The median time from diagnosis to the first endocrine event (usually GHD or CPP) was over 3 years in this cohort but continued to decline up to 13.6 years, whilst the hierarchical evolution of anterior pituitary deficits we previously reported, in which GHD is most sensitive and ACTH most robust [9] were again evident, allowing for the predictably very low prevalence of GnD in this group of still average prepubertal age at follow-up (10.8 years). Here, POMC is linked to central precocious puberty.