IGF-1 Surrogate Monitoring is a clinical strategy that utilizes the measurement of Insulin-like Growth Factor 1 (IGF-1) as a reliable indirect indicator for assessing the overall activity and secretion status of Growth Hormone (GH). Since GH is secreted in pulsatile bursts and has a very short half-life, direct measurement is impractical for routine clinical assessment. IGF-1, which is produced in response to GH and has a longer half-life, provides a stable, integrated metric of GH bioavailability and its downstream anabolic effects. This surrogate marker is crucial for evaluating growth, metabolic health, and the efficacy of certain hormone replacement therapies.
Origin
The practice originates from pediatric endocrinology and the study of growth disorders, where the GH-IGF-1 axis was first elucidated as the primary regulator of somatic growth. The recognition of IGF-1 as a stable, measurable biomarker led to its adoption in adult endocrinology for monitoring GH status and diagnosing conditions like acromegaly or GH deficiency. It functions as the definitive biomarker for the somatotropic axis.
Mechanism
Growth Hormone, released from the pituitary gland, travels to the liver and other tissues, where it stimulates the production of IGF-1. IGF-1 then acts as the primary mediator of GH’s anabolic effects, binding to its own receptors to promote cell proliferation, protein synthesis, and tissue growth. The concentration of circulating IGF-1 reflects the average daily exposure to GH, making its measurement a robust, non-pulsatile assessment of the functional status of the somatotropic axis.
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