Relación entre hiperostosis esquelética idiopática difusa, calcificación de la aorta abdominal y las alteraciones metabólicas asociadas: datos de la Cohorte Camargo

Resumen

Antecedentes y objetivo

La hiperostosis esquelética idiopática difusa (DISH, del inglés diffuse idiopathic skeletal hyperostosis) y la calcificación aórtica abdominal (CAA) se asocian a un incremento del riesgo cardiovascular. El objetivo fue analizar una posible relación entre ambas, así como las alteraciones metabólicas asociadas a la DISH.

Pacientes y método

Estudio transversal-analítico, incluido en una cohorte poblacional. La DISH (criterios de Resnick-Niwayama) y la CAA (mediante la escala AAC-24) fueron evaluadas sobre imágenes de radiología simple. Se evaluaron asimismo otras 40 variables clínicas mediante correlaciones y regresión multivariante.

Resultados

Fueron analizados 987 varones ≥ 50 años, con una edad media = 65,5 ± 9 años. Las prevalencias de DISH y CAA fueron del 21,6% y del 58,7%, respectivamente. El sujeto con DISH tenía mayor edad (68,1 ± 9 vs. 63,8 ± 9 años; p = 0,0001) y con mayor frecuencia presentaba síndrome metabólico (SM) (55,6 vs. 36,6%; p = 0,0001). La CAA fue de 3,7 ± 5 puntos en sujetos con DISH frente a 3,3 ± 5 en sujetos sin DISH (p = 0,25), y se asoció a un riesgo incrementado de DISH prevalente (OR cruda = 1,4 [IC95%: 1,01-1,9]; p = 0,04), que desapareció al ajustar por edad (OR ajustada = 1,1 [IC95%: 0,8-1,5]; p = 0,47). No se observó asociación de la DISH con la hipertensión arterial, diabetes mellitus o dislipidemia, pero mantuvieron una relación significativa tras ajustar por confusores la edad (OR = 2,2 [IC95%: 1,6-3]; p = 0,0001), el IMC (OR = 1,5 [IC95%: 1,1-2]; p = 0,007), el perímetro abdominal (OR = 1,5 [IC95%: 1,04-2,3]; p = 0,03) y el SM (OR = 1,7 [IC95%: 1,1-2,4]; p = 0,005).

Conclusiones

No se ha podido demostrar una asociación consistente entre la DISH y la CAA, presentando ambas una débil relación dependiente de la edad. La DISH ha mostrado unas asociaciones significativas con la edad, el IMC, el perímetro abdominal y el SM.

Abstract

Background and objective

Diffuse idiopathic skeletal hyperostosis (DISH) and abdominal aortic calcification (AAC) are related to an increased cardiovascular risk. The aim of this study was to analyse a possible relationship between both entities and also the association between metabolic disorders and DISH.

Patients and method

Analytic cross-sectional study in a population-based cohort. DISH (with Resnick-Niwayama criteria) and AAC (with AAC-24 scale) were assessed on plain x-ray images. Interaction terms between DISH and forty clinical covariates were also investigated, through correlation analysis and multivariate regression.

Results

Nine hundred eighty-seven males aged ≥ 50 years, with a mean age = 65,5 ± 9 years, were evaluated. Prevalence rates of DISH and AAC were 21.6% and 58.7%, respectively. DISH+ subjects were older (68.1 ± 9 vs. 63.8 ± 9 years; P = .0001) and more likely to be affected by metabolic syndrome (MS) (55.6% vs. 36.6%; P = .0001). In DISH+ subjects, the AAC was 3.7 ± 5 points, whereas in DISH− subjects it was 3.3 ± 5 (P = .25). AAC was associated with an increased risk of prevalent DISH (unadjusted OR = 1.4 [CI95%: 1.01-1.9]; P = .04), that disappeared when it was adjusted for age (adjusted OR = 1.1 [CI95%: 0.8-1.5];P = .47]. No association was found between DISH and hypertension, diabetes or dyslipidaemia; however, age (OR = 2.2 [CI95%: 1.6-3]; P = .0001), BMI (OR = 1.5 [CI95%: 1.1-2]; P = .007), waist circumference (OR = 1.5 [CI95%: 1.04-2,3]; P = .03) and MS (OR = 1.7 [CI95%: 1.1-2.4]; P = .005) showed a significant relationship with DISH after adjusting for confounders.

Conclusions

The study was not able to demonstrate a consistent association between DISH and AAC, proving only a weak and age-dependent relationship between them. DISH proved to be significantly associated with age, BMI, waist circumference and MS.