IGF-I (insulin-like growth factor-I) is a peptide hormone, produced predominantly by the liver in response to pituitary GH (growth hormone), which is involved in a wide variety of physiological processes. It acts in an endocrine, paracrine and autocrine manner to promote growth. The production of IGF-I signals the availability of nutrients needed for its anabolic actions. Recently, there has been growing interest in its role in health and disease. IGF-I has long been known to be regulated by nutrition and dysregulated in states of under- and over-nutrition, its serum concentrations falling in malnutrition and responding promptly to refeeding. This has led to interest in its utility as a nutritional biomarker. A considerable evidence base supports utility for measurement of IGF-I in nutritional contexts. Its concentration may be valuable in providing information on nutritional status, prognosis and in monitoring nutritional support. However, it is insufficiently specific for use as a screening test for under nutrition as its serum concentration is influenced by many factors other than nutritional status, notably the APR (acute-phase response) and endocrine conditions. Concentrations should be interpreted along with clinical findings and the results of other investigations such as CRP (C-reactive protein). More recently, there has been interest in free IGF-I which holds promise as a nutritional marker. The present review covers nutritional regulation of IGF-I and its dysregulation in disease, then goes on to review recent studies supporting its utility as a nutritional marker in clinical contexts. Although not currently recommended by clinical guidelines, it is likely that, in time, measurement of IGF-I will become a routine part of nutritional assessment in a number of these contexts.
Review Article| May 22 2013
Insulin-like growth factor-I (IGF-I) and clinical nutrition
*Peptide Hormones Supraregional Assay Service (SAS), Clinical Biochemistry Department, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey GU2 7XX, U.K.
†Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 5XH, U.K.
Correspondence: Dr Callum Livingstone (email firstname.lastname@example.org).
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Callum Livingstone; Insulin-like growth factor-I (IGF-I) and clinical nutrition. Clin Sci (Lond) 1 September 2013; 125 (6): 265–280. doi: https://doi.org/10.1042/CS20120663
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