Greater Bone Marrow Adiposity Predicts Bone Loss in Older Women

Abstract

Bone marrow adiposity (BMA) is associated with aging and osteoporosis, but whether BMA can predict bone loss and fractures remains unknown. Using data from the Age Gene/Environment Susceptibility (AGES)-Reykjavik study, we investigated the associations between 1 H-MRS-based measures of vertebral bone marrow adipose tissue (BMAT), annualized change in bone density/ strength by quantitative computed tomography (QCT) and DXA, and secondarily, with incident clinical fractures and radiographic vertebral fractures among older adults. The associations between BMAT and annualized change in bone density/strength were evaluated using linear regression models, adjusted for age, body mass index (BMI), diabetes, estradiol, and testosterone. Cox proportional hazards models were used to evaluate the associations between baseline BMAT and incident clinical fractures, and logistic regression models for incident vertebral fractures. At baseline, mean AE SD age was 80.9 AE 4.2 and 82.6 AE 4.2 years in women (n = 148) and men (n = 150), respectively. Mean baseline BMAT was 55.4% AE 8.1% in women and 54.1% AE 8.2% in men. Incident clinical fractures occurred in 7.4% of women over 2.8 years and in 6.0% of men over 2.2 years. Incident vertebral fractures occurred in 12% of women over 3.3 years and in 17% of men over 2.7 years. Each 1 SD increase in baseline BMAT was associated with a 3.9 mg 2 /cm 4 /year greater loss of spine compressive strength index (p value = .003), a 0.9 mg/cm 3 /year greater loss of spine trabecular BMD (p value = .02), and a 1.2 mg/cm 3 /year greater loss of femoral neck trabecular BMD (p value = .02) in women. Among men, there were no associations between BMAT and changes in bone density/strength. There were no associations between BMAT and incident fractures in women or men. In conclusion, we found greater BMAT is associated with greater loss of trabecular bone at the spine and femoral neck, and greater loss of spine compressive strength, in older women.n 326 WOODS ET AL. 29. Kennell JA, MacDougald OA. Wnt signaling inhibits adipogenesis through beta-catenin-dependent and -independent mechanisms. J Biol Chem. 2005;280(25):24004-10. 30. Ma YH, Schwartz AV, Sigurdsson S, et al. Circulating sclerostin associated with vertebral bone marrow fat in older men but not women.

Age- and BMI-related variations of fat distribution in sacral and lumbar bone marrow and their association with local muscle fat content

“…Sollmann et al reported significant correlations between PDFF of the lumbar bone marrow and the local musculature in postmenopausal, but not in premenopausal women 12 . This seemingly contradictory finding may be explained by the different anatomical locations www.nature.com/scientificreports www.nature.com/scientificreports/ investigated and the fact that our analysis comprised a relatively young study population as compared to the postmenopausal women included by Sollmann et al An inverse correlation between age and bone mineral density (BMD) was shown by several groups in the past 34,35 . In older adults, higher vertebral bone marrow fat has been shown to be associated with lower trabecular BMD and vertebral fractures 36 .…”

Generation of Two Multipotent Mesenchymal Progenitor Cell Lines Capable of Osteogenic, Mature Osteocyte, Adipogenic, and Chondrogenic Differentiation

“…MPC2 cells consistently produced high levels of the transcriptional regulator of adipogenesis, PPARγ as well as other proteins characteristic of adipocytes including adiponectin, perilipin, and fatty acid binding protein 4. Recent studies have shown that accumulation of adipose tissue within the bone marrow is detrimental to skeletal health and is associated with aging and disuse 40,41 .…”

Type 2 Diabetes Mellitus and Vertebral Fracture Risk

“…Another study reported no association between bone marrow adipose tissue and bone density/ strength nor with incident fractures. However, they reported that greater bone marrow fat was associated prospectively with greater loss of trabecular bone at the spine and femoral neck, and greater loss of spine compressive strength, in older women [46]. The study by Sheu et al found significant inverse correlations between bone marrow fat estimated with MRI and BMD (− 0.30 for femoral neck and − 0.39 for total hip) among men with diabetes but not among those without diabetes [47].…”