Many hypothesize that GH/IGF-1 axis disturbances are a major contributor to the growth failure in LPI owing to the relationship between growth hormone insensitivity syndromes and short stature (Andrews et al., 2021), in addition to the numerous reports of low concentrations of circulating GH or IGF-1 in children with LPI that exhibit growth failure (Goto et al., 1984; Esposito et al., 2006; Evelina et al., 2015; Al-Qattan et al., 2021; Niinikoski et al., 2011; Cottrell and Mushtaq, 2016). Here, IGF1 is linked to growth hormone insensitivity syndrome.