Morphological characteristics of DISH in patients with OPLL and its association with high-sensitivity CRP: inflammatory DISH
Morphological characteristics of DISH in patients with OPLL and its association with high-sensitivity CRP: inflammatory DISH
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DOI：
10.1093/rheumatology/keac051
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发表时间：
2022-05-17
期刊：
影响因子：
5.5
通讯作者：
Kawaguchi, Yoshiharu
中科院分区：
文献类型：
--
作者：
Tran Canh Tung Nguyen;Yahara, Yasuhito;Kawaguchi, Yoshiharu
目的探讨后纵韧带骨化（OPLL）患者DISH的异位骨形成是否由炎症或退行性过程引起。方法对182例颈椎OPLL患者（DISH+104例，DISH-78例）进行全脊柱CT检查和血清超敏C反应蛋白（hs-CRP）测定。在DISH+组中，异位骨形成分为扁平型和锯齿型，然后进一步分为三个亚组：组1（锯齿型为主），组2（模式等效）和组3（扁平型为主）。比较DISH+和DISH-组之间以及三个亚组之间的数据。结果扁平型以上胸椎多见，锯齿型以中、下胸椎多见。DISH+和DISH-组之间的hs-CRP水平没有差异。在三个亚组中，第3组的hs-CRP水平[平均值（s.d.）0.16（0.09）mg/dl]显著高于第1组[0.04（0.02）mg/dl]和第2组[0.08（0.06）mg/dl]。高水平hs-CRP与更多的扁平型椎体单位相关（β = 0.691，P < 0.0001），与较少的锯齿型椎体单位相关（β =-0.147，P = 0.036）。结论扁平型DISH可能是由炎症机制引起的，而不是Jaggy型DISH的退行性病变。
Objectives To characterize and clarify evidence as to whether the ectopic bone formations of DISH in patients with ossification of the posterior longitudinal ligament (OPLL) are caused by inflammatory or degenerative processes. Methods Whole-spine CT and serum high-sensitivity CRP (hs-CRP) levels were obtained from 182 cervical OPLL patients (DISH+, n = 104; DISH-, n = 78). In the DISH+ group, ectopic bone formations were categorized into Flat and Jaggy types, then further divided into three subgroups: group 1 (Jaggy-dominant pattern), group 2 (Equivalence of pattern) and group 3 (Flat-dominant pattern). Data were compared between the DISH+ and DISH- groups, and among the three subgroups. Results The upper thoracic spine was most affected by the Flat type, whereas the Jaggy type was more frequent in the middle and lower thoracic regions. There was no difference in hs-CRP levels between the DISH+ and DISH- groups. Among the three subgroups, hs-CRP levels in group 3 [mean (s.d.) 0.16 (0.09) mg/dl] were significantly higher than in group 1 [0.04 (0.02) mg/dl] and group 2 [0.08 (0.06) mg/dl]. Higher levels of hs-CRP were associated with a greater number of vertebral units with Flat-type formations (beta = 0.691, P < 0.0001) and with a lesser number of vertebral units with Jaggy-type formations (beta = -0.147, P = 0.036). Conclusion The Flat type in DISH might be caused by an inflammatory pathogenesis rather than a degenerative process presented in the Jaggy type.