JPEM Table of Contents Volume 13:Supplement 2

JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM

VOLUME 13, SUPPLEMENT 2, 2000

Proceedings of the 13th Annual National Cooperative Growth Study (NCGS) Investigators Meeting

PREFACE

The Thirteenth Annual Meeting of the National Cooperative Growth Study convened in Charleston from September 30 to October 3, 1999. Four main themes emerged, which are covered in the articles summarizing the presentations from that meeting. First, the diagnosis and therapy of a variety of pediatric bone disorders was explored. Second, the safety of using growth hormone was detailed, with a special emphasis on what happens when growth hormone is given to patients who are ill or injured. A third topic was the effects of growth hormone on body fat composition. Finally, the use of growth hormone in non-growth hormone deficient children was examined, with recommendations as to who should be treated.

A great deal of emphasis has been placed on bone density in children and adults as a risk factor for osteoporosis and fracture. The paper by Dr. Laura K. Bachrach provides a detailed discussion on the use of bone mineral density in children. Dr. Darrell M. Wilson and Dr. Nancy M. Wright review the results of growth hormone therapy in patients with hypophosphatemic rickets, idiopathic juvenile osteoporosis, and osteogenesis imperfecta. Dr. Kenneth M. Attie reports the effects of growth hormone on bone density in growth hormone deficient adults, demonstrating significant improvement in bone mass during therapy. This series of papers culminates in a discussion by Dr. Francis H. Glorieux on the newly emerging role of bisphosphonates in treating osteogenesis imperfecta. While few conclusions can be drawn at this time, many questions are raised that will surely help to guide research in the future.

During the past several years, a variety of reports have emerged suggesting that growth hormone may be harmful when used in ill adults. However, there are few controlled data regarding growth hormone therapy in ill or injured children. Dr. Maria C. Gelato reviews the physiological effects of growth hormone in critically ill patients. Dr. Gilbert P. August surveyed the NCGS investigators and received data from 67% on when practitioners would withhold growth hormone in ill children. While his report has limited scientific value, it does provide the best information available on the prescribing patterns during illness by practicing physicians. Rounding out the discussion on safety, Dr. Thomas Maneatis (Genentech) details the risks of adverse events during growth hormone therapy.

The effect of growth hormone on body composition has become a major area of interest, especially in patients receiving steroids and those with Prader-Willi syndrome. Dr. Bachrach’s report discusses the use of DEXA scanning to determine body fat composition and the regional distribution of fat. Dr. Aaron L. Carrell examines the effects of growth hormone on body fat metabolism and the distribution of fat, focusing on patients with growth hormone deficiency and Prader-Willi syndrome. Extension of these data may be of great importance in determining the long-term benefits of growth hormone therapy.

Finally, Dr. Ron G. Rosenfeld discusses the role of growth hormone in treating patients with genetic syndromes where growth hormone production appears to be normal, but short stature is frequently severe. This report offers an important look at the response of a variety of different syndromes to growth hormone therapy. While much of the data presented is uncontrolled, taken as an aggregate it begins to suggest that growth hormone therapy should be considered on a patient-by-patient basis with a careful eye on safety.

The meeting provided many memorable moments and surveyed topics of interest to most of the investigators, as demonstrated by a very high approval rating. With the publication of this series of reports, a permanent record of the proceedings of the Thirteenth Annual Meeting of the NCGS is now available. We celebrate the success of a registry that began as an FDA requirement and has become one of the more important repositories of data chronicling growth hormone therapy.

L. Lyndon Key, Jr., M.D.
Chairman
Thirteenth Annual Meeting of the National Cooperative Growth Study in Charleston

TABLE OF CONTENTS

Introduction
L.L. Key Jr., USA ... 969

Should We Treat Genetic Syndromes?
R.G. Rosenfeld and C.K. Buckway, USA ... 971

Dual Energy X-ray Absorptiometry (DEXA) Measurements of Bone Density and Body Composition: Promise and Pitfalls
L.K. Bachrach, USA ... 983

Bisphosphonate Therapy for Severe Osteogenesis Imperfecta
F.H. Glorieux, Canada ... 989

Growth Hormone and Hypophosphatemic Rickets
D.M. Wilson, USA ... 993

Just Taller or More Bone? The Impact of Growth Hormone on Osteogenesis Imperfecta and Idiopathic Juvenile Osteoporosis
N.M. Wright, USA ... 999

Effects of Growth Hormone on Adipose Tissue
A.L. Carrel and D.B. Allen, USA ... 1003

The Importance of Growth Hormone Replacement Therapy for Bone Mass in Young Growth Hormone Deficient Adults
K.M. Attie, USA ... 1011

The Growth Hormone/Insulin-like Growth Factor Axis in Critical Illness
M.C. Gelato, USA ... 1023

Survey of Clinical Practice: Growth Hormone Use During Illness
G.P. August, E.S. Lightner and A.W. Root, USA ... 1031

Growth Hormone Safety Update From the National Cooperative Growth Study
T. Maneatis, J. Baptista, K. Connelly and S. Blethen, USA ... 1035

ISSN 0334-018X/13-S2

80 pages

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