Analysis of the genome sequence of an alpaca coronavirus.

Coronaviral infection of New World camelids was first identified in 1998 in llamas and alpacas with severe diarrhea. In order to understand this infection, one of the coronavirus isolates was sequenced and analyzed. It has a genome of 31,076 nt including the poly A tail at the 3' end. This virus designated as ACoV-00-1381 (ACoV) encodes all 10 open reading frames (ORFs) characteristic of Group 2 bovine coronavirus (BCoV). Phylogenetic analysis showed that the ACoV genome is clustered closely (>99.5% identity) with two BCoV strains, ENT and LUN, and was also closely related to other BCoV strains (Mebus, Quebec, DB2), a human corona virus (strain 043) (>96%), and porcine hemagglutinating encephalomyelitis virus (>93% identity). A total of 145 point mutations and one nucleotide deletion were found relative to the BCoV ENT. Most of the ORFs were highly conserved; however, the predicted spike protein (S) has 9 and 12 amino acid differences from BCoV LUN and ENT, respectively, and shows a higher relative number of changes than the other proteins. Phylogenetic analysis suggests that ACoV shares the same ancestor as BCoV ENT and LUN.

Characteristics of a recent isolate of Sarcocystis neurona (SN7) from a horse and loss of pathogenicity of isolates SN6 and SN7 by passages in cell culture.

An isolate of Sarcocystis neurona (SN7) was obtained from the spinal cord of a horse with neurologic signs. The parasite was isolated in cultures of bovine monocytes and equine spleen cells. The organism divided by endopolygeny and completed at least one asexual cycle in cell cultures in 3 days. The parasite was maintained by subpassages in bovine monocytes for 10 months when it was found to be non-pathogenic to gamma interferon knockout (KO) mice. Revival of a low passage (10th passage) of the initial isolate stored in liquid nitrogen for 18 months retained its pathogenicity for KO mice. Merozoites (10(6)) of the late passage (22nd passage) were infective to only one of four KO mice inoculated. Similar results were obtained with SN6 isolate of S. neurona. No differences were found in Western blot patterns using antigens from the low and high passage merozoites of the SN7 and SN6 isolates. These results suggest that prolonged passage in cell culture may affect the pathogenicity of some isolates of S. neurona.

Comparative development and merozoite production of two isolates of Sarcocystis neurona and Sarcocystis falcatula in cultured cells.

The development and merozoite production of Sarcocystis falcatula and 2 isolates (SN6 and SN2) of Sarcocystis neurona were studied in various cultured cell lines inoculated with culture-derived merozoites. All 3 parasites underwent multiple cycles of schizogony in VERO cells, bovine monocytes (M617 cells), and bovine pulmonary artery endothelial cells (CPA). Sarcocystis neurona strains SN6 and SN2 formed schizonts in rat myoblasts (L6) but not in quail myoblasts (QM7); S. falcatula formed schizonts in QM7 cells but not in L6 cells. Merozoites did not develop to sarcocysts in the myoblast cells lines. During a 47-day culture period in VERO cells, SN6 produced substantially more merozoites than did SN2 or S. falcatula. M617 cells produced substantially more merozoites of SN6 than did VERO or CPA cells. During a 17-day culture period of SN6, M617 cells produced mean totals of 4.7 x 10(8) merozoites, VERO cells produced 1.9 x 10(8) merozoites, and CPA cells produced 5.9 x 10(7) merozoites. At 4-12 days after inoculation of cultured cells with SN6, M617 cells cultured in the presence of 10% fetal bovine serum (FBS) produced a mean merozoite total of 5.1 x 10(8) compared to 3.6 x 10(8) for culture medium containing 1% FBS.

Characterization of a Sarcocystis neurona isolate (SN6) from a naturally infected horse from Oregon.

An isolate of Sarcocystis neurona (SN6) was obtained from the spinal cord of a horse from Oregon with neurologic signs. The parasite was isolated in cultures of bovine monocytes and equine spleen cells. The parasite divided by endopolygeny and completed at least one asexual cycle in cell cultures in three days. Two gamma interferon knockout mice inoculated with cell culture-derived merozoites became ill 35 d later and S. neurona schizonts and merozoites were found in encephalitic lesions. The parasite in tissue sections of mice reacted with S. neurona-specific antibodies and S. neurona was reisolated from the brain of knockout mice.

Association of dehydroepiandrosterone sulfate, body composition, and physical fitness in independent community-dwelling older men and women.

