Bone marrow adiposity (BMA) is associated with aging and osteoporosis, but whether BMA can predict bone loss and fractures remains unknown. Using data from the Age Gene/Environment Susceptibility (AGES)-Reykjavik study, we investigated the associations between 1 H-MRS-based measures of vertebral bone marrow adipose tissue (BMAT), annualized change in bone density/strength by quantitative computed tomography (QCT) and DXA, and secondarily, with incident clinical fractures and radiographic vertebral fractures among older adults. The associations between BMAT and annualized change in bone density/strength were evaluated using linear regression models, adjusted for age, body mass index (BMI), diabetes, estradiol, and testosterone. Cox proportional hazards models were used to evaluate the associations between baseline BMAT and incident clinical fractures, and logistic regression models for incident vertebral fractures. At baseline, mean ± SD age was 80.9 ± 4.2 and 82.6 ± 4.2 years in women (n = 148) and men (n = 150), respectively. Mean baseline BMAT was 55.4% ± 8.1% in women and 54.1% ± 8.2% in men. Incident clinical fractures occurred in 7.4% of women over 2.8 years and in 6.0% of men over 2.2 years. Incident vertebral fractures occurred in 12% of women over 3.3 years and in 17% of men over 2.7 years. Each 1 SD increase in baseline BMAT was associated with a 3.9 mg2 /cm4 /year greater loss of spine compressive strength index (p value = .003), a 0.9 mg/cm3 /year greater loss of spine trabecular BMD (p value = .02), and a 1.2 mg/cm3 /year greater loss of femoral neck trabecular BMD (p value = .02) in women. Among men, there were no associations between BMAT and changes in bone density/strength. There were no associations between BMAT and incident fractures in women or men. In conclusion, we found greater BMAT is associated with greater loss of trabecular bone at the spine and femoral neck, and greater loss of spine compressive strength, in older women. © 2019 American Society for Bone and Mineral Research.

中文翻译：

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较高的骨髓肥胖率可预测老年妇女的骨质流失。

骨髓肥胖症（BMA）与衰老和骨质疏松症相关，但是BMA是否可以预测骨质流失和骨折尚不清楚。使用来自年龄基因/环境敏感性（AGES）-雷克雅未克研究的数据，我们调查了基于1 H-MRS的椎骨脂肪组织（BMAT）量度，通过定量计算机断层摄影术得出的骨密度/强度的年度变化（ QCT）和DXA，其次是老年人的临床骨折和X射线椎骨骨折。使用年龄，体重指数（BMI），糖尿病，雌二醇和睾丸激素调整的线性回归模型评估BMAT与骨密度/强度的年度变化之间的关联。使用Cox比例风险模型评估基线BMAT与事件临床骨折之间的关联，并使用Logistic回归模型分析椎骨骨折。基线时，女性（n = 148）和男性（n = 150）的平均±SD年龄分别为80.9±4.2和82.6±4.2岁。女性的平均基线BMAT为55.4％±8.1％，男性为54.1％±8.2％。在2.8年中，有7.4％的女性发生了事件性临床骨折，在2.2年中，有6.0％的男性发生了临床骨折。3.3岁以上的女性中有12％的人发生椎体骨折，而2.7岁以上的男性中有17％的人发生椎体骨折。基线BMAT每增加1 SD，就会使脊柱抗压强度指数损失增加3.9 mg2 / cm3 /年（p值= 0.003），使脊柱小梁BMD损失增加0.9 mg / cm3 /年（p值=）。 02）和1。女性股骨颈小梁骨密度降低2 mg / cm3 /年（p值= .02）。在男性中，BMAT与骨密度/强度变化之间没有关联。BMAT与男女骨折均无关联。总之，我们发现，年龄较大的妇女，BMAT越高与脊柱和股骨颈小梁骨的损失越大以及脊柱抗压强度的损失越大有关。©2019美国骨骼和矿物质研究学会。在老年妇女中。©2019美国骨骼和矿物质研究学会。在老年妇女中。©2019美国骨骼和矿物质研究学会。