Clinician-Researcher Embraces the Complexities of Adolescence
Frank Biro, MD, has a deep appreciation for his patients and co-workers. "I really love working with teenagers and their families," says Dr. Biro, a researcher and clinician in the Cincinnati Children's Division of Adolescent Medicine. "I have been blessed to work with a lot of truly gifted people. That's the best part of the job – great patients, great clinicians and great Researchers."
Dr. Biro should know. He's been at Cincinnati Children's for almost 20 years. He made the move from New England under the pretense that Cincinnati summers and winters are mild. After sweating through his first summer packed with 90-degree days and no air conditioning, Dr. Biro discarded the notion of mild weather. But he stayed nonetheless, and he has done a great deal since then to advance the field of adolescent medicine.
A recent study of his examines the initiation of pubertal maturation in girls and its impact on obesity. It also provides the first suggestion of an increased risk of breast cancer for these girls.
The Research found that females who enter puberty with breast development first, versus pubic hair development, have a higher body-mass index one year before, and throughout, puberty. These girls had a younger age of menarche, as well as a higher risk for obesity as young adults. Additionally, these findings parallel epidemiologic data of women diagnosed with breast cancer. "I don't want to raise concerns in parents of girls with breast development first," Dr. Biro says. "For an individual, this represents a minimal increased risk. But in a population, it may represent a much more significant and important risk."
Adolescence Affects Adulthood
Dr. Biro associates these findings with previous research showing that timing of pubertal maturation has a profound impact on what occurs in adulthood. "I think a lot of adult morbidity and mortality issues get played out in adolescence," he says. During puberty, biologic changes occur that affect scoliosis, anemia, gynecomastia, bone density and myopia, among others. For example, lipid changes during puberty in males bring about higher levels of LDL cholesterol and lower levels of HDL cholesterol. "From a biochemical standpoint, puberty is one of the most dynamic periods of a person's life."
Dr. Biro is sometimes mistaken for an endocrinologist because he has done so much research on pubertal maturation. But his studies cover more than that. Other investigations he has conducted include research on sexually transmitted diseases, self-esteem, acne, eating disorders and vaccinations in adolescents.
A recent addition to Dr. Biro's professional life is his role as principal investigator of the epidemiologic studies in the new Breast Cancer and the Environment Research Center, a joint effort between Cincinnati Children's and the University of Cincinnati. As breast cancer becomes more prevalent in women, these researchers are studying the impact environmental factors have on female development and maturation in both humans and animals.
Receiving Help From Survivors
A valuable component of this research is the direct contact Dr. Biro and his colleagues have with breast cancer survivors, who meet regularly with the investigators. Input from the survivors provides direction for the group's work. "They are an integral part of our research formulation," Dr. Biro says. "This is a wonderful opportunity to work with an incredible group of women. My colleagues and I feel privileged to work with them. They are a true inspiration to us."
Dr. Biro graduated from Harvard Medical School, and he completed a combined residency in pediatrics and internal medicine at the University of Rochester, New York, where he first became interested in teen health. He went on from there to complete a fellowship in adolescent medicine at Children's Hospital Boston.
When not immersed in the many facets of puberty, Dr. Biro enjoys spending time in his log home with wife Nancy and son Noah, 17. He talks fondly about the wildlife he watches in the woods behind his home, and he tries to carve out timein his schedule for biking and mountain hiking.
While he misses his New England roots, Dr. Biro is thankful for what he has found in Cincinnati. "Both on the research side and on the clinical side, I work with great people," he says. "I think that's the nice thing about Cincinnati. It's one of those wonderful gems in the rough."
The same can be said for Dr. Biro.
Dr. Biro is professor of clinical pediatrics and director of education in the Cincinnati Children's Division of Adolescent Medicine. His paper was published in Journal of Pediatrics (142[6]:643- 646, 2003 June).
