Mader R, Dubenski N, Lavi Idit
Rheumatic Diseases Unit, Ha'Emek Medical Center, 18101 Afula, Israel.
Rheumatol Int. 2005 Dec;26(2):132-6. doi: 10.1007/s00296-004-0529-y. Epub 2004 Nov 10.
Diffuse idiopathic skeletal hyperostosis (DISH) has been associated with various metabolic disorders considered to be cardiovascular risk factors such as obesity, diabetes mellitus, hyperinsulinemia, and hyperlipidemia. To evaluate morbidity and mortality of hospitalized patients with DISH admitted to the department of medicine. One hundred patients from a cohort of 1020 consecutive patients, aged 45 years and more, admitted to the department of medicine were diagnosed as suffering from DISH. Another group of 100 patients, age- and gender matched, admitted without DISH, served as controls. Clinical and demographic characteristics, diagnoses on admission, previous chronic diseases, chronic medical therapy, laboratory tests, and the rates of in-hospital mortality and readmissions within 1 month of discharge were collected from the hospital database, for the two groups. Uncompensated or paroxysmal atrial fibrillation was more often encountered on admission in patients with DISH (p = 0.038). Patients with DISH were more likely to suffer from elevated body mass index, arterial hypertension, diabetes mellitus, and previous cerebral vascular accidents, although the differences did not reach statistical significance. However, significantly more patients had an electrocardiographic evidence of left ventricular hypertrophy (p = 0.03). The mortality rate was similar between the two groups. The lack of significant associations for cardiovascular risk factors such as diabetes mellitus, hypertension, and high BMI should be interpreted cautiously considering the characteristics of the control group. Identification of comorbid conditions and proper therapeutic interventions may prove useful in reducing the morbidity and mortality associated with this disorder.
弥漫性特发性骨肥厚(DISH)与多种被认为是心血管危险因素的代谢紊乱有关,如肥胖、糖尿病、高胰岛素血症和高脂血症。为评估内科收治的DISH住院患者的发病率和死亡率。在连续收治的1020例年龄45岁及以上的内科患者队列中,有100例被诊断患有DISH。另一组100例年龄和性别匹配、未患DISH的患者作为对照。从医院数据库收集两组患者的临床和人口统计学特征、入院诊断、既往慢性病、慢性药物治疗、实验室检查以及出院后1个月内的院内死亡率和再入院率。DISH患者入院时更常出现未代偿或阵发性心房颤动(p = 0.038)。DISH患者更易出现体重指数升高、动脉高血压、糖尿病和既往脑血管意外,尽管差异未达到统计学意义。然而,有显著更多患者有左心室肥厚的心电图证据(p = 0.03)。两组的死亡率相似。鉴于对照组的特征,对于糖尿病、高血压和高体重指数等心血管危险因素缺乏显著关联应谨慎解读。识别合并症并采取适当的治疗干预措施可能有助于降低与该疾病相关的发病率和死亡率。