article  PubMed  CAS  Google Scholar 

  26. Gerber, A., Raab, A.P., Sobel, A.E. Vitamin A poisoning in adults: with description of a case. Am J Med, 1954, 16, 729–745.

    Article  PubMed  CAS  Google Scholar 

  27. Frame, B., Jackson, C.E., Reynolds, W.A., Umphrey, J.E. Hypercalcemia and skeletal effects in chronic hypervitaminosis A. Ann Intern Med, 1974, 80, 44–48.

    PubMed  CAS  Google Scholar 

  28. Pittsley, R.A., Yoder, F.W. Retinoid hyperostosis: skeletal toxicity associated with long-term administration of 13-cisretinoic acid for refractory ichthyosis. N Engl J Med, 1983, 308, 1012–1014.

    Article  PubMed  CAS  Google Scholar 

  29. Pennes, D.R., Ellis, C.N., Madison, K.C., Voochees, J.J., Martel, W. Early skeletal hyperostoses secondary to 13-cisretinoic acid. AJR, 1984, 141, 979–983.

    Google Scholar 

  30. Artlet, J., Abiteboul, M., Mazières, B., Laffont, F., Dedieu-snapir, G., Fauvel, J.M. Vitamin A et Hyperostose vertebrale ankylosante. Rev Rhum Mal Osteoartic, 1983, 50, 63–65.

    PubMed  Google Scholar 

  31. Forestier, J., Rotes-Querol, J. Senile ankylosing hyperostosis of the spine. Ann Rheum Dis, 1950, 9, 321–330.

    Article  PubMed  CAS  Google Scholar 

  32. Beardwell, A. Familial ankylosing vertebral hyperostosis with tylosis. Ann Rheumatol, 1969, 28, 518–523.

    Article  CAS  Google Scholar 

  33. Utsinger, P.D., Resnick, D., Shapiro, R. Diffuse skeletal abnormalities in Forestier's Disease. Arch Int Med, 1976, 136, 763–768.

    Article  CAS  Google Scholar 

  34. Boulet, P., Serre, H., Mirouze, J. Le rachis diabetique. Sem Hop Paris, 1954, 30, 2392–2410.

    Google Scholar 

  35. Recordier, A.M., Jouve, G., Allignol, J.M. L'hyperostose vertebrale chez les diabetiques. Marseille Med, 1959, 96: 711–718.

    PubMed  CAS  Google Scholar 

  36. Einaudi, G., Viara, M. Richerche sul metabolismo degli idrati di carbonio nei malata affetti da arthrosi vertebrale a carattere iperostosante. Rheumatismo, 1960, 12, 163–168.

    CAS  Google Scholar 

  37. Ott, V.R., Schwenkenbecher, H., Iser, H. Die spondylose bei diabetes mellitus. Z Rheumatol, 1963, 22, 278–290.

    CAS  Google Scholar 

  38. Cassan, P., L'hyperostose vertébrale ankylosante et ses rapports avec le diabète sucré. Etude clinique et statistique. Mémoire C.E.S., Rheumatologie, Paris, 1963.

  39. Ott, V.R., Perkovak, N., Regehr, I. Hyperostotic spondylosis and ankylosing spondylitis; correlation with disorders of carbohydrate metabolism. Proc 6th European Congress of Rheum, Lisbon, 1967, p 95.

  40. Dahmen, G. Bezeihungen der Spondylosis hyperostotica zur diabetogen Stoffwechsellage. Proc 6th European Congress of Rheum, Lisbon, 1967, p. 316.

  41. Perrotin, C. Contribution à l'étude de l'hyperostose vertébrale ankylosante: ses rapports éventuels avec l'obésité et l'étate diabétique. Thèse Méd Marseille, 1968, No. 211.

  42. Lequesne, M., Cassan, P., Nallet, J., Ryckewaert, A. Sèze, S. de. Hyperostose vertébrale et diabète sucré. Rev Rhum Mal Osteoartic, 1970, 37, 281–286.

    PubMed  CAS  Google Scholar 

  43. Bregeon, C., Chevalier, J., Bigorgne, J-C., Renier, J-C. L'hyperostose vertébrale ankylosante. Enquêtes etiologiques et recherche d'une hypersecretion de somathormone. Rev Rhum Mal Osteoartic, 1973, 40, 319–327.

