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. 2017 Apr:97:38-42.
doi: 10.1016/j.bone.2016.12.018. Epub 2016 Dec 30.

Marrow adipose tissue composition in adults with morbid obesity

Elaine W Yu  1 , Logan Greenblatt  1 , Alireza Eajazi  2 , Martin Torriani  2 , Miriam A Bredella  3
Affiliations

Marrow adipose tissue composition in adults with morbid obesity

Elaine W Yu et al. Bone. 2017 Apr.

Abstract

Patients with type 2 diabetes mellitus (T2DM) have increased fracture risk despite normal or increased bone mineral density (BMD). Elevations in marrow adipose tissue (MAT) and declines in MAT unsaturation are both associated with increased skeletal fragility. The objective of our study was to characterize the quantity and composition of MAT in adults with morbid obesity and T2DM, and to evaluate determinants of MAT. We studied 21 adults with morbid obesity prior to bariatric surgery, 8 of whom had T2DM. All subjects underwent 1H-MR spectroscopy of the lumbar spine and femur for assessment of MAT and dual-energy x-ray absorptiometry (DXA) and quantitative computed tomography (QCT) of the lumbar spine and hip for assessment of areal BMD (aBMD) and volumetric BMD (vBMD). Visceral (VAT) and subcutaneous adipose tissue (SAT) were quantified by CT at L1-L2. Subjects with T2DM had higher vBMD of the femoral neck and higher total MAT at the lumbar spine and femoral metaphysis compared to non-diabetic controls (p≤0.04). Lipid unsaturation index (UI) was significantly lower at the femoral diaphysis in T2DM (p=0.03). Within the entire cohort, HbA1c was positively associated with MAT (p≤0.03), and age was associated with higher MAT and lower MAT unsaturation (p≤0.05). Lumbar spine vBMD was inversely associated with lumbar spine MAT (p=0.04). There was an inverse association between SAT and diaphyseal MAT (p<0.05) while there were no associations with VAT. Subjects with morbid obesity and T2DM have higher MAT with a lower proportion of unsaturated lipids, despite higher femoral neck vBMD. MAT is positively associated with age and HbA1c, and inversely associated with vBMD, suggesting that MAT may serve as an imaging biomarker of skeletal health and metabolic risk.

Keywords: Dual-energy x-ray absorptiometry (DXA); Marrow adipose tissue (MAT); Marrow adipose tissue composition; Morbid obesity; Proton MR spectroscopy, bone mineral density; Quantitative computed tomography (QCT); Type 2 diabetes mellitus (T2DM).

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Figures

Figure 1
Figure 1
Voxel placement for lumbar spine (A), femoral metaphysis (B) and femoral diaphysis (C) marrow adipose tissue quantification.
Figure 2
Figure 2
1H-MR spectroscopy of L2 obtained at 3.0T with water suppression in a 58 year-old woman with obesity and type 2 diabetes mellitus demonstrating combined olefinic protons at 5.2 and 5.3 ppm (-CH=CH-, an estimate of fatty acid unsaturated bonds) and methylene protons at 1.3 ppm [(-CH2-)n, an estimate of fatty acids saturated bonds]. Residual water (H2O) is noted at 4.7 ppm.
Figure 3
Figure 3
Correlation analysis between glycemic control and marrow adiposity. There was a positive correlation between HbA1c and lumbar marrow adipose tissue.
See this image and copyright information in PMC

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References

    1. Meigs JB, Wilson PW, Fox CS, et al. Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease. J Clin Endocrinol Metab. 2006;91:2906–2912. - PubMed
    1. Bonds DE, Larson JC, Schwartz AV, et al. Risk of fracture in women with type 2 diabetes: the Women's Health Initiative Observational Study. J Clin Endocrinol Metab. 2006;91:3404–3410. - PubMed
    1. Dytfeld J, Michalak M. Type 2 diabetes and risk of low-energy fractures in postmenopausal women: meta-analysis of observational studies. Aging Clin Exp Res. 2016 - PMC - PubMed
    1. Melton LJ, 3rd, Riggs BL, Leibson CL, et al. A bone structural basis for fracture risk in diabetes. J Clin Endocrinol Metab. 2008;93:4804–4809. - PMC - PubMed
    1. Schwartz AV, Vittinghoff E, Bauer DC, et al. Association of BMD and FRAX score with risk of fracture in older adults with type 2 diabetes. JAMA. 2011;305:2184–2192. - PMC - PubMed

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