Lower serum FT3 within the reference range is associated with mortality for older adults over 80 years of age with sarcopenia

Abstract

Objective Thyroid hormones stimulate myogenesis and muscle contraction and regulate skeletal muscle cell metabolism. However, the association between thyroid hormone levels and mortality in sarcopenic older adults remains elusive. The aim of this study was to investigate the relationship between thyroid hormones and all-cause mortality in people over 80 years of age with sarcopenia. Methods This study was performed on 264 sarcopenic patients aged 80 years and older. Serum levels of thyroid hormone, including free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) were tested to evaluate thyroid status. Sarcopenia was defined using the criteria of the European Working Group on Sarcopenia in Older People. Mortality data were available for up to 38 months of follow-up. The correlation between FT3 and calf circumference (CC) or handgrip strength (HGS) was determined by Pearson correlation analysis. Kaplan-Meier analysis was used to compare the differences between FT3 tertile groups. Cox regression was used to analyze the mortality risk ratio of patients with different FT3 tertiles. Results During the follow-up period, 88 older adults died. Non-Survivors had lower serum FT3 levels (3.7 ± 0.5 vs. 3.9 ± 0.7, P = 0.001) than the Survivor. Serum FT3 was positively associated with CC and HGS (r = 0.29, P < 0.001, r = 0.21, P = 0.002, respectively). The Kaplan-Meier curve analysis demonstrated a difference in mortality among the FT3 tertile groups (log-rank test, χ2 = 11.83, P = 0.003). The high FT3 group had lower mortality compared with the low FT3 group (the adjusted HRs were 0.63 (95%CI: 0.41–0.96 P = 0.031). Conclusion Lower FT3 within the reference range is associated with higher mortality in adults over 80 years with sarcopenia and euthyroid. Routine assessment of FT3 may be an easy way to identify high-risk older adults with sarcopenia.

Association of sensitivity to thyroid hormones with all-cause mortality in euthyroid US adults: a nationwide cohort study

“…There are abundant studies associating thyroid-stimulating hormone (TSH) and free thyroxine (FT4) with mortality ( 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ). A Chinese study of 264 sarcopenic patients aged 80 years and older found that in a euthyroid population, those with lower levels of free triiodothyronine (FT3) had a higher risk of mortality ( 15 ). An American survey also found the association of ‘low–normal’ thyroid function and subclinical hypothyroidism with increased all-cause mortality ( 16 ).…”