IGF1 and malnutrition: This finding is similar to IGF-1 levels in serum and to another study depicting salivary IGF-1 peak (6.15±1.04 pg/mL) at puberty.37,38,43,89 According to previous literature, the factors influencing levels of free circulating IGF-1 in saliva are body mass index (BMI) and malnutrition status,90 which may be further explored as contributing factors to skeletal maturation status.