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

Malgo, F.; Hamdy, Neveen A. T.; Rabelink, Ton J.; Kroon, Herman M.; Claessen, Kim M J A; Pereira, Alberto M.; Biermasz, Nienke R.; Appelman‐Dijkstra, Natasha M.

doi:10.1530/eje-16-0808

Cited by 55 publications

(53 citation statements)

References 27 publications

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“…Similar to prior reports we found a weak negative association between BMSi and age, (15) and a weak positive association between BMSi and aBMD by DXA. (18) Our results are also consistent with studies that have shown BMSi to be lower in select patient populations with known skeletal fragility, including those with a history of bone stress injury, (25) type 2 diabetes, (9)(10)(11) HIV, (12) acromegaly, (13) and Gaucher's disease. (14) Our study is the first to examine BMSi in patients with DRFs and is the first to suggest a relationship between occurrence of DRF and BMSi that is independent of femoral neck aBMD.…”

Section: Discussionsupporting

confidence: 87%

“…(5) Although cyclic microindentation is mainly used for characterization of excised bone samples and in animal studies, impact microindentation is designed specifically for clinical use. (6)(7)(8) Although the precise mechanical properties reflected by impact microindentation remain to be established, recent studies using the technique have shown cortical bone properties measured in vivo at the tibial diaphysis to be worse in select patient populations with known skeletal fragility, including those with type 2 diabetes, (9)(10)(11) human immunodeficiency virus (HIV), (12) acromegaly, (13) and Gaucher's disease. (14) Notably, cross-sectional studies have shown that impact microindentation at the tibia diaphysis discriminates individuals with a history of fragility fracture in some, (15)(16)(17) but not all, studies.…”

Section: Introductionmentioning

confidence: 99%

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Bone Material Strength Index as Measured by Impact Microindentation in Postmenopausal Women With Distal Radius and Hip Fractures

Rozental

Walley

Demissie

et al. 2017

Journal of Bone and Mineral Research

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We tested whether cortical bone tissue properties assessed by in vivo impact microindentation would distinguish postmenopausal women with recent distal radius (DRF) or hip fracture (HF) from nonfracture controls (CONT). We enrolled postmenopausal women with recent DRF (n = 57), HF (n = 41), or CONT (n = 93), and used impact microindentation to assess bone material strength index (BMSi) at the anterior surface of the mid-tibia diaphysis. Areal bone mineral density (aBMD) (g/cm ) of the femoral neck (FN), total hip (TH), and lumbar spine (LS) were measured by dual-energy X-ray absorptiometry (DXA). HF and DRF subjects had significantly lower BMD than CONT at all sites (-5.6% to -8.2%, p < 0.001 for all). BMSi was 4% lower in DRF compared to CONT (74.36 ± 8.77 versus 77.41 ± 8.79, p = 0.04). BMSi was similarly lower in HF versus CONT, but the difference did not reach statistical significance (74.62 ± 8.47 versus 77.41 ± 8.79, p = 0.09). Lower BMSi was associated with increased risk of DRF (unadjusted OR, 1.43; 95% CI, 1.02 to 2.00, per SD decrease, p = 0.04), and remained statistically significant after adjustment for age, age and BMI, and age, BMI, and FN BMD (OR = 1.48 to 1.55). Lower BMSi tended to be associated with HF, but only reached borderline significance (unadjusted OR = 1.39; 95% CI, 0.96 to 2.01, p = 0.08). These results provide strong rationale for future investigations aimed at assessing whether BMSi can predict fracture in prospective studies and improve identification of women at risk for fragility fractures. © 2017 American Society for Bone and Mineral Research.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Bone Material Strength Index as Measured by Impact Microindentation in Postmenopausal Women With Distal Radius and Hip Fractures

Rozental

Walley

Demissie

et al. 2017

Journal of Bone and Mineral Research

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“…BMSi was measured in all patients by IMI using the handheld microindenter device (OsteoProbe® RUO, Active Life Scientific, CA, USA) at the midshaft of the tibia. Measurements were performed by two experienced operators (NAD and FM) according to our previously published protocol [7,8,18,19]. The patient was placed in a decubitus supine position with the tibia in external rotation.…”

