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

Background Diffuse idiopathic skeletal hyperostosis (DISH) is a rheumatic d isease characterized by a significant association with metabolic alteration s, such as an impaired lipidic profile. Methods. One-hundred-thirty consecutive patients and 40 normal subjects wer e studied. The patients were affected by type 1 and type 2 diabetes mellitu s, impaired glucose tolerance and obesity, The diagnosis of DISH was perfor med 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 t olerance test was performed in order to determine the levels of C-peptide a nd blood glucose, Results. We demonstrate a high incidence of the disease in a cohort of pati ents affected by overt and non-overt diabetes mellitus (T1DM and T2DM) as w ell as in obese subjects and a correlation between this disorder and hypert ryglyceridemia (T1DM, obese-T2DM and obese patients), hypo-HDL-cholesterole mia (obese-T2DM, non-obese-T2DM and obese patients) and hyper-LDL-cholester olemia (obese patients). In obese-T2DM patients, as well as in obese patien ts, we observed 40% of DISH, in non obese-T2DM patients the presence of DIS H was 30%, while in T1DM patients and impaired glucose tolerance 26.6% and 22.2, respectively, However, a correlation between DISH and the relative hy perinsulinemia in obese patients during an oral glucose tolerance test is n ot 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.