Study Results
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View full resultsBasic Information
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Recruitment Status
COMPLETED
Total Enrollment
1957 participants
Study Classification
OBSERVATIONAL
Study Start Date
2006-07-31
Study Completion Date
2016-12-31
Brief Summary
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By clinical examinations and withdrawing of blood samples from a large number of healthy Danish children, this study will reveal if age of pubertal onset is declining. Furthermore, the extensive normative data will provide detailed insight into normal ranges and individual changes of anthropometrics and hormone levels in healthy children during childhood and adolescence.
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Detailed Description
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The COPENHAGEN Puberty Study is a combined cross sectional and longitudinal study of healthy Danish children.
All children will be thoroughly examined and blood- and urine samples will be collected at every visit. The families fill out questionaires.
Physical examination: Height; sitting-height; weight; circumference of waist, hip, arm; measurement of fatfolds (biceps, triceps, flank, subscapularis); voice-break (yes/no), blood pressure; pubertal staging according to Tanners classification: breast development (B1-B5), genitalia development boys (G1-G5), pubic hair development (PH1-PH5), axillary hair (yes/no), sweat (yes/no), acne (yes/no
Urine sample: For measurement of FSH, LH and endocrine disrupters.
Blood sample: For measurement of hormone levels (FSH, LH, estradiol, SHBG, testosterone, DHEAS, androstenedione, inhibin A, inhibin B, Insl3, kisspeptin, ghrelin, leptin, IGF-1, IGFBP3, TSH, T4, Free T4, T3, HbA1C, calcium-ion, PTH, phosphate, 25-OH-vitamine D, AMH), endocrine disrupters (PCB´s, dioxines, parabens, phthalates), isolation of DNA and RNA to evaluate relevant polymorphisms.
Questionaire: regarding information of previous growth and health.
All children will be thoroughly examined and blood- and urine samples will be collected at every visit. The families fill out questionaires.
Physical examination: Height; sitting-height; weight; circumference of waist, hip, arm; measurement of fatfolds (biceps, triceps, flank, subscapularis); voice-break (yes/no), blood pressure; pubertal staging according to Tanners classification: breast development (B1-B5), genitalia development boys (G1-G5), pubic hair development (PH1-PH5), axillary hair (yes/no), sweat (yes/no), acne (yes/no
Urine sample: For measurement of FSH, LH and endocrine disrupters.
Blood sample: For measurement of hormone levels (FSH, LH, estradiol, SHBG, testosterone, DHEAS, androstenedione, inhibin A, inhibin B, Insl3, kisspeptin, ghrelin, leptin, IGF-1, IGFBP3, TSH, T4, Free T4, T3, HbA1C, calcium-ion, PTH, phosphate, 25-OH-vitamine D, AMH), endocrine disrupters (PCB´s, dioxines, parabens, phthalates), isolation of DNA and RNA to evaluate relevant polymorphisms.
Questionaire: regarding information of previous growth and health.
Conditions
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Puberty
Study Design
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Observational Model Type
COHORT
Study Time Perspective
PROSPECTIVE
Study Groups
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Cross- sectional cohort
Schools were randomly selected and 6203 children (50.0 % girls) were invited to participate. 1864 (1097 girls and 767 boys) (age 5.6-20.0 years) were included, resulting in an overall participation-rate of 30%. Blood samples were drawn, and a thorough clinical examination was performed in all participating children
No interventions assigned to this group
Longitudinal cohort
209 healthy Danish children (108 girls), were examined and blood samples were drawn every 6 months. In july 2011, the mean (range) number of examinations per child was 7 (2-10).
116 (63 boys and 53 girls) continued from the cross sectional study to the longitudinal study. Thus, the total number of participants in The COPENHAGEN Puberty Study was 2020 children.
No interventions assigned to this group
Eligibility Criteria
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Inclusion Criteria
* all children accepting to participate were included
Exclusion Criteria
* no children were excluded from examination or blood sampling. In case of chronic diseases, medical treatment, or ethnicity the children may be excluded from specific final data analysis.
