Diffuse idiopathic skeletal hyperostosis (DISH) and trabecular bone score (TBS) in postmenopausal women: The Camargo cohort

Autores de IDIVAL

• Stefanie Francesa Pini

  Autor

• 

  Emilio Pariente Rodrigo

  Autor

• 

  José Manuel Olmos Martínez

  Autor

• Marta Martín Millán

  Autor

• 

  Raquel Pascua Sagredo

  Autor

• 

  Victor Manuel Martínez Taboada

  Autor

• 

  José Luís Hernández Hernández

  Autor

Unidades

• INMUNOPATOLOGÍA

  

  Investigador Corresponsable

  Ricardo Blanco Alonso

Abstract

Objectives: The potential relationship between diffuse idiopathic skeletal hyperostosis (DISH) and bone micro-structure has not been studied in women. We aimed to assess the association between the trabecular bone score (TBS) and DISH in postmenopausal women, as well as the role of other parameters related to bone metabolism, such as bone mineral density (BMD), calciotropic hormones, and bone remodeling markers.Methods: Cross-sectional study, nested in a prospective population-based cohort (Camargo cohort). Clinical covariates, DISH, TBS, vitamin D, parathormone, BMD and serum bone turnover markers, were analyzed.Results: We have included 1545 postmenopausal women (mean age, 62 +/- 9 years). Those with DISH (n = 152; 8.2%) were older and had a significantly higher prevalence of obesity, metabolic syndrome, hypertension, and type 2 diabetes mellitus (p<0.05). Moreover, they had lower TBS values (p = 0.0001) despite having a higher lumbar spine BMD (p<0.0001) and a higher prevalence of vertebral fractures than women without DISH (28.6% vs. 15.1%; p = 0.002). When analyzing DISH through Schlapbach grades, women without DISH had a median TBS value consistent with a normal trabecular structure while the values for women with DISH from grades 1 to 3 were consistent with a partially degraded trabecular structure. Women with vertebral fractures and DISH had a mean TBS corresponding to a degraded trabecular structure (1.219 +/- 0.1). After adjusting for confounders, the estimated TBS means were 1.272 (1.253-1.290) in the DISH group, and 1.334 (1.328-1.339) in the NDISH group (p<0.0001).Conclusion: An association between DISH and TBS has been shown in postmenopausal women, in which hy-perostosis has been significantly and consistently related to trabecular degradation and, therefore, to deterio-ration in bone quality after adjusting for confounding variables.

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Keywords

• Diffuse idiopathic skeletal hyperostosis; Trabecular bone score; Bone turnover markers; Bone metabolic diseases; Vertebral fracture