Hyposomatomedinemia in the Men of a Veterans Administration Nursing Home: Prevalence and Correlates

Abstract

A previous study found hyposomatomedinemia to be common in the men of this VA Nursing Home. To gain information on the prevalence and correlates of this endocrine characteristic, we have measured plasma somatomedin C (SmC) in 69 Nursing Home men 55–95 years old (group I), and in 37 independent men 56–87 years old attending our geriatric medicine outpatient clinic (group II). In groups I and II, a clinical data base was compiled comprising: blood chemistries, measures of body composition – nutritional state and functional level, diagnoses, medications, and morbidity and mortality during the year after the SmC analysis. The mean ± SD for SmC was significantly (p < 0.05) lower in group I (0.35 ± 0.21 units/ml) than in group II (0.45 ± 0.13 units/ml). SmC less than 0.25 units/ml, a range consistent with severe growth hormone deficiency, was found almost exclusively in group I (31.8% of men in group I, 3.7% of men in group II). In either group I, or in groups I and II combined, SmC was significantly (p < 0.05) correlated with body weight as percentage of ideal, midarm muscle circumference (MAMC) as percent of standard, diagnosis of cerebrovascular disease, and plasma testosterone level. Men with SmC values below 0.25 units/ml had significantly (p < 0.05) lower values for body weight as percentage of ideal, and for MAMC as percentage of standard. Except for cerebrovascular disease, SmC did not correlate significantly (p > 0.05) with diagnosis, drugs, morbidity or mortality.

Serum Insulin‐Like Growth Factor I in Healthy Older Men in Relation to Physical Activity

“…Thus, the data do not exclude the possibility that immobility (as contrasted with a sedentary life style) would further lower the IGF‐I level in aging people. Militating against this postulate, however, is a previous finding that within a nursing home population, the serum IGF‐I concentration did not correlate significantly with the degree of physical dependency 25 . (3) The GH response to exercise by young people is known to be proportional to the duration and intensity of the exercise 26–28 .…”

Hyposomatomedinemia in Men with Post‐Poliomyelitis Syndrome

“…The authors have previously reported that plasma SmC is significantly lower in nursing home men than in their age‐matched healthy counterparts 43 , 44 . Because the hyposomatomedinemia of these chronically institutionalized individuals was not significantly correlated with their functional level, the writers previously concluded that physical inactivity was not the main cause for their low SmC values 44 . The present finding that the totally immobile subgroup of the male nursing home population did not differ significantly in plasma SmC level from healthy age‐matched men is consistent with the earlier conclusion that physical inactivity per se does not cause hyposomatomedinemia.…”

“…The authors have previously reported that plasma SmC is significantly lower in nursing home men than in their age‐matched healthy counterparts 43 , 44 . Because the hyposomatomedinemia of these chronically institutionalized individuals was not significantly correlated with their functional level, the writers previously concluded that physical inactivity was not the main cause for their low SmC values 44 .…”

Age‐associated endocrine deficiencies as potential determinants of femoral neck (type II) osteoporotic fracture occurrence in elderly men

“…Finally, circulating levels of bioavailable testosterone were unrelated to bone mineral density of the proximal femur and the total body in 38 healthy men between 25 and 59 years of age ( Johansson et al, 1994). It remains for future studies to determine if (or to what extent) the lower limit of the normal range for serum testosterone is associated with reduced bone formation and bone fragility in aging men (Rudman et al, 1987).…”