Philippoteaux Cécile, Badr Sammy, Lombardo Daniela, Cailliau Emeline, Ruschke Stefan, Karampinos Dimitrios C, Cotten Anne, Paccou Julien
Department of Rheumatology, Univ. Lille, CHU Lille, F-59000 Lille, France.
Department of Radiology and Musculoskeletal Imaging, Univ. Lille, CHU Lille, MABlab ULR 4490, F-59000 Lille, France.
J Endocr Soc. 2025 Feb 24;9(4):bvaf033. doi: 10.1210/jendso/bvaf033. eCollection 2025 Mar 3.
Noninvasive measurement of bone marrow adipose tissue using magnetic resonance imaging and proton density fat fraction (PDFF) may enhance clinical fractures prediction in postmenopausal women.
This study aimed to assess the association between PDFF measurements and clinical fracture incidence.
A longitudinal study was conducted. Postmenopausal women with recent osteoporotic fractures (<12 months) and with osteoarthritis without fractures were included. Lumbar spine and proximal femur PDFFs were measured at baseline using water-fat imaging (WFI) and dual-energy x-ray absorptiometry scans. Clinical fractures were recorded during follow-up.
Among 195 participants (mean age 67.4 ± 10.0 years, body mass index 27.2 ± 5.9 kg/m²), the PDFF (WFI-based) was higher at the proximal femur, particularly at the femoral head (90.0% ± 4.9%), compared to the lumbar spine (57.8% ± 9.6%). Over a mean follow-up period of 37.2 ± 11.6 months, 7 participants died, 29 (14.9%) experienced incident clinical fractures, and 1 was lost to follow-up. The lack of an association between WFI-based PDFFs and the incidence of clinical fractures was demonstrated regardless of the region of measurement (hazard ratio [HR] = 0.95 [95% CI 0.67-1.35], = 0.77 at the lumbar spine, HR = 1.07 [95% CI 0.71-1.63], = 0.74 at the femoral neck). Stepwise regression analysis did not alter these findings, and the variable "recent osteoporotic fractures" was found to be significantly associated with incident clinical fractures.
This study found no evidence of a relationship between PDFF and clinical fracture incidence in postmenopausal women. Further studies are necessary involving larger cohorts and longer follow-up periods.
使用磁共振成像和质子密度脂肪分数（PDFF）对骨髓脂肪组织进行无创测量，可能会增强对绝经后女性临床骨折的预测能力。
本研究旨在评估PDFF测量值与临床骨折发生率之间的关联。
开展了一项纵向研究。纳入近期发生骨质疏松性骨折（<12个月）的绝经后女性以及患骨关节炎但未发生骨折的绝经后女性。在基线时使用水脂成像（WFI）和双能X线吸收法扫描测量腰椎和股骨近端的PDFF。在随访期间记录临床骨折情况。
在195名参与者（平均年龄67.4±10.0岁，体重指数27.2±5.9kg/m²）中，与腰椎（57.8%±9.6%）相比，股骨近端，尤其是股骨头处基于WFI的PDFF更高（90.0%±4.9%）。在平均37.2±11.6个月的随访期内，7名参与者死亡，29名（14.9%）发生了新发临床骨折，1名失访。无论测量部位如何，均显示基于WFI的PDFF与临床骨折发生率之间无关联（风险比[HR]=0.95[95%CI 0.67-1.35]，腰椎处P=0.77，股骨颈处HR=1.07[95%CI 0.71-1.63]，P=0.74）。逐步回归分析未改变这些结果，且发现变量“近期骨质疏松性骨折”与新发临床骨折显著相关。
本研究未发现绝经后女性中PDFF与临床骨折发生率之间存在关联的证据。有必要开展涉及更大队列和更长随访期的进一步研究。
