The effects of growth hormone deficiency and growth hormone replacement therapy on bone - A meeting report

Recently, several reports have described the effects of growth hormone (GH) deficiency (GHD) on bone and the associated potential benefits of GH thera py. Not all of these reports have, however, been consistent and the results are debated. Some of the contention surrounding this issue reflects disagr eement about which bone parameters are the best indicators of bone strength and fracture risk. In November 1999, a meeting was held in Taormina, Italy , to discuss the assessment of bone in patients with GHD and the effects of GH therapy on the skeleton. The participants included endocrinologists, or thopaedists and biophysicists from around the world. During the meeting, th e advantages and disadvantages of the various indicators of bone strength w ere defined. In considering GH therapy, the delegates agreed that it had be neficial effects on bone in adults with GHD, but that further studies were needed in GH-deficient children. Finally, the participants stressed the nee d for more data to clarify which indicator of bone strength is the most app ropriate to use in adults and children with GHD, and to define fully the ro le of GH therapy in bone metabolism. It was recognized that pharmacoepidemi ological surveys, such as KIGS (Pharmacia international Growth Database) an d KIMS (Pharmacia International Metabolic Database), are valuable sources o f such data, and are, therefore, important in the development of evidence-b ased medicine. Copyright (C) 2000 S. Karger AG. Basel.