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.