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3?cm. The girls with DS reached puberty spurt between 9 and 12 years, and achieved the annual growth rate of 5.9?��?1.64?cm; then growth slowed and reached final height at 14 years. Their final height was 144?��?6.01?cm. The study performed by Bundak et al. [2007] showed that healthy Turkish boys have their pubertal onset at 11.6?��?1.2 years of age, and they achieve the annual growth rate of 10.1?��?1.6?cm. The duration of puberty is 4.9?��?0.6 years and their final height is 176?��?6?cm. The same study performed by Bundak et al. [2008] demonstrated that healthy Turkish girls have their pubertal onset at 10.1?��?1 years of age by achieving the annual growth rate of 8.5?��?1?cm. Their puberty duration is 4.9?��?1.2 years and final height is 163.7?��?6?cm. Although the age at onset of pubertal growth spurt and puberty duration of the boys with DS were similar to normal population, their pubertal annual growth rate was inadequate; thus the final height was ?2.56 SD for Turkish standards. However, the pubertal growth spurt of the girls with Down syndrome started 1 year earlier, their puberty duration was short and their annual peak height velocity was about 2�C2.5?cm lower than that for normal children and as a result, the final height was ?3.06 SD (Fig. 4a�Cd). Since Turkish girls with DS reached puberty earlier, their final height was shorter. The mean birth weight of our patients with DS was slightly lower than normal population (?0.8 SD). Final weight values also were similar to Turkish standards (boys ?0.4 SD, girls +0.5 SD). When we compared the values of our patients with growth charts for DS ages between 0 and 4 years by Fernandes et al. [2001] which have been developed for Portuguese, we found that weight and height percentiles of the boys were similar (P?>?0.05). However, at the age of 4 years, our girls were shorter than Portuguese counterparts (P? in Egyptian counterparts in the 0�C3 years group [Meguid et al., 2004], but also higher than Saudi children with DS (0�C5 years) [Al Husain, 2003]. Turkish children with DS were taller and heavier than those (0�C14 years) in Sicilian counterparts [Piro et al., 1990]. We have used growth charts by Cronk et al. [1988] for US-American children with DS for DS follow up in our department for 20 years. The comparison of the height growth charts between 1 month to 3 years showed that Turkish children with DS and US-American counterparts were similar. However, after the age of 3 years, our boys also were taller than US-American boys. These differences may be the result of time delay between these studies. When comparing final heights of Turkish DS children with growth charts for English and Irish children with DS (0�C19 years) [Styles et al., 2002] and for Swedish children with DS (0�C18 years) [Myrelid et al.