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Anastasia Ibba SSD Endocrinologia Pediatrica e Centro Screening Neonatale, Ospedale Pediatrico Microcitemico, ‘A. Cao’, AO Brotzu, Cagliari, Italy

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Francesca Corrias SSD Endocrinologia Pediatrica e Centro Screening Neonatale, Ospedale Pediatrico Microcitemico, ‘A. Cao’, AO Brotzu, Cagliari, Italy

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Chiara Guzzetti SSD Endocrinologia Pediatrica e Centro Screening Neonatale, Ospedale Pediatrico Microcitemico, ‘A. Cao’, AO Brotzu, Cagliari, Italy

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Letizia Casula SSD Endocrinologia Pediatrica e Centro Screening Neonatale, Ospedale Pediatrico Microcitemico, ‘A. Cao’, AO Brotzu, Cagliari, Italy

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Mariacarolina Salerno Dipartimento di Pediatria, Università Federico II, Napoli, Italy

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Natascia di Iorgi Dipartimento di Pediatria, IRCCS Istituto Giannina Gaslini, Università di Genova, Genova, Italy
Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-infantili, Università di Genova, Genova, Italy

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Gianluca Tornese SSD Endocrinologia Pediatrica, Clinica Pediatrica, IRCCS Materno-infantile Burlo Garofolo, Trieste, Italy

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Giuseppa Patti Dipartimento di Pediatria, IRCCS Istituto Giannina Gaslini, Università di Genova, Genova, Italy
Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-infantili, Università di Genova, Genova, Italy

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Giorgio Radetti Dipartimento di Pediatria, Ospedale Generale Regionale, Bolzano, Italy

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Mohamad Maghnie Dipartimento di Pediatria, IRCCS Istituto Giannina Gaslini, Università di Genova, Genova, Italy
Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-infantili, Università di Genova, Genova, Italy

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Marco Cappa UOC di Endocrinologia, Dipartimento Universitario Ospedaliero, Ospedale Pediatrico Bambino Gesù IRCCS, Roma, Italy

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Sandro Loche SSD Endocrinologia Pediatrica e Centro Screening Neonatale, Ospedale Pediatrico Microcitemico, ‘A. Cao’, AO Brotzu, Cagliari, Italy

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Introduction The diagnosis of growth hormone deficiency (GHD) in childhood and adolescence is based on auxological, biochemical, neuro-radiological, and genetic investigations. Since GH production is pulsatile, its secretion needs to be

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Thomas Reinehr Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Children’s Hospital, University of Witten/Herdecke, Datteln, Germany

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Martin Carlsson Endocrine Care, Pfizer Inc, New York, New York, USA

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Dionisios Chrysis Division of Pediatric Endocrinology, University of Patras, Patras, Greece

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Cecilia Camacho-Hübner Endocrine Care, Pfizer Inc, New York, New York, USA

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children with congenital adrenal hyperplasia ( 7 ) and growth disorders such as normal short stature ( 4 , 8 , 9 ), constitutional delay of growth and puberty (CDGP) ( 9 , 10 , 11 ), and idiopathic short stature ( 12 ), it has been reported that adult

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Sidsel Mathiesen Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Kaspar Sørensen Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Marianne Ifversen Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Casper P Hagen Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Jørgen Holm Petersen Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark

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Anders Juul Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Klaus Müller Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Weel-Sipman MH Vossen JM Wit JM . Pubertal development and growth after total-body irradiation and bone marrow transplantation for haematological malignancies . European Journal of Pediatrics 2000 159 31 – 37 . ( https://doi.org/10.1007/s

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Lisette van Alewijk Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands

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Kirsten Davidse Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands

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Karlijn Pellikaan Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands

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Judith van Eck Department of Paediatrics, Subdivision of Endocrinology, Erasmus University Medical Centre, Rotterdam, the Netherlands

