Prognostic value of thyroid hormones in acute ischemic stroke – a meta analysis

Jiang, Xingjun; Xing, Hongyi; Wu, Jing; Du, Ruofei; Liu, Houfu; Chen, Jixiang; Ji, Wang; Wang, Chen; Wu, Yan

doi:10.1038/s41598-017-16564-2

Cited by 49 publications

(30 citation statements)

References 58 publications

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“…We also found that FT3 levels were negatively correlated with IS incidence among young adults. This is the rst study to our knowledge to have reported such a relationship, as prior studies and meta-analysis have largely focused on correlations between low FT3 levels and severity/mortality among acute IS patients [23][24][25][26][27]. These prior studies have reported such a relationship even for low FT3 values within the standard reference range [28,29].…”

Section: Discussionmentioning

confidence: 74%

“…One study, however, found that this relationship was age-dependent, such that TT3 and FT3 levels were unrelated to IS outcomes in patients < 65 years old, whereas TT3 levels were independently predictive of poor outcomes among older patients [30]. In these prior studies, the average population ages ranged from 61.4-81.5 years [23][24][25][26][27][28], with the exception of one study with a median population age of 48 years [29]. Serum TT3 and FT3 levels are lower among healthy older individuals [31], and FT3 levels decline over time [32].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk Factors Associated with Ischemic Stroke in a Young Non-Diabetic and Non-Hypertensive Population: A Retrospective Case-Control Study

Zhang

Qiu

et al. 2020

Preprint

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Background: Globally, rates of ischemic stroke (IS) have been rising among young adults. This study was designed to identify risk factors associated with IS incidence in young adults unaffected by hypertension or diabetes.Methods: This was a retrospective case-control study of early-onset IS patients without diabetes and hypertension. Control patients were matched with healthy individuals based upon sex, age (±2 years), and BMI (±3 kg/m2) at a 1:3 ratio. Sociodemographic, clinical, and risk factor-related data pertaining to these patients was collected. The association between these risk factors and IS incidence was then assessed using conditional logistic regression models.Results: We recruited 60 IS patients and 180 controls with mean ages of 44.37±4.68 and 44.31±4.71 years, respectively, for this study. Relative to controls, IS patients had significantly higher total cholesterol (TG), homocysteine (HCY), white blood cell (WBC), absolute neutrophil count (ANC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) levels, and significantly lower high-density lipoprotein cholesterol (HDL-C) and triglyceride cholesterol (TC), free triiodothyronine (FT3), and free thyroxine (FT4) levels (all P< 0.05). After controlling for potential confounding factors, HCY and ANC were found to be significantly positively associated with IS incidence (OR 1.518, 95%CI 1.165-1.977, P= 0.002 and OR 2.418, 95%CI 1.061-5.511, P=0.036, respectively), whereas HDL-C and FT3 levels were negatively correlated with IS incidence (OR 0.001, 95%CI 0.000-0.083, P=0.003 and OR 0.053, 95%CI 0.008-0.326, P=0.002, respectively).Conclusion: In young non-diabetic and non-hypertensive patients, lower HDL-C and FT3 levels and higher HCY and ANC levels may be associated with an elevated risk of IS. Additional prospective studies of large patient cohorts will be essential to validate these findings.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated with Ischemic Stroke in a Young Non-Diabetic and Non-Hypertensive Population: A Retrospective Case-Control Study

Zhang

Qiu

et al. 2020

Preprint

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“…For example, an inverse relation between free T 3 levels and the risk for developing Alzheimer's disease (AD) was demonstrated in a 302 patient cohort with mild cognitive impairment at the beginning of the study (Quinlan et al, 2019). Similarly, lower free T 3 levels in pre-stroke individuals correlated with increased stroke severity, disability and mortality rates (Jiang et al, 2017;Lamba et al, 2018).…”

Section: Patient Studies Linking Thyroid Hormone Levels With Cns Injumentioning

confidence: 99%

Thyroid Hormone and Neural Stem Cells: Repair Potential Following Brain and Spinal Cord Injury

Vancamp¹,

Butruille²,

Demeneix³

et al. 2020

Front. Neurosci.

