Increased Bone Marrow Fat in Anorexia Nervosa
Open Access
- 1 June 2009
- journal article
- other
- Published by The Endocrine Society in Journal of Clinical Endocrinology & Metabolism
- Vol. 94 (6), 2129-2136
- https://doi.org/10.1210/jc.2008-2532
Abstract
Context: Although women with anorexia nervosa (AN) have severe depletion of body fat, a paradoxical increase in bone marrow fat has been described. Recent data suggest that marrow fat measured by 1H-magnetic resonance spectroscopy (MRS) in combination with bone mineral density (BMD) may be more valuable than either parameter alone in detecting bone weakness. Objective: The objective of the study was to investigate the effect of AN on accumulation of marrow fat in spine and femur using 1H-MRS and the relationship between marrow fat, BMD, and body composition in subjects with AN and normal-weight controls. Design: This was a cross-sectional study. Setting: The study was conducted at a referral center. Patients: Patients included 10 women with AN (29.8 ± 7.6 yr) and 10 normal-weight age-matched women (29.2 ± 5.2 yr). Interventions: There were no interventions. Main Outcomes Measure: Marrow fat content of the fourth lumbar vertebra and femur measured by 1H-MRS. BMD of spine and hip measured by dual-energy x-ray absorptiometry. Results: Subjects with AN had higher marrow fat at the fourth lumbar vertebra and femur compared with controls (P = 0.004–0.01). There was an inverse correlation between marrow fat of L4 and femur and BMD of the spine and hip (r = −0.56 to −0.71, P = 0.01–0.0002) and body mass index and sc adipose tissue of the thigh (r = −0.49 to −0.71, P = 0.03–0.0007). There was an inverse correlation between femur marrow fat and sc and total abdominal adipose tissue (r = −0.53 to −0.67, P = 0.003–0.03). Conclusion: Women with AN have greater lumbar and femoral marrow fat than controls, and marrow fat correlates inversely with BMD. This paradoxical increase in marrow fat at a time when sc and visceral fat are markedly reduced raises important questions about functional consequences of this process.Keywords
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