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Peer-reviewedCC BY-NC-NDBMC musculoskeletal disorders

Correlation of whole-body fat content and its distribution with lumbar fat content under different age, gender and BMI conditions: quantitative analysis of MRI based on deep learning.

9 affiliations
  1. 1Department of Radiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301 Yangchang Road, Shanghai, 200072, China.
  2. 2Department of Radiology, Ningbo No.2 Hospital, No. 41 Northwest Street, Haishu District, Ningbo, Zhejiang, 315010, China.
  3. 3Ningbo Key Laboratory of Digital Imaging and Medical-Engineering Interdisciplinarity, Ningbo, Zhejiang, 315010, China.
  4. 4Department of Radiotherapy Technology, Ningbo No.2 Hospital, Ningbo, Zhejiang, 315010, China.
  5. 5Department of Research and Development, Shanghai United Imaging Intelligence Co., Ltd, Shanghai, 200232, China.
  6. 6Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
  7. 7State Key Laboratory of Biomedical lmaging Science and System, Shenzhen, 518055, China.
  8. 8Department of Radiology, Ningbo No.2 Hospital, No. 41 Northwest Street, Haishu District, Ningbo, Zhejiang, 315010, China. [email protected].
  9. 9Department of Radiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301 Yangchang Road, Shanghai, 200072, China. [email protected].

Abstract

Background

The correlation between abnormal distribution of systemic fat deposition and fat content in the vertebral body remains unclear, and AI segmentation offers novel approach for large-scale quantitative analysis.Objective

To explore the effects of gender, age, and body mass index on the correlation between whole-body fat content/distribution and lumbar spine fat content using deep learning based MRI quantification technology.Methods

One hundred thirteen volunteers (63 males/50 females; 47.7 ± 13.3 years) who underwent coronal whole-body and lumbar sagittal MRI examination were enrolled. Through automatic segmentation and quantification, total adipose tissue (TAT), body-fat percentage (BF%), liver fat fraction (LFF), subcutaneous fat fraction (SAT/TAT), internal fat fraction (IAT/TAT), abdominal subcutaneous/visceral fat ratio (ASVFR), erector spinae-multifidus fat fraction (ESFF), psoas major fat fraction (PMFF) and lumbar vertebral fat fraction (VFF) were obtained. Pearson correlation was then used for stratified analysis based on sex, age (≤ 45, 46-59, ≥ 60 years) and BMI (underweight/normal/over-weight/obese). All preset variables were entered into a Lasso model (10-fold cross-validation) to identify independent VFF determinants and to calculate R² and the root-mean-square error (RMSE).Results

VFF correlated moderately with ESFF and PMFF (r_ESFF=0.53, r_PMFF=0.39), weakly with TAT and BF% (r_TAT=0.23, r_BF%=0.26), and rarely with LFF (r = 0.08). Fat distribution exhibits "site-specificity", with a relatively significant correlation between ASVFR and VFF (r=-0.40), a weak positive correlation between IAT/TAT and VFF (r = 0.29), and a slightly negative association between SAT/TAT and VFF (r=-0.29). Correlations between VFF and relevant indicators exhibited stratified differences by gender, age, and BMI, with significant gender-specific variations, insignificant age-specific variations, and ESFF being the sole indicator prominently and positively correlated with VFF across all BMI strata. The multivariate model (R² = 0.63) identified ESFF, PMFF, and ASVFR as the core drivers of VFF, rather than whole-body fat or liver fat.Conclusion

Paravertebral muscle fat infiltration and visceral-fat predominance are associated with higher lumbar marrow fat accumulation, which tends to be more effective in the female, elderly and overweight groups. The constructed multi-variable model may provide a quantitative imaging framework for future studies investigating vertebral marrow fat and bone health.

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BibTeX
@article{fang2026correlation,
  title = {{Correlation of whole-body fat content and its distribution with lumbar fat content under different age, gender and BMI conditions: quantitative analysis of MRI based on deep learning.}},
  author = {Junjie Fang and Jiazhen Zhu and Aie Liu and Chuanli Cheng and Chao Zou and Aizhu Sheng and Fang Gan and Bin Chen and Guangyu Tang},
  journal = {BMC musculoskeletal disorders},
  year = {2026},
  month = jul,
  doi = {10.1186/s12891-026-10265-6},
  url = {https://europepmc.org/article/MED/42902214},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Correlation of whole-body fat content and its distribution with lumbar fat content under different age, gender and BMI conditions: quantitative analysis of MRI based on deep learning.
AU  - Junjie Fang
AU  - Jiazhen Zhu
AU  - Aie Liu
AU  - Chuanli Cheng
AU  - Chao Zou
AU  - Aizhu Sheng
AU  - Fang Gan
AU  - Bin Chen
AU  - Guangyu Tang
PY  - 2026
DA  - 2026/07/01
JO  - BMC musculoskeletal disorders
DO  - 10.1186/s12891-026-10265-6
UR  - https://europepmc.org/article/MED/42902214
AB  - Background  The correlation between abnormal distribution of systemic fat deposition and fat content in the vertebral body remains unclear, and AI segmentation offers novel approach for large-scale quantitative analysis.Objective  To explore the effects of gender, age, and body mass index on the correlation between whole-body fat content/distribution and lumbar spine fat content using deep learning based MRI quantification technology.Methods  One hundred thirteen volunteers (63 males/50 females; 47.7 ± 13.3 years) who underwent coronal whole-body and lumbar sagittal MRI examination were enrolled. Through automatic segmentation and quantification, total adipose tissue (TAT), body-fat percentage (BF%), liver fat fraction (LFF), subcutaneous fat fraction (SAT/TAT), internal fat fraction (IAT/TAT), abdominal subcutaneous/visceral fat ratio (ASVFR), erector spinae-multifidus fat fraction (ESFF), psoas major fat fraction (PMFF) and lumbar vertebral fat fraction (VFF) were obtained. Pearson correlation was then used for stratified analysis based on sex, age (≤ 45, 46-59, ≥ 60 years) and BMI (underweight/normal/over-weight/obese). All preset variables were entered into a Lasso model (10-fold cross-validation) to identify independent VFF determinants and to calculate R² and the root-mean-square error (RMSE).Results  VFF correlated moderately with ESFF and PMFF (r_ESFF=0.53, r_PMFF=0.39), weakly with TAT and BF% (r_TAT=0.23, r_BF%=0.26), and rarely with LFF (r = 0.08). Fat distribution exhibits "site-specificity", with a relatively significant correlation between ASVFR and VFF (r=-0.40), a weak positive correlation between IAT/TAT and VFF (r = 0.29), and a slightly negative association between SAT/TAT and VFF (r=-0.29). Correlations between VFF and relevant indicators exhibited stratified differences by gender, age, and BMI, with significant gender-specific variations, insignificant age-specific variations, and ESFF being the sole indicator prominently and positively correlated with VFF across all BMI strata. The multivariate model (R² = 0.63) identified ESFF, PMFF, and ASVFR as the core drivers of VFF, rather than whole-body fat or liver fat.Conclusion  Paravertebral muscle fat infiltration and visceral-fat predominance are associated with higher lumbar marrow fat accumulation, which tends to be more effective in the female, elderly and overweight groups. The constructed multi-variable model may provide a quantitative imaging framework for future studies investigating vertebral marrow fat and bone health.
SN  - 1471-2474
ER  -