IGF1 and arthritic joint disease: Excessive GH and IGF-1 levels (>1 ng/mL and >age and sex-normalized IGF-1 levels above the upper limit of normal, respectively) are associated with multisystemic comorbidities, including congestive heart failure, sleep apnea, arthritis, impaired glucose tolerance, insulin resistance, and diabetes mellitus, as well as an elevated risk of mortality [1, 2, 4].