Marrow fat‐cortical bone relationship in β‐thalassemia: a study using MRI

Background: Growing evidence suggests that marrow adipocytes play an active role in the regulation of bone metabolism and hematopoiesis. However, research on the relationship between bone and fat in the context of hematological diseases, particularly β-thalassemia, remains limited. Purpose: To inves...

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Main Authors: Ismail, Umi Nabilah, Azlan, Che Ahmad, Khairullah, Shasha, Azman, Raja Rizal, Omar, Nur Farhayu, Md Shah, Mohammad Nazri, Jackson, Nicholas, Ng, Kwan Hoong
Format: Article
Published: John Wiley and Sons 2024
Online Access:http://psasir.upm.edu.my/id/eprint/112840/
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author Ismail, Umi Nabilah
Azlan, Che Ahmad
Khairullah, Shasha
Azman, Raja Rizal
Omar, Nur Farhayu
Md Shah, Mohammad Nazri
Jackson, Nicholas
Ng, Kwan Hoong
author_facet Ismail, Umi Nabilah
Azlan, Che Ahmad
Khairullah, Shasha
Azman, Raja Rizal
Omar, Nur Farhayu
Md Shah, Mohammad Nazri
Jackson, Nicholas
Ng, Kwan Hoong
author_sort Ismail, Umi Nabilah
building UPM Institutional Repository
collection Online Access
description Background: Growing evidence suggests that marrow adipocytes play an active role in the regulation of bone metabolism and hematopoiesis. However, research on the relationship between bone and fat in the context of hematological diseases, particularly β-thalassemia, remains limited. Purpose: To investigate the relationship between marrow fat and cortical bone thickness in β-thalassemia and to identify key determinants influencing these variables. Study Type: Prospective. Subjects: Thirty-five subjects in four subject groups of increasing disease severity: 6 healthy control (25.0 ± 5.3 years, 2 male), 4 β-thalassemia minor, 13 intermedia, and 12 major (29.1 ± 6.4 years, 15 male). Field Strength/Sequence: 3.0 T, 3D fast low angle shot sequence and T1-weighted turbo spin echo. Assessment: Analyses on proton density fat fraction (PDFF) and R2* values in femur subregions (femoral head, greater trochanter, intertrochanteric, diaphysis, distal) and cortical thickness (CBI) of the subjects' left femur. Clinical data such as age, sex, body mass index (BMI), and disease severity were also included. Statistical Tests: One-way analysis of variance (ANOVA), mixed ANOVA, Pearson correlation and multiple regression. P-values <0.05 were considered significant. Results: Bone marrow PDFF significantly varied between the femur subregions, F(2.89,89.63) = 44.185 and disease severity, F(1,3) = 12.357. A significant interaction between subject groups and femur subregions on bone marrow PDFF was observed, F(8.67,89.63) = 3.723. Notably, a moderate positive correlation was observed between PDFF and CBI (r = 0.33–0.45). Multiple regression models for both PDFF (R2 = 0.476, F(13,151) = 10.547) and CBI (R2 = 0.477, F(13,151) = 10.580) were significant. Significant predictors for PDFF were disease severity (βTMi = 0.36, βTMa = 0.17), CBI (β = 0.24), R2* (β = −0.32), and height (β = −0.29) while for CBI, the significant determinants were sex (β = −0.27), BMI (β = 0.55), disease severity (βTMi = 2.15), and PDFF (β = 0.25). Data Conclusion: This study revealed a positive correlation between bone marrow fat fraction and cortical bone thickness in β-thalassemia with varying disease severity, potentially indicating a complex interplay between bone health and marrow composition. Evidence Level: 2. Technical Efficacy: Stage 3. © 2024 International Society for Magnetic Resonance in Medicine.
