Reference Intervals for Bone Impact Microindentation in Healthy Adults: A Multi-Centre International Study

Calcified Tissue International, vol. 112, pp. 338–349

Abstract

Impact microindentation (IMI) is a novel technique for assessing bone material strength index (BMSi) in vivo, by measuring the depth of a micron-sized, spherical tip into cortical bone that is then indexed to the depth of the tip into a reference material. The aim of this study was to define the reference intervals for men and women by evaluating healthy adults from the United States of America, Europe and Australia. Participants included community-based volunteers and participants drawn from clinical and population-based studies. BMSi was measured on the tibial diaphysis using an OsteoProbe in 479 healthy adults (197 male and 282 female, ages 25 to 98 years) across seven research centres, between 2011 and 2018. Associations between BMSi, age, sex and areal bone mineral density (BMD) were examined following an a posteriori method. Unitless BMSi values ranged from 48 to 101. The mean (± standard deviation) BMSi for men was 84.4 ± 6.9 and for women, 79.0 ± 9.1. Healthy reference intervals for BMSi were identified as 71.0 to 97.9 for men and 59.8 to 95.2 for women. This study provides healthy reference data that can be used to calculate T- and Z-scores for BMSi and assist in determining the utility of BMSi in fracture prediction. These data will be useful for positioning individuals within the population and for identifying those with BMSi at the extremes of the population.

Authors 12

1. Pamela G. Rufus-Membere corresponding

   Deakin University

   Affiliation as printed

   IMPACT Institute, School of Medicine, Deakin University, Geelong, VIC, Australia. pamela.r@deakin.edu.au

   IMPACT- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia. pamela.r@deakin.edu.au

   IMPACT- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia

2. Kara L. Holloway‐Kew

   Deakin University

   Affiliation as printed

   IMPACT- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia

3. Adolfo Díez‐Pérez

   Universitat Autònoma de Barcelona · Hospital Del Mar · Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable

   Affiliation as printed

   Department of Internal Medicine, Hospital del Mar-IMIM, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain

4. Natasha M. Appelman‐Dijkstra Aachen Department of Internal Medicine: Division of Endocrinology and Center for Bone Quality

   Leiden University Medical Center

   Affiliation as printed

   Department of Internal Medicine: Division of Endocrinology and Center for Bone Quality, Leiden University Medical Center, Leiden, the Netherlands

5. Mary Bouxsein

   Beth Israel Deaconess Medical Center

   Affiliation as printed

   Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center and Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA

6. Erik Fink Eriksen

   University of Oslo · SpesialistSenteret Pilestredet Park

   Affiliation as printed

   Spesialistsenteret Pilestredet Park and Faculty of Odontology, University of Oslo, Oslo, Norway

7. Joshua N. Farr

   Mayo Clinic

   Affiliation as printed

   Kogod Center On Aging and Division of Endocrinology, Mayo Clinic, Rochester, MN, USA

8. Sundeep Khosla

   Mayo Clinic

   Affiliation as printed

   Kogod Center On Aging and Division of Endocrinology, Mayo Clinic, Rochester, MN, USA

9. Mark A. Kotowicz

   Barwon Health · Deakin University · The University of Melbourne · Western Health

   Affiliation as printed

   Barwon Health, Geelong, Australia

   Department of Medicine-Western Health, The University of Melbourne, St. Albans, Australia

   IMPACT- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia

10. Xavier Nogués

    Universitat Pompeu Fabra · Hospital Del Mar · Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable

    Affiliation as printed

    Department of Internal Medicine, Hospital del Mar-IMIM, Pompeu Fabra University Barcelona- and CIBERFES, Instituto Carlos III, Barcelona, Spain

11. Mishaela Ruth Rubin

    Columbia University

    Affiliation as printed

    Department of Medicine, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA

12. Julie Anne Pasco

    Barwon Health · Deakin University · The University of Melbourne · Western Health · Monash University

    Affiliation as printed

    Barwon Health, Geelong, Australia

    Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia

    Department of Medicine-Western Health, The University of Melbourne, St. Albans, Australia

    IMPACT- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia