Zhu L, et al. - Using chemical shift-encoded water–fat MRI, researchers assessed the correlation of insulin resistance with marrow adiposity in postmenopausal women newly diagnosed with type 2 diabetes (T2D). In 75 newly diagnosed T2D and 20 nondiabetic postmenopausal women, vertebral proton density fat fraction (PDFF) was measured with 3T-MRI. Using the homeostasis model assessment of insulin resistance (HOMA-IR), insulin sensitivity was estimated. In women with T2D, the lumbar spine PDFF was higher vs women without diabetes. The vertebral PDFF and bone mineral density were consistently inversely associated. In postmenopausal women with newly diagnosed T2D independently of body compositions, elevated HOMA-IR was associated with higher marrow fat fraction.