OBJECTIVES: To determine the association of dehydroepiandrosterone sulfate (DHEAS), body composition, and physical fitness in independent community-dwelling men and women aged 60 to 80 years. DESIGN: Cross sectional analysis. PARTICIPANTS: Independent men and women, 60 years of age and older, living in urban and suburban communities of Southeastern Wisconsin. MEASUREMENTS: History, physical examination, physical activity level, and anthropometrics were measured for every subject. Total adipose mass (TAM) and lean body mass were measured using dual energy X-ray absorptiometry. Dehydroepiandrosterone sulfate, insulin-like growth factor-1 (IGF-1), total testosterone (TT), and free testosterone (FT) were measured using radioimmunoassay. Physical fitness was measured as VO2max using exercise stress tests. Blood for lipids was analyzed using standard assays. RESULTS: In men, the DHEAS was significantly correlated to age (r = -.32), TAM (r = -.27), percent fat (r = -.30), HDL cholesterol (r = .34), TT (r = .30), VO2max (r = .23), and percent lean body mass (% LBM) (r = .33). In women, the DHEAS was not significantly correlated to any of the variables examined except body mass index (BMI) (r = .23). In men, after partialling out age, DHEAS was significantly correlated to HDL, % fat, TAM, % LBM, and TT. Multivariate analysis for men revealed that high density lipoprotein cholesterol (HDL) was the strongest predictor of serum DHEAS level, followed by % LBM, BMI, and age. The men in the highest quartile of serum DHEAS levels were different from those in the lowest quartile in terms of age, TT, FT, % fat, TAM, % LBM, HDL, and low density lipoprotein (LDL) cholesterol level. No such differences were found in the two groups of women. CONCLUSION: In this group of independent community-dwelling older men, several factors were found to be associated with the serum DHEAS concentration, whereas in a group of older women, no such associations were identified with the exception of BMI. Men in the highest quartile of serum DHEAS level, compared with those with a serum DHEAS level in the lowest quartile, were younger, leaner, more fit, had higher TT and FT levels, and had a favorable lipid profile. No such differences were identified between the women in the highest and the lowest quartiles of serum DHEAS level.

Predictors of lean body mass and total adipose mass in community-dwelling elderly men and women.

As part of an ongoing longitudinal study, we analyzed cross-sectional data to identify the predictors of lean body mass (LBM) and total adipose mass (TAM) in community-dwelling elderly men and women. Body composition analysis was done using dual energy x-ray absorptiometry. A total 262 subjects (118 women and 144 men), 60 to 80 years of age, from the urban and suburban communities of southeastern Wisconsin were studied. In women, the age (r = -.18), body mass index (BMI) (r = .43), and waist-to-hip ratio (WHR) (r = .30), and in men, BMI (r = .45) and insulin-like growth factor-1 (IGF-1) (r = .32) were identified as predictors (P < .05) of LBM. In women, the BMI (r = .87), WHR (r = .21), and functional work capacity (VO2 max) (r = -.47), and in men, the BMI (r = .83), WHR (r = .52), dehydroepiandrosterone sulfate (DHEAS) (r = -.27), total testosterone (TT) (r = -.35), free testosterone (FT) (r = -.23), physical activity (LTE) (r = -.32), and VO2 peak (r = -.59) were identified as predictors of TAM. After partialling out age in addition to the predictors identified earlier, the VO2 peak was identified as a predictor (P < .05) of LBM in both women and men, and TT, FT, and LTE as predictors (P < .05) of LBM in men. We conclude that the BMI, WHR, and VO2 peak influences LBM and TAM in both women and men. Additionally, in men LBM and TAM is influenced by hormone profile.

Characterization of monoclonal antibodies against infections laryngotracheitis virus.

Nine monoclonal antibodies (MCAs) produced against two different strains of infectious laryngotracheitis virus (ILTV) were characterized and compared to previously characterized MCA 131-6, produced against a third ILTV strain. In western blotting experiments, MCAs C, E, and 11 resembled MCA 131-6, detecting proteins of 205, 160, 115, and 90 kD as well as several proteins less than 49 kD. The other six MCAs differed from previously described ILTV MCA. MCA D detected a 90-kD protein along with several less than 49 kD. MCAs 4 and 5 each detected proteins of 205, 160, 100, 90, and 70 kD. MCA 9 detected the same proteins detected by MCAs 4 and 5 except the 160-kD protein. MCA 10 detected proteins of 100, 90, and 70 kD and several proteins less than 49 kD. MCAs C, D, and E, like MCA 131-6, failed to react with any ILTV grown in the presence of tunicamycin, suggesting that those MCAs are specific for carbohydrate-based epitopes. MCA 6 reacted with only a 100-kD protein in the presence or absence of tunicamycin. The remaining MCA detected only a 70-kD protein in the presence of tunicamycin except MCA 5, which reacted with proteins of 70 and 90 kD. Only MCA 4 and 6 neutralized ILTV infectivity.

