title: Metabolic factors in diffuse idiopathic skeletal hyperostosis - a review of clinical data.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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".
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Departments of Rheumatology and Medicine, Monash Health and Monash University, 246 Clayton Road, Clayton, Victoria, 3168, Australia.
authors.forename: Sruti
authors.initials: S
authors.lastname: Pillai
authors.affiliation: Departments of Rheumatology and Medicine, Monash Health and Monash University, 246 Clayton Road, Clayton, Victoria, 3168, Australia.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Littlejohn
keywords: Bone; DISH; diabetes; diffuse idiopathic skeletal hyperostosis; growth factors; insulin; metabolic; obesity.