However, IGFBP2 is also a ligand for several targets capable of regulating inflammation associated signalling pathways in OA including PI3K/Akt/ MAPK/ PKC pathways [30, 31] whilst low IGFBP2 serum levels are associated with risk of metabolic syndromes [28] and implicated in glucose and lipid metabolism [31]. This evidence concerns the gene AKT1 and metabolic syndrome.