Observations on nursing home residents with a history of hip fracture.

The authors evaluated nursing home residents with a prior history of hip fracture for osteopenia and its risk factors, and attempted to learn to what extent the residents' bone status had been considered by their primary care physicians. Thirty-one hip fracture residents in the Milwaukee VA nursing home were studied to determine their status with regard to bone mineral density of the proximal femur, and the following risk factors or predictors of osteopenia: history of smoking; history of fractures; calcium and vitamin D intake; underweight; immobility; hypogonadism; and administration of drugs that may accelerate bone demineralization. Data were also collected on the evaluation and management of the post hip fracture residents in three other nursing homes. In the Milwaukee nursing home, out of 31 hip fracture survivors, 74% had sustained a hip fracture before admission to the nursing home; 29% had a history of second fracture. In 84% of patients, there was no mention of osteopenia in the active medical problem list and, therefore, there was no intervention plan in place to improve or prevent further bone loss. Thirty-two percent were underweight, 36% were currently smoking, 55% were immobile, 64% were consuming at least one medication that might increase bone loss, calcium intake was less than 1,000 mg daily in 52%, and 66% were hypogonadal (serum testosterone level less than 300 ng/dL). Chart reviews of the hip fracture survivors at three other nursing homes revealed similar findings. Approximately 5-15% of nursing home residents are hip fracture survivors. They usually have severe osteopenia and multiple risk factors for further bone loss and future fractures.(ABSTRACT TRUNCATED AT 250 WORDS)

Update on llama medicine. Viral diseases.

Expanding interest in New World Camelids presents a unique challenge to veterinarians engaged in diagnosing infectious diseases of these species. Little basic research has been conducted in this area. Much of our information is incomplete and based on serologic surveys and personal communication with virologists in diagnostic laboratories. This review is a summary of our current knowledge of the common viral diseases of llamas and alpacas. It is hoped that it will serve as a catalyst for a more complete understanding of this topic in the future.

Clinical indicators derived from the patient assessment instrument in the long-stay residents of 69 VA nursing homes.

OBJECTIVES: Previous work has shown that clinical indicators reflecting occurrence of bedsores, behavioral disturbances, and deterioration of activities of daily living (ADLs) can be calculated for the long-stay residents of Veterans Affairs (VA) nursing homes from the standard biannual Patient Assessment Instrument (PAI). The present study aimed to construct national curves for these indicators, against which each facility could in the future compare its own values; and to determine the correlations between the indicator values and selected nursing home characteristics. METHODS: Eight indicators were calculated for the long-stay (more than six months) residents of the 69 VA nursing homes housing 50 or more such patients from the 1992 PAI data. The indicators were: prevalence of bedsores; incidence of bedsores; prevalence of physically aggressive behavior; incidence of aggressive behavior; and frequencies of six-month losses of eating, mobility, transfer, and toileting functions by the initially independent residents. RESULTS: There was a two- to sixfold difference between the most favorable quartile and the least favorable quartile for the eight indicators. Significant correlations across institutions were found between the prevalence and incidence of bedsores, the prevalence and incidence of aggressive behavior, and the frequencies of declines in the four ADLs by the initially independent residents. One or several of the indicators were significantly superior in nursing homes with these characteristics: a smaller size, a slower resident turnover rate, a smaller proportion of residents with nonorganic psychoses, a lower ratio of short-stay to long-stay residents, and a lower ratio of independent to dependent long-stay residents. CONCLUSIONS: These data provide national standards against which each VA nursing home can compare its PAI-derived clinical indicator values. The outcomes measured by these indicators appear to be influenced both by casemix and by environmental factors.

Relations of endogenous anabolic hormones and physical activity to bone mineral density and lean body mass in elderly men.

