Diffuse Idiopathic Skeletal Hyperostosis (DISH) in Type 2 Diabetes: A New Imaging Possibility and a New Biomarker
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ORIGINAL RESEARCH
Diffuse Idiopathic Skeletal Hyperostosis (DISH) in Type 2 Diabetes: A New Imaging Possibility and a New Biomarker Angelo Fassio1 · Giovanni Adami1 · Luca Idolazzi1 · Alessandro Giollo1 · Ombretta Viapiana1 · Emma Bosco1 · Riccardo Negrelli2 · Elena Sani3 · Damiano Sandri3 · Alessandro Mantovani3 · Giovanni Targher3 · Maurizio Rossini1 · Davide Gatti1 Received: 2 July 2020 / Accepted: 1 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract We performed a cross-sectional study to investigate the prevalence of Diffuse Idiopathic Skeletal Hyperostosis (DISH) through Dual-Energy X-ray absorptiometry (DXA) Vertebral Fracture Assessment (VFA) in a group of post-menopausal women with Type 2 Diabetes Mellitus (T2DM). We also explored several biomarkers of bone turnover metabolism, including Wnt pathway modulators. DXA-VFA was performed to detect the presence of DISH. Serum samples were collected from all patients at the time of study recruitment. 16 different serum biomarkers were tested between the two subgroups. Given the exploratory nature of the study, we did not adjust for multiplicity. At VFA analysis, among 96 individuals enrolled in the study 20 (20.8%) showed features of DISH. No statistically significant difference was found for BMD values, between the DISH and NO-DISH subgroups. Concerning blood biomarkers, DISH patients showed a significant difference only in the sclerostin serum levels (32 vs 35.5 pmol/L, for the DISH and NO-DISH subgroup, respectively; p = 0.010). After adjustment for confounding factors, sclerostin serum levels remained significantly lower in DISH group (p = 0.002). We demonstrated a non-negligible prevalence of DISH in a population of post-menopausal women affected by T2DM and suggested low serum sclerostin as a possible key feature associated with DISH presence. In addition, we propose DXA-VFA analysis, whose radiation dose is considerably lower than conventional radiography, as a viable diagnostic and prognostic mean to obtain data not only on bone health, but also for the screening for DISH in subjects at risk. Keywords Type 2 diabetes mellitus · Diffuse idiopathic skeletal hyperostosis · Densitometry · Wnt pathway · Dkk-1 · Sclerostin · Osteoporosis Abbreviations SD Standard deviation BMI Body mass index HbA1c Glycated hemoglobin hsCRP High-sensitivity C-reactive protein PTH Parathyroid hormone CTX C-terminal cross-linking telopeptide of type 1 collagen
* Angelo Fassio [email protected] 1
Rheumatology Unit, University Hospital of Verona, Policlinico GB Rossi, Piazzale A. Scuro, 37134 Verona, Italy
2
Radiology Unit, University Hospital of Verona, Verona, Italy
3
Division of Endocrinology, Diabetes and Metabolism, University Hospital of Verona, Verona, Italy
PINP Serum procollagen type 1 N-terminal propeptide Dkk-1 Dickkopf-1 RANKL Receptor activator of nuclear factor kappa-Β ligand 25(OH)D 25-Hydroxyvitamin D LDL Low-density lipoprotein HDL High-density lipoprotein HOMA-IR Homeostatic Model Asses
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