ISBN: 978-91-9878-6.
http://hdl.handle.net/2077/43460ABSTRACT:The general AIM was to investigate the possible interplay between bone and
fat tissue through clinical studies of children and adolescents. Osteocalcin
(OC), a bone formation marker, has been proposed to act as a link between
bone and energy metabolism in mice, but human data are inconclusive. The
specific aims of this thesis were: (i) to clarify the role of OC in relation to
weight, with focus on undercarboxylated OC (ucOC) and carboxylated OC
(cOC); (ii) to gain insight on how obesity and underweight affect bone and
fat tissue in children and adolescents and;(iii) to study the effect of whole
body vibration (WBV) on parameters of metabolic syndrome, bone
metabolism and body composition in children with obesity. METHODOLOGY:
Children and adolescents aged 2-24 years were included in the four studies. Study I and II were cross-sectional (case-control), and study III and IV were
interventional with a 12-week follow-up, of which study IV was a
randomized case-control study. Biochemical parameters were examined in all
four studies. Bone mass and body composition were assessed by dual-energy
X-ray absorptiometry (DXA), peripheral quantitative computed tomography,
heel DXA and laser. Methods of intervention were high-energy diet in
patients with anorexia nervosa (AN) and WBV in patients with obesity. RESULTS: Total OC and ucOC did not differ between normal-weight and
overweight subjects; however, overweight subjects had lower cOC levels,
and the measured OC forms did not correlate with insulin and glucose.
Overweight children had increased bone mineral content (BMC) and bone
mineral density (BMD) in comparison with normal-weight children, and
there was a positive correlation between BMC, BMD and body mass index
standard deviation score. Adiponectin was inversely correlated with BMC
and BMD, and was an independent determinant of BMC and BMD. Patients
with AN gained in weight and levels of all three forms of OC and BMC
increased. The WBV did not result in any anthropometric changes; however,
a reduction of sclerostin implies that WBV therapy has direct effects on bone
mechanotransduction. CONCLUSIONS: This thesis could not confirm the hypothesis that OC has a
positive effect on glucose and insulin homeostasis, although cOC was lower
in obese subjects than in normal-weight subjects. The home-based WBV
intervention study in young children with obesity did not result in any effect
on weight, metabolic parameters or calcaneal bone mass 
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