OBJECTIVE: It has been proposed that declining activities of the somatotrophic or gonadotrophic axes, or sedentary life style, are partial causes for geriatric losses of bone mineral density (BMD) and of lean body mass (LBM). The present study tested these hypotheses by determining, in both free-living and institutionalized elderly men, the correlations of bone mineral density (BMD), total body bone mineral content (TBBMC) and lean body mass (LBM) with the following predictor variables: age, body mass index, body weight, serum insulin-like growth factor I (IGF-I), serum testosterone, habitual physical activity and mobility. SUBJECTS: Forty-nine independent, community-dwelling older men, and 49 men of similar age residing in two Veterans Administration extended care facilities. The age range was 58-95 years. MEASUREMENTS: Serum IGF-I and testosterone were measured by radioimmunoassay. Habitual physical activity in the independent men and mobility in the institutionalized men were estimated by standard instruments. LBM and bone status at nine skeletal sites were determined by dual X-ray absorptiometry. RESULTS: The BMD and TBBMC values of the free living men were 4-20% higher than those of the institutionalized men. In the independent old men, serum testosterone was the strongest predictor of BMD and TBBMC, while age was the only predictor of LBM. In the chronically institutionalized men, age, body weight and immobility were the strongest predictors of body composition, and testosterone was correlated only with femoral neck BMD. CONCLUSIONS: In aging independent men, low levels of testosterone are associated with demineralization of the skeleton. Immobility and under-weight are associated with the osteopenia of old men residing in nursing homes. In this cross-sectional study of elderly men, there was no evidence of a relation of the somatotrophic axis to bone status or LBM, or of the gonadotrophic axis to LBM.

Hyposomatomedinemia and hypogonadism in hemiplegic men who live in nursing homes.

The purpose of this study was to determine the prevalence of low serum insulin-like growth factor-I (IGF-I) and testosterone in men with poststroke hemiplegia. Serum concentrations of IGF-I, total testosterone, and free testosterone were compared in healthy young men, healthy old men, and old men with poststroke hemiplegia. A low IGF-I level, below the lower 2.5 percentile of the healthy young men, occurred in 85% of the healthy old men, and in 88% of the poststroke hemiplegic patients. When a low IGF-I was defined as a value below the lower 2.5 percentile of the healthy old men, the prevalence in the hemiplegic men was 5%. For total testosterone, a value below the lower 2.5 percentile in the healthy young men occurred in 78% of the healthy old men and in 79% of the stroke survivors. Low total testosterone, defined as a value below the lower 2.5 percentile of the healthy old men, occurred in 17% of the hemiplegic men. The results with free testosterone were similar. Compared with healthy young men, most healthy old men have low serum IGF-I and testosterone levels. Old hemiplegic men resemble healthy old men in their IGF-I levels, but they have more cases of severe hypogonadism (total tostosterone < 193ng/dL). Because correction of IGF-I and testosterone deficiencies in younger adults improves muscle strength, work capacity, and quality of life, treatment with human growth hormone and testosterone may be a useful adjunct to physical measures in the rehabilitation of selected hemiplegic stroke survivors.

Serum insulin-like growth factor I in healthy older men in relation to physical activity.

OBJECTIVE: The serum level of insulin-like growth factor-I (IGF-I) is lower in old men than in young men. It has been theorized that this change may result in part from the lower level of physical activity in the elderly. The objective of the present study was to test this theory. DESIGN: Cross-sectional study. SETTING: Community-dwelling healthy men. PARTICIPANTS: Twenty-nine young men aged 21-29 and 120 older men aged 58-98. A wide range of habitual physical activity was assured in the older men by recruiting them both in senior centers and in fitness centers. MEASUREMENTS: Serum IGF-I level was measured by radioimmunoassay. Physical activity was estimated as the sum of moderate, hard, and very hard activities in leisure and occupation during the previous week as determined by the interviewer-administered Seven Day Physical Activity Recall questionnaire. RESULTS: IGF-I was significantly higher (363.7 +/- 16 ng/mL, avg +/- SEM) in the young men than in the senior center older men (219.6 +/- 5 ng/mL) or in the fitness center older men (168.3 +/- 11 ng/mL) (P < 0.01). The level of IGF-I in the senior center older men was higher than that in the fitness center older men (P = 0.05). The physical activity of the fitness center older men (128.5 +/- 15 Kcal/kg/wk, avg +/- SE) was statistically similar to that of the young men (101.3 +/- 19 Kcal/kg/wk). The physical activity levels of both of these groups were significantly higher than that of the senior center older men (33.6 +/- 3 Kcal/kg/wk) (P < 0.010). Within none of the three groups was there a significant correlation between IGF-I and physical activity. When the two groups of older men were combined, there was, in fact, an inverse correlation of IGF-I and physical activity (P = 0.001). CONCLUSION: The data do not support the hypothesis that lack of physical activity is responsible for the decline in serum IGF-I with advancing age.

