[Diffuse idiopathic skeletal hyperostosis and its relation to metabolic parameters]

Area of Science:

• Rheumatology and Endocrinology
• Metabolic Bone Disease

Context:

• Diffuse idiopathic skeletal hyperostosis (DISH) is a skeletal condition affecting the axial and peripheral skeleton.
• Established links exist between DISH and metabolic disorders, particularly type 2 diabetes mellitus and dyslipidemia.
• The precise mechanisms underlying the association between DISH and metabolic alterations remain incompletely understood.

Purpose:

• To explore the intricate relationship between metabolic factors and the pathogenesis of Diffuse idiopathic skeletal hyperostosis (DISH).
• To elucidate the roles of hyperglycemia, insulin resistance, and the growth hormone/insulin-like growth factor axis in DISH.
• To inform therapeutic strategies by identifying factors that influence DISH progression.

Summary:

• Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by excessive bone formation in the skeleton.
• Metabolic alterations, including type 2 diabetes, hyperglycemia, and insulin resistance, are strongly associated with DISH.
• The growth hormone (GH) and insulin-like growth factor (IGF) system, including IGF binding proteins (IGFBP2, IGFBP3), are implicated in the disease process.
• Management recommendations advise against medications that exacerbate hyperinsulinemia in patients with DISH.

Impact:

• Provides a deeper understanding of the metabolic underpinnings of Diffuse idiopathic skeletal hyperostosis (DISH).
• Highlights the potential influence of hormonal pathways, such as the GH/IGF axis, on skeletal hyperostosis.
• Informs clinical practice regarding medication choices for symptomatic relief in DISH patients with metabolic comorbidities.