Abstract
Osteoporosis (OP) is a major disease that affects 200 million people worldwide. Fatty acid metabolism plays an important role in bone health and plays an important role in bone quality and remodeling. Increased bone marrow fat quantity has been shown to be associated with a decrease in bone mineral density (BMD), which is used to predict fracture risk. Chemical-Shift Encoded magnetic resonance imaging (CSE-MRI) allows noninvasive and quantitative assessment of adipose tissues (AT). The aim of our study was to assess hip or proximal femoral bone marrow adipose tissue (BMAT), thigh muscle (MUS), and subcutaneous adipose tissue (SAT) in 128 OP subjects matched for age, BMD, weight and height with different degrees of fracture risk assessed through the FRAX score (low, moderate and high). Our results showed an increase in BMAT and in MUS in high compared to low fracture risk patients. We also assessed the relationship between fracture risk as assessed by FRAX and AT quantities. Overall, the results of this study suggest that assessment of adipose tissue via 3T CSE-MRI provides insight into the pathophysiology fracture risk by showing differences in the bone marrow and muscle fat content in subjects with similarly osteoporotic BMD as assessed by DXA, but with varying degrees of fracture risk as assessed by FRAX.
Highlights
Osteoporosis (OP) is a disease of fragile bones which increases fracture risk (Fx) in the aging population and represents an important public health problem
An increase in bone marrow adipose tissue (BMAT) has been associated with higher fracture risk in post-menopausal women and in men with osteoporotic bone mineral density (BMD) using Magnetic Resonance Spectroscopy (MRS) (Machann et al, 2017; Ruschke et al, 2017; Cordes et al, 2016; Di Pietro et al, 2016; Tufts et al, 2016; Ojanen et al, 2014; Karampinos et al, 2014; Patsch et al, 2013; Wang et al, 2012; Baum et al, 2012; Bredella et al, 2011; Li et al, 2011; Machann et al, 2008; Yeung et al, 2005; LeBlanc et al, 1999) or Chemical-Shift Encoded MRI (CSE-MRI) (Bray et al, 2018; Martel et al, 2018; Nemeth et al, 2018a; Martel et al, 2019; Bray et al, 2018; Wang et al, 2016; Bolan et al, 2013; Maas et al, 2001)
In BMAT, we found a higher quantity of Proton Density Fat Fraction (PDFF) in HIGH subjects compared to LOW subjects (+5%, p = 0.032)
Summary
Osteoporosis (OP) is a disease of fragile bones which increases fracture risk (Fx) in the aging population and represents an important public health problem. Fx risk assessment is commonly made using dual-energy x-ray absorptiometry (DXA), which allows assessment of the mineralized component of bone (both trabecular and cortical) via estimation of areal bone mineral density (BMD) This measurement allows the computation of a T-Score, which has been used as a means to define OP status (Hillier et al, 2011; Kim et al, 2019a; Elde and Madsen, 2019; Asirvatham et al, 2018; Choi et al, 2018). Using two or three echoes, fat-water separation is feasible using a post-processing method such as IDEAL and
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