Metabolic Factors in Diffuse Idiopathic Skeletal Hyperostosis – A Review of Clinical Data

Sruti Pillai , Geoffrey Littlejohn*
Departments of Rheumatology and Medicine, Monash Health and Monash University, 246 Clayton Road, Clayton, Victoria, 3168, Australia

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© Pillai and Littlejohn; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Suite H, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, 3168, Australia; Tel: 613 95942575; Fax: 613 95945588; E-mail:



We aimed to review the literature linking metabolic factors to Diffuse Idiopathic Skeletal Hyperostosis (DISH), in order to assess associations between growth factors and DISH.


We identified studies in our personal database and PubMed using the following keywords in various combinations: “diffuse idiopathic skeletal hyperostosis”, “ankylosing hyperostosis”, “Forestier’s disease”, “diabetes”, “insulin”, “obesity”, “metabolic”, “growth factors”, “adipokines”, “glucose tolerance” and “chondrocytes”.


We were not able to do a systematic review due to variability in methodology of studies. We found positive associations between obesity (especially abdominal obesity), Type 2 diabetes mellitus, glucose intolerance, hyperinsulinemia and DISH.


Current research indicates that certain metabolic factors associate with DISH. More precise studies deriving from these findings on these and other newly identified bone-growth factors are needed.

Keywords: Bone, diabetes, DISH, diffuse idiopathic skeletal hyperostosis, growth factors, insulin, metabolic, obesity..