Marrow (MAT) and subcutaneous (SAT) adipose tissues display different metabolic profiles and varying associations with aging, bone density, and fracture risk. Using a non-invasive imaging methodology, we aimed to investigate the associations between MAT, SAT, and visceral fat (VAT) with bone volume, bone remodeling markers, insulin resistance, and circulating inflammatory mediators in a population of older men. In this cross-sectional study, 96 healthy men (mean age 67 ± 5.5) were assessed for anthropometric parameters, body composition, serum biochemistry, and inflammatory panel. Using single-energy computed tomography images, MAT (in L2 and L3 and both hips), VAT, and SAT (at the level of L2–L3 and L4–L5) were measured employing Slice-O-Matic software (Tomovision), which enables specific tissue demarcation applying previously reported Hounsfield unit thresholds. MAT volume was similar in all anatomical sites and independent of BMI. In all femoral regions of interest (ROIs) there was a strong negative association between bone and MAT volumes (r = − 0.840 to − 0.972, p < 0.001), with location-dependent variations in the lumbar spine. Unlike VAT and SAT, no associations between MAT and serum glucose, inflammatory markers or insulin resistance indicators were found. Bone decline occurred without red marrow expansion; thus lost bone was mainly (if not exclusively) replaced by MAT. In conclusion, strong inverse correlations between MAT and bone mass, which have been previously observed in women, were also confirmed in older men. However, MAT volume in all ROIs was interrelated and unlike women, mainly independent of VAT or SAT. The lack of strong association between MAT vs VAT/SAT, and its discordant associations with metabolic and inflammatory mediators provide further evidence on MAT’s distinct attributes in older men.
Marrow fat Visceral fat Subcutaneous fat Osteoporosis Older men
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This project was partially funded the National Medical Research Council of Singapore [Singapore] and Australian Institute for Musculoskeletal Science [AIMSS; St Albans, Australia].
Compliance with Ethical Standards
Conflict of interest
The authors Ebrahim Bani Hassan, Oddom Demontiero, Sara Vogrin, Alvin Ng, and Gustavo Duque have no conflict of interest or any competing financial interests. We have full control of all primary data and that agree to allow the journal to review the data if required.
Human and Animal Rights and Informed Consent
Ethical approval was obtained from the Singapore General Hospital Institutional Review Board before commencement of the study, and written informed consent obtained from all participants prior to their participation.
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