{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T07:23:51Z","timestamp":1775892231111,"version":"3.50.1"},"reference-count":42,"publisher":"The Journal of Rheumatology","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"accepted":{"date-parts":[[2025,6,2]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by calcification and ossification, predominantly affecting the axial skeleton. DISH is associated with obesity, diabetes mellitus, and hypertension, all included in the metabolic syndrome (MetS). The aim of this study was to investigate the prevalence of DISH in patients with MetS and the influence of obesity on spinal radiographic changes related to DISH vs degenerative changes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients diagnosed with MetS were categorized into 4 obesity classes (World Health Organization criteria). Based on Resnick criteria, patients were classified as DISH or non-DISH. Radiographs were assessed for degenerative (d)-spondylophytes and DISH-related chunky (Drc)-spondylophytes, and their association with obesity was analyzed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 124 patients were included, of whom 42 (33.9%) were identified as having DISH. The mean BMI was 39.8 (SD 6.3), with obesity classes distributed as follows: preobese (n = 7), obesity class I (n = 19), II (n = 38), and III (n = 60). Higher obesity classes (II and III) were significantly associated with an increased number of Drc-spondylophytes in all patients. In DISH, obesity class \u2265 II was linked to a greater number of Drc-spondylophytes (14.8 [SD 10.3] vs 9.7 [SD 7.7]), whereas no association was found between obesity and d-spondylophytes. Overall, patients with DISH had fewer d-spondylophytes than those without DISH (2.7 [SD 2.7] vs 4.1 [SD 4.1]; <jats:italic>P<\/jats:italic> = 0.04).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>One-third of patients with MetS were classified as having DISH. In contrast to degenerative spine disease, obese MetS classes II and III were significantly associated with radiographic spinal changes attributed to DISH.<\/jats:p>\n               <\/jats:sec>","DOI":"10.3899\/jrheum.2025-0243","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T08:35:15Z","timestamp":1751358915000},"page":"1028-1033","source":"Crossref","is-referenced-by-count":2,"title":["Influence of Obesity on Radiographic Changes in Patients With Diffuse Idiopathic Skeletal Hyperostosis"],"prefix":"10.3899","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1602-7649","authenticated-orcid":false,"given":"David","family":"Kiefer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michail","family":"Godolias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8465-6207","authenticated-orcid":false,"given":"Philipp","family":"Sewerin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5668-4497","authenticated-orcid":false,"given":"Uta","family":"Kiltz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2624-7485","authenticated-orcid":false,"given":"Styliani","family":"Tsiami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana","family":"Andreica","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9475-9362","authenticated-orcid":false,"given":"Xenofon","family":"Baraliakos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2262","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"2025100105301406000_52.10.1028.1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.9.4.321"},{"key":"2025100105301406000_52.10.1028.2","doi-asserted-by":"publisher","DOI":"10.1148\/119.3.559"},{"key":"2025100105301406000_52.10.1028.3","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3109\/03009748109095298","article-title":"Spondylosis deformans and diffuse idiopathic skeletal hyperostosis (DISH) in Finland","volume":"10","author":"Julkunen","year":"1981","journal-title":"Scand J Rheumatol"},{"key":"2025100105301406000_52.10.1028.4","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1111\/jgs.14810","article-title":"Diffuse idiopathic skeletal hyperostosis (DISH) and impaired physical function: the Rancho Bernardo study","volume":"65","author":"Katzman","year":"2017","journal-title":"J Am Geriatr Soc"},{"key":"2025100105301406000_52.10.1028.5","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s00774-014-0583-9","article-title":"Prevalence of diffuse idiopathic skeletal hyperostosis (DISH) of the whole spine and its association with lumbar spondylosis and knee osteoarthritis: the ROAD study","volume":"33","author":"Kagotani","year":"2015","journal-title":"J Bone Miner Metab"},{"key":"2025100105301406000_52.10.1028.6","doi-asserted-by":"crossref","first-page":"41","DOI":"10.4055\/cios.2018.10.1.41","article-title":"Prevalence of diffuse idiopathic skeletal hyperostosis diagnosed by whole spine computed tomography: a preliminary study","volume":"10","author":"Kim","year":"2018","journal-title":"Clin Orthop