Department of Radiology, Michigan State University, East Lansing, MI 48824, USA.
J Diabetes Complications. 2012 Jan-Feb;26(1):1-9. doi: 10.1016/j.jdiacomp.2011.11.001. Epub 2012 Jan 17.
Increased marrow adiposity is often associated with bone loss. Little is known about the regulation of marrow adiposity in humans. Marrow adiposity is increased in several mouse models including type I (T1)-diabetic mice, which also display bone loss. However, the impact of metabolic disease on marrow adiposity in humans has yet to be examined. This study measured bone marrow adiposity levels with iterative decomposition of water and fat with echo asymmetry and least-squares estimation magnetic resonance imaging and determined their relationship with T1-diabetes, bone mineral density (BMD), and serum lipid levels. Participants were adult T1-diabetic patients (glycosylated hemoglobin averaging 7.70%±0.4%) and age- and body-mass-index-matched nondiabetic subjects. Consistent with previous reports, serum osteocalcin levels were lower in subjects with T1-diabetes compared to controls (reaching statistical significance in females) and negatively correlated with disease duration (r=-0.50, P<.01). Furthermore, femur neck BMD inversely correlated with diabetes severity (r=-0.417, P<.05). While marrow adiposity was not altered by T1-diabetes, there was a striking positive correlation between vertebral, femur, and tibia marrow adiposity and serum lipid levels (low-density lipoprotein, total cholesterol, cholesterol:high-density lipoprotein ratio, and triglyceride; r≥0.383), reaching a significance of P<.001 in some comparisons. Marrow adiposity also displayed strong intrasubject correlations at multiple bone sites (r≥0.411, P<.05), increased with age (r=0.410, P<.05 at vertebral sites), and was reciprocally related to bone density (r≥-0.378, P<.05). Taken together, our data suggest that marrow adiposity may be an indicator of elevated serum lipid levels and decreased bone density.
骨髓脂肪增多通常与骨丢失有关。然而，人类骨髓脂肪增多的调节机制知之甚少。在包括 1 型（T1）糖尿病小鼠在内的几种小鼠模型中，骨髓脂肪增多，这些小鼠也表现出骨丢失。然而，代谢性疾病对人类骨髓脂肪增多的影响尚未得到检验。本研究采用水脂分解迭代法和最小二乘法估计磁共振成像来测量骨髓脂肪增多水平，并确定其与 T1 糖尿病、骨密度（BMD）和血清脂质水平的关系。参与者为成年 T1 糖尿病患者（糖化血红蛋白平均 7.70%±0.4%）和年龄及体重指数匹配的非糖尿病对照者。与先前的报道一致，T1 糖尿病患者的血清骨钙素水平低于对照组（女性达到统计学意义），且与疾病持续时间呈负相关（r=-0.50，P<.01）。此外，股骨颈 BMD 与糖尿病严重程度呈负相关（r=-0.417，P<.05）。虽然 T1 糖尿病并未改变骨髓脂肪增多，但椎体、股骨和胫骨骨髓脂肪增多与血清脂质水平呈显著正相关（低密度脂蛋白、总胆固醇、胆固醇：高密度脂蛋白比值和甘油三酯；r≥0.383），在某些比较中达到 P<.001 的显著水平。骨髓脂肪增多在多个骨部位也显示出强烈的个体内相关性（r≥0.411，P<.05），随年龄增长而增加（r=0.410，椎体部位 P<.05），与骨密度呈负相关（r≥-0.378，P<.05）。综上所述，我们的数据表明，骨髓脂肪增多可能是血清脂质水平升高和骨密度降低的一个指标。
