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The role of growth factors in degenerative joint disorders.

It is postulated that osteoarthritis (OA) is associated with an imbalance between cytokine related cartilage degradation, and maintenance of proliferative and synthetic cell responses related to growth factor activity. Insulin, insulin-like growth factor (IGF-1) and growth hormone (GH) were evaluated and compared in patients with OA, and nonosteoarthritic controls. Serum levels of IGF-1 were diminished, and levels of insulin and growth hormone elevated compared to controls. In patients with diffuse idiopathic skeletal hyperostosis (DISH), serum levels of insulin and GH were elevated, but IGF-1 levels were normal. Our results suggest an interplay of growth peptides in the pathophysiology of these common disorders. The profile of growth peptide findings further distinguishes DISH from OA.