Quantitative ultrasound at the calcaneus in premenopausal women and their postmenopausal mothers

The aim of the study was to establish a relationship between mothers’ and daughters’ bone status. Forty-eight postmenopausal women and their 48 premenopausal daughters were evaluated. The analysis was made for the whole group and for two subgroups: 27 healthy mothers and their 27 daughters; and 21 fractured mothers and their 21 daughters. The subgroups were matched for age and years since menopause (YSM), and height, weight, and body mass index (BMI) did not differ significantly. Bone status was evaluated by ultrasound measurement at the heel using the Achilles system (Lunar, Madison, WI), which measures speed of sound (SOS [m/sec]) and broadband ultrasound attenuation (BUA [dB/MHz]). The Achilles software also calculates a stiffness index (SI [%]). Ultrasound values for BUA, SOS, stiffness index, and Z score were significantly lower both in mothers with previous fractures and in their daughters, compared with respective values in mothers without fractures and their daughters. Future values in daughters were predicted using a stepwise, multiple regression analysis separately in the whole group and in the two subgroups. Future values were predicted in two models taking into consideration mothers’ present SOS, BUA, and age or present SOS, BUA, and YSM. In both models, daughters’ present SOS, BUA, age, height, and weight were taken into consideration. Predictive values were found to be high for daughters of women having had fractures (r = 0.72–0.87, p = 0.015–0.00007, SEE = 6.0–15.8) and lower for all daughters studied (r = 0.38–0.62, p = 0.03–0.0001, SEE = 8.8–21.5). In daughters of mothers without past fractures, prediction was not possible. Heritability of ultrasound values in daughters of women with past fractures ranged between 52% and 76%, whereas in the whole group the range was 14%–40%. In conclusion, the data indicate that, as a group, the daughters of women with osteoporotic fracture are likely to be at an increased risk for fractures because they have relatively low ultrasound values. Their future ultrasound values can be predicted on the basis of a single ultrasound evaluation with the condition that there is a history of maternal past fracture.