Metabolic Syndrome is a Predisposing Factor for Diffuse Idiopathic Skeletal Hyperostosis.

Objective Diffuse idiopathic skeletal hyperostosis (DISH) causes spinal ankylosis, which can result in patients suffering specific spinal fractures that lead to a reduction in the activities of daily life (ADL) in elderly patients. Currently, DISH is associated with diabetes mellitus and cardiovascular disease; however, association between DISH and metabolic syndrome has not been established. The purpose of this study was to investigate a potential association between DISH and metabolic syndrome. Methods We retrospectively reviewed clinical data from consecutive subjects undergoing the musculoskeletal health medical checkups, and enrolled 327 subjects (174 men and 153 women, mean 63.4±13.7-years). Subjects who had spinal ankylosis at least four contiguous vertebral bodies were classified as the DISH group (n=39) while the others were part of the non-DISH group (n=288). The definition of the metabolic syndrome comes from used by the Japanese Society for Internal Medicine. Age, gender, body max index (BMI), hematological evaluation, blood pressure, presence of metabolic syndrome, the visceral fat area on abdominal CT and spinal epidural lipomatosis (SEL) on MRI were evaluated. Results Compared to the Non-DISH group, in the DISH group, mean age (DISH group: 74.3-years, Non-DISH group：61.9-years, p<0.001), male prevalence were higher (DISH group: 82.1％, Non-DISH group: 49.3%, p<0.001), and BMI was greater (DISH group: 24.8, Non-DISH group: 23.0 p=0.006). the metabolic syndrome was more frequently observed in DISH group (28.9%) than in the Non-DISH group (16.0%) (p=0.045). The visceral fat area was significantly larger in the DISH group than in the Non-DISH group (DISH group: 130.7 ± 58.2 cm2, Non-DISH group 89.0 ± 48.1 cm2, p < 0.001). The prevalence of SEL was similar between the two groups (10.3% in the DISH group vs. 8.7% in the Non-DISH group; p = 0.464). Poisson regression analysis revealed that the metabolic syndrome was significantly associated with DISH with odds ratio of 2.0 (95% confidence interval 1.0-3.7, p=0.004). Conclusion Metabolic syndrome was significantly associated with DISH. Our data showed metabolic syndrome is potentially related to DISH.