Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Magnetic Resonance (MR) Research, GE Healthcare, Beijing, China.
Front Endocrinol (Lausanne). 2022 Sep 20;13:980576. doi: 10.3389/fendo.2022.980576. eCollection 2022.
Chronic kidney disease (CKD) has a significant negative impact on bone health. Bone marrow is an essential component of bone, mainly composed of trabecular bone and fat. The IDEAL-IQ sequence of MRI allows indirect quantification of trabecular bone mass by R2* and direct quantification of bone marrow fat content by FF map, respectively.
Our objective was to explore the association of CKD severity with bone marrow using IDEAL-IQ and whether mineral and bone metabolism markers alter this association.
We recruited 68 CKD patients in this cross-sectional research (15 with CKD stages 3-4, 26 with stage 5, and 27 with stage 5d). All patients underwent lumbar spine IDEAL-IQ, BMD, and several bone metabolism markers (iPTH, 25-(OH)-VitD, calcium and phosphorus). Multiple linear regression analysis was used to examine the association of CKD severity with MRI measurements (R2* and FF).
More severe CKD was associated with a higher R2* value [CKD 5d versus 3-4: 30.077 s (95% CI: 12.937, 47.217), for trend < 0.001], and this association was attenuated when iPTH was introduced [CKD 5d versus 3-4: 19.660 s (95% CI: 0.205, 39.114), for trend = 0.042]. Furthermore, iPTH had an association with R2* value [iPTH (pg/mL): 0.033 s (95% CI: 0.001, 0.064), = 0.041]. Besides, FF was mainly affected by age and BMI, but not CKD.
The bone marrow R2* value measured by IDEAL-IQ sequence is associated with CKD severity and iPTH. The R2* of IDEAL-IQ has the potential to reflect lumbar bone changes in patients with CKD.
慢性肾脏病（CKD）对骨骼健康有显著的负面影响。骨髓是骨骼的重要组成部分，主要由小梁骨和脂肪组成。MRI 的 IDEAL-IQ 序列分别通过 R2*间接定量小梁骨量，通过 FF 图直接定量骨髓脂肪含量。
本研究旨在探讨 IDEAL-IQ 技术评估 CKD 严重程度与骨髓之间的相关性，以及矿物质和骨代谢标志物是否改变这种相关性。
本横断面研究纳入 68 例 CKD 患者（3-4 期 15 例，5 期 26 例，5d 期 27 例）。所有患者均行腰椎 IDEAL-IQ、骨密度和多项骨代谢标志物（iPTH、25-（OH）-VitD、钙、磷）检测。采用多元线性回归分析评估 CKD 严重程度与 MRI 测量值（R2*和 FF）的相关性。
随着 CKD 严重程度的增加，R2值逐渐升高[5d 期比 3-4 期：30.077 s（95%CI：12.937，47.217），趋势检验<0.001]，当引入 iPTH 后，这种相关性减弱[5d 期比 3-4 期：19.660 s（95%CI：0.205，39.114），趋势检验=0.042]。此外，iPTH 与 R2值相关[iPTH（pg/mL）：0.033 s（95%CI：0.001，0.064），=0.041]。此外，FF 主要受年龄和 BMI 的影响，而与 CKD 无关。
IDEAL-IQ 序列测量的骨髓 R2值与 CKD 严重程度和 iPTH 相关。IDEAL-IQ 的 R2值有可能反映 CKD 患者腰椎的变化。
