Quantification of bone marrow fat fraction in type 2 Diabetes Mellitus using Dixon MRI

Abstract

Background: Due its chronic nature, diabetes mellitus (DM) can damage several body systems. In the skeletal system it can cause bone loss, increased bone marrow fat content and even osteoporosis. Recently, skeletal fragility is a known complication of type2 DM (T2DM) with increased fracture risk.

Aim of study: to evaluate the utility of Dixon magnetic resonance imaging (MRI) to quantify bone marrow fat (BMF) and assess the fat fraction (FF). As evidence that non mineralized component may be important in the evaluation of bone strength.

Patients and methods: This case control study included 50 participants classified into 2 groups: group A (control group) included 30 normal healthy age, sex and body mass index (BMI) matched population, group B included 20 T2DM patients without microvascular complications, Dixon MRI of lumbosacral spine and both hips was performed for all participants with quantification of bone marrow FF.

Results: The study showed a statistically significant difference in FF measured by Dixon MRI in lumbar vertebrae but not femoral neck between T2DM cases and control. This may be explained by higher FF normally in femur more than the vertebrae. Pairwise comparisons with Bonferroni correction for multiple tests revealed that FF in lumbar vertebrae was statistically significantly higher in the non-complicated diabetic group vs. the control group (p-value =.001)

Conclusion: T2DM is associated with changes in the bone quality with increased bone marrow FF that can be reliably assessed using Dixon MRI. This can be used as potential therapeutic target for drugs to restore proper BMF content, early prevention and treatment of fractures.