Section: Bone Materials Strength Indexmentioning

confidence: 99%

Treatments of osteoporosis increase bone material strength index in patients with low bone mass

et al. 2020

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Effects on bone material properties of two-year antiosteoporotic treatment were assessed using in vivo impact microindentation (IMI) in patients with low bone mineral density (BMD) values. Antiresorptive treatment, in contrast to vitamin D ± calcium treatment alone, induced BMD-independent increases in bone material strength index, measured by IMI, the magnitude of which depended on pretreatment values. Introduction Bone material strength index (BMSi), measured by IMI in vivo, is reduced in patients with fragility fractures, but there is no information about changes in values during long-term therapy. In the present study, we assessed changes in BMSi in patients receiving antiosteoporotic treatments for periods longer than 12 months. Methods We included treatment-naive patients with low bone mass who had a BMSi measurement with OsteoProbe® at presentation and consented to a repeat measurement after treatment. Results We studied 54 patients (34 women), median age 58 years, of whom 30 were treated with bisphosphonates or denosumab (treatment group) and 24 with vitamin D ± calcium alone (control group). There were no differences in clinical characteristics between the two groups with the exception of a higher number of previous fragility fractures in the treatment group. Baseline hip BMD and BMSi values were lower in the treatment group. After 23.1 ± 6.6 months, BMSi increased significantly in the treatment group (82.4 ± 4.3 vs 79.3 ± 4.1; p < 0.001), but did not change in the control group (81.5 ± 5.2 vs 82.2 ± 4.1; p = 0.35). Changes in BMSi with antiresorptives were inversely related with baseline values (r = − 0.43; p = 0.02) but not with changes in BMD. Two patients in the control group with large decreases in BMSi values sustained incident fractures. Conclusion In patients at increased fracture risk, antiresorptive treatments induced BMD-independent increases in BMSi values, the magnitude of which depended on pretreatment values.

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“…Sosa and Eriksen found that low bone material strength assessed in cortical bone at the anterior tibia constitutes an independent risk factor for all osteoporotic fractures and is related to increased severity of vertebral fractures. Malgo et al compared patients with acromegaly versus controls and found significantly different (worse) bone strength parameters in acromegalic patients as evaluated by microindentation. Acromegaly is a rare disease caused by uncontrolled growth hormone production by a pituitary adenoma.…”

Section: Bone and Cartilage Microindentation Analysismentioning

confidence: 99%

Assessment of Fracture Toughness in Bone Tissue Engineering

Nobile

2019

Polymer Engineering & Sci

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The fracture mechanisms affecting bone tissue can be described as a damage accumulation process due to the initiation and propagation of microcracks. Fracture risk does not solely depend on strength but also on fracture toughness. To replace damaged bone or cartilage tissues, hydrogels are required to provide appropriate stiffness or deformation properties as well as resistance to fracture. However, failure properties, such as the resistance to fracture, must be evaluated by fracture toughness techniques. Microindentation has emerged as a novel technique for the measurement of material properties of cortical bone. The application of this test for fracture toughness determination in these tissues can become widespread because of the simplicity of the test. The aims of this article are to discuss clinical application of fracture toughness analysis and to present a well tested and more realistic approach for estimating fracture toughness in bone. POLYM. ENG. SCI., 59:2402–2405, 2019. © 2019 Society of Plastics Engineers

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

Cited by 55 publications

References 27 publications

Bone Material Strength Index as Measured by Impact Microindentation in Postmenopausal Women With Distal Radius and Hip Fractures

Bone Material Strength Index as Measured by Impact Microindentation in Postmenopausal Women With Distal Radius and Hip Fractures

Treatments of osteoporosis increase bone material strength index in patients with low bone mass

Assessment of Fracture Toughness in Bone Tissue Engineering

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