The occurrence of pressure ulcers in three nursing homes.

BACKGROUND: In the 27 nursing homes located within the Veterans Affairs (VA) Central Region, the proportion of residents with pressure ulcers in 1986 varied from 2% to 16%. Three of these nursing homes were selected for study: nursing home A from the highest prevalence quintile, B from close to the median, and C from the lowest quintile. METHODS: Two indicators of pressure ulcer occurrence were calculated: the point-in-time prevalence of bedsores and the percentage of residents who were free of pressure ulcers at the beginning of a six-month study period but who had bedsores six months later. Data were also collected in each nursing home to determine the bedsore status at the time of admission and the resident's location if and when a bedsore began. RESULTS: The three institutions were generally similar in available measures of casemix and severity of illness. The ratio of nursing and medical personnel to residents was 29%-76% lower in nursing home A than in B or C. In nursing home A, the turnover of nursing personnel was about twice as rapid as that in B or C. In each institution the pressure ulcer statistics showed little variation from one six-month period to another. The average rates in nursing home A were 15.3% for prevalence and 10.3% for the six-month conversion from bedsore-negative to bedsore-positive status. The average rates in facilities B and C were, respectively, 6.9% and 3.5% for prevalence and 4.7% and 4.2% for the six-month conversion from negative to positive status. Furthermore, the number of new bedsores that developed during uninterrupted nursing home residence, per 100,000 resident days, was 36.5 in A, 10.8 in B, and 2.1 in C. CONCLUSIONS: The pressure ulcer statistics in nursing homes B and C were consistently superior to those in A. the interinstitutional differences could not be explained by the comparisons of scoring methodologies and of casemixes that were made. It is hypothesized that more favorable staffing patterns in B and C than in A contributed to more effective prevention of bedsores in the former two institutions.

Comparison of clinical indicators in two nursing homes.

OBJECTIVE: Pressure ulcer prevalences in 30 VA nursing homes in 1986 ranged from 0% to 15%. The institutions with lowest ("A") and highest ("B") prevalence were selected for further examination. DESIGN: Analysis of nursing home files for five study periods, each lasting 6 months. SETTING: A and B were 60-bed rural and 280-bed urban facilities, respectively. MEASUREMENTS: Eleven outcome indicators were calculated for each study period: prevalences and incidences of pressure ulcer, aggressive behavior and disruptive behavior, 6-month declines in each of the four activities of daily living (ADLs), and prevalence of underweight. RESULTS: Populations in A and B were similar with regard to age, sex, length of stay, degree of dependency, and level of nursing care. All indicators for the first study period were more favorable in A than in B. In addition, underweight (body mass index < 22 kg/M2) was significantly less prevalent in A than in B. The differences between the two institutions in the indicators were persistent over the five study periods from 1988 to 1991. CONCLUSIONS: The populations of A and B were similar in the available measures of severity of illness. Nevertheless, the residents in nursing home A were significantly less likely to experience adverse outcomes than were the residents in nursing home B. The virtual absence of pressure ulcers, physical aggression, and verbal disruption in nursing home A, despite the presence of many immobile and demented residents, suggested that these complications can mostly be prevented.

A simple method to quantify the changes in activities of daily living of long-stay nursing home populations.

This report describes a simple method to quantify changes in the activities of daily living (ADLs) over a 6-month time period in long-stay VA nursing home populations. In these institutions, each resident receives a score of one to five every 6 months describing the degree of dependence in eating, mobility, transfer and toileting ("patient assessment instrument" or PAI). From these data, quantitative indicators can be calculated for the studied population: the average score for each ADL at the beginning and end of the period, and the average 6-month change in this score; the proportions of all residents whose ADL score improved, remained unchanged or worsened; the proportion of initially independent residents whose ADL score worsened, and the proportion of initially dependent residents whose score improved. The method was applied in two VA nursing homes (A and B). The profiles of ADL outcomes in the two nursing homes differed in several respects. For example, in nursing home A, 80% or more of the population either remained unchanged or improved in ADLs and only 2 to 18% deteriorated. In nursing home B, on the other hand, only 50 to 60% of the population remained unchanged or improved and 36 to 50% deteriorated. For the initially independent residents, the frequency of deterioration of ADLs in nursing home B was several times greater than that in nursing home A. The described method of quantifying ADL outcomes could readily be applied to the PAI data that are available in all VA nursing homes.(ABSTRACT TRUNCATED AT 250 WORDS)

Low circulating levels of insulin-like growth factors and testosterone in chronically institutionalized elderly men.