Minimum Eligible Age
5 Years
Maximum Eligible Age
20 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
Sponsors
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The Ministry of Science, Technology and Innovation, Denmark
OTHER_GOV
Sponsor Role
collaborator
European Commission
OTHER
Sponsor Role
collaborator
Rigshospitalet, Denmark
OTHER
Sponsor Role
lead
Responsible Party
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Anders Juul
Professor
Responsibility Role
PRINCIPAL_INVESTIGATOR
Principal Investigators
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Anders Juul, PhD, DMSc
Role: STUDY_DIRECTOR
Rigshospitalet, dept. of Growth and Reproduction
Locations
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Department of Growth and Reproduction, Rigshospitalet
Copenhagen, , Denmark
Site Status
Countries
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Denmark
References
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Courant F, Aksglaede L, Antignac JP, Monteau F, Sorensen K, Andersson AM, Skakkebaek NE, Juul A, Bizec BL. Assessment of circulating sex steroid levels in prepubertal and pubertal boys and girls by a novel ultrasensitive gas chromatography-tandem mass spectrometry method. J Clin Endocrinol Metab. 2010 Jan;95(1):82-92. doi: 10.1210/jc.2009-1140. Epub 2009 Nov 20.
Reference Type
BACKGROUND
Aksglaede L, Sorensen K, Petersen JH, Skakkebaek NE, Juul A. Recent decline in age at breast development: the Copenhagen Puberty Study. Pediatrics. 2009 May;123(5):e932-9. doi: 10.1542/peds.2008-2491.
Reference Type
RESULT
Sorensen K, Aksglaede L, Petersen JH, Juul A. Recent changes in pubertal timing in healthy Danish boys: associations with body mass index. J Clin Endocrinol Metab. 2010 Jan;95(1):263-70. doi: 10.1210/jc.2009-1478. Epub 2009 Nov 19.
Reference Type
RESULT
Sorensen K, Aksglaede L, Munch-Andersen T, Aachmann-Andersen NJ, Petersen JH, Hilsted L, Helge JW, Juul A. Sex hormone-binding globulin levels predict insulin sensitivity, disposition index, and cardiovascular risk during puberty. Diabetes Care. 2009 May;32(5):909-14. doi: 10.2337/dc08-1618. Epub 2009 Feb 5.
Reference Type
RESULT
Juul A, Sorensen K, Aksglaede L, Garn I, Rajpert-De Meyts E, Hullstein I, Hemmersbach P, Ottesen AM. A common deletion in the uridine diphosphate glucuronyltransferase (UGT) 2B17 gene is a strong determinant of androgen excretion in healthy pubertal boys. J Clin Endocrinol Metab. 2009 Mar;94(3):1005-11. doi: 10.1210/jc.2008-1984. Epub 2008 Dec 16.
Reference Type
RESULT
Sorensen K, Aksglaede L, Munch-Andersen T, Aachmann-Andersen NJ, Leffers H, Helge JW, Hilsted L, Juul A. Impact of the growth hormone receptor exon 3 deletion gene polymorphism on glucose metabolism, lipids, and insulin-like growth factor-I levels during puberty. J Clin Endocrinol Metab. 2009 Aug;94(8):2966-9. doi: 10.1210/jc.2009-0313. Epub 2009 May 5.
Reference Type
RESULT
Sorensen K, Aksglaede L, Petersen JH, Leffers H, Juul A. The exon 3 deleted growth hormone receptor gene is associated with small birth size and early pubertal onset in healthy boys. J Clin Endocrinol Metab. 2010 Jun;95(6):2819-26. doi: 10.1210/jc.2009-2484. Epub 2010 Apr 9.
Reference Type
RESULT
Sorensen K, Mouritsen A, Mogensen SS, Aksglaede L, Juul A. Insulin sensitivity and lipid profiles in girls with central precocious puberty before and during gonadal suppression. J Clin Endocrinol Metab. 2010 Aug;95(8):3736-44. doi: 10.1210/jc.2010-0731. Epub 2010 May 19.
Reference Type
RESULT
Hagen CP, Aksglaede L, Sorensen K, Main KM, Boas M, Cleemann L, Holm K, Gravholt CH, Andersson AM, Pedersen AT, Petersen JH, Linneberg A, Kjaergaard S, Juul A. Serum levels of anti-Mullerian hormone as a marker of ovarian function in 926 healthy females from birth to adulthood and in 172 Turner syndrome patients. J Clin Endocrinol Metab. 2010 Nov;95(11):5003-10. doi: 10.1210/jc.2010-0930. Epub 2010 Aug 18.
Reference Type
RESULT
Aksglaede L, Sorensen K, Boas M, Mouritsen A, Hagen CP, Jensen RB, Petersen JH, Linneberg A, Andersson AM, Main KM, Skakkebaek NE, Juul A. Changes in anti-Mullerian hormone (AMH) throughout the life span: a population-based study of 1027 healthy males from birth (cord blood) to the age of 69 years. J Clin Endocrinol Metab. 2010 Dec;95(12):5357-64. doi: 10.1210/jc.2010-1207. Epub 2010 Sep 15.
