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Yin H, Lin W, Xie F, He C, Chen T, Zheng G, Wang Z. MRI-based Vertebral Bone Quality Score for Osteoporosis Screening Based on Different Osteoporotic Diagnostic Criteria Using DXA and QCT. Calcif Tissue Int 2023; 113:383-392. [PMID: 37493798 DOI: 10.1007/s00223-023-01115-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/07/2023] [Indexed: 07/27/2023]
Abstract
In this study, we aim to evaluate the correlation between T score measured by dual X-ray absorptiometry (DXA), volumetric bone mineral density (vBMD) derived from quantitative computed tomography (QCT) and MRI-based vertebral bone quality (VBQ), explore the diagnostic performance of VBQ in osteoporosis and determine the recognition value of VBQ in osteoporotic fracture in a relatively large cohort of elderly patients scheduled to undergo spinal surgery. A total of 260 patients were enrolled in the study. DXA and QCT were used to evaluate osteoporotic status. We calculated the lumbar VBQ score, analyzed the correlation between T score, vBMD and VBQ, and explored whether VBQ was an influential factor of bone quality and fracture by binary logistic regression as well as the diagnostic performance of VBQ in osteoporosis and fracture by ROC curve. VBQ was negatively correlated with vBMD and T score. (r = - 0.487 vs. r = - 0.220). The VBQ score was a risk factor for osteoporosis under the QCT diagnostic criteria (OR = 2.245, 95% CI 1.456-3.460) and osteoporotic fractures (OR = 1.496, 95% CI 1.097-2.040). It exhibited superior discriminant performance for osteoporosis diagnosed by QCT, with a cutoff value of 3.70 and an AUC of 0.7354. Its cutoff value for osteoporotic fractures was 3.72, and its AUC was 0.6717. In a cohort of elderly patients scheduled to undergo spinal surgery, the VBQ score was more strongly associated with vBMD than the T score and could identify patients with osteoporosis and corresponding vertebral compression fracture (VCF).
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Affiliation(s)
- Houjie Yin
- Department of Spine Surgery, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde Foshan), Foshan, Guangdong, China
- The Second Clinical Medical College of Southern Medical University, Guangzhou, Guangdong, China
| | - Wentao Lin
- Department of Spine Surgery, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde Foshan), Foshan, Guangdong, China
| | - Faqin Xie
- Department of Spine Surgery, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde Foshan), Foshan, Guangdong, China
| | - Chaoqin He
- Department of Spine Surgery, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde Foshan), Foshan, Guangdong, China
- The Second Clinical Medical College of Southern Medical University, Guangzhou, Guangdong, China
| | - Tao Chen
- Department of Spine Surgery, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde Foshan), Foshan, Guangdong, China
- The Second Clinical Medical College of Southern Medical University, Guangzhou, Guangdong, China
| | - Guanghao Zheng
- Department of Spine Surgery, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde Foshan), Foshan, Guangdong, China
- The Second Clinical Medical College of Southern Medical University, Guangzhou, Guangdong, China
| | - Zhiyun Wang
- Department of Spine Surgery, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde Foshan), Foshan, Guangdong, China.
