<scp>MRI</scp>‐based abnormalities in young adults at risk of adverse bone health due to childhood‐onset metabolic &amp; endocrine conditions

McComb, Christie; Harpur, A.; Yacoubian, Calum; Leddy, Cheryl L.; Anderson, George; Shepherd, Sheila; Perry, Colin; Shaikh, M Guftar; Foster, John E.; Ahmed, S Faisal

doi:10.1111/cen.12367

Cited by 11 publications

(20 citation statements)

References 25 publications

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“…Increased trabecular spacing is not universally associated with increased bone marrow adiposity . Although this association may be encountered in GH deficiency, in other conditions such as osteogenesis imperfecta, the two parameters do not show an association . It is also possible that in states of GH resistance such as T1DM, bone marrow adiposity may be increased.…”

Section: Discussionmentioning

confidence: 99%

“…1H‐MRS was performed using a 6‐channel body array (anterior) and a 12‐channel spine coil (posterior). Spectra were obtained from a 20‐mm × 20‐mm × 20‐mm volume within the vertebral body of L 3 , using a method that has been described previously . Analysis was performed following fitting of the spectrum in the time domain using a nonlinear least‐squares algorithm, AMARES, in the Java‐based magnetic resonance user interface (jMRUI) software package .…”

Section: Methodsmentioning

confidence: 99%

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Deficits in Trabecular Bone Microarchitecture in Young Women With Type 1 Diabetes Mellitus

Abdalrahaman

McComb

Foster

et al. 2015

Journal of Bone and Mineral Research

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The pathophysiological mechanism of increased fractures in young adults with type 1 diabetes mellitus (T1DM) is unclear. We conducted a case-control study of trabecular bone microarchitecture and vertebral marrow adiposity in young women with T1DM. Thirty women with T1DM with a median age (range) age of 22.0 years (16.9, 36.1) attending one outpatient clinic with a median age at diagnosis of 9.7 years (0.46, 14.8) were compared with 28 age-matched healthy women who acted as controls. Measurements included MRI-based assessment of proximal tibial bone volume/total volume (appBV/TV), trabecular separation (appTb.Sp), vertebral bone marrow adiposity (BMA), and abdominal adipose tissue and biochemical markers of GH/IGF-1 axis (IGF-1, IGFBP3, ALS) and bone turnover. Median appBV/TV in cases and controls was 0.3 (0.22, 0.37) and 0.33 (0.26, 0.4), respectively (p ¼ 0.018) and median appTb.Sp in T1DM was 2.59 (2.24, 3.38) and 2.32 (2.03, 2.97), respectively (p ¼ 0.012). The median appBV/TV was 0.28 (0.22, 0.33) in those cases with retinopathy (n ¼ 15) compared with 0.33 (0.25, 0.37) in those without retinopathy (p ¼ 0.02). Although median visceral adipose tissue in cases was higher than in controls at 5733 mm 3 (2030,11,144) and 3460 mm 3 (1808, 6832), respectively (p ¼ 0.012), there was no difference in median BMA, which was 31.1% (9.9, 59.9) and 26.3% (8.5, 49.8) in cases and controls, respectively (p ¼ 0.2). Serum IGF-1 and ALS were also lower in cases, and the latter showed an inverse association to appTbSp (r ¼ -0.30, p ¼ 0.04). Detailed MRI studies in young women with childhood-onset T1DM have shown clear deficits in trabecular microarchitecture of the tibia. Underlying pathophysiological mechanisms may include a microvasculopathy.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Deficits in Trabecular Bone Microarchitecture in Young Women With Type 1 Diabetes Mellitus

Abdalrahaman

McComb

Foster

et al. 2015

Journal of Bone and Mineral Research

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“…There may be a place to incorporate evaluation with bone histomorphometry as a form of monitoring in those treated with bisphosphonate to guide duration of therapy. Newer modalities of bone imaging including high-resolution pQCT and micro-MRI [30,46] may allow assessment of bone microarchitecture, and these findings may closely correlate with bone biopsy results [47], although such imaging modalities are currently only available as research tools. …”

Section: Assessment Of Bone Healthmentioning

confidence: 99%

Skeletal Fragility in Children with Chronic Disease

2016

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Skeletal fragility associated with underlying childhood chronic disease is a systemic disorder of poor bone growth and reduction in bone turnover which can lead to abnormal bone mass, geometry and microarchitecture. Due to the growth potential unique to children, remarkable bone recovery following a transient threat to the bone can occur if there is concurrent growth. Addressing bone health in these children should focus on improvement in growth, puberty and removing the primary insult. In conditions where there is a little scope for bone recovery and limited residual growth, bone-targeted therapy may need to be considered, even though there is currently limited evidence. The importance of early detection of signs of bone fragility, by active screening for vertebral fracture using newer imaging techniques such as dual-energy X-ray absorptiometry lateral vertebral morphometry, may now be possible. There is currently, a paucity of evidence to support prophylactic use of anti-resorptive therapy. Where poor growth and low bone turnover are seen, the use of growth-promoting therapies and anabolic bone-protective agents may be more physiological and should be evaluated in well-designed trials. Collaborative studies on long-term fracture outcome and well-designed trials of bone-protective therapies are needed and to be encouraged.

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“…Thorough, in vivo assessment of adiposity at multiple sites, including abdominal, total body and bone marrow, requires several methods of imaging and hitherto this has rarely been performed in humans . There is an increasing realization that a comprehensive assessment of bone requires an assessment of bone microarchitecture as well as bone densitometry . Metabolic conditions that may affect bone health, such as diabetes, are also associated with marked alterations in body composition, adiposity and BMA .…”

Section: Introductionmentioning

confidence: 99%

The relationship between adiposity, bone density and microarchitecture is maintained in young women irrespective of diabetes status

Abdalrahaman

McComb

Foster

et al. 2017

Clinical Endocrinology

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MRI‐based abnormalities in young adults at risk of adverse bone health due to childhood‐onset metabolic & endocrine conditions

Abstract: MRI provides valuable detailed information on the micro-architecture and adiposity of bones and is capable of showing clear differences in bone parameters in a range of clinical conditions associated with abnormal bone health.

Cited by 11 publications

References 25 publications

Deficits in Trabecular Bone Microarchitecture in Young Women With Type 1 Diabetes Mellitus

Deficits in Trabecular Bone Microarchitecture in Young Women With Type 1 Diabetes Mellitus

Skeletal Fragility in Children with Chronic Disease

The relationship between adiposity, bone density and microarchitecture is maintained in young women irrespective of diabetes status

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