Reference Type
RESULT
Mogensen SS, Aksglaede L, Mouritsen A, Sorensen K, Main KM, Gideon P, Juul A. Diagnostic work-up of 449 consecutive girls who were referred to be evaluated for precocious puberty. J Clin Endocrinol Metab. 2011 May;96(5):1393-401. doi: 10.1210/jc.2010-2745. Epub 2011 Feb 23.
Reference Type
RESULT
Aksglaede L, Christiansen P, Sorensen K, Boas M, Linneberg A, Main KM, Andersson AM, Skakkebaek NE, Juul A. Serum concentrations of Anti-Mullerian Hormone (AMH) in 95 patients with Klinefelter syndrome with or without cryptorchidism. Acta Paediatr. 2011 Jun;100(6):839-45. doi: 10.1111/j.1651-2227.2011.02148.x. Epub 2011 Feb 25.
Reference Type
RESULT
Frederiksen H, Aksglaede L, Sorensen K, Nielsen O, Main KM, Skakkebaek NE, Juul A, Andersson AM. Bisphenol A and other phenols in urine from Danish children and adolescents analyzed by isotope diluted TurboFlow-LC-MS/MS. Int J Hyg Environ Health. 2013 Nov;216(6):710-20. doi: 10.1016/j.ijheh.2013.01.007. Epub 2013 Mar 13.
Reference Type
RESULT
Mouritsen A, Hagen CP, Sorensen K, Aksglaede L, Mieritz MG, Main KM, Almstrup K, Rajpert-De Meyts E, Juul A. Androgen receptor CAG repeat length is associated with body fat and serum SHBG in boys: a prospective cohort study. J Clin Endocrinol Metab. 2013 Mar;98(3):E605-9. doi: 10.1210/jc.2012-3778. Epub 2013 Feb 7.
Reference Type
RESULT
Mouritsen A, Aksglaede L, Soerensen K, Hagen CP, Petersen JH, Main KM, Juul A. The pubertal transition in 179 healthy Danish children: associations between pubarche, adrenarche, gonadarche, and body composition. Eur J Endocrinol. 2012 Dec 31;168(2):129-36. doi: 10.1530/EJE-12-0191. Print 2013 Feb.
Reference Type
RESULT
Hilsted L, Rustad P, Aksglaede L, Sorensen K, Juul A. Recommended Nordic paediatric reference intervals for 21 common biochemical properties. Scand J Clin Lab Invest. 2013 Feb;73(1):1-9. doi: 10.3109/00365513.2012.721519. Epub 2012 Sep 26.
Reference Type
RESULT
Mieritz MG, Frederiksen H, Sorensen K, Aksglaede L, Mouritsen A, Hagen CP, Skakkebaek NE, Andersson AM, Juul A. Urinary phthalate excretion in 555 healthy Danish boys with and without pubertal gynaecomastia. Int J Androl. 2012 Jun;35(3):227-35. doi: 10.1111/j.1365-2605.2012.01279.x.
Reference Type
RESULT
Frederiksen H, Sorensen K, Mouritsen A, Aksglaede L, Hagen CP, Petersen JH, Skakkebaek NE, Andersson AM, Juul A. High urinary phthalate concentration associated with delayed pubarche in girls. Int J Androl. 2012 Jun;35(3):216-26. doi: 10.1111/j.1365-2605.2012.01260.x. Epub 2012 Mar 19.
Reference Type
RESULT
Hagen CP, Aksglaede L, Sorensen K, Mouritsen A, Andersson AM, Petersen JH, Main KM, Juul A. Individual serum levels of anti-Mullerian hormone in healthy girls persist through childhood and adolescence: a longitudinal cohort study. Hum Reprod. 2012 Mar;27(3):861-6. doi: 10.1093/humrep/der435. Epub 2012 Jan 2.
Reference Type
RESULT
Busch AS, Hagen CP, Main KM, Pereira A, Corvalan C, Almstrup K, Mericq V, Juul A. Genetic Variation of Follicle-Stimulating Hormone Action Is Associated With Age at Testicular Growth in Boys. J Clin Endocrinol Metab. 2017 May 1;102(5):1740-1749. doi: 10.1210/jc.2016-4013.
Reference Type
RESULT
Busch AS, Hagen CP, Almstrup K, Juul A. Circulating MKRN3 Levels Decline During Puberty in Healthy Boys. J Clin Endocrinol Metab. 2016 Jun;101(6):2588-93. doi: 10.1210/jc.2016-1488. Epub 2016 Apr 8.
Reference Type
RESULT
Almstrup K, Lindhardt Johansen M, Busch AS, Hagen CP, Nielsen JE, Petersen JH, Juul A. Pubertal development in healthy children is mirrored by DNA methylation patterns in peripheral blood. Sci Rep. 2016 Jun 28;6:28657. doi: 10.1038/srep28657.
