Li Guanwu, Xu Zheng, Fan Jingzheng, Yuan Wei, Zhang Lina, Hou Lingmi, Wu Dongmei, Chang Shixin, Calimente Horea, Hu Jiani
1Department of Radiology, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China 2Xinzhuang Community Health Center, Shanghai, China 3East Hospital, Tongji University School of Medicine, Shanghai, China 4Department of Spinal Disease Unit, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China 5First Affiliated Hospital of Dalian Medical University, Dalian, China 6Affiliated Hospital of North Sichuan Medical College, Sichuan, China 7Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China 8Department of Radiology, Wayne State University, Detroit, MI.
Menopause. 2017 Jan;24(1):105-111. doi: 10.1097/GME.0000000000000732.
To assess the differential features of marrow adiposity between osteoarthritis (OA) and osteoporosis (OP) in postmenopausal women using water/fat MRI.
This cross-sectional study included 97 postmenopausal women (OA [n = 25], OA + osteopenia [n = 27], OA + OP [n = 23], and OP groups [n = 22]). Water/fat MRI, dual-energy x-ray absorptiometry and biochemical analysis were performed to assess vertebral marrow fat fraction, bone mineral density, and bone biomarkers, respectively. Harris Hip Score was recorded to evaluate hip function.
There were significant differences in marrow fat content among the OA, OA + osteopenia, and OA + OP groups, between OP and OA participants with normal bone mass or osteopenia (all P < 0.05); no significant difference was observed between OA + OP and OP groups. Serum levels of leptin and β-Crosslaps in OA with normal bone mass and osteopenic OA groups were higher than in OP group. Marrow fat fraction was inversely correlated with Harris Hip Score (r = -0.371, P = 0.013), bone mineral density (r = -0.554, P = 0.009) and leptin levels (r = -0.610, P < 0.001). In multivariate regression analysis, marrow fat fraction was found to have a consistent and unchanged inverse association with leptin levels (Sβ = -0.311, P = 0.002) and bone mineral density (Sβ = -0.265, P = 0.006) after adjusting for age, years since menopause, and body mass index.
Postmenopausal OA with OP have a phenotype with higher marrow adiposity. OA and OP could coexist, for the presence of a specific subgroup of OA with increased marrow fat accumulation and high risk of developing OP.
采用水/脂肪磁共振成像（MRI）评估绝经后女性骨关节炎（OA）和骨质疏松症（OP）患者骨髓脂肪含量的差异特征。
这项横断面研究纳入了97名绝经后女性（OA组[n = 25]、OA + 骨量减少组[n = 27]、OA + OP组[n = 23]和OP组[n = 22]）。分别采用水/脂肪MRI、双能X线吸收法和生化分析来评估椎体骨髓脂肪分数、骨密度和骨生物标志物。记录Harris髋关节评分以评估髋关节功能。
OA组、OA + 骨量减少组和OA + OP组之间的骨髓脂肪含量存在显著差异，OP组与骨量正常或骨量减少的OA参与者之间也存在显著差异（均P < 0.05）；OA + OP组与OP组之间未观察到显著差异。骨量正常的OA组和骨量减少的OA组中瘦素和β-交联羧基末端肽的血清水平高于OP组。骨髓脂肪分数与Harris髋关节评分（r = -0.371，P = 0.013）、骨密度（r = -0.554，P = 0.009）和瘦素水平（r = -0.610，P < 0.001）呈负相关。在多变量回归分析中，在调整年龄、绝经年限和体重指数后，发现骨髓脂肪分数与瘦素水平（Sβ = -0.311，P = 0.002）和骨密度（Sβ = -0.265，P = 0.006）始终存在负相关。
绝经后合并OP的OA患者具有骨髓脂肪含量较高的表型。OA和OP可能共存，因为存在一个特定的OA亚组，其骨髓脂肪积累增加且发生OP的风险较高。
