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Patients differ in how they process and store energy, build or lose muscle, and respond to changes in appetite or activity

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PI3K/Akt/mTOR and MAPK/ERK Pathway Activation In research settings, IGF-1 LR3 activates the PI3K/Akt pathway (involved in survival, glucose metabolism, and protein synthesis), the RAS/MAPK pathway (regulating growth and differentiation), the mTOR pathway (governing anabolic protein synthesis signalling), and IRS-1/2 cross-talk with insulin receptor signalling the full complement of IGF-1R-mediated downstream effects

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