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  3. 'Fast Ossifier' in diffuse idiopathic skeletal hyperostosis: a sex-modulated, heterogeneous phenotype with accelerated ossification and early trabecular decline.

'Fast Ossifier' in diffuse idiopathic skeletal hyperostosis: a sex-modulated, heterogeneous phenotype with accelerated ossification and early trabecular decline.

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Autores de IDIVAL

Autores ajenos al IDIVAL

  • Sgaramella G
  • Fierro-Andrés P
  • Bonome M
  • Solares S

Unidades

Abstract

BACKGROUND: Diffuse idiopathic skeletal hyperostosis (DISH) is considered a slowly progressive condition, typically requiring a decade to achieve full radiographic development. However, some individuals exhibit accelerated ossification. This study aimed to characterise the clinical profile of these patients, referred to as Fast Ossifiers (FO). METHODS: Study nested within the Camargo Cohort, integrating cross-sectional and longitudinal data (baseline (E0), 5 year (E1) and 10 year assessments (E2)). Propensity Score matching was applied. FO was defined as progression of =2 grades in Schlapbach's Scale between consecutive assessments. We evaluated inflammation, insulin resistance (via Triglyceride-Glucose Index (TyG)), Visceral Adiposity Index (VAI), intact parathormone (iPTH), bone turnover markers and Trabecular Bone Score (TBS). RESULTS: We analysed 455 DISH cases and 455 matched controls. During follow-up, 61 individuals fulfilled FO criteria (18%<60 years; 49% female; 65.6% obese; 72.1% hypertensive). Compared with controls, FO subjects had higher TyG (8.65±0.9 vs 8.39±0.4; p=0.002), FO-females showed higher visceral adiposity (VAI 2.30±2 vs 1.44±0.1; p=0.024), and both sexes presented elevated iPTH at E2. In multivariable models, FO was associated with high TyG (adjusted OR=9.31; 95% CI: 1.04 to 36; p=0.046), low TBS (adjusted OR=0.002; 95% CI: 0.001 to 0.61) and higher alkaline phosphatase levels (79 vs 69 (U/L); p=0.043). CONCLUSIONS: FO represents an active variant that challenges the view of DISH as a quiescent disease affecting older men. Rather than a single entity, FO emerges as a convergent phenotype driven by diverse metabolic pathways and linked to accelerated skeletal changes, including ossification and early trabecular impairment.

© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.

Datos de la publicación

ISSN/ISSNe:
2056-5933, 2056-5933

RMD Open  BMJ PUBLISHING GROUP

Tipo:
Article
Páginas:
-
PubMed:
40983397

Citas Recibidas en Web of Science: 2

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Keywords

  • Biomarkers; Bone Density; Inflammation; Severity of Illness Index

Campos de Estudio

Proyectos asociados

Estudio del metabolismo óseo y mineral de la población femenina postmenopáusica y masculina mayor de 50 años atendida por un Centro de Salud en Cantabria.

Investigador Principal: José Luís Hernández Hernández

PI21/00532 . INSTITUTO DE SALUD CARLOS III. . 2022

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