Low free T3 to free T4 ratio was associated with low muscle mass and impaired physical performance in community-dwelling aged population

Kong, Sung Hye; Kim, Jung Hee; Park, Y. J.; Lee, Joong Ho; Hong, A Ram; Shin, Chan Soo; Cho, N. H.

doi:10.1007/s00198-019-05137-w

Cited by 18 publications

(47 citation statements)

References 30 publications

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“…These inconsistent results were caused by different definition of skeletal muscle mass, small sample size, cross‐sectional method and gender. Previous studies showed that male had stronger relationship with muscle mass than female 4,5 . The associations of thyroid hormones with muscle mass could be diluted in mixed gender.…”

Section: Introductionmentioning

confidence: 93%

“…In one study, the free T3, T4 or TSH had no association with skeletal muscle mass index which was adjusted with height squared (appendicular skeletal muscle mass/height 2 ) in 94 euthyroid elderly persons 4 . Another study using same defined skeletal muscle mass index reported that in euthyroid elderly men (n = 918), skeletal muscle mass index had inverse correlation with free T4 and positive relationship with free T3, but these relationships were not observed in elderly euthyroid women (n = 1215) 5 . The other trial reported that free T3 had a negative association with BMI adjusted muscle mass (appendicular lean mass/BMI) in over 50 years euthyroid elderly (n = 6278) 6 …”

Section: Introductionmentioning

confidence: 97%

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The prospective relationship between low muscle mass and thyroid hormones among 198 069 euthyroid men and women; comparing different definitions of low muscle mass

et al. 2020

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Objective The impact of thyroid hormones within normal range on muscle mass remains unknown. We examined the association between new onset of low muscle mass (LMM) and thyroid hormones among euthyroid men and women with three different definitions of LMM in prospective cohort study. Methods We performed a cohort study of 198 069 Korean adults (mean age of 39.2 years), free of LMM at baseline, who participated in a repeated screening examination and were followed up annually or biennially for up to 6.3 years. Thyroid‐stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxin (FT4) levels were measured by an electrochemiluminescent immunoassay. Muscle mass was assessed using a bioelectrical impedance analyser. LMM was defined as the appendicular skeletal muscle mass (ASM) by body weight (ASM/weight, LMM‐W), height squared (ASM/height2, LMM‐H) and BMI (ASM/BMI, LMM‐B) of one standard deviation below the sex‐specific mean for young reference group. Results During a median follow‐up of 3.1 years (interquartile range, 2.0‐4.1 years), new‐onset LMM‐W, LMM‐H and LMM‐B occurred in 17 856 (incident rate, 27.8 per 1000 person‐years), 8307 (incident rate, 13.4 per 1000 person‐years) and 13 990 participants (incident rate, 24.5 per 1000 person‐years) in each. In euthyroid men, FT4 was inversely and FT3 positively associated with incident LMM‐W in a dose‐response manner. TSH and FT4 had inverse dose‐response relationship with incident LMM‐B. Incident LMM‐H of euthyroid men has no apparent associations with any thyroid hormones. Euthyroid women had no dose‐response relationship between thyroid hormones and any definition of LMM. Conclusions Among euthyroid men, FT4 had inverse dose‐response association with new onset of LMM defined with weight (LMM‐W) and BMI (LMM‐B). Height squared LMM (LMM‐H) had no apparent relationship with any thyroid hormones. Euthyroid women had no dose‐responsive association between thyroid hormones and incident LMM.

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Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 97%

The prospective relationship between low muscle mass and thyroid hormones among 198 069 euthyroid men and women; comparing different definitions of low muscle mass

et al. 2020

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“…Besides, Low T3 was also reported to be a useful predictor of poor clinical outcomes in patients with pyogenic liver abscess (19), chronic fatigue syndrome (22), community-acquired pneumonia (23), secondary hemophagocytic lymph histiocytosis (24), and respiratory failure (34). In a community dwelling elderly population, low fT3 was linked to low muscle mass and poor physical ability (35). In MINOCA patients, two recent case studies have shown that thyroid diseases such as thyrotoxicosis may be a potential cause for MINOCA, suggesting that thyroid hormones may play an important role in the pathogenesis of MINOCA and may have an impact on the prognosis of such patients group (36,37).…”

