Association between thyroid hormone levels and frailty in an older inpatient cohort: a cross-sectional study

Liu, Yang; Sun, Qi; Zhang, Min; Min, Ren; Chen, Ping; Liang, Ting

doi:10.21037/apm-21-1102

Cited by 8 publications

(12 citation statements)

References 34 publications

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“…We observed that TSH levels were correlated with prevalent frailty and fatigue. Our result was thus in agreement with others that a higher TSH concentration was associated with frailty in both male and female patients [19,27,28] . The possible explanation of the role of TSH on frailty is that high TSH levels may contribute to overt and subclinical hypothyroidism, all of which may precipitate the development of overall metabolic reduction, cardiovascular decompensation, and neuromuscular abnormalities [29–32] .…”

Section: Discussionsupporting

confidence: 93%

“…Frailty is regarded as the manifestation of aging and showed great heterogeneity as well. [2,19] Therefore, comprehensively evaluating the thyroid status and exploring the relationship between thyroid hormone concentrations and frailty among the oldest-old might help uncover the intricate pathogenesis of aging. Therefore, our study investigated the correlation between each thyroid hormone with frailty diagnosed by FRAIL scale among a group of communitydwelling oldest-old.…”

Section: Discussionmentioning

confidence: 99%

“…Subclinical hypothyroidism may simply be a derivative of the naturally shifting TSH levels in conjunction with increasing age, and its risk effect on frailty might be a pure reflection of aging. [19,24] In addition, it was reported that though replacement therapy with levothyroxine was confirmed to bring benefits to elderly patients with overt hypothyroidism, the clinical benefits of levothyroxine supplementation among those with subclinical hypothyroidism was absent. [25,26] Therefore, the predictive value of subclinical hypothyroidism on frailty among the elderly should be treated with discretion, and the degree of TSH deviation and the presence of autoimmune markers should also be taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

“…TSH values between 0.35 and 4.94 mIU/L were adopted as reference. The reference ranges for fT4, T4, fT3, and T3 were as follows: (1) fT4: 9.01 to 19.05 pmol/L; (2) T4: 62.88 to 150.80 nmol/L; (3) fT3: 2.63 to 5.70 pmol/L; and (4) T3: 0.88 to 2.44 nmol/L [19] …”

Section: Methodsmentioning

confidence: 99%

“…The reference ranges for fT4, T4, fT3, and T3 were as follows: (1) fT4: 9.01 to 19.05 pmol/L; (2) T4: 62.88 to 150.80 nmol/L; (3) fT3: 2.63 to 5.70 pmol/L; and (4) T3: 0.88 to 2.44 nmol/L. [19] Potential covariates Demographic information including age, gender, body mass index, marital status, and educational levels was collected through interviews and questionnaires. Information regarding physical comorbidities such as hypertension, coronary heart disease, cerebral artery diseases, chronic obstructive pulmonary disease, diabetes mellitus, cancer, and osteoporosis was gathered based on a self-reporting mechanism.…”

Section: Frail Scalementioning

confidence: 99%

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Association between thyroid hormone levels and frailty in the community-dwelling oldest-old: a cross-sectional study

Guan

Luo

Huang

et al. 2022

Chinese Medical Journal

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Background: Changes in thyroid hormone levels are commonly recognized characters among the elderly, which were reported to potentially influence incident frailty. Therefore, we examined the cross-sectional associations of thyroid hormones (THs) with frailty as well as the five components characterizing frailty (fatigue, resistance, ambulation, number of illnesses, and loss of weight) among the oldest-old. Methods: Four hundred and eighty-seven community-dwelling oldest-old from a local community in Haidian District, Beijing, participated in our recruitment campaign between April 2019 and May 2020. The primary outcomes were a definitive diagnosis of frailty according to the FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, Loss of weight) and a positive score for each frailty subdomain. Demographic information (age, sex, marital status, and educational status), comorbidities, and details on the participants’ lifestyles were recorded. Serum THs including free triiodothyronin (fT3), triiodothyronine (T3), free thyroxine (fT4), and thyroxine (T4) and thyroid stimulating hormone (TSH) levels were also measured at the beginning of our study. Logistic regressions were conducted to screen for potential risk factors for frailty and its subdomains. Results: Among the total 487 subjects at enrollment, 60 (12.23%) of them were diagnosed with subclinical hypothyroidism and 110 (22.59%) of the total population scored positive for frailty. Logistic regression analyses adjusted for all potential confounders, showed that frailty was significantly associated with the serum TSH concentration (odds ratio [OR]: 1.06), fT3 concentration (OR: 0.54), and subclinical hypothyroidism score (OR: 2.18). The association between fT4 and frailty was absent in our observational study. The fT3/fT4 ratio characterizing peripheral hormone conversion was also tested to be correlated with frailty. Conclusion: Subclinical hypothyroidism, higher TSH level, lower fT3 level, and decreased fT3/fT4 ratio were all associated with frailty assessed by the FRAIL scale among the community-dwelling oldest-old, suggesting a relevant role of thyroid function in aging. Future longitudinal studies are warranted to determine the casual relationship between thyroid dysfunction and frailty in the oldest-old.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%