In 97 (9.4 %) patients, the diagnosis was based on serum IGF-1 concentrations ≤2 SD in combination with two or more additional pituitary hormone deficiencies, whereas in 7 (0.7 %) patients either retesting was considered unnecessary because of CO-GHD due to evident hypothalamic pituitary disease (n = 2 NFPAs), or the diagnostic procedure was unknown (n = 4 NFPAs and n = 1 CD). This evidence concerns the gene IGF1 and hypopituitarism.