A1 Journal article – refereed

Human Bone Marrow Adipose Tissue is a Metabolically Active and Insulin-Sensitive Distinct Fat Depot

List of Authors: Tam T. Pham, Kaisa K. Ivaska, Jarna C. Hannukainen, Kirsi A. Virtanen, Martin E. Lidell, Sven Enerbäck, Keijo Mäkelä, Riitta Parkkola, Sauli Piirola, Vesa Oikonen, Pirjo Nuutila, Riku Kiviranta

Publication year: 2020

Journal: Journal of Clinical Endocrinology and Metabolism

Journal name in source: The Journal of clinical endocrinology and metabolism

Journal acronym: J Clin Endocrinol Metab

Volume number: 105

Issue number: 7

Number of pages: 11

ISSN: 0021-972X

eISSN: 1945-7197

DOI: http://dx.doi.org/10.1210/clinem/dgaa216



Bone marrow (BM) in adult long bones is rich in adipose tissue, but the functions of BM adipocytes are largely unknown. We set out to elucidate the metabolic and molecular characteristics of BM adipose tissue (BMAT) in humans.


Our aim was to determine if BMAT is an insulin-sensitive tissue, and whether the insulin sensitivity is altered in obesity or type 2 diabetes (T2DM).


This was a cross-sectional and longitudinal study.


The study was conducted in a clinical research center.

Patients or Other Participants

Bone marrow adipose tissue glucose uptake (GU) was assessed in 23 morbidly obese subjects (9 with T2DM) and 9 healthy controls with normal body weight. In addition, GU was assessed in another 11 controls during cold exposure. Bone marrow adipose tissue samples for molecular analyses were collected from non-DM patients undergoing knee arthroplasty.


Obese subjects were assessed before and 6 months after bariatric surgery and controls at 1 time point.

Main Outcome Measure

We used positron emission tomography imaging with 2-[18F]fluoro-2-deoxy-D-glucose tracer to characterize GU in femoral and vertebral BMAT. Bone marrow adipose tissue molecular profile was assessed using quantitative RT-PCR.


Insulin enhances GU in human BMAT. Femoral BMAT insulin sensitivity was impaired in obese patients with T2DM compared to controls, but it improved after bariatric surgery. Furthermore, gene expression analysis revealed that BMAT was distinct from brown and white adipose tissue.


Bone marrow adipose tissue is a metabolically active, insulin-sensitive and molecularly distinct fat depot that may play a role in whole body energy metabolism.

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Last updated on 2021-24-06 at 08:22