Osteoporosis is associated with increased marrow fat content and decreased marrow fat unsaturation: A proton MR spectroscopy study

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Abstract
To use proton magnetic resonance spectroscopy (1H‐MRS) to evaluate vertebral marrow fat, and to determine whether bone density correlates with fat content and fat unsaturation levels in postmenopausal women. Fifty‐three women (mean age = 70 years) underwent dual energy x‐ray absorptiometry and 1H‐MRS, and 12 young female controls (mean age = 28 years) underwent 1H‐MRS of the lumber spine. Water and lipid peak amplitudes were measured to calculate fat content and fat unsaturation index. Spearman's correlation tests and a t‐test comparison of means were applied. 1H‐MRS was successful in 15 normal, 15 osteopenic, and 20 osteoporotic subjects, and in all controls. Marrow fat content was significantly elevated in osteoporotic (65.5% ± 10%) and osteopenic (63.5% ± 9.3%) subjects compared to normal subjects (56.3% ± 11.2%) and young controls (29% ± 9.6%). The fat unsaturation index was significantly decreased in osteoporotic (0.091 ± 0.013) and osteopenic (0.097 ± 0.014) subjects compared to normal subjects (0.114 ± 0.016) and young controls (0.127 ± 0.031). A good inverse correlation was observed between the fat content and the unsaturation index (rs = −0.53, P < 0.0001). Osteoporosis is associated with increased marrow fat. As marrow fat increases, saturated lipids appear to increase preferentially to unsaturated lipids. J. Magn. Reson. Imaging 2005;22:279–285.