Endocrinology and Diabetes Research Unit, Schneider Childrens Medical Center of Israel, Petah Tikva 49202, Israel
Address correspondence to: Zvi Laron, M.D., Endocrinology and Diabetes Research Unit, Schneider Childrens Medical Center of Israel, 14 Kaplan Street, Petah Tikva 49202, Israel. E-mail: laronz{at}clalit.org.il.
To the editor:
We thank Dr. Baroncelli et al. (1) for their comments, which reinforce our findings but do not solve the query whether the use of dual-energy x-ray absorptiometry in children and adults should be limited and only volumetric bone mineral density (BMD) should be employed, adjusting BMD for height. Dr. Baroncelli et al. have introduced a new calculation for bone area/bone volume that his group has found as a useful index in the evaluation of BMD. Nevertheless, it remains controversial whether patients with congenital untreated or long-standing GH/IGF-I deficiency are osteopenic and, if not, whether their bones are weaker or stronger compared with healthy subjects. Our study does not exclude the role of IGF-I on bone accretion (2). Only long-term studies allowing for fracture incidence determination might clarify this issue. Last, but not least, many x-rays of the skeleton of the Israeli cohort comprising 60 patients have been performed, and they are at present being summarized (Kornreich, L., and Z. Laron, manuscript in preparation).
Received December 18, 2003.
References
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