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Anita C S Hokken-Koelega Department of Paediatrics, Subdivision of Endocrinology, Erasmus University Medical Centre, Rotterdam, the Netherlands
Academic Centre for Growth, Erasmus University Medical Centre, Rotterdam, the Netherlands
Dutch Growth Research Foundation, Rotterdam, the Netherlands

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Theo C J Sas Department of Paediatrics, Subdivision of Endocrinology, Erasmus University Medical Centre, Rotterdam, the Netherlands
Diabeter, National Diabetes Care and Research Centre, Rotterdam, the Netherlands

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Sabine Hannema Department of Paediatrics, Subdivision of Endocrinology, Erasmus University Medical Centre, Rotterdam, the Netherlands
Department of Paediatric Endocrinology, Leiden University Medical Centre, Leiden, the Netherlands

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Aart J van der Lely Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands

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Laura C G de Graaff Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
Academic Centre for Growth, Erasmus University Medical Centre, Rotterdam, the Netherlands

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the participant. The first question: 'I visit the physician because of…' was a multiple-choice question with 13 answer options, including the names of various rEC like Turner syndrome, Klinefelter syndrome, growth hormone deficiency and the options 'I

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Mirjana Doknic Neuroendocrine Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade, Serbia
Faculty of Medicine, University of Belgrade, Belgrade, Serbia

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Marko Stojanovic Neuroendocrine Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade, Serbia
Faculty of Medicine, University of Belgrade, Belgrade, Serbia

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Ivan Soldatovic Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Institute of Medical Statistics and Informatics, Belgrade, Serbia

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Tatjana Milenkovic Mother and Child Health Care Institute of Serbia ‘Dr Vukan Cupic’, Belgrade, Serbia

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Vera Zdravkovic Faculty of Medicine, University of Belgrade, Belgrade, Serbia
University Children’s Clinic, Belgrade, Serbia

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Maja Jesic Faculty of Medicine, University of Belgrade, Belgrade, Serbia
University Children’s Clinic, Belgrade, Serbia

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Sladjana Todorovic Mother and Child Health Care Institute of Serbia ‘Dr Vukan Cupic’, Belgrade, Serbia

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Katarina Mitrovic Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Mother and Child Health Care Institute of Serbia ‘Dr Vukan Cupic’, Belgrade, Serbia

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Rade Vukovic Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Mother and Child Health Care Institute of Serbia ‘Dr Vukan Cupic’, Belgrade, Serbia

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Dragana Miljic Neuroendocrine Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade, Serbia
Faculty of Medicine, University of Belgrade, Belgrade, Serbia

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Dragan Savic Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia

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Mihajlo Milicevic Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia

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Aleksandar Stanimirovic Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia

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Vojislav Bogosavljevic Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia

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Sandra Pekic Neuroendocrine Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade, Serbia
Faculty of Medicine, University of Belgrade, Belgrade, Serbia

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Emilija Manojlovic-Gacic Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

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Aleksandar Djukic Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

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Danica Grujicic Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia

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Milan Petakov Neuroendocrine Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Belgrade, Serbia
Faculty of Medicine, University of Belgrade, Belgrade, Serbia

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Introduction Patients with childhood-onset GH deficiency (COGHD) represent a heterogeneous group in terms of etiology of growth hormone deficiency (GHD), time of GHD onset and recombinant human GH (rhGH) replacement commencement, duration

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Mei Li Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Yanfei Chen Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Binrong Liao Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Jing Tang Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Jingzi Zhong Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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Dan Lan Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China

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development before 8 years of age, accelerated linear growth, progressive bone age (BA, >1 year than chronological age), GnRH stimulation test, and gynecological ultrasound according to Consensus Statement for the Diagnosis and Treatment of Central Precocious

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Raja Padidela Royal Manchester Children’s Hospital and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK

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Moira S Cheung Evelina London Children’s Hospital, London, UK

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Vrinda Saraff Birmingham Women’s and Children’s Hospital, Birmingham, UK

