title: Vertebral bone marrow fat associated with lower trabecular BMD and prevalent vertebral fracture in older adults.
abstract: BACKGROUND
  Bone marrow fat (BMF) and bone mineral density (BMD) by dual x-ray energy absorptiometry (DXA) are negatively correlated. However, little is known about the association of BMF with fracture or with separate trabecular and cortical bone compartments.
  
  
  OBJECTIVE
  Our objective was to assess the relationships between vertebral BMF, BMD by quantitative computed tomography, and fracture in older adults.
  
  
  METHODS
  We conducted a cross-sectional study in the Age Gene/Environment Susceptibility-Reykjavik cohort.
  
  
  METHODS
  Outcomes measures included vertebral BMF (L1-L4) measured with magnetic resonance spectroscopy, quantitative computed tomography and DXA scans of the hip and spine, and DXA vertebral fracture assessments. Previous clinical fracture was determined from medical records.
  
  
  RESULTS
  In 257 participants without recent bone-active medication use, mean age was 79 (SD 3.1) years. Mean BMF was 53.5% ± 8.1% in men and 55.0% ± 8.4% in women. Those with prevalent vertebral fracture (21 men, 32 women) had higher mean BMF in models adjusted for BMD. In separate models by sex, the difference was statistically significant only in men (57.3% vs 52.8%, P = 0.02). BMF was associated with lower trabecular volumetric BMD (vBMD) at the spine (-10.5% difference for each 1 SD increase in BMF, P < 0.01), total hip, and femoral neck, but not with cortical vBMD, in women. In men, BMF was marginally associated with trabecular spine vBMD (-6.1%, P = 0.05). Total hip and spine areal BMD (aBMD) were negatively correlated with BMF in women only.
  
  
  CONCLUSIONS
  Higher marrow fat correlated with lower trabecular, but not cortical, BMD in older women but not men. Higher marrow fat was associated with prevalent vertebral fracture in men, even after adjustment for BMD.
authors.affiliation: University of California, San Francisco, San Francisco, California 94107, USA. aschwartz@psg.ucsf.edu
authors.forename: Ann V
authors.initials: AV
authors.lastname: Schwartz
authors.forename: Sigurdur
authors.initials: S
authors.lastname: Sigurdsson
authors.forename: Trisha F
authors.initials: TF
authors.lastname: Hue
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lang
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Clifford J
authors.initials: CJ
authors.lastname: Rosen
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Kristin
authors.initials: K
authors.lastname: Siggeirsdottir
authors.forename: Gunnar
authors.initials: G
authors.lastname: Sigurdsson
authors.forename: Diana
authors.initials: D
authors.lastname: Oskarsdottir
authors.forename: Keerthi
authors.initials: K
authors.lastname: Shet
authors.forename: Lisa
authors.initials: L
authors.lastname: Palermo
authors.forename: Vilmundur
authors.initials: V
authors.lastname: Gudnason
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Li
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D001853:Bone Marrow / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D016103:Spinal Fractures / Q000209:etiology / Q000378:metabolism*
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