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Huber FA, Singhal V, Tuli S, Becetti I, López López AP, Bouxsein ML, Misra M, Bredella MA. Two-year Skeletal Effects of Sleeve Gastrectomy in Adolescents with Obesity Assessed with Quantitative CT and MR Spectroscopy. Radiology 2023; 307:e223256. [PMID: 37310246 PMCID: PMC10315522 DOI: 10.1148/radiol.223256] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/18/2023] [Accepted: 04/27/2023] [Indexed: 06/14/2023]
Abstract
Background Sleeve gastrectomy (SG) is effective in the treatment of cardiometabolic complications of obesity but is associated with bone loss. Purpose To determine the long-term effects of SG on vertebral bone strength, density, and bone marrow adipose tissue (BMAT) in adolescents and young adults with obesity. Materials and Methods This 2-year prospective nonrandomized longitudinal study enrolled adolescents and young adults with obesity who underwent either SG (SG group) or dietary and exercise counseling without surgery (control group) at an academic medical center from 2015 to 2020. Participants underwent quantitative CT of the lumbar spine (L1 and L2 levels) to assess bone density and strength, proton MR spectroscopy to assess BMAT (L1 and L2 levels), and MRI of the abdomen and thigh to assess body composition. Student t and Wilcoxon signed-rank tests were used to compare 24-month changes between and within groups. Regression analysis was performed to evaluate associations between body composition, vertebral bone density, strength, and BMAT. Results A total of 25 participants underwent SG (mean age, 18 years ± 2 [SD], 20 female), and 29 underwent dietary and exercise counseling without surgery (mean age, 18 years ± 3, 21 female). Body mass index (BMI) decreased by a mean of 11.9 kg/m2 ± 5.21 [SD] after 24 months in the SG group (P < .001), while it increased in the control group (mean increase, 1.49 kg/m2 ± 3.10; P = .02). Mean bone strength of the lumbar spine decreased after surgery compared with that in control subjects (mean decrease, -728 N ± 691 vs -7.24 N ± 775; P < .001). BMAT of the lumbar spine increased after SG (mean lipid-to-water ratio increase, 0.10 ± 0.13; P = .001). Changes in vertebral density and strength correlated positively with changes in BMI and body composition (R = 0.34 to R = 0.65, P = .02 to P < .001) and inversely with vertebral BMAT (R = -0.33 to R = -0.47, P = .03 to P = .001). Conclusion SG in adolescents and young adults reduced vertebral bone strength and density and increased BMAT compared with those in control participants. Clinical trial registration no. NCT02557438 © RSNA, 2023 See also the editorial by Link and Schafer in this issue.
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Affiliation(s)
- Florian A. Huber
- From the Department of Radiology (F.A.H., M.A.B.), Neuroendocrine
Unit (V.S., S.T., I.B., A.P.L.L., M.M.), and Endocrine Unit (M.L.B.),
Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey
6E, Boston, MA 02114; Institute of Diagnostic and Interventional Radiology,
University Hospital Zurich, University of Zurich, Zurich, Switzerland (F.A.H.);
Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard
Medical School, Boston, Mass (V.S., I.B., M.M.); MGH Weight Center, Boston, Mass
(V.S.); and Department of Orthopedic Surgery, Beth Israel Deaconess Medical
Center and Harvard Medical School, Boston, Mass (M.L.B.)
| | - Vibha Singhal
- From the Department of Radiology (F.A.H., M.A.B.), Neuroendocrine
Unit (V.S., S.T., I.B., A.P.L.L., M.M.), and Endocrine Unit (M.L.B.),
Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey
6E, Boston, MA 02114; Institute of Diagnostic and Interventional Radiology,
University Hospital Zurich, University of Zurich, Zurich, Switzerland (F.A.H.);
Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard
Medical School, Boston, Mass (V.S., I.B., M.M.); MGH Weight Center, Boston, Mass
(V.S.); and Department of Orthopedic Surgery, Beth Israel Deaconess Medical
Center and Harvard Medical School, Boston, Mass (M.L.B.)
| | - Shubhangi Tuli
- From the Department of Radiology (F.A.H., M.A.B.), Neuroendocrine
Unit (V.S., S.T., I.B., A.P.L.L., M.M.), and Endocrine Unit (M.L.B.),
Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey
6E, Boston, MA 02114; Institute of Diagnostic and Interventional Radiology,
University Hospital Zurich, University of Zurich, Zurich, Switzerland (F.A.H.);
Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard
Medical School, Boston, Mass (V.S., I.B., M.M.); MGH Weight Center, Boston, Mass
(V.S.); and Department of Orthopedic Surgery, Beth Israel Deaconess Medical
Center and Harvard Medical School, Boston, Mass (M.L.B.)
