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

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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.

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Acknowledgments

Dr. Moorthi was supported by a career development award from the American Society of Bone and Mineral Research (ASBMR). Additional funding for the support of this study was from the Indiana Clinical and Translational Sciences Institute funded by the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award (UL1TR001108).

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA

    R. N. Moorthi, K. Ponsler-Sipes & S. M. Moe

  2. Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA

    W. Fadel & G. J. Eckert

  3. Richard M. Fairbanks School of Public Health, Indianapolis, IN, 46202, USA

    W. Fadel & G. J. Eckert

  4. Roudebush Veterans Administration Medical Center, Indianapolis, IN, 46202, USA

    S. M. Moe

  5. Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA

    C. Lin

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  1. R. N. Moorthi
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Correspondence to R. N. Moorthi.

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Moorthi, R.N., Fadel, W., Eckert, G.J. et al. Bone marrow fat is increased in chronic kidney disease by magnetic resonance spectroscopy. Osteoporos Int 26, 1801–1807 (2015). https://doi.org/10.1007/s00198-015-3064-7

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  • DOI: https://doi.org/10.1007/s00198-015-3064-7

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