{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:03:40Z","timestamp":1789038220470,"version":"build-2803163510"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pathological causes account for approximately 15%\u201320% of short-stature cases, whereas about 80% of short-statured children have no identifiable underlying etiology and are classified as idiopathic short stature (ISS). ISS represents a highly heterogeneous group, and ongoing debates persist due to the limited availability of observational data and advances in genetic research. Despite its high prevalence, long-term auxological data comparing familial, constitutional, and combined variants across pubertal stages remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Our study aimed to characterize the clinical and laboratory features at presentation and to evaluate the longitudinal growth patterns of children initially diagnosed with ISS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort of 171 children with ISS (46.2% female) was analyzed. Participants were classified as prepubertal (Group 1;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009121) and pubertal (Group 2;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200950), each further subdivided into familial (a), constitutional (b), and combined (c) subgroups. Anthropometric, familial, and biochemical parameters were assessed at presentation and final follow-up. Standard deviation scores (SDS) were calculated based on national growth references. Intergroup comparisons were performed using ANOVA or the Kruskal\u2013Wallis test with\n                      <jats:italic>post hoc<\/jats:italic>\n                      corrections. Statistical significance was accepted at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age at first evaluation was 7.94\u2009\u00b1\u20094.46 years; mean height SDS was \u22122.45\u2009\u00b1\u20090.34 with proportionate body proportions and normal birth parameters. Bone age averaged 6.57\u2009\u00b1\u20094.28 years (\u22481.4-year delay). The prepubertal\/pubertal distribution was 121 (70.8%) vs. 50 (29.2%); combined phenotypes comprised 53.5% of the cohort. Over 1.85\u2009\u00b1\u20091.40 years of follow-up, mean \u0394Height SDS was +0.35\u2009\u00b1\u20090.56; pubertal subgroups, particularly 2b and 2c, showed the most significant gains (\u0394Height SDS +0.58 and +0.53; both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001 vs. prepubertal). \u0394Height SDS correlated positively with baseline bone-age delay (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and inversely with age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Growth velocity was normal in all. BMI SDS rose modestly overall (\u22120.63\u2009\u00b1\u20090.99 to \u22120.49\u2009\u00b1\u20090.92;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) and remained below +2 SDS in all cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ISS subtypes display distinct auxological courses. Bone-age delay is a key predictor of subsequent catch-up growth, most evident in pubertal CDGP and combined phenotypes. Given the high rate of spontaneous improvement, especially after pubertal onset, careful longitudinal monitoring should precede pharmacologic therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1783065","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T06:48:17Z","timestamp":1773298097000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Familial, constitutional, and combined idiopathic short stature: longitudinal growth patterns and pubertal effects"],"prefix":"10.3389","volume":"14","author":[{"given":"Erkut","family":"G\u00fcrlek","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Ankara University School of Medicine","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirmen","family":"K\u0131z\u0131lcan \u00c7etin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Ankara University School of Medicine","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"\u00d6zsu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Ankara University School of Medicine","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehra","family":"Aycan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Ankara University School of Medicine","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merih","family":"Berbero\u011flu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Ankara University School of Medicine","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeynep","family":"\u015e\u0131klar","sequence":"additional","affiliation":[{"name":"Department of 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