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The following is a summary of “Diffuse idiopathic skeletal hyperostosis as a marker for incident diabetes mellitus in cardiovascular disease patients,” published in the May 2025 issue of Rheumatology by Harlianto et al. 

Diffuse idiopathic skeletal hyperostosis (DISH) was commonly identified incidentally on medical imaging and was associated with a high prevalence of type 2 diabetes mellitus (T2DM).  

Researchers conducted a retrospective study to evaluate the absolute incidence rate of type 2 diabetes mellitus in patients with cardiovascular disease along with and without DISH detected incidentally.  

They included 3,395 individuals with cardiovascular disease without diabetes from the prospective Second Manifestation of ARTerial disease cohort, DISH was assessed at baseline using Resnick criteria on chest radiographs. Incident T2DM was confirmed by an adjudication committee. Adjusted incidence rate ratios and numbers needed to screen were calculated.  

The results showed DISH was present in 263 (7.7%) individuals. After a median follow-up of 11.1 years (IQR: 7.1–15.2), 317 developed T2DM. The incidence rate of T2DM was higher in those with DISH compared to those without (17.1 vs 7.8 per 1000 person-years), DISH was linked to incident T2DM in multivariate analysis (incidence rate ratio: 1.47; 95% CI: 1.03–2.06), with the highest incidence rate ratio in those with the most extensive ossification (incidence rate ratio: 2.01; 95% CI: 1.15–3.29). The number needed to screen for T2DM over 11.1 years in individuals with screen-detected DISH was 7, comparable to overweight (n=8), obesity (n=5), hypertension (n=9), and hyperlipidemia (n=13).  

Investigators concluded that DISH was linked to increased rates of incident T2DM in individuals’ with cardiovascular disease, independent of established risk factors, and could serve as an imaging marker to identify those at higher risk. 

Source: academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keaf268/8151561