Precision medicine in pediatric growth disorders: Integrating clinical phenotype, genetics, IGF-1 biology and artificial intelligence: A systematic scoping review of PubMed-indexed literature (2000-2026).

Ecombinant human growth hormone (rhGH) has been used for four decades under a largely population-based dosing paradigm, yet growth response varies substantially among children with apparently similar auxological phenotypes.

(1) to synthesize evidence on monogenic and polygenic genetic determinants of pediatric growth faltering and/or short stature and their diagnostic yield; (2) to evaluate GH-IGF-1 axis biomarkers and pharmacogenetic markers, including the IGF-1/IGFBP-3 molar ratio as a likely better indicator of bioactive IGF-1 than IGF-1 alone, together with mathematical/machine-learning prediction models, for individualizing rhGH therapy; and (3) to appraise artificial intelligence (artificial intelligence) and digital-health tools, bone-age algorithms, facial-recognition phenotyping, adherence-prediction models, and smartphone growth-monitoring, as instruments for operationalizing precision endocrinology in children and adolescents with growth disorders.