Surg"},{"key":"2025100105301406000_52.10.1028.7","doi-asserted-by":"crossref","first-page":"E1418","DOI":"10.1097\/BRS.0000000000000615","article-title":"Diffuse idiopathic skeletal hyperostosis association with thoracic spine kyphosis: a cross-sectional study for the Health Aging and Body Composition Study","volume":"39","author":"Nardo","year":"2014","journal-title":"Spine"},{"key":"2025100105301406000_52.10.1028.8","first-page":"1635","article-title":"The prevalence of diffuse idiopathic skeletal hyperostosis in an outpatient population in the Netherlands","volume":"35","author":"Westerveld","year":"2008","journal-title":"J Rheumatol"},{"key":"2025100105301406000_52.10.1028.9","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jos.2016.09.003","article-title":"Prevalence of thoracic diffuse idiopathic skeletal hyperostosis (DISH) in Japanese: results of chest CT-based cross-sectional study in Japanese","volume":"22","author":"Mori","year":"2017","journal-title":"J Orthop Sci"},{"key":"2025100105301406000_52.10.1028.10","doi-asserted-by":"crossref","first-page":"174","DOI":"10.5115\/acb.2018.51.3.174","article-title":"Prevalence of diffuse idiopathic skeletal hyperostosis among elderly subjects referred for radiological investigation in tertiary hospital at Oman","volume":"51","author":"Sirasanagandla","year":"2018","journal-title":"Anat Cell Biol"},{"key":"2025100105301406000_52.10.1028.11","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-022-01545-x"},{"key":"2025100105301406000_52.10.1028.12","doi-asserted-by":"crossref","first-page":"rkac060","DOI":"10.1093\/rap\/rkac060","article-title":"Patients with diffuse idiopathic skeletal hyperostosis have an increased burden of thoracic aortic calcifications","volume":"6","author":"Harlianto","year":"2022","journal-title":"Rheumatol Adv Pract"},{"key":"2025100105301406000_52.10.1028.13","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.3390\/diagnostics12051088","article-title":"The prevalence and characteristics of diffuse idiopathic skeletal hyperostosis (DISH): a cross-sectional study of 1519 Japanese individuals","volume":"12","author":"Ikuma","year":"2022","journal-title":"Diagnostics"},{"key":"2025100105301406000_52.10.1028.14","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1177\/21925682221136844","article-title":"Diffuse idiopathic skeletal hyperostosis prevalence, characteristics, and associated comorbidities: a cross-sectional study of 1815 whole spine CT scans","volume":"14","author":"Ahmed","year":"2024","journal-title":"Glob Spine J"},{"key":"2025100105301406000_52.10.1028.15","doi-asserted-by":"publisher","DOI":"10.1080\/030097402320318422"},{"key":"2025100105301406000_52.10.1028.16","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.jos.2016.02.001","article-title":"The prevalence of diffuse idiopathic skeletal hyperostosis in Japan \u2013 the first report of measurement by CT and review of the literature","volume":"21","author":"Hirasawa","year":"2016","journal-title":"J Orthop Sci"},{"key":"2025100105301406000_52.10.1028.17","doi-asserted-by":"crossref","first-page":"22181","DOI":"10.1038\/s41598-021-01092-x","article-title":"Prevalence and characteristics of thoracic diffuse idiopathic skeletal hyperostosis in 3299 black patients","volume":"11","author":"Yoshihara","year":"2021","journal-title":"Sci Rep"},{"key":"2025100105301406000_52.10.1028.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2008.01.010"},{"key":"2025100105301406000_52.10.1028.19","doi-asserted-by":"crossref","first-page":"116","DOI":"10.2174\/1874312901408010116","article-title":"Metabolic factors in diffuse idiopathic skeletal hyperostosis \u2013 a review of clinical data","volume":"8","author":"Pillai","year":"2014","journal-title":"Open Rheumatol J"},{"key":"2025100105301406000_52.10.1028.20","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S"},{"key":"2025100105301406000_52.10.1028.21","doi-asserted-by":"crossref","first-page":"910.e15","DOI":"10.1016\/j.crad.2018.06.008","article-title":"Abdominal fat distribution in diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis patients compared to controls","volume":"73","author":"Dan Lantsman","year":"2018","journal-title":"Clin Radiol"},{"key":"2025100105301406000_52.10.1028.22","first-page":"506","article-title":"Diffuse idiopathic skeletal hyperostosis: a distinct clinical entity","volume":"5","author":"Mader","year":"2003","journal-title":"Isr Med Assoc J"},{"key":"2025100105301406000_52.10.1028.23","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199703000-00003"},{"key":"2025100105301406000_52.10.1028.24","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-010-1409-9"},{"key":"2025100105301406000_52.10.1028.25","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1002\/acr.23115","article-title":"Cross-sectional and longitudinal associations of diffuse idiopathic skeletal hyperostosis and thoracic