OBJECTIVE: To determine the prevalences of and the associations between hyposomatomedinemia and hypogonadism in healthy young men, healthy old men, and chronically institutionalized old men. DESIGN: Survey with serial blood tests. SETTING: Veterans Affairs nursing home and young and old men living in the community. SUBJECTS: Three groups were studied: healthy young men (20-29 years old, n = 32), healthy old men (59-98 years old, n = 30), and chronically institutionalized old men (59-95 years old, n = 112). MEASUREMENTS: Plasma insulin-like growth factor-I (IGF-I), total testosterone (TT), free testosterone (FT), and plasma insulin-like growth factor-II (IGF-II) were measured. In subjects with low testosterone level, serum luteinizing hormone (LH) was also determined. In a subset of chronically institutionalized old men with low IGF-I, the serum growth hormone (GH) level was analyzed during the first 4 hours of sleep. RESULTS: A low IGF-I level (defined as a value below the lower 2.5 percentile of the comparison group) occurred in 85% of the healthy old men when compared with healthy young men (P < 0.001), in 90% of the chronically institutionalized old men when compared with healthy young men (P < 0.001), and in 26% of the chronically institutionalized old men when compared with healthy old men (P < 0.001). In chronically institutionalized old men with low IGF-I compared with healthy young men, nocturnal peaks of serum GH were < 2 ng/mL in most cases. Low TT (defined as a value below the lower 2.5 percentile of the comparison group) occurred in 86% of the healthy old men when compared with healthy young men (P < 0.001), in 88% of the chronically institutionalized old men when compared with healthy young men (P < 0.001), and in 28% of the chronically institutionalized old men when compared with healthy old men (P < 0.001). The results of FT were similar. In 80% of the institutionalized old men with low TT and FT, the serum LH level was low (< 20 mU/mL). In 53% of the institutionalized old men, the IGF-II level was below the lower 2.5 percentile of the healthy old men (P < 0.001). In both healthy and institutionalized old men, IGF-I and IGF-II levels were significantly correlated to each other (r = 0.6), but neither was significantly correlated to TT or FT. In the institutionalized old men, IGF-I was inversely correlated with age and with a diagnosis of dementia; TT and FT were inversely correlated with age and with the degree of dependency in ADL's. CONCLUSIONS: Compared with healthy young men, most healthy old men have low serum IGF-I, TT, and FT levels. The geriatric hyposomatomedinemia and hypogonadism are more severe in institutionalized old men. In the latter group, both endocrine deficiencies are usually of central origin, but their occurrences are not significantly associated. Healthy old men usually have a low level of IGF-I compared with healthy young men, but a similar level of IGF-II; institutionalized old men are usually low in both values.

Prevalence of low plasma IGF-I in poliomyelitis survivors.

OBJECTIVE: To compare plasma levels of insulin-like growth factor-I (IGF-I, also termed somatomedin C) in polio survivors and healthy control subjects and to determine their relation to selected clinical characteristics. DESIGN: Cross sectional study. SETTING: Polio survivors living in the community recruited from the Wisconsin Polio Support Group. PARTICIPANTS: A total of 124 polio survivors (49 males and 75 females), ages 35 to 77 years, and 261 healthy control subjects (139 males and 122 females) of similar age. MEASUREMENTS: Plasma IGF-I levels were compared in polio survivors and age-matched control subjects. In the polio survivor group, the relation of IGF-I to selected clinical characteristics was examined before and after adjusting for covariates. RESULTS: Statistical analyses showed that the IGF-I concentrations were significantly lower in the polio survivors than in the controls. This difference was reflected in the means and standard errors of the two groups (0.45 +/- 0.02 vs 0.60 +/- 0.02 units/mL, P < 0.01). Plasma IGF-I below 0.35 units/mL in adults indicates little or no growth hormone secretion. In polio survivors, 38% of the plasma IGF-I values were < 0.35 units/mL compared with 19% in the healthy group. Univariate analysis showed that IGF-I in the polio survivors was significantly correlated with age, gender, and body mass index, and with dependency, pain, and difficulty in the activities of daily living (ADLs). The correlations with ADL dysfunction were independent of the correlations with age, gender, and body mass index. IGF-I level did not correlate with the subjective report of recent decline in functional status. CONCLUSION: Lower levels of IGF-I are seen in polio survivors, and this finding correlates with ADL dysfunction. The hyposomatomedinemic tendency of polio survivors may have an adverse effect on their neuromuscular function and quality of life.