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Atrial natriuretic peptide (ANP) exert potent lipolytic effects by activating hormone-sensitive lipase in adipocytes, however the role of ANP in ketogenesis remains unknown (91)

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Attempts to improve linear growth by rhIGF-I treatment has been reported to result in some improvements in a few affected children but not all (134, 135) It is beyond the scope of this chapter to review the overwhelming evidence from cell biology experiments demonstrating the important role of IGFBPs in modulating IGF bioactivity and the role of IGFBP proteases and their actions at the cellular level