Bone Marrow Adiposity and Fragility Fractures in Postmenopausal Women: The ADIMOS Case-Control Study
Authors' conclusion
No difference in lumbar spine PDFF was found between those with osteoporotic fractures and controls. However, imaging-based proximal femur PDFF may discriminate between postmenopausal women with and without clinical vertebral fractures, independently of age, CCI, and BMD.
Study context
- Population
- Postmenopausal women, Lille University Hospital, France; Proton density fat fraction (PDFF) of lumbar spine and proximal femur by chemical shift-based water-fat separation magnetic resonance imaging (MRI), plus DXA
- Participants
- 199 women
- Comparison
- Postmenopausal women with recent osteoporotic fractures vs without fractures
- Casesn = 100
- Controlsn = 99reference
- Outcome
- Relationship between lumbar spine PDFF and osteoporotic fractures
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Lumbar spine and proximal femur PDFF, adjusted for age, CCI and BMD
- No statistically significant differences between cases and controls at the lumbar spine or proximal femur
- Analysis of covariance adjusted for age, Charlson comorbidity index (CCI) and BMD
Observational data: associations, not effects.
Further findings
Adjusted mean
| Outcome | Controls | P value |
|---|---|---|
| Femoral neck PDFF, clinical vertebral fractures (n = 52) vs controlsLower with clinical vertebral fractures | 83.0% (SE 0.8) | P = 0.020 |
| Femoral diaphysis PDFF, clinical vertebral fractures vs controlsLower with clinical vertebral fractures | 81.6% (SE 0.9) | P = 0.029 |
- Femoral neck PDFF, clinical vertebral fractures (n = 52) vs controls: Clinical vertebral fractures adjusted mean 79.3% (SE 1.2)
- Femoral diaphysis PDFF, clinical vertebral fractures vs controls: Clinical vertebral fractures adjusted mean 77.7% (SE 1.4)
Baseline differences: age and BMD
- Controls significantly younger
- P < 0.001
- Controls had significantly higher BMD at all sites
- P < 0.001 for all sites
Fracture types among cases
- Clinical vertebral fractures
- 52
- Nonvertebral fractures
- 48
Original publication
Bone Marrow Adiposity and Fragility Fractures in Postmenopausal Women: The ADIMOS Case-Control Study. J Clin Endocrinol Metab. Published 5 April 2023. doi:10.
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