Camargo Interior Primary Care Center, Servicio Cántabro de Salud. Departamento de Medicina y Psiquiatría (Universidad de Cantabria). Instituto de Investigación Valdecilla (IDIVAL), Santander, Cantabria, Spain.
Hospital at Home Department, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Valdecilla (IDIVAL), Santander, Cantabria, Spain.
Clin Rheumatol. 2023 Jul;42(7):1931-1942. doi: 10.1007/s10067-023-06574-z. Epub 2023 Mar 18.
INTRODUCTION/OBJECTIVES: DISH has traditionally been considered a non-inflammatory rheumatic disorder. Currently, an inflammatory component has been theorized in the early phases of this condition (EDISH). The study is aimed at investigating a possible relationship between EDISH and chronic inflammation.
Analytical-observational study: participants from the Camargo Cohort Study were enrolled. We collected clinical, radiological, and laboratory data. C-reactive protein (CRP), albumin-to-globulin ratio (AGR), and triglyceride-glucose (TyG) index were assessed. EDISH was defined by Schlapbach's scale grades I or II. A fuzzy matching with tolerance factor = 0.2 was performed. Subjects without ossification (NDISH), sex- and age-matched with cases (1:4), acted as controls. Definite DISH was an exclusion criterion. Multivariable analyses were performed.
We evaluated 987 persons (mean age 64 ± 8 years; 191 cases with 63.9% women). EDISH subjects presented more frequently obesity, T2DM, MetS, and the lipid pattern [↑TG ↓TC]. TyG index and alkaline phosphatase (ALP) were higher. Trabecular bone score (TBS) was significantly lower (1.310 [0.2] vs. 1.342 [0.1]; p = 0.025). CRP and ALP showed the highest correlation (r = 0.510; p = 0.0001) at lowest TBS level. AGR was lower, and its correlations with ALP (r = - 0.219; p = 0.0001) and CTX (r = - 0.153; p = 0.022), were weaker or non-significant in NDISH. After adjustment for potential confounders, estimated CRP means for EDISH and NDISH were 0.52 (95% CI: 0.43-0.62) and 0.41 (95% CI: 0.36-0.46), respectively (p = 0.038).
EDISH was associated with chronic inflammation. Findings revealed an interplay between inflammation, trabecular impairment, and the onset of ossification. Lipid alterations were similar to those observed in chronic-inflammatory diseases. Key Points • An inflammatory component has been theorized in early stages of DISH (EDISH) • In EDISH group compared to non-DISH, we observed significantly higher correlations between biomarkers and some relevant variables. In particular, with alkaline phosphatase (ALP) and with trabecular bone score (TBS) • EDISH has shown to be associated with chronic inflammation • The lipid alterations observed in the EDISH group were similar to those observed in chronic-inflammatory diseases.
简介/目的：DISH 传统上被认为是一种非炎症性风湿性疾病。目前，有人提出这种疾病的早期阶段存在炎症成分（EDISH）。本研究旨在探讨 EDISH 与慢性炎症之间可能存在的关系。
分析性观察研究：招募了来自 Camargo 队列研究的参与者。我们收集了临床、放射学和实验室数据。评估了 C 反应蛋白（CRP）、白蛋白-球蛋白比值（AGR）和甘油三酯-葡萄糖（TyG）指数。EDISH 定义为 Schlapbach 量表等级 I 或 II。采用模糊匹配，容差因子 = 0.2。与病例（1:4）性别和年龄匹配、无骨化（NDISH）的受试者作为对照。明确的 DISH 是排除标准。进行了多变量分析。
我们评估了 987 人（平均年龄 64 ± 8 岁；191 例，其中 63.9%为女性）。EDISH 组更常出现肥胖、2 型糖尿病、代谢综合征和血脂异常[↑TG ↓TC]。TyG 指数和碱性磷酸酶（ALP）更高。小梁骨评分（TBS）明显较低（1.310 [0.2] 与 1.342 [0.1]；p = 0.025）。CRP 和 ALP 在最低 TBS 水平下相关性最高（r = 0.510；p = 0.0001）。AGR 较低，与 ALP（r = - 0.219；p = 0.0001）和 CTX（r = - 0.153；p = 0.022）的相关性较弱或无统计学意义在 NDISH 中。在调整了潜在混杂因素后，EDISH 和 NDISH 的估计 CRP 平均值分别为 0.52（95%CI：0.43-0.62）和 0.41（95%CI：0.36-0.46）（p = 0.038）。
EDISH 与慢性炎症有关。研究结果显示炎症、小梁骨损伤和骨化的发生之间存在相互作用。脂质改变与慢性炎症性疾病观察到的相似。关键点• DISH 的早期阶段（EDISH）被认为存在炎症成分。• 在 EDISH 组与非-DISH 组相比，我们观察到生物标志物与一些相关变量之间的相关性显著增加。特别是与碱性磷酸酶（ALP）和小梁骨评分（TBS）• EDISH 与慢性炎症有关。• 在 EDISH 组观察到的脂质改变与慢性炎症性疾病观察到的相似。
