Impaired trabecular and cortical microarchitecture in daughters of women with osteoporotic fracture: the MODAM study

Abstract

We investigated the familial resemblance of bone microarchitecture parameters between postmenopausal mothers with fragility fracture and their premenopausal daughters using high-resolution peripheral quantitative computed tomography (HR-pQCT). We found that daughters of women with fracture have lower total volumetric bone mineral density (vBMD), thinner cortices, and impaired trabecular microarchitecture at the distal radius and tibia, compared to controls. Familial resemblance of areal bone mineral density (aBMD) in mothers and daughters has been widely studied, but not its morphological basis, including microarchitecture. We compared aBMD, vBMD, bone size, and bone microarchitecture at the distal radius and tibia assessed by HR-pQCT in mothers and their premenopausal daughters. We included 115 women aged 43 ± 8years whose mothers had sustained a fragility fracture and 206 women aged 39 ± 9years whose mothers had never sustained a fragility fracture. Women whose mothers had fracture had significantly (p < 0.05) lower aBMD at the lumbar spine, total hip, femoral neck, mid-distal radius, and ultradistal radius compared to controls. In similar multivariable models, women whose mothers had a fracture had lower total vBMD at the distal radius (-5%, 0.3 standard deviation [SD]; p < 0.005) and distal tibia (-7%, 0.4 SD; p < 0.005). They also had lower cortical thickness and area at the distal radius (-5%, 0.3 SD and -4%, 0.2 SD, respectively; p < 0.005) and at the distal tibia (-6%, 0.3 SD and -4%, 0.3SD, respectively; p < 0.005). Trabecular vBMD was lower at the distal radius (-5%, 0.3 SD; p < 0.05) and tibia (-8%, 0.4 SD; p < 0.005), with a more spaced and heterogeneous trabecular network (4 and 7% at the radius and 5 and 9%, at the tibia, p < 0.05, for Tb.Sp and Tb.Sp.SD, respectively). Premenopausal daughters of women who had sustained fragility fracture have lower total and trabecular vBMD, thinner cortices, as well as impaired trabecular microarchitecture at the distal radius and tibia, compared with premenopausal daughters of women without fracture.