| | - Imen Becetti
- From the Department of Radiology (F.A.H., M.A.B.), Neuroendocrine
Unit (V.S., S.T., I.B., A.P.L.L., M.M.), and Endocrine Unit (M.L.B.),
Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey
6E, Boston, MA 02114; Institute of Diagnostic and Interventional Radiology,
University Hospital Zurich, University of Zurich, Zurich, Switzerland (F.A.H.);
Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard
Medical School, Boston, Mass (V.S., I.B., M.M.); MGH Weight Center, Boston, Mass
(V.S.); and Department of Orthopedic Surgery, Beth Israel Deaconess Medical
Center and Harvard Medical School, Boston, Mass (M.L.B.)
| | - Ana Paola López López
- From the Department of Radiology (F.A.H., M.A.B.), Neuroendocrine
Unit (V.S., S.T., I.B., A.P.L.L., M.M.), and Endocrine Unit (M.L.B.),
Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey
6E, Boston, MA 02114; Institute of Diagnostic and Interventional Radiology,
University Hospital Zurich, University of Zurich, Zurich, Switzerland (F.A.H.);
Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard
Medical School, Boston, Mass (V.S., I.B., M.M.); MGH Weight Center, Boston, Mass
(V.S.); and Department of Orthopedic Surgery, Beth Israel Deaconess Medical
Center and Harvard Medical School, Boston, Mass (M.L.B.)
| | - Mary L. Bouxsein
- From the Department of Radiology (F.A.H., M.A.B.), Neuroendocrine
Unit (V.S., S.T., I.B., A.P.L.L., M.M.), and Endocrine Unit (M.L.B.),
Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey
6E, Boston, MA 02114; Institute of Diagnostic and Interventional Radiology,
University Hospital Zurich, University of Zurich, Zurich, Switzerland (F.A.H.);
Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard
Medical School, Boston, Mass (V.S., I.B., M.M.); MGH Weight Center, Boston, Mass
(V.S.); and Department of Orthopedic Surgery, Beth Israel Deaconess Medical
Center and Harvard Medical School, Boston, Mass (M.L.B.)
| | - Madhusmita Misra
- From the Department of Radiology (F.A.H., M.A.B.), Neuroendocrine
Unit (V.S., S.T., I.B., A.P.L.L., M.M.), and Endocrine Unit (M.L.B.),
Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey
6E, Boston, MA 02114; Institute of Diagnostic and Interventional Radiology,
University Hospital Zurich, University of Zurich, Zurich, Switzerland (F.A.H.);
Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard
Medical School, Boston, Mass (V.S., I.B., M.M.); MGH Weight Center, Boston, Mass
(V.S.); and Department of Orthopedic Surgery, Beth Israel Deaconess Medical
Center and Harvard Medical School, Boston, Mass (M.L.B.)
| | - Miriam A. Bredella
- From the Department of Radiology (F.A.H., M.A.B.), Neuroendocrine
Unit (V.S., S.T., I.B., A.P.L.L., M.M.), and Endocrine Unit (M.L.B.),
Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Yawkey
6E, Boston, MA 02114; Institute of Diagnostic and Interventional Radiology,
University Hospital Zurich, University of Zurich, Zurich, Switzerland (F.A.H.);
Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard
Medical School, Boston, Mass (V.S., I.B., M.M.); MGH Weight Center, Boston, Mass
(V.S.); and Department of Orthopedic Surgery, Beth Israel Deaconess Medical
Center and Harvard Medical School, Boston, Mass (M.L.B.)
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Liu Z, Huang D, Zhang Y, Chang R, Zhang X, Jiang Y, Ma X. Accuracy and applicability of dual-energy computed tomography in quantifying vertebral bone marrow adipose tissue compared with magnetic resonance imaging. Insights Imaging 2022; 13:181. [DOI: 10.1186/s13244-022-01326-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/03/2022] [Indexed: 11/28/2022] Open
Abstract
Abstract
Objectives
To evaluate the accuracy of dual-energy computed tomography (DECT) in quantifying bone marrow adipose tissue (BMAT) and its applicability in the study of osteoporosis (OP).
