Session Information
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Diffuse Idiopathic Skeletal Hyperostosis (DISH) is an incompletely understood condition characterized by new bone formation affecting the spine. Despite reported links between DISH and obesity, the nature of the relationship is unknown. To investigate further, we constructed an obesity genetic risk score (GRS) for BMI and assessed association with DISH.
Methods: A convenience sample of 3,117 patients from the COPDGene Study was used to investigate the association between BMI GRS and DISH. Two readers visually scored spine imaging for DISH based on Resnick criteria. BMI served as the obesity phenotype. Genotyping was performed using the Illumina Omni-Express Chip. A 97 SNP BMI GRS based on validated GWAS loci was calculated. Univariate analyses assessing association of age, sex, race, diabetes status (self-report or taking anti-diabetic medication), BMI GRS with DISH were performed. In addition, a logistic regression model adjusted for age, sex, race, and diabetes, was used to evaluate the association of BMI GRS with DISH. The association of the BMI GRS with BMI served as a positive control. The COPDGene study, initiated 2007-2011, enrolled 10,129 smokers to define subtypes and genetic associations of smoking related lung disease. HRCT of the chest, DNA, demographic and anthropometric data and medical history were obtained.
Results: We analyzed 437 DISH cases and 2,680 controls among men and women in the COPDGene study with available HRCTs of the chest. See Table 1 for odds ratios (OR) for the univariate and multivariate models. On univariate analysis, DISH correlated with male sex, increasing BMI and increasing age. The correlation between BMI and BMI GRS was significant (p<0.0001). The OR between DISH and BMI GRS was 1.02 (95% CI 1.00-1.04, p=0.019), but when separated by race subgroups, the p-value was not significant in either African Americans or non-Hispanic whites. In the overall multivariate model, there was no significant association between DISH and BMI GRS with OR 1.004 (95% CI 0.99-1.02, p=0.68). Table 1. Association between DISH and clinical features and BMI GRS
| Variable | Odds Ratio | Adjusted* Odds Ratio | Confidence Interval | P-value |
| Age (years) | 1.06 | 1.07 | 1.06-1.08 | <0.0001 |
| Gender (male) | 2.96 | 3.50 | 2.72-4.50 | <0.0001 |
| Race (non-Hispanic White) | 1.52 | 0.94 | 0.71-1.24 | 0.64 |
| BMI (kg/m^2) | 1.09 | 1.12 | 1.10-1.14 | <0.0001 |
| DM (reported history and medications) | 2.64 | 1.49 | 1.13-1.97 | 0.005 |
| BMI GRS | 1.02 | 1.00 | 0.99-1.02 | 0.68 |
*Adjusted for age, gender, race, DM history
Conclusion: Our results suggest obesity does not share a direct genetic association with DISH. However, it is associated with DISH, which may be due to effects of a shared mechanism such as inflammation. In addition, direct and indirect effects of elevated leptin levels and decreased adiponectin levels, present in obese patients, may play a role to alter bone formation. The role of smoking remains to be elucidated. More studies are needed to further explore the mechanism driving the relationship between obesity and DISH.
To cite this abstract in AMA style:
Wang M, Ishimori M, Kinney G, Ianculsecu I, Regan E, Weisman M, Goodarzi M. Diffuse Idiopathic Skeletal Hyperostosis and Obesity- Is There a Causal Relationship? [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/diffuse-idiopathic-skeletal-hyperostosis-and-obesity-is-there-a-causal-relationship/. Accessed .« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/diffuse-idiopathic-skeletal-hyperostosis-and-obesity-is-there-a-causal-relationship/