Associations between Bone Material Strength Index, Calcaneal Quantitative Ultrasound and Bone Mineral Density in Men

Abstract Objectives Impact microindentation (IMI) measures bone material strength index (BMSi) in vivo. This study investigated how IMI is associated with calcaneal quantitative ultrasound and bone densitometry parameters in men. Methods BMSi was measured on the tibial plateau using the OsteoProbe in 377 men (ages 33-96yr) from the Geelong Osteoporosis Study. Broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness index (SI) were assessed at the calcaneus using an ultrasonometer. Areal BMD was measured at several skeletal sites using dual-energy X-ray absorptiometry. Linear associations between parameters were tested using Pearson’s correlation. Multivariable regression techniques were used to determine associations between BMSi and other measures of bone, independent of confounders. Results BMSi was negatively correlated with age (r = -0.171, p=0.001), weight (r = -0.100, p=0.052) and body mass index (r = -0.187, p=0.001), and positively with height (r = +0.109, p=0.034). There was some evidence to support a positive association between BMSi and BUA (β=0.052, p=0.037), SOS (β=0.013, p=0.144) and SI (β=0.036, p=0.051). After age adjustment, this association was attenuated. No correlations were observed between BMSi and BMD at any skeletal site (r-values ranged from -0.006 to +0.079, all p>0.13). Conclusion There was a small positive association between BMSi and QUS parameters, which were not independent of age. No associations were detected between BMSi and BMD. This suggests that BMSi and QUS are capturing common age-dependent properties of bone. Further research on the utility of IMI alone and complementary to conventional bone testing methods for predicting fracture risk is warranted.

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Bone material strength index as measured by impact microindentation is altered in patients with acromegaly

Acta Endocrinologica ◽

10.1530/eje-16-0808 ◽

2017 ◽

Vol 176 (3) ◽

pp. 339-347 ◽

Cited By ~ 20

Author(s):

F Malgo ◽

N A T Hamdy ◽

T J Rabelink ◽

H M Kroon ◽

K M J A Claessen ◽

...

Keyword(s):

Cortical Bone ◽

Tissue Level ◽

Material Strength ◽

Strength Index ◽

Mineral Density ◽

Cross Sectional ◽

Bone Material ◽

Normal Bone Mineral Density ◽

Bone Material Strength ◽

Impact Microindentation

Objective Acromegaly is a rare disease caused by excess growth hormone (GH) production by the pituitary adenoma. The skeletal complications of GH and IGF-1 excess include increased bone turnover, increased cortical bone mass and deteriorated microarchitecture of trabecular bone, associated with a high risk of vertebral fractures in the presence of relatively normal bone mineral density (BMD). We aimed to evaluate tissue-level properties of bone using impact microindentation (IMI) in well-controlled patients with acromegaly aged ≥18 years compared to 44 controls from the outpatient clinic of the Centre for Bone Quality. Design and methods In this cross-sectional study, bone material strength index (BMSi) was measured in 48 acromegaly patients and 44 controls with impact microindentation using the osteoprobe. Results Mean age of acromegaly patients (54% male) was 60.2 years (range 37.9–76.5), and 60.5 years (range 39.8–78.6) in controls (50% male). Patients with acromegaly and control patients had comparable BMI (28.2 kg/m2 ± 4.7 vs 26.6 kg/m2 ± 4.3, P = 0.087) and comparable BMD at the lumbar spine (1.04 g/cm2 ± 0.21 vs 1.03 g/cm2 ± 0.13, P = 0.850) and at the femoral neck (0.84 g/cm2 ± 0.16 vs 0.80 g/cm2 ± 0.09, P = 0.246). BMSi was significantly lower in acromegaly patients than that in controls (79.4 ± 0.7 vs 83.2 ± 0.7; P < 0.001). Conclusion Our data indicates that tissue-level properties of cortical bone are significantly altered in patients with controlled acromegaly after reversal of long-term exposure to pathologically high GH and IGF-1 levels. Our findings also suggest that methods other than DXA should be considered to evaluate bone fragility in patients with acromegaly.

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Bone Material Strength index as measured by Impact Microindentation is low in Patients with Primary Hyperparathyroidism

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab207 ◽

2021 ◽

Author(s):

Manuela Schoeb ◽

Elizabeth M Winter ◽

Maria A Sleddering ◽

Mirjam A Lips ◽

Abbey Schepers ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Material Properties ◽

Fragility Fractures ◽

Material Strength ◽

Strength Index ◽

Mineral Density ◽

Bone Material ◽

Bone Material Properties ◽

Bone Material Strength ◽

Impact Microindentation

Abstract Context In primary hyperparathyroidism (PHPT) bone mineral density (BMD) is typically decreased in cortical bone and relatively preserved in trabecular bone. An increased fracture rate is observed however not only at peripheral sites but also at the spine, and fractures occur at higher BMD values than expected. We hypothesized that components of bone quality other than BMD are affected in PHPT as well. Objective To evaluate bone material properties using Impact Microindentation (IMI) in PHPT patients. Methods In this cross-sectional study, Bone Material Strength index (BMSi) was measured by IMI at the midshaft of the tibia in 37 patients with PHPT (28 women), 11 of whom had prevalent fragility fractures, and 37 euparathyroid controls (28 women) matched for age, gender and fragility fracture status. Results Mean age of PHPT patients and controls was 61.8±13.3 and 61.0±11.8 years, respectively, p=0.77. Calcium and PTH levels were significantly higher in PHPT patients but BMD at the lumbar spine (0.92±0.15 vs 0.89±0.11, p=0.37) and the femoral neck (0.70±0.11 vs 0.67±0.07, p=0.15) were comparable between groups. BMSi however was significantly lower in PHPT patients than in controls (78.2±5.7 vs 82.8±4.5, p<0.001). In addition, BMSi was significantly lower in 11 PHPT patients with fragility fractures than in the 26 PHPT patients without fragility fractures (74.7±6.0 vs 79.6±5.0, p=0.015). Conclusion Our data indicate that bone material properties are altered in PHPT patients and most affected in those with prevalent fractures. IMI might be a valuable additional tool in the evaluation of bone fragility in patients with PHPT.

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