Relationship between diffuse idiopathic skeletal hyperostosis, abdominal aortic calcification and associated metabolic disorders: Data from the Camargo Cohort

Abstract

Background and objective

Diffuse idiopathic skeletal hyperostosis (DISH) and abdominal aortic calcification (AAC) are related to an increased cardiovascular risk. The aim of this study was to analyze a possible relationship between both entities and also the association between metabolic disorders and DISH.

Patients and method

Analytic cross-sectional study in a population-based cohort. DISH (with Resnick-Niwayama criteria) and AAC (with AAC-24 scale) were assessed on plain X-ray images. Interaction terms between DISH and forty clinical covariates were also investigated, through correlation analysis and multivariate regression.

Results

Nine hundred eighty-seven males aged ≥50 years, with a mean age = 65.5 ± 9 years, were evaluated. Prevalence rates of DISH and AAC were 21.6% and 58.7%, respectively. DISH+ subjects were older (68.1 ± 9 vs. 63.8 ± 9 years; p = 0.0001) and more likely to be affected by metabolic syndrome (MS) (55.6% vs. 36.6%; p = 0.0001). In DISH+ subjects, the AAC was 3.7 ± 5 points, whereas in DISH− subjects it was 3.3 ± 5 (p = 0.25). AAC was associated with an increased risk of prevalent DISH (unadjusted OR = 1.4 [95% CI: 1.01–1.9]; p = 0.04), that disappeared when it was adjusted for age (adjusted OR = 1.1 [95% CI: 0.8–1.5]; p = 0.47). No association was found between DISH and hypertension, diabetes or dyslipidemia; however, age (OR = 2.2 [95% CI: 1.6–3]; p = 0.0001), BMI (OR = 1.5 [95% CI: 1.1–2]; p = 0.007), waist circumference (OR = 1.5 [95% CI: 1.04–2.3]; p = 0.03) and MS (OR = 1.7 [95% CI: 1.1–2.4]; p = 0.005) showed a significant relationship with DISH after adjusting for confounders.

Conclusions

The study was not able to demonstrate a consistent association between DISH and AAC, proving only a weak and age-dependent relationship between them. DISH proved to be significantly associated with age, BMI, waist circumference and MS.

Resumen

Antecedentes y objetivo

La hiperostosis esquelética idiopática difusa (DISH, del inglés diffuse idiopathic skeletal hyperostosis) y la calcificación aórtica abdominal (CAA) se asocian a un incremento del riesgo cardiovascular. El objetivo fue analizar una posible relación entre ambas, así como las alteraciones metabólicas asociadas a la DISH.

Pacientes y método

Estudio transversal-analítico, incluido en una cohorte poblacional. La DISH (criterios de Resnick-Niwayama) y la CAA (mediante la escala AAC-24) fueron evaluadas sobre imágenes de radiología simple. Se evaluaron asimismo otras 40 variables clínicas mediante correlaciones y regresión multivariante.

Resultados

Fueron analizados 987 varones ≥ 50 años, con una edad media = 65,5 ± 9 años. Las prevalencias de DISH y CAA fueron del 21,6% y del 58,7%, respectivamente. El sujeto con DISH tenía mayor edad (68,1 ± 9 vs. 63,8 ± 9 años; p = 0,0001) y con mayor frecuencia presentaba síndrome metabólico (SM) (55,6 vs. 36,6%; p = 0,0001). La CAA fue de 3,7 ± 5 puntos en sujetos con DISH frente a 3,3 ± 5 en sujetos sin DISH (p = 0,25), y se asoció a un riesgo incrementado de DISH prevalente (OR cruda = 1,4 [IC95%: 1,01-1,9]; p = 0,04), que desapareció al ajustar por edad (OR ajustada = 1,1 [IC95%: 0,8-1,5]; p = 0,47). No se observó asociación de la DISH con la hipertensión arterial, diabetes mellitus o dislipidemia, pero mantuvieron una relación significativa tras ajustar por confusores la edad (OR = 2,2 [IC95%: 1,6-3]; p = 0,0001), el IMC (OR = 1,5 [IC95%: 1,1-2]; p = 0,007), el perímetro abdominal (OR = 1,5 [IC95%: 1,04-2,3]; p = 0,03) y el SM (OR = 1,7 [IC95%: 1,1-2,4]; p = 0,005).

Conclusiones

No se ha podido demostrar una asociación consistente entre la DISH y la CAA, presentando ambas una débil relación dependiente de la edad. La DISH ha mostrado unas asociaciones significativas con la edad, el IMC, el perímetro abdominal y el SM.