Using Marrow Adipose Tissue to Diagnose Osteoporosis and Predict Fragility Fractures

Summary Yearly 144,000 osteoporotic Australians fracture, that costs circa $4 billion. If fracture (Fx) risk is identified early, most Fx are preventable.

Project Details

Osteoporosis (OP) diagnosis and Fx risk estimation mostly relies on bone mineral density (BMD). However, up to 82% of people with Fx are not osteoporotic according to their BMD (T-scores> -2.5). Hence, they are not classified at risk of Fx and treated. Also, BMD improvement due to OP treatment does not explain >75% of reductions in Fx risk. Therefore, sensitive, specific and non-invasive methods for predicting Fx are mandatory.

In aged and osteoporotic bone, high levels of marrow adipose tissue (MAT) is a common observed feature. There is strong evidence that MAT expansion drives bone and red marrow atrophy by inducing a lipotoxic milieu that affects tissues in its vicinity; which is associated with altered matrix synthesis, abnormal mineralization, and reduced bone formation and mechanical resistance. MAT is inversely correlated with bone and unlike BMD can provide indirect information on other aspects of bone structure/strength, e.g. osteoblast health, collagen crosslinks and bone formation; and hence can act as a predictor of Fx.

Therefore, through two related studies we will: 1. Validate prediction of Fx risk using MAT and test its higher predictive value compared to BMD; 2. Identify the best imaging technologies that non-invasively, accurately and affordably quantify bone, red marrow and MAT volume.