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The relation between cardiovascular calcifications and diffuse idiopathic skeletal hyperostosis

Netanja I Harlianto1, Esther Pompe2, Wouter Foppen2

  • 1University Medical Center Utrecht, Utrecht, Netherlands. netanjaharlianto@gmail.com.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|August 11, 2026
PubMed

Insights

Diffuse idiopathic skeletal hyperostosis (DISH) is linked to thoracic aortic and aortic valve calcifications. This study found no association with coronary artery or mitral valve calcifications in male smokers.

Area of Science:

  • Cardiovascular Imaging and Radiology
  • Rheumatology and Skeletal Diseases
  • Medical Diagnostics

Background:

  • Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by calcification and ossification of soft tissues.
  • Previous studies suggest a potential link between DISH and vascular calcifications, but conclusive evidence is lacking.
  • Understanding this association is crucial for cardiovascular risk assessment in individuals with DISH.

Purpose of the Study:

  • To investigate the relationship between Diffuse idiopathic skeletal hyperostosis (DISH) and calcifications in the coronary arteries, thoracic aorta, aortic valve, and mitral annulus/valve.
  • To determine if DISH is an independent risk factor for specific types of vascular calcification.

Main Methods:

  • Utilized chest computed tomography (CT) data from 3514 male participants in the NELSON lung cancer screening trial.
  • Quantified calcification volumes using validated automatic software and assessed DISH presence based on Resnick criteria.
  • Employed multivariate linear and logistic regression models to analyze associations between DISH and vascular calcifications.

Main Results:

  • Diffuse idiopathic skeletal hyperostosis (DISH) was identified in 6.9% of the study cohort.
  • Individuals with DISH exhibited significantly higher thoracic aortic calcification volumes and a greater prevalence of aortic valve calcifications.
  • Multivariate analyses confirmed an independent association between DISH and thoracic aortic calcifications (OR: 1.55) and aortic valve calcifications (OR: 1.53).
  • No significant association was found between DISH and coronary artery or mitral valve/annulus calcifications.

Conclusions:

  • An independent relationship exists between Diffuse idiopathic skeletal hyperostosis (DISH) and calcifications in the thoracic aorta and aortic valve.
  • The study did not find a significant association between DISH and coronary artery or mitral valve calcifications.
  • These findings highlight the importance of considering aortic calcifications in patients diagnosed with DISH.
Abstract

Keywords:
Aorta calcificationsAortic valveCoronary artery diseaseDiffuse idiopathic skeletal hyperostosisMitral valve

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