Interest in growth hormone (GH) is inextricably linked to the need for in depth understanding of the somatomedins (insulin-like growth factors) which are polypeptides structurally similar to insulin and with broad physiological activity. To date, the most commonly known is Insulin-Like Growth Factor I (IGF-I). Despite considerable current knowledge of IGF-I, however, its bioactivity is incompletely understood. Measurement of IGF-I is of the utmost importance in the diagnosis and treatment of, for example acromegaly and growth hormone deficiency. The development of recombinant IGF-I, has allowed its use in such cases. Clinical practice, however, shows that few young/adult patients will benefit from treatment with the rIGF-I, mecasermin, given the number of adverse effects found. This review focuses on current knowledge mainly related to IGF-I and the use of its recombinant form (rIGF-I) in clinical practice. Several functions of IGI-II have been elucidated but their clinical significance is unclear.

Department of Internal Medicine 3 Nephrology Rheumatology and Endocrinology University Hospital and Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic 1 P Pavlova 6 779 00 Olomouc Czech Republic

Minimally Invasive Endocrine Surgery Unit Department of Surgery Oncology and Gastroenterology University of Padova Italy Via Giustiniani 2 35128 Padova Italy

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