Bone marrow fat is increased in chronic kidney disease by magnetic resonance spectroscopy

Ranjani Moorthi, W. Fadel, G. J. Eckert, K. Ponsler-Sipes, Sharon Moe, C. Lin

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Summary: In aging, the bone marrow fills with fat and this may lead to higher fracture risk. We show that a bone marrow fat measurement by magnetic resonance spectroscopy (MRS), a newer technique not previously studied in chronic kidney disease (CKD), is useful and reproducible. CKD patients have significantly higher bone marrow fat than healthy adults. Introduction: Renal osteodystrophy leads to increased morbidity and mortality in patients with CKD. Traditional bone biopsy histomorphometry is used to study abnormalities in CKD, but the bone marrow, the source of osteoblasts, has not been well characterized in patients with CKD. Methods: To determine the repeatability of bone marrow fat fraction assessment by MRS and water-fat imaging (WFI) at four sites in patients with CKD, testing was performed to determine the coefficients of reproducibility and intraclass coefficients (ICCs). We further determined if this noninvasive technique could be used to determine if there are differences in the percent bone marrow fat in patients with CKD compared to matched controls using paired t tests. Results: The mean age of subjects with CKD was 59.8 ± 7.2 years, and the mean eGFR was 24 ± 8 ml/min. MRS showed good reproducibility at all sites in subjects with CKD and controls, with a coefficient of reproducibilities ranging from 2.4 to 13 %. MRS and WFI assessment of bone marrow fat showed moderate to strong agreement (ICC 0.6–0.7) at the lumbar spine, with poorer agreement at the iliac crest and no agreement at the tibia. The mean percent bone marrow fat at L2–L4 was 13.8 % (95 % CI 8.3–19.7) higher in CKD versus controls (p < 0.05). Conclusions: MRS is a useful and reproducible technique to study bone marrow fat in CKD. Patients with CKD have significantly higher bone marrow fat than healthy adults; the relationship with bone changes requires further analyses.

Original languageEnglish
Pages (from-to)1801-1807
Number of pages7
JournalOsteoporosis International
Volume26
Issue number6
DOIs
StatePublished - Feb 21 2015

Fingerprint

Chronic Renal Insufficiency
Magnetic Resonance Spectroscopy
Bone Marrow
Fats
Chronic Kidney Disease-Mineral and Bone Disorder
Bone and Bones
Water
Osteoblasts
Tibia
Spine
Morbidity
Biopsy

Keywords

  • Adipogenesis
  • Marrow fat
  • Spectroscopy
  • Water-fat imaging

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Bone marrow fat is increased in chronic kidney disease by magnetic resonance spectroscopy. / Moorthi, Ranjani; Fadel, W.; Eckert, G. J.; Ponsler-Sipes, K.; Moe, Sharon; Lin, C.

In: Osteoporosis International, Vol. 26, No. 6, 21.02.2015, p. 1801-1807.

Research output: Contribution to journalArticle

Moorthi, Ranjani ; Fadel, W. ; Eckert, G. J. ; Ponsler-Sipes, K. ; Moe, Sharon ; Lin, C. / Bone marrow fat is increased in chronic kidney disease by magnetic resonance spectroscopy. In: Osteoporosis International. 2015 ; Vol. 26, No. 6. pp. 1801-1807.
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AU - Eckert, G. J.

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AU - Moe, Sharon

AU - Lin, C.

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AB - Summary: In aging, the bone marrow fills with fat and this may lead to higher fracture risk. We show that a bone marrow fat measurement by magnetic resonance spectroscopy (MRS), a newer technique not previously studied in chronic kidney disease (CKD), is useful and reproducible. CKD patients have significantly higher bone marrow fat than healthy adults. Introduction: Renal osteodystrophy leads to increased morbidity and mortality in patients with CKD. Traditional bone biopsy histomorphometry is used to study abnormalities in CKD, but the bone marrow, the source of osteoblasts, has not been well characterized in patients with CKD. Methods: To determine the repeatability of bone marrow fat fraction assessment by MRS and water-fat imaging (WFI) at four sites in patients with CKD, testing was performed to determine the coefficients of reproducibility and intraclass coefficients (ICCs). We further determined if this noninvasive technique could be used to determine if there are differences in the percent bone marrow fat in patients with CKD compared to matched controls using paired t tests. Results: The mean age of subjects with CKD was 59.8 ± 7.2 years, and the mean eGFR was 24 ± 8 ml/min. MRS showed good reproducibility at all sites in subjects with CKD and controls, with a coefficient of reproducibilities ranging from 2.4 to 13 %. MRS and WFI assessment of bone marrow fat showed moderate to strong agreement (ICC 0.6–0.7) at the lumbar spine, with poorer agreement at the iliac crest and no agreement at the tibia. The mean percent bone marrow fat at L2–L4 was 13.8 % (95 % CI 8.3–19.7) higher in CKD versus controls (p < 0.05). Conclusions: MRS is a useful and reproducible technique to study bone marrow fat in CKD. Patients with CKD have significantly higher bone marrow fat than healthy adults; the relationship with bone changes requires further analyses.

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KW - Water-fat imaging

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