Diffuse idiopathic skeletal hyperostosis in diabetes mellitus, impaired glucose tolerance and obesity.

BACKGROUND

Diffuse idiopathic skeletal hyperostosis (DISH) is a rheumatic disease characterized by a significant association with metabolic alterations, such as an impaired lipidic profile.

METHODS

One-hundred-thirty consecutive patients and 40 normal subjects were studied. The patients were affected by type 1 and type 2 diabetes mellitus, impaired glucose tolerance and obesity. The diagnosis of DISH was performed by clinical examination and X-ray study of the thoracolumbar spine. The determination of total cholesterol, triglycerides, HLD-cholesterol and LDL-cholesterol was realized by routine biochemical methods; an oral glucose tolerance test was performed in order to determine the levels of C-peptide and blood glucose.

RESULTS

We demonstrate a high incidence of the disease in a cohort of patients affected by overt and non-overt diabetes mellitus (T1DM and T2DM) as well as in obese subjects and a correlation between this disorder and hypertryglyceridemia (T1DM, obese-T2DM and obese patients), hypo-HDL-cholesterolemia (obese-T2DM, non-obese-T2DM and obese patients) and hyper-LDL-cholesterolemia (obese patients). In obese-T2DM patients, as well as in obese patients, we observed 40% of DISH, in non obese-T2DM patients the presence of DISH was 30%, while in T1DM patients and impaired glucose tolerance 26.6% and 22.2, respectively. However, a correlation between DISH and the relative hyperinsulinemia in obese patients during an oral glucose tolerance test is not documented.

CONCLUSIONS

Our study confirms the prevalence of DISH in diabetes mellitus and obesity, the association with an impaired lipidic profile and the low percentage of symptomatic patients.