Hirota Ryosuke, Teramoto Atsushi, Yoshimoto Mitsunori, Takashima Hiroyuki, Yasuda Naomi, Tsukamoto Arihiko, Iesato Noriyuki, Emori Makoto, Iba Kousuke, Kawaharada Nobuyoshi, Yamashita Toshihiko
Department of Orthopaedic Surgery, School of Medicine, Sapporo Medical University, Sapporo 060-8556, Japan.
Faculty of Health Sciences, Hokkaido University, Sapporo 060-0808, Japan.
J Clin Med. 2023 Aug 20;12(16):5412. doi: 10.3390/jcm12165412.
Diffuse idiopathic skeletal hyperostosis (DISH) is a noninflammatory spondyloarthropathy characterized by ectopic calcification of spinal cord tissue. Its etiology is possibly polygenic. However, its pathogenesis and systemic effects remain unclear. Recent studies have reported a high prevalence of DISH in heart failure patients. The authors investigated how the incidence and severity of DISH are associated with vascular calcification and the occurrence of cardiovascular events. In this retrospective chart review study, 500 patients with cardiovascular disease who underwent surgery (cardiovascular events group) and 500 patients with non-cardiovascular disease who underwent computed tomography scans (non-cardiovascular events group) were randomly selected to investigate the degree of ossification of the anterior longitudinal ligament and the incidence of DISH. We found that the incidence of DISH was higher in patients with cardiovascular events and that patients with DISH had more calcification of the coronary arteries and aorta. Next, we examined the relationship between the degree of coronary and aortic calcification, the incidence of DISH, and the degree of ossification of the anterior longitudinal ligament in the non-cardiovascular event group. The prevalence of DISH in the cardiovascular and non-cardiovascular groups was 31.4% and 16.5%, respectively ( = 0.007). Aortic calcification and a predominant degree of vascular calcification with a certain level of ossification of the anterior longitudinal ligament suggest some correlation between DISH and cardiovascular events. This study is important in understanding the pathophysiology and pathogenesis of DISH.
弥漫性特发性骨肥厚（DISH）是一种非炎性脊柱关节病，其特征为脊髓组织的异位钙化。其病因可能是多基因的。然而，其发病机制和全身影响仍不清楚。最近的研究报告称心力衰竭患者中DISH的患病率很高。作者调查了DISH的发病率和严重程度如何与血管钙化及心血管事件的发生相关。在这项回顾性图表审查研究中，随机选择了500例接受手术的心血管疾病患者（心血管事件组）和500例接受计算机断层扫描的非心血管疾病患者（非心血管事件组），以调查前纵韧带的骨化程度和DISH的发病率。我们发现心血管事件患者中DISH的发病率更高，且患有DISH的患者冠状动脉和主动脉钙化更多。接下来，我们在非心血管事件组中检查了冠状动脉和主动脉钙化程度、DISH发病率以及前纵韧带骨化程度之间的关系。心血管组和非心血管组中DISH的患病率分别为31.4%和16.5%（ = 0.007）。主动脉钙化以及在前纵韧带一定程度骨化情况下血管钙化占主导地位表明DISH与心血管事件之间存在某种关联。这项研究对于理解DISH的病理生理学和发病机制具有重要意义。