    PubMed  CAS  Google Scholar 

  44. Hajkova, Z., Streda, A., Skrha, F. Hyperostotic spondylosis and diabetes mellitus. Ann Rheum Dis, 1965, 24, 536–543.

    Article  PubMed  CAS  Google Scholar 

  45. Julkunen, H., Karava, R., Viljanen, V. Hyperostosis of the spine in diabetes mellitus and acromegaly. Diabetologia, 1966, 2, 123–126.

    Article  PubMed  CAS  Google Scholar 

  46. Julkunen, H., Pyorala, K., Lehtovirta, E. Hyperostosis of the spine in relation to age and hyperglycaemia in men aged 30—69. Ann Med Intern Fenn, 1968, 57, 1–7.

    PubMed  CAS  Google Scholar 

  47. Schilling, F., Schachert, M., Gamp, A., Bopp, A. Die beziehungen der spondylosis hyperostotica zur konstitution und zu stoffwechselstorungen. Med Klin, 1965, 60, 165–169.

    Google Scholar 

  48. Schoen, D., Eggstein, M., Vogt, W. Ist die hyperostatische spondylosis deformans eine diabetische osteopathie? Fortschr Rontgenstr, 1969, 110, 524–539.

    Article  CAS  Google Scholar 

  49. Resnick, D., Shaul, S.R., Robins, J.M. Diffuse idiopathic skeletal hyperostosis (DISH); Forestier's Disease with extraspinal manifestations. Radiology, 1975, 115, 513–524.

    PubMed  CAS  Google Scholar 

  50. Dambacher, M.A., Ott, V.R. Endokrinologischosteologische aspekte der spondylosis hyperostotica. In: Spondylosis hyperostotica; Ott, V.R. (ed). Ferdinand Enke Verlag, Stuttgart, 1982.

    Google Scholar 

  51. Bray, G.A. Obesity: A Review. DM 1979, 10, 1–85.

    Google Scholar 

  52. Keyes, A., Fidonza, F., Karranen, M.J. Indices of relative weight and obesity. J Chron Dis, 1972, 25, 329–343.

    Article  PubMed  Google Scholar 

  53. Littlejohn, G.O., Herington, A.C., Smythe, H.A. Studies into various growth factors in diffuse idiopathic skeletal hyperostosis (DISH) [Forestier's Disease]. Rev Rhum Mal Osteoartic, 1981, June, Abs 987.

  54. Littlejohn, G.O., Smythe, H.A. Marked hyperinsulinemia after glucose challenge in patients with diffuse idiopathic skeletal hyperostosis (DISH). J Rheumatol, 1981, 8, 965–968.

    PubMed  CAS  Google Scholar 

  55. Jackson, W.P.V., Von Mieghem, W., Keller, P. Insulin excess as the initial lesion in diabetes. Lancet, 1, 1972, 1040–1044.

    Article  PubMed  CAS  Google Scholar 

  56. Felig, P., Soman, V. Insulin receptors in diabetes and other conditions. Am J Med, 1979, 67, 913–918.

    Article  PubMed  CAS  Google Scholar 

  57. Savage, P.J., Dippe, S.E., Bennett, P.H., Gordon, Pl., Roth, J., Rushforth, N.B., Miller, M. Hyperinsulinemia and hypoinsulinemia: Insulin responses to oral carbohydrate over a wide spectrum of glucose tolerance. Diabetes, 1975, 24, 362–368.

    Article  PubMed  CAS  Google Scholar 

  58. Bennett, P.H., Burch, T.A., Miller, M. Diabetes mellitus in American (Pima) Indians. Lancet, 1971, 2, 125–128.

    Article  PubMed  CAS  Google Scholar 

  59. Henrard, J-C., Bennett, P-H. Etude épidémiologique de l'hyperostose vertébrale. Enquête dans une population adulte d'indiens d'amérique. Rev Rhum Mal Osteoartic, 1973, 40, 581–591.

    PubMed  CAS  Google Scholar 

  60. Littlejohn, G.O., Hall, S. Diffuse idiopathic skeletal hyperostosis and new bone formation in male gouty subjects. Rheumatol Int, 1982, 2, 83–86.

