Bone marrow fat composition as a novel imaging biomarker in postmenopausal women with prevalent fragility fractures
- PMID: 23558967
- PMCID: PMC3720702
- DOI: 10.1002/jbmr.1950
Bone marrow fat composition as a novel imaging biomarker in postmenopausal women with prevalent fragility fractures
Abstract
The goal of this magnetic resonance (MR) imaging study was to quantify vertebral bone marrow fat content and composition in diabetic and nondiabetic postmenopausal women with fragility fractures and to compare them with nonfracture controls with and without type 2 diabetes mellitus. Sixty-nine postmenopausal women (mean age 63 ± 5 years) were recruited. Thirty-six patients (47.8%) had spinal and/or peripheral fragility fractures. Seventeen fracture patients were diabetic. Thirty-three women (52.2%) were nonfracture controls. Sixteen women were diabetic nonfracture controls. To quantify vertebral bone marrow fat content and composition, patients underwent MR spectroscopy (MRS) of the lumbar spine at 3 Tesla. Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometry (DXA) of the hip and lumbar spine (LS) and quantitative computed tomography (QCT) of the LS. To evaluate associations of vertebral marrow fat content and composition with spinal and/or peripheral fragility fractures and diabetes, we used linear regression models adjusted for age, race, and spine volumetric bone mineral density (vBMD) by QCT. At the LS, nondiabetic and diabetic fracture patients had lower vBMD than controls and diabetics without fractures (p = 0.018; p = 0.005). However, areal bone mineral density (aBMD) by DXA did not differ between fracture and nonfracture patients. After adjustment for age, race, and spinal vBMD, the prevalence of fragility fractures was associated with -1.7% lower unsaturation levels (confidence interval [CI] -2.8% to -0.5%, p = 0.005) and +2.9% higher saturation levels (CI 0.5% to 5.3%, p = 0.017). Diabetes was associated with -1.3% (CI -2.3% to -0.2%, p = 0.018) lower unsaturation and +3.3% (CI 1.1% to 5.4%, p = 0.004) higher saturation levels. Diabetics with fractures had the lowest marrow unsaturation and highest saturation. There were no associations of marrow fat content with diabetes or fracture. Our results suggest that altered bone marrow fat composition is linked with fragility fractures and diabetes. MRS of spinal bone marrow fat may therefore serve as a novel tool for BMD-independent fracture risk assessment.
Keywords: BONE MARROW FAT; FRAGILITY FRACTURES; MR SPECTROSCOPY; TYPE 2 DIABETES MELLITUS; UNSATURATION LEVEL.
Copyright © 2013 American Society for Bone and Mineral Research.
Figures
![Figure 1](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3720702/bin/nihms-464947-f0001.gif)
![Figure 2](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3720702/bin/nihms-464947-f0002.gif)
Comment in
-
Bone marrow composition, diabetes, and fracture risk: more bad news for saturated fat.J Bone Miner Res. 2013 Aug;28(8):1718-20. doi: 10.1002/jbmr.2013. J Bone Miner Res. 2013. PMID: 23794182 No abstract available.
Similar articles
-
Skeletal Fragility in Adult People Living With Type 1 Diabetes.Endocr Pract. 2024 Jun;30(6):592-597. doi: 10.1016/j.eprac.2024.03.392. Epub 2024 Mar 29. Endocr Pract. 2024. PMID: 38556079 Review.
-
Saturated and Unsaturated Bone Marrow Lipids Have Distinct Effects on Bone Density and Fracture Risk in Older Adults.J Bone Miner Res. 2022 Apr;37(4):700-710. doi: 10.1002/jbmr.4504. Epub 2022 Jan 31. J Bone Miner Res. 2022. PMID: 35038186 Free PMC article.
-
People with HIV infection had lower bone mineral density and increased fracture risk: a meta-analysis.Arch Osteoporos. 2021 Feb 27;16(1):47. doi: 10.1007/s11657-021-00903-y. Arch Osteoporos. 2021. PMID: 33638754 Review.
-
Quantitative computed tomography discriminates between postmenopausal women with low spine bone mineral density with vertebral fractures and those with low spine bone mineral density only: the SHATTER study.Osteoporos Int. 2020 Apr;31(4):667-675. doi: 10.1007/s00198-020-05317-z. Epub 2020 Jan 28. Osteoporos Int. 2020. PMID: 31993717
-
Marrow adipose tissue composition in adults with morbid obesity.Bone. 2017 Apr;97:38-42. doi: 10.1016/j.bone.2016.12.018. Epub 2016 Dec 30. Bone. 2017. PMID: 28043896 Free PMC article.
Cited by
-
Relationship between Femoral Proximal Bone Quality Assessment by MRI IDEAL-IQ Sequence and Body Mass Index in Elderly Men.Tomography. 2024 May 20;10(5):816-825. doi: 10.3390/tomography10050062. Tomography. 2024. PMID: 38787022 Free PMC article.
-
Assessment of Calcaneal Spongy Bone Magnetic Resonance Characteristics in Women: A Comparison between Measures Obtained at 0.3 T, 1.5 T, and 3.0 T.Diagnostics (Basel). 2024 May 18;14(10):1050. doi: 10.3390/diagnostics14101050. Diagnostics (Basel). 2024. PMID: 38786348 Free PMC article.
-
Bibliometric and visualized analysis of type 2 diabetic osteoporosis from 2013 to 2022.Arch Osteoporos. 2024 Apr 22;19(1):30. doi: 10.1007/s11657-024-01386-3. Arch Osteoporos. 2024. PMID: 38647606
-
Associations of gestational diabetes and proton density fat fraction of vertebral bone marrow and paraspinal musculature in premenopausal women.Front Endocrinol (Lausanne). 2024 Jan 16;14:1303126. doi: 10.3389/fendo.2023.1303126. eCollection 2023. Front Endocrinol (Lausanne). 2024. PMID: 38292769 Free PMC article.
-
Quantitative MR Analysis of Changes in the Radius Bone Marrow in Osteoporosis.J Osteoporos. 2023 Dec 27;2023:7861495. doi: 10.1155/2023/7861495. eCollection 2023. J Osteoporos. 2023. PMID: 38179189 Free PMC article.
References
-
- Rosen CJ, Bouxsein ML. Mechanisms of disease: is osteoporosis the obesity of bone? Nat Clin Pract Rheumatol. 2006;2(1):35–43. - PubMed
-
- Kassem M, Marie PJ. Senescence-associated intrinsic mechanisms of osteoblast dysfunctions. Aging Cell. 2011;10(2):191–197. - PubMed
-
- Foo C, Frey S, Yang HH, Zellweger R, Filgueira L. Downregulation of beta-catenin and transdifferentiation of human osteoblasts to adipocytes under estrogen deficiency. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 2007;23(9):535–540. - PubMed
-
- Warriner AH, Mugavero MJ. Bone changes and fracture risk in individuals infected with HIV. Current rheumatology reports. 2010;12(3):163–169. - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical