IGF-1 belonged to the insulin gene family, is a mitogenic polypeptide growth factor that stimulate the proliferation and survival of various cell types including muscle, bone, and cartilage tissue in vitro. It is produced primarily by the liver as an endocrine hormone as well as in target tissues in a paracrine/autocrine fashion. The production of IGF-1 is stimulated by growth hormone (GH) and can be retarded by undernutrition, growth hormone insensitivity, lack of growth hormone receptors, or failures of the downstream signaling pathway post GH receptor including SHP2 and STAT5B.