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Insulin-like growth factor-1 (IGF-1) is a protein hormone similar in structure and function to insulin, but with a much higher growth-promoting activity than insulin. It stimulates proliferation and survival of various cell types including muscle, bone, and cartilage tissue. IGFs are predominantly produced in the liver, although a variety of tissues produce IGFs at distinctive times. Circulating IGF-1 is almost totally protein-bound to IGF binding proteins (IGFBPs).