Even though IGF1 mRNA expression is increased in limb muscles of COPD patients, AKT activation remains unaltered.39, 45, 57 AKT activity is relatively increased in cachectic patients compared with non‐cachectic patients and healthy controls,40, 44 while the decrease in IGF1 mRNA expression in this group would generally implicate a decrease of IGF1/AKT signalling. This evidence concerns the gene IGF1 and chronic obstructive pulmonary disease.