Reference Type
RESULT
Busch AS, Ljubicic ML, Upners EN, Fischer MB, Hagen CP, Fluck CE, Johannsen TH, Frederiksen H, Juul A. Serum steroid metabolome dynamics in infancy: a longitudinal cohort study of healthy infants. Eur J Endocrinol. 2025 Sep 30;193(4):403-411. doi: 10.1093/ejendo/lvaf193.
Reference Type
DERIVED
Sorensen K, Hagen CP, Juul A. Higher peak height velocity in early maturing girls depends on insulin rather than fat mass or IGF-I. Eur J Endocrinol. 2024 Sep 30;191(4):381-388. doi: 10.1093/ejendo/lvae115.
Reference Type
DERIVED
Busch AS, Ljubicic ML, Upners EN, Fischer MB, Kolby N, Eckert-Lind C, Jespersen K, Andersson AM, Frederiksen H, Johannsen TH, Hegaard HK, Sharif H, Hagen CP, Juul A. Cohort profile: The COPENHAGEN Minipuberty Study-A longitudinal prospective cohort of healthy full-term infants and their parents. Paediatr Perinat Epidemiol. 2021 Sep;35(5):601-611. doi: 10.1111/ppe.12777. Epub 2021 Jun 22.
Reference Type
DERIVED
Albrethsen J, Ljubicic ML, Juul A. Longitudinal Increases in Serum Insulin-like Factor 3 and Testosterone Determined by LC-MS/MS in Pubertal Danish Boys. J Clin Endocrinol Metab. 2020 Oct 1;105(10):dgaa496. doi: 10.1210/clinem/dgaa496.
Reference Type
DERIVED
Busch AS, Hojgaard B, Hagen CP, Teilmann G. Obesity Is Associated with Earlier Pubertal Onset in Boys. J Clin Endocrinol Metab. 2020 Apr 1;105(4):dgz222. doi: 10.1210/clinem/dgz222.
Reference Type
DERIVED
Busch AS, Hollis B, Day FR, Sorensen K, Aksglaede L, Perry JRB, Ong KK, Juul A, Hagen CP. Voice break in boys-temporal relations with other pubertal milestones and likely causal effects of BMI. Hum Reprod. 2019 Aug 1;34(8):1514-1522. doi: 10.1093/humrep/dez118.
Reference Type
DERIVED
Busch AS, Hagen CP, Assens M, Main KM, Almstrup K, Juul A. Differential Impact of Genetic Loci on Age at Thelarche and Menarche in Healthy Girls. J Clin Endocrinol Metab. 2018 Jan 1;103(1):228-234. doi: 10.1210/jc.2017-01860.
Reference Type
DERIVED
Kolby N, Busch AS, Aksglaede L, Sorensen K, Petersen JH, Andersson AM, Juul A. Nocturnal Urinary Excretion of FSH and LH in Children and Adolescents With Normal and Early Puberty. J Clin Endocrinol Metab. 2017 Oct 1;102(10):3830-3838. doi: 10.1210/jc.2017-01192.
Reference Type
DERIVED
Lindhardt Johansen M, Hagen CP, Mieritz MG, Wolthers OD, Heuck C, Petersen JH, Juul A. Pubertal Progression and Reproductive Hormones in Healthy Girls With Transient Thelarche. J Clin Endocrinol Metab. 2017 Mar 1;102(3):1001-1008. doi: 10.1210/jc.2016-2871.
Reference Type
DERIVED
Bisgaard A, Sorensen K, Johannsen TH, Helge JW, Andersson AM, Juul A. Significant gender difference in serum levels of fibroblast growth factor 21 in Danish children and adolescents. Int J Pediatr Endocrinol. 2014;2014(1):7. doi: 10.1186/1687-9856-2014-7. Epub 2014 May 23.
Reference Type
DERIVED
Nielsen J, Jensen RB, Juul A. Increased sex hormone-binding globulin levels in children and adolescents with thyrotoxicosis. Horm Res Paediatr. 2013;79:157-61. doi: 10.1159/000348837. Epub 2013 Mar 27.
Reference Type
DERIVED
Hagen CP, Sorensen K, Anderson RA, Juul A. Serum levels of antimullerian hormone in early maturing girls before, during, and after suppression with GnRH agonist. Fertil Steril. 2012 Nov;98(5):1326-30. doi: 10.1016/j.fertnstert.2012.07.1118. Epub 2012 Aug 14.
Reference Type
DERIVED
Other Identifiers
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KF01282214
Identifier Type: -
Identifier Source: org_study_id
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