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

Egon Burian,Jan Syväri,Hans Hauner,Nico Sollmann,Ernst J Rummeny,Claus Zimmer,Michael Dieckmeyer,Thomas Baum,Daniela Junker,Christina Holzapfel,Jan S Kirschke,Dimitrios C Karampinos,Theresa Drabsch

doi:10.1038/s41598-020-66649-8

Egon Burian, Jan Syväri + Show 11 more

Open Access

https://doi.org/10.1038/s41598-020-66649-8

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Abstract

This analysis investigated the age- and BMI-related variations of fat distribution in sacral and lumbar bone marrow and their association with local muscle fat content in order to detect fat distribution patterns and variations in healthy adults using proton density fat fraction (PDFF) measurements. A six-echo 3D spoiled gradient-echo sequence was used for chemical shift encoding-based water-fat separation at the sacral and lower lumbar region in 103 healthy volunteers. PDFF values of the sacrum, 5th lumbar vertebral body, the gluteal and paraspinal muscles were determined. Correlation with age was significant (p < 0.05) for PDFF of the sacrum (men (m): r = 0.58; women (w): r = 0.54), L5 (m: r = 0.58; w: r = 0.54), the gluteal (m: r = 0.51; w: r = 0.44) and paraspinal (m: r = 0.36; w: r = 0.49) muscles in both genders. BMI correlated significantly with the paraspinal musculature in men (r = 0.46) and women (r = 0.33). Correlation testing revealed significant correlations (p < 0.05) between the two osseous (m: r = 0.63, w: r = 0.75) and the muscle compartments (m: r = 0.63, w: r = 0.33) in both genders. Bone marrow and muscle fat infiltration patterns were not significantly associated with each other at the sacral and lower lumbar spine region. The presented data suggest that the two compartments may have distinct pathophysiological fat infiltration patterns. However, further clinical studies are needed to support the results.

Highlights

This analysis investigated the age- and BMI-related variations of fat distribution in sacral and lumbar bone marrow and their association with local muscle fat content in order to detect fat distribution patterns and variations in healthy adults using proton density fat fraction (PDFF) measurements
No significant differences between men and women could be detected in PDFF values of the sacrum (p = 0.903), vertebral body L5 (p = 0.741) and the gluteal muscles (p = 0.167) (Table 1)
Significant positive correlations between age and PDFF in both osseous as well as the paraspinal muscle compartments could be detected, while the paraspinal muscle PDFF correlated with BMI

Summary

Introduction

This analysis investigated the age- and BMI-related variations of fat distribution in sacral and lumbar bone marrow and their association with local muscle fat content in order to detect fat distribution patterns and variations in healthy adults using proton density fat fraction (PDFF) measurements. What is the immanent clinical use of evaluating and comparing ectopic fat distribution patterns in the paraspinal and gluteal musculature and the fat content of the vertebral bone marrow in a healthy study collective besides elucidating the interplay of osseous and adjacent muscle tissue on a fundamental level? An age-dependent correlation between the structural composition of the local lumbar musculature and vertebral bone marrow fat has been described recently[12]. Structural composition of vertebral bone marrow and muscle can be assessed using magnetic resonance spectroscopy (MRS) and chemical shift encoding-based water–fat magnetic resonance imaging (MRI)[20,21] This allows for calculating surrogate values like the proton density fat fraction (PDFF), and with MRS the fat (un)saturation levels[9,20,21,22,23]

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