PurposeTo determine serum insulin-like growth factor 1 (IGF-I) levels in healthy Chinese adults, establish reference ranges for serum IGF-I levels and observe the effects of age, sex, body mass index (BMI) and geographical region on serum IGF-I levels.MethodsIn total, 2791 healthy adults (1339 males and 1452 females) from the north (Beijing) and south (Guizhou Province) of China were recruited following a questionnaire survey, physical examination and laboratory examination. Both sexes were divided into 13 groups according to age (18, 19, 20–24, 25–29, 30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, 65–69 and ≥70 years). The serum IGF-I levels were measured by performing a chemiluminescent assay (Immulite 2000®), and the LMS (Lambda-Mu-Sigma) method was applied to construct smooth centile curves of age-specific IGF-I levels.ResultsSerum IGF-I levels in the adults gradually decreased with increasing age from 18 to 70 years in both the male and female participants. Although the decrease in the level of IGF-1 was more pronounced in females than in males, no significant difference was observed between the sexes, except in the 60- to 64-year-old age group (P = 0.0329). The multiple linear regression model showed that there was an inverse relationship between the serum IGF-I level and BMI (P<0.001), and the serum IGF-I level in the Guizhou population was higher than that in the Beijing population (P<0.05).ConclusionThe normal reference ranges for age- and sex-specific serum IGF-I levels were established for the first time in a large sample of Chinese adults. The serum IGF-I levels were significantly influenced by age, BMI and geographical region.