Linear growth in a 15.5-year-old boy with constitutional delay of growth and puberty (CDGP). Height relative to peers may decrease slightly prior to the usual adolescent age range, but this effect is accentuated when the individual with delayed puberty fails to undergo a growth spurt in concert with his or her peers. Consequently, height relative to peers (height percentile or height SDS) decreases in the early teenage years. In CDGP, a late growth spurt will facilitate subsequent catch-up growth, but adult heights are often slightly shorter than expected based on parental heights. Physical markers of puberty are also delayed. LH, luteinizing hormone; FSH, follicle-stimulating hormone; IgF1, insulin-like growth factor; GnRH, gonadotropin releasing hormone; hCG, human chorionic gonadotropin; BMI, body mass index; GI, gastrointestinal; GH, growth hormone; CNS, central nervous system. Source: Variants of Pubertal Progression, Pediatric Endocrinology and Inborn Errors of Metabolism, 2e Citation: Sarafoglou K, Hoffmann GF, Roth KS. Pediatric Endocrinology and Inborn Errors of Metabolism, 2e; 2017 Available at: http://accesspediatrics.mhmedical.com/DownloadImage.aspx?image=/data/books/2042/saraped2_ch35_f001.png&sec=154114767&BookID=2042&ChapterSecID=154114760&imagename= Accessed: November 05, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved