Longitudinal Changes in Serum Markers of Bone Metabolism and Bone Material Strength in Premenopausal Women with Distal Radial Fracture

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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The Mechanical Strength of Rabbit Femurs Fixed with Calcium Phosphate Cement after Fracture

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.343-344.1160 ◽

2011 ◽

Vol 343-344 ◽

pp. 1160-1162

Author(s):

Jing Chen ◽

Xiao Na Li ◽

Shi En Tan ◽

Wei Yi Chen

Keyword(s):

Calcium Phosphate ◽

Calcium Phosphate Cement ◽

Bending Test ◽

Control Group ◽

Material Strength ◽

Maximum Pressure ◽

Tension Stress ◽

Bone Material ◽

Three Point Bending ◽

Bone Material Strength

In this study, we invesgated the mechanical properties of the rabbit femurs fixed with calcium phosphate cement (CPC). Twenty adult rabbits were randomly divided into the control group and the group treated with femur fracture artifically, then fixed with CPC. Two weeks after surgery, all rabbits were sacrificed, and femurs were removed for the three point bending test to examine the changes of mechanical parameters of the femurs. Our results showed that although the maximum tension stress of the femurs in the treatment group was smaller than the control, its crosss-sectional area became bigger, which improved the ablity of the femur to bear more loading with the maximum pressure and absorbed energy during destroy up to 83.5% and 64.3% of normal bone material strength. It indicated that it was practicable to fix the fractured femur with CPC from the biomechanical view piont.

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Advanced Glycation Endproducts and Bone Material Strength in Type 2 Diabetes

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2016-1437 ◽

2016 ◽

Vol 101 (6) ◽

pp. 2502-2510 ◽

Cited By ~ 90

Author(s):

Jessica R. Furst ◽

Leonardo C. Bandeira ◽

Wen-Wei Fan ◽

Sanchita Agarwal ◽

Kyle K. Nishiyama ◽

...

Keyword(s):

Material Properties ◽

Reference Point ◽

Advanced Glycation Endproducts ◽

Material Strength ◽

Advanced Glycation ◽

Bone Material ◽

Glycation Endproducts ◽

Reference Point Indentation ◽

Bone Material Strength

Abstract Context: Skeletal deterioration, leading to an increased risk of fracture, is a known complication of type 2 diabetes mellitus (T2D). Yet plausible mechanisms to account for skeletal fragility in T2D have not been clearly established. Objective: The objective of the study was to determine whether bone material properties, as measured by reference point indentation, and advanced glycation endproducts (AGEs), as determined by skin autofluorescence (SAF), are related in patients with T2D. Design: This was a cross-sectional study. Setting: The study was conducted at a tertiary medical center. Patients: Sixteen postmenopausal women with T2D and 19 matched controls participated in the study. Main Outcome Measures: Bone material strength index (BMSi) by in vivo reference point indentation, AGE accumulation by SAF, and circulating bone turnover markers were measured. Results: BMSi was reduced by 9.2% in T2D (P = .02) and was inversely associated with the duration of T2D (r = −0.68, P = .004). Increased SAF was associated with reduced BMSi (r = −0.65, P = .006) and lower bone formation marker procollagen type 1 amino-terminal propeptide (r = −0.63, P = .01) in T2D, whereas no associations were seen in controls. SAF accounted for 26% of the age-adjusted variance in BMSi in T2D (P = .03). Conclusions: Bone material properties are impaired in postmenopausal women with T2D as determined by reference point indentation. The results suggest a role for the accumulation of AGEs to account for inferior BMSi in T2D.

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Applications of a New Handheld Reference Point Indentation Instrument Measuring Bone Material Strength

Journal of Medical Devices ◽

10.1115/1.4024829 ◽

2013 ◽

Vol 7 (4) ◽

Cited By ~ 37

Author(s):

Connor Randall ◽

Daniel Bridges ◽

Roberto Guerri ◽

Xavier Nogues ◽

Lluis Puig ◽

...

Keyword(s):

Clinical Trials ◽

Soft Tissue ◽

Reference Point ◽

Material Strength ◽

Bone Material ◽

Reference Point Indentation ◽

Instrument Measuring ◽

Bone Material Strength ◽

Large Animals

A novel, hand-held Reference Point Indentation (RPI) instrument, measures how well the bone of living patients and large animals resists indentation. The results presented here are reported in terms of Bone Material Strength, which is a normalized measure of how well the bone resists indentation, and is inversely related to the indentation distance into the bone. We present examples of the instrument's use in: (1) laboratory experiments on bone, including experiments through a layer of soft tissue, (2) three human clinical trials, two ongoing in Barcelona and at the Mayo Clinic, and one completed in Portland, OR, and (3) two ongoing horse clinical trials, one at Purdue University and another at Alamo Pintado Stables in California. The instrument is capable of measuring consistent values when testing through soft tissue such as skin and periosteum, and does so handheld, an improvement over previous Reference Point Indentation instruments. Measurements conducted on horses showed reproducible results when testing the horse through tissue or on bare bone. In the human clinical trials, reasonable and consistent values were obtained, suggesting the Osteoprobe® is capable of measuring Bone Material Strength in vivo, but larger studies are needed to determine the efficacy of the instrument's use in medical diagnosis.

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

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa179 ◽

2020 ◽

Author(s):

Pamela Rufus-Membere ◽

Kara L Holloway-Kew ◽

Adolfo Diez-Perez ◽

Mark A Kotowicz ◽

Julie A Pasco

Keyword(s):

Quantitative Ultrasound ◽

Broadband Ultrasound Attenuation ◽

Positive Association ◽

Material Strength ◽

Strength Index ◽

Mineral Density ◽

Bone Material ◽

Skeletal Site ◽

Bone Material Strength ◽

Calcaneal Quantitative Ultrasound

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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