Acromegaly is known to be associated with high levels of IGF-1, which through activation of the IGF-1 receptor, results in cell proliferation and growth advantage, whereas the associated IGFBP3 bioactivity promotes an apoptotic advantage.17–20 Thus, excess GH, by inducing both IGFBP3 and IGF-1 levels, promotes dysregulated cell growth balance characterized by dynamic signals for cell apoptosis versus cell growth advantage. This evidence concerns the gene IGF1 and acromegaly.