IGF1 and liver disorder: For instance, in hypopituitary patients with three or more pituitary deficiencies, especially those who are younger than 40 years and have a BMI of below 25 kg/m2, a low serum IGF-I level (below the lower limit of the reference range for age), in the absence of catabolic conditions or liver diseases, is highly indicative of severe AGHD13–16.