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spelling upm-1128402024-11-06T04:13:26Z http://psasir.upm.edu.my/id/eprint/112840/ Marrow fat‐cortical bone relationship in β‐thalassemia: a study using MRI Ismail, Umi Nabilah Azlan, Che Ahmad Khairullah, Shasha Azman, Raja Rizal Omar, Nur Farhayu Md Shah, Mohammad Nazri Jackson, Nicholas Ng, Kwan Hoong Background: Growing evidence suggests that marrow adipocytes play an active role in the regulation of bone metabolism and hematopoiesis. However, research on the relationship between bone and fat in the context of hematological diseases, particularly β-thalassemia, remains limited. Purpose: To investigate the relationship between marrow fat and cortical bone thickness in β-thalassemia and to identify key determinants influencing these variables. Study Type: Prospective. Subjects: Thirty-five subjects in four subject groups of increasing disease severity: 6 healthy control (25.0 ± 5.3 years, 2 male), 4 β-thalassemia minor, 13 intermedia, and 12 major (29.1 ± 6.4 years, 15 male). Field Strength/Sequence: 3.0 T, 3D fast low angle shot sequence and T1-weighted turbo spin echo. Assessment: Analyses on proton density fat fraction (PDFF) and R2* values in femur subregions (femoral head, greater trochanter, intertrochanteric, diaphysis, distal) and cortical thickness (CBI) of the subjects' left femur. Clinical data such as age, sex, body mass index (BMI), and disease severity were also included. Statistical Tests: One-way analysis of variance (ANOVA), mixed ANOVA, Pearson correlation and multiple regression. P-values <0.05 were considered significant. Results: Bone marrow PDFF significantly varied between the femur subregions, F(2.89,89.63) = 44.185 and disease severity, F(1,3) = 12.357. A significant interaction between subject groups and femur subregions on bone marrow PDFF was observed, F(8.67,89.63) = 3.723. Notably, a moderate positive correlation was observed between PDFF and CBI (r = 0.33–0.45). Multiple regression models for both PDFF (R2 = 0.476, F(13,151) = 10.547) and CBI (R2 = 0.477, F(13,151) = 10.580) were significant. Significant predictors for PDFF were disease severity (βTMi = 0.36, βTMa = 0.17), CBI (β = 0.24), R2* (β = −0.32), and height (β = −0.29) while for CBI, the significant determinants were sex (β = −0.27), BMI (β = 0.55), disease severity (βTMi = 2.15), and PDFF (β = 0.25). Data Conclusion: This study revealed a positive correlation between bone marrow fat fraction and cortical bone thickness in β-thalassemia with varying disease severity, potentially indicating a complex interplay between bone health and marrow composition. Evidence Level: 2. Technical Efficacy: Stage 3. © 2024 International Society for Magnetic Resonance in Medicine. John Wiley and Sons 2024 Article PeerReviewed Ismail, Umi Nabilah and Azlan, Che Ahmad and Khairullah, Shasha and Azman, Raja Rizal and Omar, Nur Farhayu and Md Shah, Mohammad Nazri and Jackson, Nicholas and Ng, Kwan Hoong (2024) Marrow fat‐cortical bone relationship in β‐thalassemia: a study using MRI. Journal of Magnetic Resonance Imaging. ISSN 1053-1807; eISSN: 1522-2586 https://onlinelibrary.wiley.com/doi/10.1002/jmri.29366 10.1002/jmri.29366
spellingShingle Ismail, Umi Nabilah
Azlan, Che Ahmad
Khairullah, Shasha
Azman, Raja Rizal
Omar, Nur Farhayu
Md Shah, Mohammad Nazri
Jackson, Nicholas
Ng, Kwan Hoong
Marrow fat‐cortical bone relationship in β‐thalassemia: a study using MRI
title Marrow fat‐cortical bone relationship in β‐thalassemia: a study using MRI
title_full Marrow fat‐cortical bone relationship in β‐thalassemia: a study using MRI
title_fullStr Marrow fat‐cortical bone relationship in β‐thalassemia: a study using MRI
title_full_unstemmed Marrow fat‐cortical bone relationship in β‐thalassemia: a study using MRI
title_short Marrow fat‐cortical bone relationship in β‐thalassemia: a study using MRI
title_sort marrow fat‐cortical bone relationship in β‐thalassemia: a study using mri
url http://psasir.upm.edu.my/id/eprint/112840/
http://psasir.upm.edu.my/id/eprint/112840/
http://psasir.upm.edu.my/id/eprint/112840/