Insulin-Like Growth Factor-1 and Atherosclerosis: Mechanistic Insights and Clinical Implications.

Authors

Lianjie Hou

Published in

QJM : monthly journal of the Association of Physicians. Sep 12, 2026. Epub Sep 12, 2026.

Abstract

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality worldwide, with persistent residual risk despite optimal management of conventional risk factors. Insulin-like growth factor-1 (IGF-1), the principal effector of the growth hormone-IGF-1 axis, exerts dose-dependent dual effects on atherogenesis, yet its clinical value remains controversial and incompletely clarified. This review provides a concise overview of the core mechanistic basis of IGF-1 in atherosclerotic pathogenesis, synthesizes key epidemiological and clinical cohort evidence on the association between circulating IGF-1 and atherosclerotic cardiovascular events, evaluates its utility as a predictive and prognostic biomarker, and systematically summarizes the translational potential of IGF-1 axis-targeted interventions. Physiological IGF-1 concentrations confer endothelial protection, anti-inflammatory effects and plaque stability, whereas deviation to either excess or deficiency accelerates atherosclerotic progression. Circulating IGF-1 exhibits a non-linear association with ASCVD risk and prognosis, with routine clinical application currently limited by assay heterogeneity and metabolic confounders. Normalization of the IGF-1 axis at physiological levels delivers measurable vascular benefits, and pathway-selective modulators represent a promising direction for future translational research.

PMID:
42742130
Bibliographic data and abstract were imported from PubMed on 15 Sep 2026.

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