    Article  PubMed  CAS  Google Scholar 

  61. Raisz, L.G., Mundy, G.R., Dietrich, J.W., Canalis, E.M. Hormonal regulation of mineral metabolism in International Review of Physiology, Endocrine Physiology II, Vol 16, p 222, Editor: McCann, S.M., University Park Press, Baltimore, 1977.

    Google Scholar 

  62. Sosenki, I.R., Kitzmiller, J.L., Loo, S.W. The infant of the diabetic mother. Correlation of increased cord and c-peptide levels with macrosomia and hypoglycemia. N Engl J Med, 1979, 301, 859–862.

    Article  PubMed  Google Scholar 

  63. Flier, J.S., Young, J.B., Landsberg, L. Familial insulin resistance with acanthosis nigricans, acral hypertrophy and muscle cramps. NEMJ, 1980, 303, 970–973.

    CAS  Google Scholar 

  64. Phillips, L.S., Vassilopoulou-Sellin, R. Somatomedins (Second of 2 parts) NEJM, 1980, 302, 438–446.

    PubMed  CAS  Google Scholar 

  65. Chertow, B.S., Sivitz, W.I., Baranetsky, N.G., Styer, T.B., Sorensen, B.J., Schikman, C.H., Norris, R.M., Ozuk, B.A. Vitamin A palmitate decreases intravenous glucose tolerance in man. Acta Vitaminol Enzymol, 1982, 4, 291–298.

    PubMed  CAS  Google Scholar 

  66. Fineberg, S.E., Merimee, T.J., Rabinowitz, D., Edgar, P.J. Insulin secretion in acromegaly. J Clin Endocrinol Metab, 1970, 30, 288–292.

    Article  PubMed  CAS  Google Scholar 

  67. Wolodzko, L. Secretion of growht hormone in women with hyperostosis frontalis interna. Endokrynol Pol, 1980, 31(1), 33–41.

    PubMed  CAS  Google Scholar 

  68. Wolodzko, L. Insulin secretion in women with hyperostosis frontalis interna. Endokrynol Pol, 1980, 31(1) 43–50.

    PubMed  CAS  Google Scholar 

  69. Hirsh, E.F., Morgan, R.A. Causal significance to traumatic ossification of the fibrocartilage in tendon insertions. Arch Surg, 1939, 39, 824–837.

    Google Scholar 

  70. Ball, J. Enthesopathy of rheumatoid and ankylosing spondylitis. Ann Rheum Dis, 1971, 30, 213–223.

    Article  PubMed  CAS  Google Scholar 

  71. Dolgo-Saburoff, B. Uber Ursprung und insertion des Skelettmuskeln. Anat Anz, 1929, 68, 30–87.

    Google Scholar 

  72. Cooper, R.R., Misol, S. Tendon and ligament insertion: a light and electron microscopic study. J Bone J Surg, 1970, 52A, 1–20.

    Google Scholar 

  73. Resnick, D., Niwayama, G: Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). Radiology, 1976, 119, 559–568.

    PubMed  CAS  Google Scholar 

  74. Tsukamoto, Y., Onitsuka, H., Lee, K. Radiologic aspects of diffuse idiopathic skeletal hyperostosis of the spine. Am J Roentgenol, 1977, 129, 913–918.

    CAS  Google Scholar 

  75. Artlet, J., Jacqueline, F., Depeyre, M., Mazières, B., Gayrard, M. La hanche dans l'hyperostose vertébrale. Rev Rheum, 1978, 45, 17–26.

    Google Scholar 

  76. Jowsey, J. Metabolic diseases of bone. Philadelphia, Saunders, 1977, pp. 102–203.

    Google Scholar 

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  1. Monash University Department of Medicine, Rheumatology Unit, Prince Henry's Hopital, St. Kilda Road, 3004, Melbourne, Victoria, Australia

    G. O. Littlejohn

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Littlejohn, G.O. Insulin and new bone formation in diffuse idiopathic skeletal hyperostosis. Clin Rheumatol 4, 294–300 (1985). https://doi.org/10.1007/BF02031611

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