骨髓脂肪增多和肌内脂肪增多与较低的 vBMD 相关，但与无症状性椎体骨折无关。
Greater bone marrow fat and myosteatosis are associated with lower vBMD but not asymptomatic vertebral fracture.
机构信息
Department of Radiology, Beijing Jishuitan Hospital, Beijing, China.
Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
出版信息
Eur Radiol. 2023 Jan;33(1):578-586. doi: 10.1007/s00330-022-08979-x. Epub 2022 Aug 6.
OBJECTIVES
Organ fat may affect bone metabolism and be associated with vertebral fracture (VF). This study aimed to explore relationships between VF, adiposity indexes measured by MRI, and volumetric BMD (vBMD) measured by quantitative CT (QCT).
METHODS
Four hundred volunteers, ranging in age from 22 to 83 years, were recruited and underwent same-day abdominal QCT and chemical shift-encoded (CSE) MRI. We used MRI to quantify the fat content of bone marrow (BMF), psoas major and paraspinal muscles, and the liver. Abdominal fat, VF, and vBMD of the lumbar spine were measured by QCT. For VF discrimination analysis, we examined both the whole cohort (60 VF cases in 30 men and 30 women) and a restricted subgroup of those aged over 50 years (50 VF cases in 23 men and 27 women).
RESULTS
Amongst the men, a 1 SD increase in BMF was associated with a 27.67 (95% CI, -32.71 to -22.62) mg/cm decrease in vBMD after adjusting for age and BMI. Amongst women, all adiposity indexes except for liver fat were significantly associated with vBMD, with BMF having the strongest association (β, -24.00; 95% CI, -28.54 to -19.46 mg/cm). Similar findings were also observed in participants aged over 50 years. The associations of adiposity indexes with vertebral fracture were not significant after adjusting for age in both sexes aged over 50 years.
CONCLUSIONS
In both sexes, higher bone marrow fat was associated with lower vBMD at the spine. However, marrow fat and other adipose tissues were not associated with radiographic-based prevalent vertebral fractures.
KEY POINTS
• In both sexes, higher bone marrow fat was associated with lower vBMD at the spine. • Among women, all adiposity indexes except for liver fat content were significantly associated with vBMD, with bone marrow fat having the strongest association. • Marrow fat and other adipose tissues were not associated with radiographic-based asymptomatic vertebral fractures.
目的
器官脂肪可能会影响骨骼代谢，并与椎体骨折（VF）有关。本研究旨在探讨 VF 与 MRI 测量的肥胖指数以及定量 CT（QCT）测量的体积骨密度（vBMD）之间的关系。
方法
招募了 400 名年龄在 22 至 83 岁之间的志愿者，并对其进行了腹部 QCT 和化学位移编码（CSE）MRI 同日检查。我们使用 MRI 来量化骨髓（BMF）、腰大肌和脊柱旁肌肉以及肝脏的脂肪含量。通过 QCT 测量腹部脂肪、VF 和腰椎 vBMD。对于 VF 判别分析，我们检查了整个队列（30 名男性和 30 名女性中有 60 例 VF）和年龄超过 50 岁的受限亚组（23 名男性和 27 名女性中有 50 例 VF）。
结果
在男性中，调整年龄和 BMI 后，BMF 每增加 1 个标准差，vBMD 就会降低 27.67（95%CI，-32.71 至 -22.62）mg/cm。在女性中，除了肝脏脂肪外，所有肥胖指数都与 vBMD 显著相关，而 BMF 的相关性最强（β，-24.00；95%CI，-28.54 至 -19.46 mg/cm）。在年龄超过 50 岁的参与者中也观察到了类似的发现。在年龄超过 50 岁的男女中，调整年龄后，肥胖指数与椎体骨折的相关性并不显著。
结论
在两性中，骨髓脂肪含量较高与脊柱 vBMD 较低有关。然而，骨髓脂肪和其他脂肪组织与基于影像学的无症状椎体骨折无关。
关键点
在两性中，骨髓脂肪含量较高与脊柱 vBMD 较低有关。
在女性中，除了肝脏脂肪含量外，所有肥胖指数都与 vBMD 显著相关，而骨髓脂肪的相关性最强。
骨髓脂肪和其他脂肪组织与基于影像学的无症状椎体骨折无关。
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