Osteoporosis International

, Volume 27, Issue 6, pp 2057–2064 | Cite as

The effects of body mass index on the hereditary influences that determine peak bone mass in mother–daughter pairs (KNHANES V)

  • K. M. Kim
  • Y. J. Kim
  • S. H. Choi
  • S. Lim
  • J. H. Moon
  • J. H. Kim
  • S. W. Kim
  • H. C. Jang
  • C. S. ShinEmail author
Original Article



A daughter’s bone mineral density (BMD) is significantly correlated with her mother’s BMD, but the daughter’s body mass index (BMI) could modulate this association. Maternal inheritance dominantly affects daughters with a lower BMI, but BMI could compensate for hereditary influences in daughters with a higher BMI in terms of daughter’s BMD.


Achieving optimal peak bone mass at a young age is the best way to protect against future osteoporosis and subsequent fractures. Although environmental components influence bone mass accrual, but peak bone mass is largely programmed by inheritance. The aims of this study were to investigate the influence of maternal inheritance on the daughter’s bone mass and to assess whether these influences differ according to the daughter’s body mass index (BMI).


We used data obtained from the 2010 Korean National Health and Nutrition Examination Survey V and included 187 mother–daughter pairs. Bone mineral density (BMD) was measured at the lumbar spine (LS), femur neck (FN), and total hip (TH) by using dual-energy X-ray absorptiometry (DXA). The daughter group was stratified into two groups according to the mean BMI (21.4 kg/m2).


The daughters’ BMD correlated significantly with both their BMI and their mothers’ Z-score for each skeletal site. In the daughters with a lower BMI (≤21.4 kg/m2), the BMDs at the FN and TH were affected more by the mothers’ Z-score than by the daughters’ BMI. Meanwhile, the influence of the daughters’ BMI on their BMD was higher than that of their mothers’ Z-score in daughters with a higher BMI (>21.4 kg/m2). Moreover, the mothers’ Z-scores were a significant predictor of their daughters having Z-scores < −1.0 only in daughters with a lower BMI.


This study suggests that maternal inheritance is an important determinant of the daughters’ bone mass, but that this hereditary factor may vary according to the daughters’ BMI.


Body mass index Bone mineral density Genetic inheritance Osteoporosis Peak bone mass 



Lumbar spine


Femur neck


Total hip


Dual-energy x-ray absorptiometry


Body mass index



This study was supported by a research grant 02-2013-051 from Seoul National University Bundang Hospital and by a Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2014R1A1A3051310).

Authors’ role: study design: KMK and CSS. Data collection: KMK and YJK. Data analysis: KMK, YJK, and CSS. Data interpretation: KMK, SHC, SL, HCJ, SWK, and CSS. Drafting manuscript: KMK, YJK, and CSS. Approving final version of manuscript: KMK, YJK, SHC, SL, SHC, SWK, HCJ, and CSS. CSS takes responsibility for the integrity of the data analysis.

Compliance with ethical standards

Conflicts of interest


Supplementary material

198_2016_3487_MOESM1_ESM.docx (18 kb)
Supplementary Table 1 (DOCX 17 kb)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2016

Authors and Affiliations

  • K. M. Kim
    • 1
    • 2
  • Y. J. Kim
    • 1
    • 2
  • S. H. Choi
    • 1
    • 2
  • S. Lim
    • 1
    • 2
  • J. H. Moon
    • 1
    • 2
  • J. H. Kim
    • 2
    • 3
  • S. W. Kim
    • 2
    • 4
  • H. C. Jang
    • 1
    • 2
  • C. S. Shin
    • 2
    • 3
    Email author
  1. 1.Department of Internal MedicineSeoul National University Bundang HospitalSeongnamKorea
  2. 2.Department of Internal MedicineSeoul National University College of MedicineSeoulKorea
  3. 3.Department of Internal MedicineSeoul National University HospitalSeoulKorea
  4. 4.Department of Internal MedicineSeoul National University Borame HospitalSeoulKorea

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