Characterization of fatty acid composition of bone marrow by 3-T MRI in patients with Crohn's disease.

Abstract

To investigate changes in the fatty acid composition of the lumbar vertebral bone marrow in patients with Crohn's disease (CD) and its relationships with disease activity and complex disease behavior. This study, designed as a single-center, cross-sectional, and prospective trial, was conducted between September 2023 and February 2025, with 83 CD patients and 70 healthy individuals. Disease activity was evaluated using the CD activity index (CDAI). Disease behavior was recorded based on the Montreal classification. Quantitative analysis of saturated, unsaturated, monounsaturated, and polyunsaturated fatty acids (SFA, UFA, MUFA, and PUFA) for lumbar vertebrae by using a two-dimensional bipolar multi-echo 3-T MRI. Spearman correlation and logistic regression analyses were employed. PUFA was significantly lower, whereas MUFA was significantly higher in the CD than in the control group (p = 0.03 and 0.04, respectively). CDAI was positively correlated with UFA and PUFA (r = 0.30 and 0.47; p = 0.01 and p < 0.001, respectively), and negatively correlated with SFA (r = -0.29, p = 0.01). The complicated disease behavior negatively correlated with PUFA only (r = -0.31; p = 0.01). Regression analysis showed that PUFA was an independent risk factor for CDAI (p = 0.01). PUFA and disease duration were independent impact factors for complicated disease behavior (p = 0.02 and 0.01, respectively). CD patients exhibited alterations in bone marrow fatty acid composition compared to healthy controls. Bone marrow PUFA was a potential predictor of disease activity state and complicated disease behavior. Questions What was the relationship of bone marrow fatty acids with disease activity and complex disease behavior in patients with Crohn's disease (CD)? Findings Alterations in bone marrow fatty acid composition were found in CD. Polyunsaturated fatty acids were related to disease activity and complex disease behavior. Clinical relevance Non-invasive MRI imaging assessment of bone marrow fatty acids in vivo has the potential to monitor disease activity and treatment response, which may provide a new imaging marker for insight into the inflammation in CD.