Methods
A total of 83 patients with low back pain (59.77 ± 7.46 years, 30 males) were enrolled. All patients underwent lumbar DECT and magnetic resonance imaging (MRI) scanning within 48 h, and the vertebral fat fraction (FF) was quantitatively measured, recorded as DECT-FF and MRI-FF. A standard quantitative computed tomography (QCT) phantom was positioned under the waist during DECT procedure to realize the quantization of bone mineral density (BMD). The intraclass correlation coefficient (ICC) and Bland–Altman method was used to evaluate the agreement between DECT-FF and MRI-FF. The Pearson test was used to study the correlation between DECT-FF, MRI-FF, and BMD. With BMD as a gold standard, the diagnostic efficacy of DECT-FF and MRI-FF in different OP degrees was compared by receiver operating characteristic (ROC) curve and DeLong test.
Results
The values of DECT-FF and MRI-FF agreed well (ICC = 0.918). DECT-FF and MRI-FF correlated with BMD, with r values of −0.660 and −0.669, respectively (p < 0.05). In the diagnosis of OP and osteopenia, the areas under curve (AUC) of DECT-FF was, respectively, 0.791 and 0.710, and that of MRI-FF was 0.807 and 0.708, and there was no significant difference between AUCs of two FF values (with Z values of 0.503 and 0.066, all p > 0.05).
Conclusion
DECT can accurately quantify the BMAT of vertebrae and has the same applicability as MRI in the study of OP.
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Vauclard A, Bellio M, Valet C, Borret M, Payrastre B, Severin S. Obesity: Effects on bone marrow homeostasis and platelet activation. Thromb Res 2022. [DOI: 10.1016/j.thromres.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Solomon N, Sailer A, Dixe de Oliveira Santo I, Pillai A, Heng LXX, Jha P, Katz DS, Zulfiqar M, Sugi M, Revzin MV. Sequelae of Eating Disorders at Imaging. Radiographics 2022; 42:1377-1397. [PMID: 35930473 DOI: 10.1148/rg.220018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Although eating disorders are common, they tend to be underdiagnosed and undertreated because social stigma tends to make patients less likely to seek medical attention and less compliant with medical treatment. Diagnosis is crucial because these disorders can affect any organ system and are associated with the highest mortality rate of any psychiatric disorder. Because of this, imaging findings, when recognized, can be vital to the diagnosis and management of eating disorders and their related complications. The authors familiarize the radiologist with the pathophysiology and sequelae of eating disorders and provide an overview of the related imaging findings. Some imaging findings associated with eating disorders are nonspecific, and others are subtle. The presence of these findings should alert the radiologist to correlate them with the patient's medical history and laboratory results and the clinical team's findings at the physical examination. The combination of these findings may suggest a diagnosis that might otherwise be missed. Topics addressed include (a) the pathophysiology of eating disorders, (b) the clinical presentation of patients with eating disorders and their medical complications and sequelae, (c) the imaging features associated with common and uncommon sequelae of eating disorders, (d) an overview of management and treatment of eating disorders, and (e) conditions that can mimic eating disorders (eg, substance abuse, medically induced eating disorders, and malnourishment in patients with cancer). Online supplemental material is available for this article. ©RSNA, 2022.
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Affiliation(s)
- Nadia Solomon
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Anne Sailer
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Irene Dixe de Oliveira Santo
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Aishwarya Pillai
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Lauren Xuan Xin Heng
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Priyanka Jha
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Douglas S Katz
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Maria Zulfiqar
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Mark Sugi
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
| | - Margarita V Revzin
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room TE-2, New Haven, CT 06520 (N.S., A.S., I.D.d.O.S., A.P., M.V.R.); Department of Science, Northern Arizona University, Flagstaff, Ariz (L.X.X.H.); Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (P.J., M.S.); Department of Radiology, New York University Long Island School of Medicine, Mineola, NY (D.S.K.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.Z.)
