Some studies suggest that augmenting endothelial IGF-1 signalling limits paracellular vascular leakage by increasing the expression or activation of proteins forming endothelial cell–cell junctions.21,22 However, as most cholesterol accumulation in the arterial wall is presumed to be via transcellular transport,5 the relevance of IGF-1 to atherosclerosis via endothelial junctions alone is unclear. Here, IGF1 is linked to atherosclerosis.