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Poonam Dharmaraj Alder Hey Children’s NHS Foundation Trust, Liverpool, UK

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chondrocytes and mineralisation of growth plates causing rickets. These conditions lead to soft and often deformed bones, with skeletal abnormalities and short stature giving rise to lifelong pain, impaired physical function, and disability. Additionally

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Min Yang Graduate School, Beijing University of Chinese Medicine, Beijing, China
Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China

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Xiangling Deng Graduate School, Beijing University of Chinese Medicine, Beijing, China
Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China

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Shunan Wang Graduate School, Beijing University of Chinese Medicine, Beijing, China
Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China

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Bo Zhou Graduate School, Beijing University of Chinese Medicine, Beijing, China
Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China

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Wenquan Niu Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China

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Zhixin Zhang International Medical Services, China-Japan Friendship Hospital, Beijing, China
Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China

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remaining 20% of variance by environmental factors such as nutrition status and psychological stress ( 26 ). Among people affected by short stature, 37% have familial short stature, 27% have a constitutional growth delay, and 17% have both ( 27 , 28 , 29

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Teodoro Durá-Travé Department of Pediatrics, School of Medicine, University of Navarra, Pamplona, Spain
Department of Pediatrics, Navarra Hospital Complex, Pamplona, Spain
Navarra Institute for Health Research (IdisNA), Pamplona, Spain

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Fidel Gallinas-Victoriano Department of Pediatrics, Navarra Hospital Complex, Pamplona, Spain

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María Malumbres-Chacon Department of Pediatrics, Navarra Hospital Complex, Pamplona, Spain

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Lotfi Ahmed-Mohamed Department of Pediatrics, Navarra Hospital Complex, Pamplona, Spain

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María Jesús Chueca -Guindulain Department of Pediatrics, Navarra Hospital Complex, Pamplona, Spain
Navarra Institute for Health Research (IdisNA), Pamplona, Spain

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Sara Berrade-Zubiri Department of Pediatrics, Navarra Hospital Complex, Pamplona, Spain
Navarra Institute for Health Research (IdisNA), Pamplona, Spain

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boys younger than 9 years of age that is progressive and accompanied by advancement of skeletal age and accelerated linear growth ( 1 , 2 , 3 ). The phenomenon is much more common in girls than in boys ( 4 , 5 ). On the other hand, idiopatic

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Heike Hoyer-Kuhn Department of Paediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany

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Angela Huebner Department of Paediatrics, University Children’s Hospital Dresden, Dresden, Germany

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Anette Richter-Unruh University Children’s Hospital Bochum, Bochum, Nordrhein-Westfalen, Germany

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Markus Bettendorf University Children’s Hospital Heidelberg, Heidelberg, Germany

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Tilman Rohrer University Children’s Hospital Homburg, Homburg, Germany

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Klaus Kapelari University Children’s Hospital Innsbruck, Innsbruck, Austria

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Stefan Riedl Department of Pediatric, Medical University of Vienna, Vienna, Austria
St.Anna Kinderspital, Medical University of Vienna, Vienna, Austria

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Klaus Mohnike Department of Biometrics, Otto von Guericke Universität Magdeburg, Magdeburg, Sachsen-Anhalt, Germany

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Helmuth-Günther Dörr University Children’s Hospital Erlangen, Erlangen, Germany

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Friedrich-Wilhelm Roehl Department of Biometrics, Otto von Guericke Universität Magdeburg, Magdeburg, Sachsen-Anhalt, Germany

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Katharina Fink Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany

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Reinhard W Holl Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany

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Joachim Woelfle University Children’s Hospital Erlangen, Erlangen, Germany

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effects on growth pattern and final height have been detected and published previously ( 12 , 13 , 14 ). As HC therapy is the standard of care for pediatric patients ( 12 , 15 , 16 ), we selected 1311 patients exclusively on HC among 1571 patients in

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