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The prevalence of diffuse idiopathic skeletal hyperostosis in African blacks
B Cassim1, G M Mody, D L Rubin
1Department of Medicine, King Edward VIII Hospital, Durban, South Africa.
Insights
Diffuse idiopathic skeletal hyperostosis (DISH) affects 3.9% of African Blacks over 40. Prevalence increases with age, with 52.4% of DISH patients having diabetes.
Area of Science:
- Rheumatology
- Epidemiology
- Radiology
Background:
- Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory spinal condition.
- Its prevalence varies significantly across different ethnic groups and geographic locations.
- Understanding DISH prevalence in African Black populations is crucial for comparative epidemiology.
Purpose of the Study:
- To determine the prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in African Black adults over 40 years old.
- To investigate the association between DISH and diabetes mellitus in this population.
- To compare DISH prevalence with other ethnic groups.
Main Methods:
- Retrospective analysis of 1000 lateral chest radiographs.
- Prospective analysis of 500 consecutive medical admissions.
- Radiographic assessment for DISH criteria.
Main Results:
- Overall DISH prevalence was 3.9% (3.8% males, 4.2% females).
- Prevalence increased with age, from 1% (40-49 years) to 13.6% (over 70 years).
- Diabetes prevalence was 52.4% in the 21 DISH patients identified prospectively.
Conclusions:
- DISH is not uncommon in African Blacks over 40, with prevalence rising with age.
- A high prevalence of diabetes was observed in DISH patients.
- DISH prevalence in this population is lower than in Israeli Jews, suggesting ethnic variations.
Abstract:
The prevalence of diffuse idiopathic skeletal hyperostosis (DISH) was studied in a hospital based population of African Blacks over the age of 40 years. The study was based on an analysis of the lateral chest radiographs of 1000 patients in a retrospective study and 500 consecutive medical admissions in a prospective study. The overall prevalence of DISH was 3.9% (males 3.8% and females 4.2%). There was a rise in the prevalence of DISH with increasing age from 1% in the 40-49 year age group to 13.6% in those over 70 years. The prevalence of diabetes was 52.4% in the 21 patients with DISH who were seen in the prospective analysis. Ankylosing spondylitis, which is associated with HLA-B27, is rare in African Blacks. However, DISH is not uncommon but its prevalence is lower than in a similar hospital based study of Jews in Israel.