Mean Bone Material Strength Index Values for Women are Lower Than Those for Men: Data from a Single Geographical Location

Bone material strength index (BMSi) values are obtained using impact microindentation, which assesses the ability of bone to resist indentation. Differences in BMSi between men and women are unclear, and to date, BMSi sex differences have not been compared for individuals from the same population. Therefore, we compared BMSi values for men and women drawn from the same geographical location in Australia. Participants (n = 220) were from the Geelong Osteoporosis Study. BMSi was measured, following international published guidelines, using an OsteoProbe for participants at recent follow-up phases (women 2022-2023 and men 2016-2022). Women (n = 55) were age matched to men (n = 165) in a 1:3 ratio. A two-sample t test was used to determine the intergroup difference in mean BMSi. Linear regression was also performed, adjusting for weight and height. Median (IQR) ages for men and women were 67.0 (61.7-71.5) and 67.4 (62.0-71.2) years (p = 0.998). Men were heavier (81.0 +/- 10.9 vs 71.0 +/- 13.9 kg, p < 0.001) and taller (173.9 +/- 6.4 vs 161.5 +/- 7.5 cm, p < 0.001) than women. Mean (+/- SD) BMSi for women (75.7 +/- 7.4) was lower than for men (82.8 +/- 6.8) (p < 0.001). The difference persisted after adjustment for weight and height (mean +/- SE: 76.5 +/- 1.1 vs 82.5 +/- 0.6, p < 0.001). Given the higher fracture risk observed for women, the higher mean BMSi values in men are consistent with cross sectional data suggesting this measure may be useful in fracture prediction.

Automated summary

This study compared the bone material strength index (BMSi) values of men and women from the same geographical location in Australia. The results showed that men had significantly higher BMSi values than women, indicating that male bones are more resistant to indentation. This difference persisted even after adjusting for weight and height. Therefore, BMSi may have predictive value for fractures.