kyphosis in older men and women","volume":"69","author":"Katzman","year":"2017","journal-title":"Arthritis Care Res"},{"key":"2025100105301406000_52.10.1028.26","first-page":"e51357","article-title":"Examining the association between the extent of anterior longitudinal ligament ossification progression and comorbidities in diffuse idiopathic skeletal hyperostosis","volume":"15","author":"Ishimura","year":"2023","journal-title":"Cureus"},{"key":"2025100105301406000_52.10.1028.27","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1080\/03009742.2020.1846779","article-title":"Diffuse idiopathic skeletal hyperostosis in elderly Icelanders and its association with the metabolic syndrome: the AGES-Reykjavik Study","volume":"50","author":"Au\u00f0unsson","year":"2021","journal-title":"Scand J Rheumatol"},{"key":"2025100105301406000_52.10.1028.28","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1186\/s13075-020-02278-w","article-title":"Cardiovascular disease in diffuse idiopathic skeletal hyperostosis (DISH): from theory to reality-a 10-year follow-up study","volume":"22","author":"Glick","year":"2020","journal-title":"Arthritis Res Ther"},{"key":"2025100105301406000_52.10.1028.29","doi-asserted-by":"crossref","first-page":"21349","DOI":"10.1038\/s41598-021-00798-2","article-title":"Increased risk of stroke in patients with diffuse idiopathic skeletal hyperostosis: a nationwide population-based cohort study","volume":"11","author":"Cheng","year":"2021","journal-title":"Sci Rep"},{"key":"2025100105301406000_52.10.1028.30","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000214949.75361.f4"},{"key":"2025100105301406000_52.10.1028.31","first-page":"i","article-title":"Report of a WHO consultation","volume":"894","year":"2000","journal-title":"World Health Organ Tech Rep Ser"},{"key":"2025100105301406000_52.10.1028.32","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1016\/j.spinee.2022.06.001","article-title":"Spondylophyte classification based on biomechanical effects on segmental stiffness","volume":"22","author":"Farshad","year":"2022","journal-title":"Spine J"},{"key":"2025100105301406000_52.10.1028.33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12565-010-0080-8","article-title":"Vertebral spinal osteophytes","volume":"86","author":"Klaassen","year":"2011","journal-title":"Anat Sci Int"},{"key":"2025100105301406000_52.10.1028.34","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-9260(82)80062-7"},{"key":"2025100105301406000_52.10.1028.35","doi-asserted-by":"crossref","first-page":"243","DOI":"10.2106\/00004623-196244020-00003","article-title":"Osteophytes of the vertebral column: an anatomical study of their development according to age, race, and sex with considerations as to their etiology and significance","volume":"44","author":"Nathan","year":"1962","journal-title":"J Bone Joint Surg"},{"key":"2025100105301406000_52.10.1028.36","doi-asserted-by":"publisher","DOI":"10.1016\/0049-0172(78)90036-7"},{"key":"2025100105301406000_52.10.1028.37","first-page":"310","article-title":"Intervertebral disc lesions in diffuse idiopathic skeletal hyperostosis (DISH)","volume":"19","author":"di Girolamo","year":"2001","journal-title":"Clin Exp Rheumatol"},{"key":"2025100105301406000_52.10.1028.38","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1177\/0284185118761205","article-title":"Degenerative changes of the thoracic spine do exist in patients with diffuse idiopathic skeletal hyperostosis: a detailed thoracic spine CT analysis","volume":"59","author":"Slonimsky","year":"2018","journal-title":"Acta Radiol"},{"key":"2025100105301406000_52.10.1028.39","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.066415"},{"key":"2025100105301406000_52.10.1028.40","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.11.2777"},{"key":"2025100105301406000_52.10.1028.41","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.11.2745"},{"key":"2025100105301406000_52.10.1028.42","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1002\/jor.23267","article-title":"Histological characteristics of diffuse idiopathic skeletal hyperostosis","volume":"35","author":"Kuperus","year":"2017","journal-title":"J Orthop Res"}],"container-title":["The Journal of Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3899\/jrheum.2025-0243","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T12:31:14Z","timestamp":1759321874000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.jrheum.org\/lookup\/doi\/10.3899\/jrheum.2025-0243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":42,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,1]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.3899\/jrheum.2025-0243"],"URL":"https:\/\/doi.org\/10.3899\/jrheum.2025-0243","relation":{},"ISSN":["0315-162X","1499-2752"],"issn-type":[{"value":"0315-162X","type":"print"},{"value":"1499-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]}}}