To use proton magnetic resonance spectroscopy (¹H‐MRS) to evaluate vertebral marrow fat, and to determine whether bone density correlates with fat content and fat unsaturation levels in postmenopausal women.

Fifty‐three women (mean age = 70 years) underwent dual energy x‐ray absorptiometry and ¹H‐MRS, and 12 young female controls (mean age = 28 years) underwent ¹H‐MRS of the lumber spine. Water and lipid peak amplitudes were measured to calculate fat content and fat unsaturation index. Spearman's correlation tests and a t‐test comparison of means were applied.

¹H‐MRS was successful in 15 normal, 15 osteopenic, and 20 osteoporotic subjects, and in all controls. Marrow fat content was significantly elevated in osteoporotic (65.5% ± 10%) and osteopenic (63.5% ± 9.3%) subjects compared to normal subjects (56.3% ± 11.2%) and young controls (29% ± 9.6%). The fat unsaturation index was significantly decreased in osteoporotic (0.091 ± 0.013) and osteopenic (0.097 ± 0.014) subjects compared to normal subjects (0.114 ± 0.016) and young controls (0.127 ± 0.031). A good inverse correlation was observed between the fat content and the unsaturation index (r_s = −0.53, P < 0.0001).

Osteoporosis is associated with increased marrow fat. As marrow fat increases, saturated lipids appear to increase preferentially to unsaturated lipids. J. Magn. Reson. Imaging 2005;22:279–285. © 2005 Wiley‐Liss, Inc.