The Free Triiodothyronine/Free Thyroxine Ratio Is Associated with Frailty in Older Adults: A Longitudinal Multisetting Study

Okoye, Chukwuma; Arosio, Beatrice; Carino, Silvia; Putrino, Luana; Franchi, Riccardo; Rogani, Sara; Cesari, Matteo; Mari, Daniela; Vitale, Giovanni; Calsolaro, Valeria; Monzani, Fabio

doi:10.1089/thy.2022.0422

Cited by 3 publications

(3 citation statements)

References 37 publications

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“…The findings of our study observed U-shaped associations between FT3/FT4 ratio level and mortality, which could be interpreted as indicating an optimal FT3/FT4 ratio level that balances the lowest mortality risk. An Italian study focusing on older adults discovered an inverse correlation between FT3/FT4 ratio value and frailty degree and mortality risk using logistic analysis ( 38 ). However, nonlinear relationships of FT3/FT4 ratio values with frailty degree and mortality were not examined.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, excessive TH levels can produce reactive oxygen species ( 43 ), which might trigger and maintain cell damage, induce physiological abnormalities, and facilitate disease progression ( 44 , 45 ). Furthermore, participants with a risk of mortality might be in a frailty status, such as starvation, chronic inflammation, impaired liver function, and sarcopenia, which may play a role in the impairment of peripheral T4 deiodination ( 38 ).…”

Section: Discussionmentioning

confidence: 99%

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

Yu,

Liu,

Song

et al. 2024

European Thyroid Journal

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Background This study aimed to examine the associations of thyroid hormone sensitivity indices, including free triiodothyronine to free thyroxine (FT3/FT4) ratio, thyroid feedback quantile-based index by FT4 (TFQIFT4), thyroid-stimulating hormone index (TSHI), and thyrotrophic thyroxine resistance index (TT4RI) with all-cause mortality in euthyroid adults. Methods The study included 6243 euthyroid adults from the National Health and Nutrition Examination Survey (NHANES) 2007–2012. FT3/FT4 ratio, TFQIFT4, TSHI, and TT4RI were calculated. The multivariable Cox proportional hazard regression, restricted cubic spline (RCS), and subgroup analysis were conducted. Results Individuals in quartile 4th (Q4) had lower all-cause mortality than those in quartile 1st (Q1) of FT3/FT4 ratio (OR 0.70, 95% CI (0.51, 0.94)). Regarding TFQIFT4, individuals in Q4 of TFQIFT4 had a 43% higher all-cause mortality than those in Q1 (OR 1.43, 95% CI (1.05, 1.96)) (P <0.05, all). Compared with participants in Q1, no associations of TSHI and TT4RI with mortality were found. TFQIFT4 was linearly and positively associated with mortality. However, the FT3/FT4 ratio showed a U-shaped association with mortality. Conclusions Increased risk for all-cause mortality was positively associated with TFQIFT4, suggesting that increased risk for all-cause mortality was associated with decreased central sensitivity to thyroid hormones. Furthermore, the FT3/FT4 ratio showed a U-shaped association with mortality, with an inflection point at 0.5. However, more cohort studies are needed to validate the conclusions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Yu,

Liu,

Song

et al. 2024

European Thyroid Journal

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“…Hemoglobin is also a hematological biomarker that is negatively associated with frailty [ 56 ]. The FT3/FT4 ratio has been found to be associated with frailty [ 57 ]. Moreover, Marzetti al.…”

Section: Instruments Used To Identify Frailtymentioning

confidence: 99%

Predictive Strategies to Reduce the Risk of Rehospitalization with a Focus on Frail Older Adults: A Narrative Review

Bag Soytas,

Levinoff,

Smith

et al. 2023

Epidemiologia

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Frailty is a geriatric syndrome that has physical, cognitive, psychological, social, and environmental components and is characterized by a decrease in physiological reserves. Frailty is associated with several adverse health outcomes such as an increase in rehospitalization rates, falls, delirium, incontinence, dependency on daily living activities, morbidity, and mortality. Older adults may become frailer with each hospitalization; thus, it is beneficial to develop and implement preventive strategies. The present review aims to highlight the epidemiological importance of frailty in rehospitalization and to compile predictive strategies and related interventions to prevent hospitalizations. Firstly, it is important to identify pre-frail and frail older adults using an instrument with high validity and reliability, which can be a practically applicable screening tool. Comprehensive geriatric assessment-based care is an important strategy known to reduce morbidity, mortality, and rehospitalization in older adults and aims to meet the needs of frail patients with a multidisciplinary approach and intervention that includes physiological, psychological, and social domains. Moreover, effective multimorbidity management, physical activity, nutritional support, preventing cognitive frailty, avoiding polypharmacy and anticholinergic drug burden, immunization, social support, and reducing the caregiver burden are other recommended predictive strategies to prevent post-discharge rehospitalization in frail older adults.

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Predictive value of free triiodothyronine to free thyroxine ratio on contrast-associated acute kidney injury and poor prognosis in euthyroid patients after percutaneous coronary intervention

Zeng,

Zhang,

Liang

et al. 2024

Int Urol Nephrol

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The Free Triiodothyronine/Free Thyroxine Ratio Is Associated with Frailty in Older Adults: A Longitudinal Multisetting Study

Cited by 3 publications

References 37 publications

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

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

Predictive Strategies to Reduce the Risk of Rehospitalization with a Focus on Frail Older Adults: A Narrative Review

Predictive value of free triiodothyronine to free thyroxine ratio on contrast-associated acute kidney injury and poor prognosis in euthyroid patients after percutaneous coronary intervention

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