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Shu JB, Kim TY. Bone marrow adiposity in diabetes and clinical interventions. Curr Opin Endocrinol Diabetes Obes 2022; 29:303-309. [PMID: 35776685 DOI: 10.1097/med.0000000000000741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW This study aims to review bone marrow adipose tissue (BMAT) changes in people with diabetes, contributing factors, and interventions. RECENT FINDINGS In type 1 diabetes (T1D), BMAT levels are similar to healthy controls, although few studies have been performed. In type 2 diabetes (T2D), both BMAT content and composition appear altered, and recent bone histomorphometry data suggests increased BMAT is both through adipocyte hyperplasia and hypertrophy. Position emission tomography scanning suggests BMAT is a major source of basal glucose uptake. BMAT is responsive to metabolic interventions. SUMMARY BMAT is a unique fat depot that is influenced by metabolic factors and proposed to negatively affect the skeleton. BMAT alterations are more consistently seen in T2D compared to T1D. Interventions such as thiazolidinedione treatment may increase BMAT, whereas metformin treatment, weight loss, and exercise may decrease BMAT. Further understanding of the role of BMAT will provide insight into the pathogenesis of diabetic bone disease and could lead to targeted preventive and therapeutic strategies.
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Affiliation(s)
- Jessica B Shu
- University of California, San Francisco and the San Francisco VA Health Care System, San Francisco, California, USA
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Pachón-Peña G, Bredella MA. Bone marrow adipose tissue in metabolic health. Trends Endocrinol Metab 2022; 33:401-408. [PMID: 35396163 PMCID: PMC9098665 DOI: 10.1016/j.tem.2022.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/25/2022] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
Recent studies have highlighted the role of bone marrow adipose tissue (BMAT) as a regulator of skeletal homeostasis and energy metabolism. While long considered an inert filler, occupying empty spaces from bone loss and reduced hematopoiesis, BMAT is now considered a secretory and metabolic organ that responds to nutritional challenges and secretes cytokines, which indirectly impact energy and bone metabolism. The recent advances in our understanding of the function of BMAT have been enabled by novel noninvasive imaging techniques, which allow longitudinal assessment of BMAT in vivo following interventions. This review will focus on the latest advances in our understanding of BMAT and its role in metabolic health. Imaging techniques to quantify the content and composition of BMAT will be discussed.
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Affiliation(s)
| | - Miriam A Bredella
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
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Bredella MA, Fazeli PK, Bourassa J, Rosen CJ, Bouxsein ML, Klibanski A, Miller KK. The effect of short-term high-caloric feeding and fasting on bone microarchitecture. Bone 2022; 154:116214. [PMID: 34571202 PMCID: PMC8671292 DOI: 10.1016/j.bone.2021.116214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/15/2021] [Accepted: 09/20/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND States of chronic overnutrition and undernutrition are both associated with impaired bone health and increased fracture risk but there are no data on bone microarchitecture following short-term controlled nutritional challenges. OBJECTIVE The purpose of our study was to evaluate the impact of short-term high-caloric feeding and fasting on bone microarchitecture. We hypothesized that both high-caloric feeding and fasting would have negative effects on microarchitecture. MATERIALS AND METHODS We recruited 23 adult healthy subjects (13 males, 10 females, mean age 33.2 ± 1.4 years, mean BMI 26.0 ± 1.5 kg/m2). Subjects underwent an in-patient 10-day high-caloric visit (caloric intake with goal to achieve 7% weight gain), after which they went home to resume a normal diet for 13-18 days (stabilization period), and were then readmitted for a 10-day in-patient fasting stay (no caloric intake). All subjects underwent HRpQCT (XtremeCT, Scanco Medical AG, Brüttisellen, Switzerland) of the distal tibia and distal radius after each visit to assess volumetric bone mineral density (vBMD), trabecular and cortical microarchitecture, and strength estimates. The Wilcoxon signed rank test was used to perform within group comparisons. RESULTS During the high-caloric period, there was a mean increase in weight by 6.3 + 1.7% (p < 0.0001). There were no significant changes in bone parameters in the distal tibia or distal radius (p > 0.05). During the stabilization period there was a significant reduction in weight by -2.7 + 1.9% (p < 0.0001) but no change in bone parameters (p > 0.05). During the fasting period there was a further reduction in weight by -8.8 + 1.2% (p < 0.0001). In the distal tibia, there was a significant increase in total and cortical vBMD, trabecular and cortical parameters as well as strength estimates (p < 0.05). In the distal radius there was an increase in total and trabecular vBMD (p < 0.05), while there were no changes in other microarchitecture parameters or strengths estimates. CONCLUSION Short-term fasting after high-caloric feeding improves vBMD, bone microarchitecture and strength estimates of the distal tibia, while short-term high-caloric feeding does not change vBMD or microarchitecture. These results suggest that short-term fasting after high-caloric feeding in healthy individuals improves bone health and that these changes can be detected using HRpQCT in-vivo.
