Endocrine complication diagnosis
Short stature was diagnosed if the participant height z-score was < -2. Growth hormone provocative tests were performed in those with short stature who met the following criteria, i) height velocity < 4 cm/year, ii) delayed BA ≥2 years, and iii) IGF-1 concentration < -2 SD compared with BA- and sex-matched reference range. Growth hormone deficiency was defined as peak serum growth hormone concentration <7 ng/mL upon two provocative tests. Delayed puberty was defined as the absence of breast development by the age of 13 years or the absence of menarche by 15 years in girls, and the absence of testicular enlargement ≥ 4 mL by 14 years of age in boys. Hypothyroidism was diagnosed if TSH concentrations ≥ 10 mIU/L or low free T4 as compared to laboratory reference range.