Low free triiodothyronine levels are associated with risk of frailty in older adults with type 2 diabetes mellitus

Xiu, Shuangling; Mu, Zhijing; Zhao, Lei; Sun, Lina

doi:10.1016/j.exger.2020.111013

Cited by 10 publications

(24 citation statements)

References 33 publications

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“…However, associations between fT4 and frailty or its components were absent in our observational study. Our results were in accordance with two other studies which also investigated the relationship between fT3 and frailty [27,33] . Xiu et al [33] determined that low fT3 levels, rather than fT4 and TSH, were associated with a significantly higher chance of frailty among type 2 diabetes mellitus elder inpatients, while Bano et al [40] also determined an inverse relationship between fT3 levels and frailty based on a cohort of 62 inpatients with hip fracture and 50 controls.…”

Section: Discussionsupporting

confidence: 91%

“…[3,39] Therefore, lowered fT3 levels are associated with the loss of muscle mass and strength, further causing restricted movement and reduced gait speed. [33,40] The relationship between fT3/fT4 ratio representing the degree of thyroxin peripheral conversion and frailty were also tested in our research, and the ratio was found to be an effective predictor of frailty. Our result was in line with findings in several previous studies.…”

Section: Discussionmentioning

confidence: 94%

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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: 91%

Section: Discussionmentioning

confidence: 94%

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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“…In our study, reduced levels of free T3 were associated with five GSs, including the risk of malnutrition, frailty, and sarcopenia. Previously, it was demonstrated that lower free T3 levels were associated with grip strength, SPPB scores [50,51], and the risk of frailty in older adults [52,53], including long-lived individuals [54].…”

Section: Discussionmentioning

confidence: 99%

Analyzing Successful Aging and Longevity: Risk Factors and Health Promoters in 2020 Older Adults

Kashtanova

Taraskina

Erema

et al. 2022

IJERPH

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Geriatric syndromes (GSs) and aging-associated diseases (AADs) are common side effects of aging. They are affecting the lives of millions of older adults and placing immense pressure on healthcare systems and economies worldwide. It is imperative to study the factors causing these conditions and develop a holistic framework for their management. The so-called long-lived individuals—people over the age of 90 who managed to retain much of their health and functionality—could be holding the key to understanding these factors and their health implications. We analyzed the health status and lifestyle of the long-lived individuals and identified risk factors for GSs. Family history greatly contributes to the health and prevention of cognitive decline in older adults. Lifestyle and certain socioeconomic factors such as education, the age of starting to work and retiring, job type and income level, physical activity, and hobby were also associated with certain GSs. Moreover, the levels of total protein, albumin, alpha-1 globulins, high-density lipoprotein, free triiodothyronine, and 25-hydroxyvitamin D were direct indicators of the current health status. The proposed mathematical model allows the prediction of successful aging based on family history, social and economic factors, and life-long physical activity (f1 score = 0.72, AUC = 0.68, precision = 0.83 and recall = 0.64).

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“…A previous cross-sectional study [39] found a positive association between frailty and TSH concentration and a negative association between frailty and T3 concentration, activity of daily living score, and instrumental activity of daily living score. Low levels of FT3 are associated with an increased risk of frailty in elderly type 2 diabetes patients, and FT3 can serve as a biomarker of frailty [40].…”

Section: Relationship Between Th and Frailty In Hospitalized Elderly ...mentioning

confidence: 99%

Correlation analysis of FT3/FT4 and frailty in elderly patients with coronary heart disease

Zhou

et al. 2023

Preprint

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Purpose: To explore the effect of thyroid hormone (TH) on the risk of frailty in elderly patients with CHD. Methods: Fried scale was used to assess frailty of participants. The predictive value of TH for frailty was determined using the patient's operating characteristic curve. Univariate analysis was used to examine potential factors affecting frailty. Multivariate logistic regression model was utilized to analyze the relationship between TH and frailty. Results:A total of 277 elderly patients with CHD were included in the study, of which 29.96% were in a state of frailty. FT3/FT4 predicted frailty with the largest area under the curve of 0.634. Unordered multinomial logistic regression analysisshowed that a lower T3 level was a risk factor for pre-frailty (P < 0.05). Lower levels of T3, FT3, and FT3/FT4 were risk factors for frailty (P< 0.05) after adjusting for demographic variables and blood indexes. Conclusion: The predictive value of FT3/FT4 for frailty was more accurate than that of a single index. Moreover, T3≤1.095nmol/L, FT3≤4.085pmol/L, and FT3/FT4≤0.336 were shown to be the influencing factors of frailty, while T3≤1.095nmol/L is an independent risk factor pre-frailty. Suggesting new ideas for the prevention and treatment of frailty in elderly patients with CHD.

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Low free triiodothyronine levels are associated with risk of frailty in older adults with type 2 diabetes mellitus

Cited by 10 publications

References 33 publications

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

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

Analyzing Successful Aging and Longevity: Risk Factors and Health Promoters in 2020 Older Adults

Correlation analysis of FT3/FT4 and frailty in elderly patients with coronary heart disease

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