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Affiliation(s)
- Miriam A Bredella
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America.
| | - Pouneh K Fazeli
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
| | - Jenna Bourassa
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
| | - Clifford J Rosen
- Maine Medical Center Research Institute, Scarborough, ME, United States of America
| | - Mary L Bouxsein
- Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
| | - Anne Klibanski
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
| | - Karen K Miller
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
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Bredella MA, Buckless C, Fazeli PK, Rosen CJ, Torriani M, Klibanski A, Miller KK. Bone marrow adipose tissue composition following high-caloric feeding and fasting. Bone 2021; 152:116093. [PMID: 34186250 PMCID: PMC8323345 DOI: 10.1016/j.bone.2021.116093] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Bone marrow adipose tissue (BMAT) plays a role in systemic energy metabolism and responds to nutritional changes. Chronic starvation as well as visceral adiposity are associated with BMAT accumulation. Two types of BMAT have been described which differ in anatomic location (proximal-regulated-rBMAT vs distal-constitutive-cBMAT) and composition (higher unsaturated lipids of cBMAT compared to rBMAT). OBJECTIVE To determine the response of BMAT composition to short-term high-caloric feeding and fasting. We hypothesized that high-feeding and caloric restriction would be associated with differences in BMAT composition according to the skeletal site. MATERIALS AND METHODS We examined 23 healthy subjects (13 m, 10 f, mean age 33 ± 7 years, BMI 26 ± 1.5 kg/m2) who were admitted for a 10-day high-caloric stay (caloric intake with goal to achieve 7% weight gain) followed by discharge home for 13-18 days to resume normal diet (stabilization period), followed by a 10-day fasting stay (no caloric intake). Subjects underwent single voxel proton MR spectroscopy (1H-MRS) at 3T of the lumbar spine (L4) (rBMAT), the femoral diaphysis and distal tibial metaphysis (cBMAT) to determine BMAT composition (unsaturation index, UI and saturation index, SI). Within group comparisons were performed by the Wilcoxon signed rank test. RESULTS After the high-calorie visit, SI of L4 increased compared to baseline (0.62 ± 0.27 to 0.70 ± 0.28, p = 0.02), and there was a trend of an increase in femoral SI and UI (p ≥ 0.07), while there was no significant change in tibial BMAT (p ≥ 0.13). During the stabilization period, SI of L4 decreased (0.70 ± 0.28 to 0.57 ± 0.21, p < 0.0001) and SI of the femoral diaphysis decreased (5.37 ± 2.27 to 5.09 ± 2.43, p = 0.03), while there was no significant change in UI or tibial BMAT (p ≥ 0.14). During the fasting period, SI of L4 increased (0.57 ± 0.21 to 0.63 ± 0.30, p = 0.03), while there was no change in UI (p = 0.7). SI and UI of femoral diaphysis decreased (5.09 ± 2.43 to 4.68 ± 2.15, p = 0.03, and 0.62 ± 0.42 to 0.47 ± 0.37, p = 0.02, respectively) and UI of the tibial metaphysis decreased (1.48 ± 0.49 to 1.24 ± 0.57, p = 0.04). CONCLUSION 1H-MRS is able to quantify BMAT composition during short-term nutritional challenges, showing a significant increase in SI of rBMAT during high caloric feeding and a differential response to fasting with an increase in SI of rBMAT and a decrease in SI and UI of femoral cBMAT and decrease in UI of tibial cBMAT.
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Affiliation(s)
- Miriam A Bredella
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America.
| | - Colleen Buckless
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
| | - Pouneh K Fazeli
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
| | - Clifford J Rosen
- Maine Medical Center Research Institute, Scarborough, ME, United States of America
| | - Martin Torriani
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
| | - Anne Klibanski
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
| | - Karen K Miller
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States of America
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