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Article History

Received: 26 January 2026

Accepted: 27 April 2026

First Online: 25 June 2026

Ethics

Acknowledgements: We thank all participating children and their parents, and the paediatric endocrinology teams at the participating centres for their contributions to recruitment, sampling, data collection and psychosocial assessments. We also thank the Ege University Pediatric Endocrinology Research Laboratory team for technical support with autoantibody analyses, and the research nurses/field staff for study coordination and data management. We also acknowledge the support of the Ege University Scientific Research Projects Coordination Unit.

Data availability: The datasets generated and analysed during the current study are not publicly available because they contain participant-level clinical and psychometric data from minors. De-identified data underlying the findings may be made available from the corresponding author upon reasonable request after publication and for 5 years thereafter, for non-commercial academic research with a methodologically sound proposal, subject to approval by the study investigators, and, where required, the relevant ethics committee and/or institutional data-sharing procedures. Data may not be used to identify participants or shared with third parties.

Funding: Open access funding provided by the Scientific and Technological Research Council of Türkiye (TÜBİTAK). This study was supported by the Ege University Scientific Research Projects Coordination Unit (project no: 32332; Multidisciplinary Priority Area Research Project Program). No other external funding was received.

Authors’ relationships and activities: The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

Contribution statement: UCY conceived and designed the study, coordinated the multicentre protocol, curated the data, performed the analyses, and drafted the manuscript. DÖK, DG and SÖ contributed to study design and supervision, supported interpretation, and critically revised the manuscript. ÖKK, İBB, İG, AA, DE, EGB, ÖFY, SÖ, HGB, SKÇ, FG, KD, ÖK, SAA and BEF served as site investigators and were responsible for local implementation, recruitment, clinical characterisation and dataset verification. GYB and BÖ developed and supervised the psychometric protocol, trained investigators, interpreted psychosocial outcomes, and reviewed the manuscript. MS and the Ege University laboratory team developed the autoantibody testing workflow, performed assays and quality control, and interpreted immunological data. RDO advised on epidemiological/public health aspects and the analysis plan. DG supervised the study as senior author. DÖK is the guarantor, had full access to all data and takes responsibility for data integrity, analytical accuracy, and completeness of reporting. All authors interpreted results, revised the manuscript, and approved the final version.