Especially, in conditions characterized by development of cachexia such as chronic heart failure or chronic obstructive pulmonary disease, abnormalities in the IGF-I/GH axis can have a significant impact on diseases and prognosis [35, 43–46].This can also be applied this study cohort, who, with an average poor nutritional status and a measurably elevated risk of malnutrition and were carrying a crucial factor contributing to the development of a GH resistance. Here, IGF1 is linked to malnutrition.