Insulin-like Growth Factor

insulin-like growth factor (IGF), formerly called somatomedin, any of several peptide hormones that function primarily to stimulate growth but that also possess some ability to decrease blood glucose levels. IGFs were discovered when investigators began studying the effects of biological substances on cells and tissues outside the body. The name insulin-like growth factor reflects the fact that these substances have insulin-like actions in some tissues, though they are far less potent than insulin in decreasing blood glucose concentrations. Furthermore, their fundamental action is to stimulate growth, and, though IGFs share this ability with other growth factors—such as epidermal growth factor, platelet-derived growth factor, and nerve growth factor—IGFs differ from these substances in that they are the only ones with well-described endocrine actions in humans.

There are two IGFs: IGF-1 and IGF-2. These two factors, despite the similarity of their names, are distinguishable in terms of specific actions on tissues because they bind to and activate different receptors. The major action of IGFs is on cell growth. Indeed, most of the actions of pituitary growth hormone are mediated by IGFs, primarily IGF-1. Growth hormone stimulates many tissues, particularly the liver, to synthesize and secrete IGF-1, which in turn stimulates both hypertrophy (increase in cell size) and hyperplasia (increase in cell number) of most tissues, including bone. Serum IGF-1 concentrations progressively increase during childhood and peak at the time of puberty, and they progressively decrease thereafter (as does growth hormone secretion). Children and adults with deficiency of growth hormone have low serum IGF-1 concentrations compared with healthy individuals of the same age. In contrast, patients with high levels of growth hormone (e.g., acromegaly) have increased serum IGF-1 concentrations. The production of IGF-2 is less dependent on the secretion of growth hormone than is the production of IGF-1, and IGF-2 is much less important in stimulating linear growth.

Although serum IGF concentrations seem to be determined by production by the liver, these substances are produced by many tissues, and many of the same tissues also have receptors for them. In addition, there are multiple serum binding proteins for IGFs that may stimulate or inhibit the biological actions of the factors. It is likely that the growth-promoting actions of IGFs occur at or very near the site of their formation; in effect, they probably exert their major actions by way of paracrine (acting on neighbouring cells) and autocrine (self-stimulating) effects.