Section: Discussionmentioning

confidence: 99%

Low Free Triiodothyronine as a Predictor of Poor Prognosis in Patients With Myocardial Infarction With Non-Obstructive Coronary Arteries

et al. 2021

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BackgroundLow free triiodothyronine (fT3) level is strongly associated with poor prognosis in various patient populations. However, the role of fT3 in the risk of clinical outcomes in myocardial infarction with non-obstructive coronary arteries (MINOCA) has not been studied. Our study aimed to evaluate the association between low fT3 levels and the clinical outcomes of MINOCA patients.MethodsA total of 218 MINOCA patients without a history of thyroid disease were enrolled in the study. Demographic, baseline clinical data, thyroid hormones, and other biochemical parameters were assessed in all patients. According to the fT3 levels, the present study was classified into two groups: the low fT3 group (fT3<3.5 pmol/L) and the normal fT3 group (fT3 3.5-6.5 pmol/L). The endpoint of the study was major adverse cardiac events (MACE).ResultsFifty-nine patients were in the low fT3 group and 159 patients were in the normal fT3 group. Over the two years of follow-up, 36 MACE have occurred. The occurrence of MACE was higher in the low fT3 group compared with normal fT3 group (25.4% vs 13.2%; P=0.031). Kaplan-Meier survival curves showed a significantly increased risk of MACE in patients with low fT3 (log-rank P=0.027). Multivariable logistic regression analysis stated that high fT3 was independently associated with lower risk of MACE after two years of follow up (OR, 0.623; 95% CI, 0.399- 0.972; P=0.037).ConclusionLow fT3 levels were significantly associated with increased risk of MACE in patients with MINOCA. This finding suggests that the fT3 levels may serve as a potential biomarker in risk stratification of MINOCA patients.

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“…In a smaller study of fifty-one elderly fit subjects, levels of thyroid hormones (FT3/FT4 ratio) were correlated with aerobic endurance capacity and strength [ 26 ]. Recently, Kong et al, in a Korean population aged 40–69 years, demonstrated that a low FT3/FT4 ratio, but not serum FT3 or FT4 alone, was associated with low muscle mass and impaired physical performance [ 15 ]. Serum TSH level was shown to be inversely correlated with handgrip strength in a large cross-sectional study in Germany [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…This could reflect either reduction in deiodinase (DIO) activity with age, and/or development of thyroid hormone resistance with increasing age [ 14 ]. In an euthyroid population (40–69 years) from Korea, low serum FT3/FT4 was found to be a reliable index for low muscle mass and impaired physical performance [ 15 ]. Similar results were found in a cohort of centenarians and offspring, where THs levels predict disability, mortality, and cognitive level [ 13 ]; in another recent work in the same cohort THs, specifically FT3/FT4 ratio, levels were inversely associated with frailty score [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Thyroid hormone signaling is associated with physical performance, muscle mass, and strength in a cohort of oldest-old: results from the Mugello study

et al. 2020

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Thyroid hormones (THs) play a crucial role in the homeostasis of muscle function, such as myogenesis and energy metabolism, suggesting that the thyroid may be also involved in the entropic processes of muscle aging. The aim of the present study is to evaluate the effect of TH signaling on physical performance, muscle mass, and strength in a cohort of community-dwelling oldest-old subjects (> 90 years). The study population was selected in a rural area of central Italy (Mugello, Tuscany), and the design was cross-sectional. Four hundred seventy-five subjects (130 males and 345 females) were enrolled, representing about 65% of all the nonagenarians living in the Mugello area. After adjusting for multiple confounding factors (sex, age, diabetes, and levothyroxine administration), the lowest quartile of FT3/FT4 ratio distribution showed lower physical performance compared to the other quartiles (β ± SE: − 0.49 ± 0.12; p < 0.001), whereas the highest quartile of FT3/FT4 ratio was associated with higher skeletal muscle index (β ± SE: 1.11 ± 0.42; p = 0.009). In addition, the lowest quartile of FT4 showed a statistically significant higher handgrip strength (β ± SE: 1.78 ± 0.68; p = 0.009) compared to all other quartiles. This study demonstrates that nonagenarians with higher FT3/FT4 ratios had better preserved muscle function, therefore successfully overcoming the imbalance of homeostatic and entropic processes involved in muscle aging. However, we could not establish a cause-effect relationship due to the cross-sectional design of the study.

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Low free T3 to free T4 ratio was associated with low muscle mass and impaired physical performance in community-dwelling aged population

Cited by 18 publications

References 30 publications

The prospective relationship between low muscle mass and thyroid hormones among 198 069 euthyroid men and women; comparing different definitions of low muscle mass

The prospective relationship between low muscle mass and thyroid hormones among 198 069 euthyroid men and women; comparing different definitions of low muscle mass

Low Free Triiodothyronine as a Predictor of Poor Prognosis in Patients With Myocardial Infarction With Non-Obstructive Coronary Arteries

Thyroid hormone signaling is associated with physical performance, muscle mass, and strength in a cohort of oldest-old: results from the Mugello study

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