Vibha Singhal1, Amita Bose2, Yini Liang2, Gitanjali Srivastava3, Susan Goode4, Fatima Cody Stanford1, Madhusmita Misra5, Miriam A Bredella6. 1. Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, United States; Division of Pediatric Endocrinology, Massachusetts General Hospital for Children and Harvard Medical School, United States; Massachusetts General Hospital Weight Center, United States. 2. Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, United States. 3. Department of Medicine, Section on Endocrinology, Diabetes, Nutrition & Weight Management, Boston Medical Center, United States; Department of Medicine, Division of Diabetes, Endocrinology & Metabolism, Vanderbilt University School of Medicine, United States; Department of Pediatrics, Vanderbilt University School of Medicine, United States. 4. Division of Pediatric Gastroenterology, Massachusetts General Hospital for Children and Harvard Medical School, United States. 5. Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, United States; Division of Pediatric Endocrinology, Massachusetts General Hospital for Children and Harvard Medical School, United States. 6. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, United States. Electronic address: mbredella@mgh.harvard.edu.
Abstract
BACKGROUND: Marrow adipose tissue (MAT) is increasingly recognized as an active and dynamic endocrine organ that responds to changes in nutrition and environmental milieu. Compared to normal weight controls, adolescent girls with anorexia nervosa have higher MAT content, which is associated with impaired skeletal integrity, but data are limited regarding MAT content in adolescents with obesity and how this interacts with bone endpoints. OBJECTIVE: To evaluate (i) MAT content in adolescents with obesity compared to normal-weight controls, (ii) the association of MAT with bone endpoints, and (iii) whether these associations of MAT are affected by body weight. METHODS: We assessed MAT, bone endpoints, and body composition in 60 adolescent girls 14-21 years old: 45 with obesity (OB) and 15 normal-weight controls (NW-C). We used (i) DXA to assess areal bone mineral density (aBMD) at the lumbar spine and total hip, and total body fat and lean mass, (ii) proton magnetic resonance spectroscopy (1H-MRS) to assess MAT at the 4th lumbar vertebra and femur, and MRI to assess visceral (VAT) and subcutaneous adipose tissue (SAT), (iii) high resolution peripheral quantitative CT (HR-pQCT) to assess volumetric BMD (vBMD), (iv) individual trabeculae segmentation to evaluate trabecular bone (plate-rod morphology), and (v) finite element analysis to assess stiffness (a strength estimate) at the distal radius and tibia. RESULTS: Groups did not differ for age or height. Weight, BMI, and areal BMD Z-scores at all sites were higher in the OB group (p<0.0001). MAT was lower in OB at the femoral diaphysis (p= <0.0001) and the lumbar spine (p=0.0039). For the whole group, MAT at the lumbar spine and femoral diaphysis was inversely associated with BMI, total fat mass, lean mass, and VAT. Even after controlling for body weight, independent inverse associations were observed of femoral diaphyseal and lumbar MAT with total tibial vBMD, and of lumbar MAT with radial trabecular vBMD. CONCLUSION: Adolescent girls with obesity have lower MAT than normal-weight controls despite having an excess of total body fat. These findings confirm that MAT is regulated uniquely from other adipose depots in obesity. MAT was inversely associated with vBMD, emphasizing an inverse relationship between MAT and bone even in adolescent girls with obesity.
BACKGROUND: Marrow adipose tissue (MAT) is increasingly recognized as an active and dynamic endocrine organ that responds to changes in nutrition and environmental milieu. Compared to normal weight controls, adolescent girls with anorexia nervosa have higher MAT content, which is associated with impaired skeletal integrity, but data are limited regarding MAT content in adolescents with obesity and how this interacts with bone endpoints. OBJECTIVE: To evaluate (i) MAT content in adolescents with obesity compared to normal-weight controls, (ii) the association of MAT with bone endpoints, and (iii) whether these associations of MAT are affected by body weight. METHODS: We assessed MAT, bone endpoints, and body composition in 60 adolescent girls 14-21 years old: 45 with obesity (OB) and 15 normal-weight controls (NW-C). We used (i) DXA to assess areal bone mineral density (aBMD) at the lumbar spine and total hip, and total body fat and lean mass, (ii) proton magnetic resonance spectroscopy (1H-MRS) to assess MAT at the 4th lumbar vertebra and femur, and MRI to assess visceral (VAT) and subcutaneous adipose tissue (SAT), (iii) high resolution peripheral quantitative CT (HR-pQCT) to assess volumetric BMD (vBMD), (iv) individual trabeculae segmentation to evaluate trabecular bone (plate-rod morphology), and (v) finite element analysis to assess stiffness (a strength estimate) at the distal radius and tibia. RESULTS: Groups did not differ for age or height. Weight, BMI, and areal BMD Z-scores at all sites were higher in the OB group (p<0.0001). MAT was lower in OB at the femoral diaphysis (p= <0.0001) and the lumbar spine (p=0.0039). For the whole group, MAT at the lumbar spine and femoral diaphysis was inversely associated with BMI, total fat mass, lean mass, and VAT. Even after controlling for body weight, independent inverse associations were observed of femoral diaphyseal and lumbar MAT with total tibial vBMD, and of lumbar MAT with radial trabecular vBMD. CONCLUSION: Adolescent girls with obesity have lower MAT than normal-weight controls despite having an excess of total body fat. These findings confirm that MAT is regulated uniquely from other adipose depots in obesity. MAT was inversely associated with vBMD, emphasizing an inverse relationship between MAT and bone even in adolescent girls with obesity.
Authors: Thomas Baum; Samuel P Yap; Dimitrios C Karampinos; Lorenzo Nardo; Daniel Kuo; Andrew J Burghardt; Umesh B Masharani; Ann V Schwartz; Xiaojuan Li; Thomas M Link Journal: J Magn Reson Imaging Date: 2011-08-16 Impact factor: 4.813
Authors: N Abdalrahaman; C McComb; J E Foster; R S Lindsay; R Drummond; G A McKay; C G Perry; S F Ahmed Journal: Clin Endocrinol (Oxf) Date: 2017-08-04 Impact factor: 3.478
Authors: Miriam A Bredella; Martin Torriani; Reza Hosseini Ghomi; Bijoy J Thomas; Danielle J Brick; Anu V Gerweck; Clifford J Rosen; Anne Klibanski; Karen K Miller Journal: Obesity (Silver Spring) Date: 2010-05-13 Impact factor: 5.002