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Abbreviations PED performance enhancing drug AAS anabolic-androgenic steroids PI3K phosphoinositol 3-kinase mTOR mammalian target of rapamycin FOXO3a Forkhead boxO3a MuRF-1 muscle RING finger 1 GSK3 glycogen synthase kinase 3 MGF muscle-specific IGF-I MAPK mitogen activated protein kinase IRS insulin receptor substrate P-III-NP procollagen type III amino-terminal propeptide ALS acid-labile subunit Footnotes Conflicts of Interests: JMG receives research support from Pfizer, Inc

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Cases of slipped capital femoral epiphysis with or without osteonecrosis have been reported in pediatric patients receiving products indicated to treat growth failure and/or short stature, including INCRELEX

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Nomuscle stimulation remains essential