Does vertebral bone marrow fat content correlate with abdominal adipose tissue, lumbar spine bone mineral density, and blood biomarkers in women with type 2 diabetes mellitus?

Abstract

Purpose To compare vertebral bone marrow fat content quantified with proton MR spectroscopy (1H-MRS) with the volume of abdominal adipose tissue, lumbar spine volumetric bone mineral density (vBMD), and blood biomarkers in postmenopausal women with and without type 2 diabetes mellitus (T2DM). Materials and Methods Thirteen postmenopausal women with T2DM and 13 age- and BMI-matched healthy controls were included in this study. All subjects underwent 1H-MRS of L1–L3 to quantify vertebral bone marrow fat content (FC) and unsaturated lipid fraction (ULF). QCT was performed to assess vBMD of L1–L3. The volumes of abdominal subcutaneous/visceral/total adipose tissue were determined from the QCT images and adjusted for abdominal body volume (SATadj/VATadj/TATadj). Fasting blood tests included plasma glucose and HbA1c. Results Mean FC showed an inverse correlation with vBMD (r=−0.452; p<0.05) in the whole study population. While mean FC was similar in the diabetic women and healthy controls (69.3 ± 7.5% vs. 67.5 ± 6.1%; p>0.05), mean ULF was significantly lower in the diabetic group (6.7 ± 1.0% vs. 7.9 ± 1.6%; p<0.05). SATadj and TATadj correlated significantly with mean FC in the whole study population (r=0.538 and r=0.466; p<0.05). In contrast to the control group, significant correlations of mean FC with VATadj and HbA1c were observed in the diabetic group (r=0.642 and r=0.825; p<0.05). Conclusion This study demonstrated that vertebral bone marrow fat content correlates significantly with SATadj, TATadj, and lumbar spine vBMD in postmenopausal women with and without T2DM, but with VATadj and HbA1c only in women with T2DM.

Bone marrow composition, diabetes, and fracture risk: More bad news for saturated fat

“…First and foremost is the provocative conclusion that it is the composition, rather than the amount, of marrow fat that is correlated with fracture history and diabetes. This finding corroborates previous studies that found lower unsaturation in osteoporosis and in diabetes, both of which involve elevated fracture risk, (5,12) but contrasts with studies that have shown an inverse relationship between the quantity of marrow fat and BMD or bone mass. (3,9,10,13) Additionally, this finding raises the issue of causality-does marrow fat become less unsaturated before a fracture, or afterward?…”

Assessment of whole spine vertebral bone marrow fat using chemical shift‐encoding based water‐fat MRI

“…Furthermore, MRS-based vertebral bone marrow fat correlated significantly with visceral adipose tissue and HbA1c values in women with type 2 diabetes mellitus. 27 In the context of osteoporosis, MRS-based vertebral bone marrow fat was inversely associated with BMD. 6,7 Patsch et al demonstrated that MRS-based vertebral bone marrow fat composition may serve as a novel tool for BMDindependent fracture risk assessment (28).…”

Quantitative imaging methods in osteoporosis

“…In contrast to controls without diabetes, higher mean vertebral bone marrow fat content is significantly correlated with visceral adipose tissue and HbA1C in persons with type 2 diabetes, representing worse metabolic profiles (140). The concept of high-saturated fatassociated adipose inflammation and insulin resistance has been proposed; however, underlying molecular mechanisms remain to be elucidated.…”