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Neurodegenerative diseases are characterized by chronic neuronal and/or glial cell loss, while traumatic injury is often accompanied by the acute loss of both. Multipotent neural stem cells (NSCs) in the adult mammalian brain spontaneously proliferate, forming neuronal and glial progenitors that migrate toward lesion sites upon injury. However, they fail to replace neurons and glial cells due to molecular inhibition and the lack of pro-regenerative cues. A major challenge in regenerative biology therefore is to unveil signaling pathways that could override molecular brakes and boost endogenous repair. In physiological conditions, thyroid hormone (TH) acts on NSC commitment in the subventricular zone, and the subgranular zone, the two largest NSC niches in mammals, including humans. Here, we discuss whether TH could have beneficial actions in various pathological contexts too, by evaluating recent data obtained in mammalian models of multiple sclerosis (MS; loss of oligodendroglial cells), Alzheimer's disease (loss of neuronal cells), stroke and spinal cord injury (neuroglial cell loss). So far, TH has shown promising effects as a stimulator of remyelination in MS models, while its role in NSC-mediated repair in other diseases remains elusive. Disentangling the spatiotemporal aspects of the injury-driven repair response as well as the molecular and cellular mechanisms by which TH acts, could unveil new ways to further exploit its proregenerative potential, while TH (ant)agonists with cell type-specific action could provide safer and more target-directed approaches that translate easier to clinical settings.

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“…Their median age was 69 (62-75) years, with men being the predominate gender (58.8 %). The median NIHSS score was 7 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Among all the patients, 80 (31.4 %) patients received specific intravenous thrombolysis treatment.…”

Section: Baseline Characteristics Of Study Populationmentioning

confidence: 99%

“…Among these hormones, T3 has the highest prognostic value in AIS. Low serum levels of T3, even within normal ranges, are associated with worse functional prognosis after ischaemic stroke, but are equivocal for mortality [7]. Low T3 concentration with normal or slightly reduced TSH is seen in many disorders [8].…”

Section: Introductionmentioning

confidence: 99%

Nonthyroidal Illness Syndrome in Ischaemic Stroke Patients is Associated with Increased Mortality

Taroza

Rastenytė

Podlipskytė

et al. 2019

Exp Clin Endocrinol Diabetes

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Background Results of studies on associations between triiodothyronine serum levels and mortality after acute ischemic stroke (AIS) are inconsistent. Therefore, the aim of this prospective study was to evaluate links between serum levels of thyroid axis associated hormones and all-cause mortality during 1 year after AIS. Methods and results This study involved 255 patients with AIS. Patients were divided into two groups: those who survived 1 year after their index stroke and those who not, and by quartiles of free triiodothyronine (FT3) and ΔFT3 (difference between basal FT3 and repeated FT3 on discharge) hormone serum concentrations. To assess serum levels of thyroid stimulating hormone (TSH), FT3 and free tetraiodothyronine (FT4), venous blood was taken from all included patients on admission to hospital. On discharge, blood tests were repeated for 178 (69.8%) patients. Study endpoints were overall mortality within 30, 90 and 365 days after AIS. Results Compared with the survivals, those who died had significantly lower mean FT3, FT3/FT4 ratio in all periods and lower median TSH within 30 days. Higher FT3 serum levels versus lower, even after adjustment for included important variables, remained significant for lower odds of death within 365 days after AIS (OR=0.57; 95% CI: 0.33–0.97, p=0.04), but added insignificant additional predictive value to the NIHSS score or age. Kaplan–Meier survival curves demonstrated that the first FT3 quartile was significantly associated with increased mortality compared with all other quartiles within 365 days after AIS. With ΔFT3 quartiles no such association was found. Conclusions. Higher FT3 levels on admission versus lower are significantly associated with lower mortality within 365 days after AIS. FT3 serum levels changes over time didn’t show any association with mortality within first year.

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Prognostic value of thyroid hormones in acute ischemic stroke – a meta analysis

Cited by 49 publications

References 58 publications

Risk Factors Associated with Ischemic Stroke in a Young Non-Diabetic and Non-Hypertensive Population: A Retrospective Case-Control Study

Risk Factors Associated with Ischemic Stroke in a Young Non-Diabetic and Non-Hypertensive Population: A Retrospective Case-Control Study

Thyroid Hormone and Neural Stem Cells: Repair Potential Following Brain and Spinal Cord Injury

Nonthyroidal Illness Syndrome in Ischaemic Stroke Patients is Associated with Increased Mortality

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