Does Obesity Contribute to DISH?

Question: Does Obesity Contribute to DISH?

Diffuse idiopathic skeletal hyperostosis (DISH) is the hardening of the spinal ligaments where they attach to bone. One of the most commonly affected ligaments is the anterior longitudinal ligament, which is located in front of the vertebral column.

Answer: Though the cause of this condition is still unclear, studies have shown an association between high BMI (obesity) and DISH. In combination with other factors (diet, metabolic disorders, genetics), DISH can lead to back pain, disability, and more rarely myelopathy. It can also lead to a propensity for spinal fractures, even when they are brought on by a mild degree of trauma.

You may or may not have pain when you have DISH, but symptoms can include spinal stiffness, including morning stiffness. If you do have pain, it may be more noticeable in the area where the ligaments have hardened, which is generally 2 or more vertebral levels of the spinal column. Such pain can be in the cervical, thoracic and lumbar spinal regions. If in your neck area, you may have throat problems, such as hoarseness or difficulty swallowing.

Men and the elderly are the most at risk for DISH. DISH is related to abnormal bone cell activity, which is what results in the hardening of the anterior longitudinal ligament at the sites where it attaches to the bone. Researchers have also linked it with the presence of diabetes.

_Sources:

Sarzi-Puttini, Piercarlo; Atzeni, Fabiola. New developments in our understanding of DISH (diffuse idiopathic skeletal hyperostosis). Crystal deposition diseases Current Opinion in Rheumatology. May 2004.

Kiss C, Szilágyi M, Paksy A, Poór G. Risk factors for diffuse idiopathic skeletal hyperostosis: a case-control study. Verlaan JJ, Oner FC, Maat GJ. Diffuse idiopathic skeletal hyperostosis in ancient clergymen.
Westerveld LA, van Ufford HM, Verlaan JJ, Oner FC. The prevalence of diffuse idiopathic skeletal hyperostosis in an outpatient population in the Netherlands.