{
  "abstract": "Introduction Early-life exposures, such as nutritional deficiencies, stress, smoking, toxins, medications, diseases, infections and inflammation may affect multiple physiological and metabolic systems in the offspring, including hormonal regulation, bone metabolism and mineralisation, and body composition. Moreover, the effect of these early-life exposures on later health may potentially be mediated through adverse neonatal epigenetic reprogramming of bone-related genes affecting health later in life, especially skeletal development and bone density. Thus, to advance this research further, the overall aim of the project is to investigate if (a) neonatal epigenetic and genetic signature; (b) maternal risk factors during preconception and pregnancy, such as medicine use, diseases, socioeconomic status, major life events, weight, growth and lifestyle; (c) risk factors at birth, such as instrumental delivery, mode of delivery, medicine use, injuries, diseases, weight, size for gestational age, ponderal index, gestational age; and (d) childhood risk factors, such as diseases, medicine use, major life events, weight, growth and lifestyle are associated with hormonal status, lipids, bone turnover markers, bone mineral density, fat mass and lean body mass at age 18–19 years.Methods and analysis Population-based, nationwide, cross-sectional clinical study with potential for longitudinal reassessment. Danish women and men aged 18–19 years old will be selected at random from the Danish National Population Registry and invited if they have available neonatal dried blood spot cards. A total of 2000 individuals will be enrolled. The study combines register data, and neonatal epigenetic and genetic analyses from stored blood with clinical and survey data. Body composition will be measured using dual-energy X-ray absorptiometry. Adult blood and hair samples will be obtained to assess hormonal status, lipids and bone turnover markers. Height, weight, waist and hip circumference, and blood pressure will be measured. Questionnaires on well-being, sleep patterns, dietary and exercise habits, onset of puberty, use of cannabis, nicotine, alcohol and pain medication will be included. Information on medicine use, diseases, socioeconomic status, major life events, weight, growth and lifestyle will be obtained from the national administrative and health registers at the time of conception and during pregnancy for the parents, as well as from the participants throughout their lifetime. Health registries include the Danish Medical Birth Register, the National Patient Register, the Danish National Prescription Register, the National Child Health Register and Statistics Denmark. Multivariate regression analyses will be performed.Ethics and dissemination This nationwide study has been approved by the Regional Committees on Health Research Ethics for Southern Denmark (S-20230105). The study participants will be enrolled in the study following their informed written consent. Results will be submitted for publication. The Strengthening the Reporting of Observational Studies in Epidemiology Statement guidelines will be used for reporting.Trial registration number NCT06509776.",
  "authors": [
    {
      "affiliations": [
        "Research Unit for Diet and Health, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark",
        "Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark"
      ],
      "name": "Mina Nicole Händel"
    },
    {
      "affiliations": [
        "Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark",
        "Translational Research Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark",
        "Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"
      ],
      "name": "Niklas Rye Jørgensen"
    },
    {
      "affiliations": [
        "Department of Congenital Diseases, Statens Serum Institut, Copenhagen, Denmark"
      ],
      "name": "Jonas Bybjerg-Grauholm"
    },
    {
      "affiliations": [
        "Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark",
        "Department of Endocrinology and Nephrology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark"
      ],
      "name": "Rasmus Bo Jansen"
    },
    {
      "affiliations": [
        "Department of Endocrinology, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark"
      ],
      "name": "Pia Eiken"
    },
    {
      "affiliations": [
        "Department of Medicine, Zealand University Hospital, Køge, Denmark"
      ],
      "name": "Charlotte Landbo Tofteng"
    },
    {
      "affiliations": [
        "Department of Endocrinology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark"
      ],
      "name": "Anne Pernille Hermann"
    },
    {
      "affiliations": [
        "Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark"
      ],
      "name": "Pernille Bach-Mortensen"
    },
    {
      "affiliations": [
        "Research Unit for Diet and Health, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark",
        "Section for General Practise, Department of Public Health, University of Copenhagen, Copenhagen, Denmark",
        "The Boden Initiative, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia"
      ],
      "name": "Berit Lilienthal Heitmann"
    },
    {
      "affiliations": [
        "Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark"
      ],
      "name": "Katrine Hass Rubin"
    },
    {
      "affiliations": [
        "Department of Endocrinology, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"
      ],
      "name": "Bente Lomholt Langdahl"
    },
    {
      "affiliations": [
        "Steno Diabetes Centre North Denmark, Aalborg University, Aalborg, Denmark"
      ],
      "name": "Peter Vestergaard"
    },
    {
      "affiliations": [
        "Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark",
        "Department of Public Health, University of Southern Denmark, Odense, Denmark",
        "Department of Medicine, Holbæk Hospital, Holbæk, Denmark"
      ],
      "name": "Bo Abrahamsen"
    }
  ],
  "title": "Early life determinants of skeletal maturation, body composition and endocrine health in young adults (EPIPEAK): protocol for a nationwide birth cohort study",
  "uid": "cc1d976d-c225-5e81-a0a2-b33ac1b682a0"
}