Magnetic Resonance Imaging–Measured Bone Marrow Adipose Tissue Area Is Inversely Related to Cortical Bone Area in Children and Adolescents Aged 5–18 Years

Gao, Yan; Zong, Kuang; Gao, Zackary; Rubin, Mishaela R.; Chen, Jun; Heymsfield, Steven B.; Gallagher, Dympna; Shen, Wei

doi:10.1016/j.jocd.2015.03.002

Cited by 22 publications

(14 citation statements)

References 35 publications

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“…Indeed, higher fraction of BMAT was associated with lower BMD values (50). A magnetic resonance imagining (MRI) study of 185 healthy children (5-18 years old) with wide range of body mass index (BMI) found an inverse correlation between BMAT and right femoral cortical bone area after adjusting for weight, total body fat, subcutaneous adipose tissue, visceral adipose tissue, and skeletal muscle (51). However, a longitudinal study demonstrating early-onset osteoporosis in individuals with obesity is lacking.…”

Section: Excess Bmat and Inflammatory Cytokinesmentioning

confidence: 99%

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The Bones of Children With Obesity

et al. 2020

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Excess adiposity in childhood may affect bone development, ultimately leading to bone frailty. Previous reports showing an increased rate of extremity fractures in children with obesity support this fear. On the other hand, there is also evidence suggesting that bone mineral content is higher in obese children than in normal weight peers. Both adipocytes and osteoblasts derive from multipotent mesenchymal stem cells (MSCs) and obesity drives the differentiation of MSCs toward adipocytes at the expense of osteoblast differentiation. Furthermore, adipocytes in bone marrow microenvironment release a number of pro-inflammatory and immunomodulatory molecules that up-regulate formation and activation of osteoclasts, thus favoring bone frailty. On the other hand, body adiposity represents a mechanical load, which is beneficial for bone accrual. In this frame, bone quality, and structure result from the balance of inflammatory and mechanical stimuli. Diet, physical activity and the hormonal milieu at puberty play a pivotal role on this balance. In this review, we will address the question whether the bone of obese children and adolescents is unhealthy in comparison with normal-weight peers and discuss mechanisms underlying the differences in bone quality and structure. We anticipate that many biases and confounders affect the clinical studies conducted so far and preclude us from achieving robust conclusions. Sample-size, lack of adequate controls, heterogeneity of study designs are the major drawbacks of the existing reports. Due to the increased body size of children with obesity, dual energy absorptiometry might overestimate bone mineral density in these individuals. Magnetic resonance imaging, peripheral quantitative CT (pQCT) scanning and high-resolution pQCT are promising techniques for the accurate estimate of bone mineral content in obese children. Moreover, no longitudinal study on the risk of incident osteoporosis in early adulthood of children and adolescents with obesity is available. Finally, we will address emerging dietary issues (i.e., the likely benefits for the bone health of polyunsaturated fatty acids and polyphenols) since an healthy diet (i.e., the Mediterranean diet) with balanced intake of certain nutrients associated with physical activity remain the cornerstones for achieving an adequate bone accrual in young individuals regardless of their adiposity degree.

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Section: Excess Bmat and Inflammatory Cytokinesmentioning

confidence: 99%

“…MRI makes a 3D reliable reproduction of trabecular and cortical bone, appendicular and central skeleton in different anatomical planes, with the advantage of not exposing the child to ionizing radiations. However, its use is currently limited to research purposes (51,109).…”

Section: Techniques To Investigate Bone Density Content and Microstmentioning

confidence: 99%

The Bones of Children With Obesity

et al. 2020

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“…In some studies, the relative BM fat proportion measured at a specific site (often the spine) can even be negatively associated with the whole body BMD (23,35) or other bone site BMD (33, 34), which is surprising considering the expected heterogeneity of BMA development and phenotype according to the site and the potential interference of BMA in the local bone remodelling. This inverse relationship has been reported in young or old men and women (23,24,35,36), even though post-menopausal women can exhibit the most consistent association compared to old men (33, 34). Indeed, women experience a rapid loss of bone and a spurt of BMA development at menopause (22).…”

Section: Bm Adiposity Is Associated With Bone Lossmentioning

confidence: 70%

MECHANISMS IN ENDOCRINOLOGY: Bone marrow adiposity and bone, a bad romance?

Rharass¹,

Lucas²

2018

European Journal of Endocrinology

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Bone marrow adipocytes (BMA) constitute an original and heterogeneous fat depot whose development appears interlinked with bone status throughout life. The gradual replacement of the hematopoietic tissue by BMA arises in a well-ordered way during childhood and adolescence concomitantly to bone growth and continues at a slower rate throughout the adult life. Importantly, BM adiposity quantity is found well associated with BMD (Bone Mineral Density) loss at different skeletal sites in primary osteoporosis such as in ageing or menopause but also in secondary osteoporosis consecutive to anorexia nervosa. Since BMA and osteoblasts originate from a common mesenchymal stem cell, adipogenesis is considered as a competitive process that disrupts osteoblastogenesis. Besides, most factors secreted by bone and bone marrow cells (ligands and antagonists of the Wnt/β-catenin pathway, BMP and others) reciprocally regulate the two processes. Hormones such as oestrogens, glucocorticoids, parathyroid and growth hormones that control bone remodelling also modulate the differentiation and the activity of BMA. Actually, BMA could also contribute to bone loss through the release of paracrine factors altering osteoblast and /or osteoclast formation and function. Based on clinical and fundamental studies, this review aims at presenting and discussing these current arguments that support but also challenge the involvement of BMA in the bone mass integrity.

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“…Organs such as heart, liver, and brain have high resting metabolic rates relative to their masses which is highly relevant to investigations of the effects of weight perturbations (gain and loss) on resting energy expenditure. MRI can also provide estimates of bone marrow adipose tissue [30]. …”

Section: Body Composition Measurement Methodsmentioning

confidence: 99%

Current body composition measurement techniques

Lemos

Gallagher

2017

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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196

147

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Purpose of review The current article reviews the most innovative and precise, available methods for quantification of in-vivo human body composition. Recent findings Body composition measurement methods are continuously being perfected. Ongoing efforts involve multisegmental and multifrequency bioelectrical impedance analysis, quantitative magnetic resonance for total body water, fat, and lean tissue measurements, imaging to further define ectopic fat depots. Available techniques allow for the measurement of fat, fat-free mass, bone mineral content, total body water, extracellular water, total adipose tissue and its subdepots (visceral, subcutaneous, and intermuscular), skeletal muscle, select organs, and ectopic fat depots. Summary There is an ongoing need for methods that yield information on metabolic and biological functions. Based on the wide range of measurable properties, analytical methods and known body composition models, clinicians, and scientists can quantify a number of body components and with longitudinal assessment, can track changes in health and disease with implications for understanding efficacy of nutritional and clinical interventions, diagnosis, prevention, and treatment in clinical settings. With the greater need to understand precursors of health risk beginning prior to conception, a gap exists in appropriate in-vivo measurement methods with application beginning during gestation, that is, fetal development.

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Magnetic Resonance Imaging–Measured Bone Marrow Adipose Tissue Area Is Inversely Related to Cortical Bone Area in Children and Adolescents Aged 5–18 Years

Cited by 22 publications

References 35 publications

The Bones of Children With Obesity

The Bones of Children With Obesity

MECHANISMS IN ENDOCRINOLOGY: Bone marrow adiposity and bone, a bad romance?

Current body composition measurement techniques

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