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  • Original Article
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Relation between bone mineral density, biological markers and anthropometric measures in 4-year-old children: a pilot study within the IDEFICS study



To investigate the relationship between bone mineral density (BMD), anthropometric characteristics, levels of biological markers for growth, bone turnover, insulin resistance and fat mass in 4-year-old Swedish children.


Descriptive study with 41 children (28 boys) who had anthropometric measurements and blood samples taken and heel dual-energy X-ray absorptiometry and laser (DXL) performed. The study participants were divided into groups of normal-weight (n=28) and overweight or obese (n=13) children.


There was a significant difference in bone mineral content (BMC), BMD and bone mineral apparent density (BMAD) between overweight and normal-weight children. There was a significant positive correlation between BMC, BMD, BMAD and body mass index standard deviation scores (r=0.36, 0.34 and 0.29, P<0.01, respectively), waist circumference (r=0.32, 0.30, P<0.01 and r=0.26, P<0.05, respectively) and subscapular skinfold (r=0.26, 0.25 and 0.23, P<0.05, respectively). BMC and BMD correlated significantly with the sum of skinfold measures (r=0.25 and 0.23, P<0.05, respectively). Adiponectin was significantly inversely correlated with BMC, BMD and BMAD (r=−0.41, −0.40 and −0.41, P<0.01, respectively). Adiponectin was not correlated with skinfold measures. Multiple regression analysis revealed that adiponectin was an independent determinant of BMD, BMC and BMAD.


To our knowledge, this is the first study investigating BMD assessed by heel-DXL in relation to anthropometry and metabolic markers in 4-year-old children. Adiponectin was significantly inversely correlated with bone mass parameters. Adiponectin may have an independent role in bone development and metabolism in young children.

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This study was conducted as part of the IDEFICS study and is published on behalf of its European Consortium ( We gratefully acknowledge the financial support of the European Community within the Sixth RTD Framework Programme Contract No. 016181 (FOOD). This study was also supported by a grant from the County Council of Östergötland, Sweden. We thank all participants and their parents for their contribution. We acknowledge Anne Dohsé for the DXL measurements and Claudia Börnhorst for her statistical expertise. We also thank the New Research Amanuensis programme for medical students at the Sahlgrenska Academy, University of Gothenburg, Sweden.

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Statement of ethics

We certify that all applicable institutional and governmental regulations pertaining to the ethical use of human volunteers were followed during this research. Approval by the appropriate ethics committees was obtained by the centres carrying out the fieldwork. Study children did not undergo any procedure before both they and their parents gave consent for examinations, collection of samples, subsequent analysis and storage of personal data and collected samples. The children and their parents could consent to single components of the study while abstaining from others.

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Correspondence to B Tubić.

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Tubić, B., Magnusson, P., Swolin-Eide, D. et al. Relation between bone mineral density, biological markers and anthropometric measures in 4-year-old children: a pilot study within the IDEFICS study. Int J Obes 35 (Suppl 1), S119–S124 (2011).

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