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MrOS: Increased bone marrow fat in older men with diabetes, affects fracture risk
Older men with type 2 diabetes have higher levels of vertebral bone marrow fat vs. men without disease, and the increase is associated with both femoral neck and total hip bone mineral density, according to an analysis of the Osteoporotic Fractures in Men study.
“Our findings may suggest a novel pathway of [bone marrow fat] and BMD in bone metabolism among subjects with diabetes,” Jane A. Cauley, DrPH, professor of epidemiology and associate dean for research at the University of Pittsburgh, and colleagues wrote. “Individuals with type 2 diabetes are known to be more susceptible to fracture, despite their high BMD. The link between [bone marrow fat] and diabetes may provide insight into the paradoxical relationship among BMD, fracture and diabetes. With the increase in life expectancy and the epidemic of diabetes, understanding the underlying mechanisms that links diabetes with [bone marrow fat] and how it may affect fracture risk is essential.”
Cauley and colleagues analyzed data from 156 older men recruited from the Pittsburgh site of the Osteoporotic Fractures in Men (MrOS) study, a prospective cohort study designed to identify risk factors associated with osteoporosis and osteoporotic fractures (mean age, 81 years; mean BMI, 28.1 kg/m²; 24% with type 2 diabetes). All men underwent DXA scans to determine areal BMD of the lumber spine, total hip and femoral neck, as well as proton magnetic resonance spectroscopy at three vertebral levels of the lumbar spine to determine bone marrow fat (average fat content across L1, L2 and L3), and peripheral quantitative CT to measure volumetric BMD. Researchers used linear regression analysis to examine the association between bone marrow fat and BMD and bone marrow fat and diabetes, adjusting for age, race and BMI.
Researchers found that the men with type 2 diabetes had higher levels of bone marrow fat vs. those without diabetes (58.9% vs. 54.6%; P = .035), as well as a greater total hip and lumbar spine BMD (P = .04 and .007, respectively).
After adjusting for age, race and BMI, researchers found that the higher levels of bone marrow fat persisted in the diabetes group (P = .034); there were no correlations between bone marrow fat and age. There were no correlations between bone marrow fat and BMD in the overall cohort; however, when stratified by diabetes status, bone marrow fat was inversely correlated with total hip BMD (r = –0.39; P = .017) and femoral neck BMD (r = –0.3; P = .064) for men with type 2 diabetes.
“Unlike previous studies, the overall correlation between [bone marrow fat] and BMD in our study was weak and not statistically significant,” the researchers wrote. “However, when participants were stratified by type 2 diabetes status, negative and moderate correlations were found with femoral neck and total hip BMD and [bone marrow fat] among men with diabetes.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.