Prevalence of diffuse idiopathic skeletal hyperostosis and association with coronary artery calcifications in Slovenia

Abstract

Abstract

Introduction

The aim of this study was to analyze the epidemiological aspects of diffuse idiopathic skeletal hyperostosis (DISH) patients in Slovenia, to evaluate the relationship between CCTA-derived EAT (epicardial adipose tissue) density and CAC (coronary artery calcifications) in patients with and without DISH, and study influencing factors of these parameters.

Patients and methods

The research comprised patients referred for coronary CTA due to a clinical suspicion of coronary artery disease. DISH, CAC score and EAT attenuation were quantified using non-contrast imaging. Diagnosis of DISH was based on Resnick criteria. The CTA was assessed for the presence of obstructive CAD (coronary artery disease). The association between DISH and the extent of CAC was explored, using correlation analysis and multivariate regression.

Results

The study cohort included 219 participants. The prevalence of DISH was 7,8%. In univariate logistic regression, BMI (OR 1,133, p=0,005), age (OR 1,055, p=0,032) and diabetes (OR 3,840, p=0,015) were significantly associated with the condition. However, this association did not persist on multinomial multivariate analysis, but gender, age, hypertension and EAT attenuation were found to be significantly associated with the increasing CAC strata.

Conclusions

The prevalence of DISH found is comparable with prior literature. There was no independent relationship between the prevalence of DISH and CACS. Our data point to a more nuanced and perhaps non-causal link between coronary artery disease and DISH.

Keywords: Diffuse idiopathic skeletal hyperostosis, coronary artery calcification, epicardial adipose tissue, metabolic syndrome, body mass index, coronary artery disease