IGF1 and hypogonadism: Following a comprehensive multivariate logistic regression analysis of seven key variables, we identified Age (OR =1.138, 95% CI 1.041-1.248, P < 0.05), IGF-1<-2SD (OR =1.962, 95% CI1.163-3.321, P < 0.05) and Hypogonadism (OR =2.951, 95% CI1.085-8.444, P < 0.05) as independent risk factors for low bone mass in the pediatric and adolescent population with TDT, as outlined in Figure 1.