FSH and longitudinal changes in bone marrow adipose tissue composition in older adults
Tiffany Y Kim1, Trisha F Hue2, Susan K Ewing2
1Endocrine Research Unit, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Bone
|December 17, 2025
Summary
Bone marrow adipose tissue (BMAT) composition changes with aging, showing increased unsaturated BMAT in older adults. Higher follicle-stimulating hormone (FSH) in women correlates with these changes and impacts bone density.
Area of Science:
- Gerontology
- Metabolic studies
- Bone biology
Background:
- Bone marrow adipose tissue (BMAT) composition is linked to aging, with lower unsaturated fat levels observed in older individuals.
- Prospective changes in BMAT composition during aging and the influence of follicle-stimulating hormone (FSH) on bone and fat metabolism remain unclear.
Purpose of the Study:
- To investigate longitudinal changes in BMAT composition in older adults.
- To examine the association between serum FSH levels and BMAT composition and its changes over time.
- To explore the relationship between BMAT changes and bone mineral density (BMD) in aging women.
Main Methods:
- Longitudinal study of 236 women and 245 men (mean age 81 years) from the AGES-Reykjavik Bone Marrow Adipose cohort.
- Sex-stratified linear regression models were used, adjusting for covariates like estradiol and testosterone.
- Analysis focused on changes in total, saturated, and unsaturated BMAT over a mean follow-up of 2.6-3.3 years.
Main Results:
- Total and saturated BMAT remained stable over time in both sexes.
- Unsaturated BMAT significantly increased annually in both women (+0.26%/year) and men (+0.24%/year).
- In women, increased unsaturated BMAT was associated with reduced vertebral trabecular volumetric BMD. Higher baseline FSH in women correlated with higher saturated BMAT and longitudinally with a greater increase in unsaturated BMAT.
Conclusions:
- In older adults, BMAT composition undergoes changes with aging, characterized by an increase in unsaturated BMAT, while total BMAT remains stable.
- In women, serum FSH levels are associated with both cross-sectional BMAT composition and longitudinal changes in unsaturated BMAT.
- These findings highlight the dynamic nature of BMAT during aging and suggest a role for FSH in modulating BMAT composition and potentially bone health.
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