Cardiovascular
Metabolic Syndrome and Cardiovascular Risk in Patients with Diffuse Idiopathic Skeletal Hyperostosis

https://doi.org/10.1016/j.semarthrit.2008.01.010Get rights and content

Objectives

To assess the likelihood of patients with diffuse idiopathic skeletal hyperostosis (DISH) to be affected by metabolic syndrome (MS) and to evaluate the risk for the development of coronary heart disease (CHD) in these patients.

Methods

Ninety-five patients without cardiovascular disease were enrolled, including 47 patients with established DISH and 48 age- and sex-matched patients without DISH. Data regarding body build, use of medications, concomitant diseases, blood pressure, and smoking habits were collected. Blood tests included fasting glucose, insulin levels, and lipid profile. Patients were classified as having MS based on the definitions of the World Health Organization (WHO-MS), and The National Cholesterol Education Program Adult Treatment Panel III (NCEP-MS). Risk assessment for the development of CHD was performed using the Framingham risk scoring system.

Results

Patients with DISH had a significantly higher body mass index and waist circumference, while no significant differences were observed for serum total cholesterol, high-density lipoprotein, low-density lipoprotein, or triglyceride serum levels. NCEP-MS and WHO-MS were significantly more prevalent in DISH patients compared with the control group (P = 0.001 and 0.007, respectively). The odds ratio of patients with DISH meeting the NCEP-MS was 3.88 and for WHO-MS was 3.61. The Framingham score for CHD was higher in DISH patients (P = 0.004), conferring a significantly higher 10-year CHD risk (P = 0.007).

Conclusions

Patients with DISH have a significantly higher likelihood to be affected by MS than non-DISH patients. They also have a significantly higher CHD risk. Patients with DISH should be encouraged to take measures to reduce cardiovascular disease risks.

Section snippets

Materials and Methods

Ninety-five consecutive patients attending our Rheumatic Diseases Unit were enrolled in the study. Forty-seven patients fulfilled the diagnostic criteria for DISH as suggested by Resnick and Niwayama (4), and 48 patients were diagnosed with OA without evidence of DISH. Patients were excluded from the study if they had a history of known angina pectoris, myocardial infarction, transient ischemic attacks, stroke, or peripheral vascular diseases. Data regarding demographics, smoking and medical

Results

The results revealed that patients with DISH had a significantly higher BMI and WC, while no significant differences were observed for age, sex distribution, serum total cholesterol, HDL, low-density lipoprotein, or TG levels (Table 1). Serum uric acid levels did not differ between the 2 groups. Significantly higher proportions of patients with DISH fulfilled the NCEP-MS parameters of WC, high blood pressure, and DM and were significantly more likely to meet the definition of NCEP-MS (Table 2).

Discussion

This study demonstrates that patients with DISH are significantly more likely to be affected by MS compared with age- and sex-matched patients without DISH. The 10-year CHD risk of patients with DISH is also significantly higher than the control group. The major contributors for the diagnosis of MS were high WC and HT for both NCEP-MS and WHO-MS, while hyperglycemia was a significant contributor only for NCEP-MS.

DISH is characterized by the production of coarse flowing osteophytes involving, in

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