Zoulakis Michail, Axelsson Kristian F, Litsne Henrik, Johansson Lisa, Lorentzon Mattias
University of Gothenburg, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Osteoporosis Centre, Gothenburg, Sweden.
Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden.
J Clin Endocrinol Metab. 2025 Apr 3. doi: 10.1210/clinem/dgaf216.
Recent research links bone marrow adiposity (BMAT) to osteoporosis and fracture risk. Typically, BMAT is assessed via magnetic resonance imaging (MRI), a costly and less accessible method. A new method uses high-resolution peripheral quantitative computed tomography (HR-pQCT) to quantify BMAT.
To investigate if BMAT, derived from HR-pQCT images, is associated with fracture incidence and osteoporosis prevalence in older women.
2984 women aged 75-80 years from the SUPERB cohort were included between March 2013 and May 2016. Bone characteristics, including bone densitometry (DXA) and HR-pQCT of the ultra-distal tibia, were assessed. Bone marrow fat fraction (BMFF) was measured using HR-pQCT. Incident fractures were tracked until March 2023. Linear regression was used to analyze associations between BMFF, anthropometrics, and bone mineral density (BMD). Cox and Poisson regression examined BMFF's association to incident fractures.
BMFF was inversely associated to body mass index (r= -0.21, p < 0.001) and hip BMD (r = -0.50, p < 0.001). Over a median follow-up of 7.3 years, 797 major osteoporotic fractures (MOF), 1069 any fractures, and 235 hip fractures occurred. Higher BMFF (per SD) increased the risk of MOF (HR = 1.24, 95% CI 1.15-1.34), any fracture (HR = 1.20, 95% CI 1.12-1.28), hip fracture (HR = 1.22, 95% CI 1.06-1.40), and vertebral fracture (HR = 1.24, 95% CI 1.12-1.38) in multivariable Cox models adjusted for age, body mass index and clinical risk factors. Mediation analysis indicated that a significant proportion of these associations were mediated by femoral neck bone mineral density (FN-BMD).
Higher BMFF is associated with lower BMD and higher fracture risk in older women.
近期研究将骨髓脂肪含量（BMAT）与骨质疏松症及骨折风险联系起来。通常，BMAT是通过磁共振成像（MRI）来评估的，这是一种成本高昂且难以普及的方法。一种新方法使用高分辨率外周定量计算机断层扫描（HR-pQCT）来量化BMAT。
研究从HR-pQCT图像得出的BMAT是否与老年女性的骨折发生率和骨质疏松症患病率相关。
2013年3月至2016年5月期间，纳入了来自SUPERB队列的2984名75至80岁的女性。评估了包括骨密度测定（DXA）和胫骨超远端的HR-pQCT在内的骨骼特征。使用HR-pQCT测量骨髓脂肪分数（BMFF）。追踪至2023年3月的新发骨折情况。采用线性回归分析BMFF、人体测量学指标和骨矿物质密度（BMD）之间的关联。Cox回归和泊松回归检验BMFF与新发骨折的关联。
BMFF与体重指数呈负相关（r = -0.21，p < 0.001），与髋部BMD呈负相关（r = -0.50，p < 0.001）。在中位随访7.3年期间，发生了797例严重骨质疏松性骨折（MOF）、1069例任何骨折以及235例髋部骨折。在根据年龄、体重指数和临床风险因素进行调整的多变量Cox模型中，较高的BMFF（每标准差）增加了MOF（HR = 1.24，95%CI 1.15 - 1.34）、任何骨折（HR = 1.20，95%CI 1.12 - 1.28）、髋部骨折（HR = 1.22，95%CI 1.06 - 1.40）和椎体骨折（HR = 1.24，95%CI 1.12 - 1.38）的风险。中介分析表明，这些关联中有很大一部分是由股骨颈骨矿物质密度（FN-BMD）介导的。
较高的BMFF与老年女性较低的BMD和较高的骨折风险相关。
