Vezyroglou G, Mitropoulos A, Antoniadis C
Rheumatology Department, Asklepieion Hospital, Voula, Athens, Greece.
J Rheumatol. 1996 Apr;23(4):672-6.
I addition to diabetes mellitus (DM), high incidence of common metabolic conditions such as dyslipidemia (DL) and hyperuricemia (HU) has been found in patients with diffuse idiopathic skeletal hyperostosis (DISH). Our objective was to confirm such observations comparing data from patients with DISH and appropriate controls.
One hundred randomly identified inpatients with DISH were compared with 100 DISH-free inpatients with various rheumatic disorders matched for age, sex, body mass index, and excess body weight. The prevalence of metabolic disturbances was compared in the 2 groups. Data was analyzed statistically by chi-squared test and 4-fold table analysis.
In our DISH population, metabolic abnormalities were found in 70%, versus 45% in the control population (p < 0.0001). High prevalence of DL and/or HU associated with DM was observed among patients with DISH (p < 0.0001). Patients with uncomplicated diabetes (or DL or HU) were almost equally distributed between the 2 groups, with no significant differences (p > 0.1). Combined metabolic features of DM+DL, DM+HU, or DM+DL+HU were shown to be the main risk factor for DISH (K = 14). They may constitute a metabolic syndrome with high diagnostic specificity (u = 1.0) and nosologic sensitivity (g = 1.0), despite their lowest prevalence (0.07). Dyslipidemia occurred with the highest prevalence (p = 0.36), the highest positive predictive value (v = 0.44) and, together with HU and diabetes, the highest nosologic specificity (f = 0.55 in both cases).
We found metabolic disturbances confined to the group with DISH. Followup studies of the number of bridging ossifications in identically aged patients or bridging ossifications/year/patient could be a useful tool to determine their effect on the extent and progression rates of DISH.
除糖尿病（DM）外，在弥漫性特发性骨肥厚（DISH）患者中还发现血脂异常（DL）和高尿酸血症（HU）等常见代谢性疾病的发病率较高。我们的目的是通过比较DISH患者和适当对照的数据来证实这些观察结果。
将100例随机确定的DISH住院患者与100例无DISH的、年龄、性别、体重指数和超重情况相匹配的各种风湿性疾病住院患者进行比较。比较两组代谢紊乱的患病率。采用卡方检验和四格表分析对数据进行统计学分析。
在我们的DISH人群中，70%发现有代谢异常，而对照组为45%（p<0.0001）。在DISH患者中观察到与DM相关的DL和/或HU的高患病率（p<0.0001）。单纯糖尿病（或DL或HU）患者在两组中分布几乎相等，无显著差异（p>0.1）。DM+DL、DM+HU或DM+DL+HU的联合代谢特征被证明是DISH的主要危险因素（K=14）。尽管它们的患病率最低（0.07），但它们可能构成一种诊断特异性高（u=1.0）和疾病分类敏感性高（g=1.0）的代谢综合征。血脂异常的患病率最高（p=0.36），阳性预测值最高（v=0.44），并且与HU和糖尿病一起，疾病分类特异性最高（两种情况均为f=0.55）。
我们发现代谢紊乱仅限于DISH组。对年龄相同的患者的桥接骨化数量或每年/患者的桥接骨化数量进行随访研究，可能是确定它们对DISH的程度和进展速度影响的有用工具。
