Low free triiodothyronine levels are associated with risk of frailty in older adults with type 2 diabetes mellitus
EXPERIMENTAL GERONTOLOGY
Authors: Xiu, Shuangling; Mu, Zhijing; Zhao, Lei; Sun, Lina
Abstract
Objectives: With aging populations around the world, frailty is becoming more prevalent increasing the need to early identify those at risk of frailty. The association between thyroid hormone levels and frailty in subjects with type 2 diabetes mellitus (T2DM) remains unclear. The objective of the study was to evaluate the relationship between thyroid hormone concentrations and frailty in older adults with T2DM. Methods: A total of 240 older adults with T2DM were divided into three groups according to the frailty phenotype criteria: robust group (n = 94), pre-frail (n = 110) and frail group (n = 36). Concentrations of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH), 25-hydroxyvitamin D-3 [25(OH) D3], highly sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were determined. Handgrip strength was measured using a Jamar hand dynamometer. Physical function was assessed by gait speed and the timed go and up (TUG) test. Logistic regression analysis was performed to evaluate the association between FT3 and frailty. Results: The FT3 level was the lowest among frail people (2.56 +/- 0.42 pg/mL), followed by pre-frail participants (2.73 +/- 0.38 pg/mL), with the highest among the robust subjects (2.83 +/- 0.43 pg/mL). FT3 level was positively correlated with handgrip strength and gait speed (R = 0.313, P < 0.001; R = 0.250, P < 0.001, respectively), while negatively correlated with TUG time (R=-0.276, P < 0.001). After adjusting for age, sex, TSH, 25(OH) D3 and estimate glomerular filtration rate (eGFR), logistic regression showed that low FT3 was significantly associated with an increased risk of frailty (odds ratio (OR): 4.53; 95% confidence interval (CI): 1.89-10.83; P = 0.001). Conclusion: Low levels of FT3 were associated with an increased risk of frailty in older adults with T2DM. Measuring FT3 might be useful for identifying those at high risk of frailty.
Efficiency of Thyroid Function Test in the Prediction o f Atrial Fibrillation Following Open Heart Surgery
JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN
Authors: Ozturk, Selen; Kayacioglu, Ilyas; Sensoz, Yavuz; Ozdemir, Kemal; Ozturk, Ibrahim
Abstract
Objective: To analyse the efficiency of thyroid function tests (thyroid stimulating hormone, thyroxine and tri-iodothyronine) on prediction of postoperative atrial fibrillation. Study Design: Meta-analysis. Place of Study: Siyami Ersek Chest and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey. Methodology: Literature review was carried out in PubMed, Science Direct and Ovid Database. No date limitations was applied. Trials, which evaluated the preoperative levels of thyroid stimulating hormone, thyroxine and tri-iodothyronine in cardiac surgery patients, were included. Only the articles in English language were reviewed. We evaluated the results with fix or random effect models according to the presence of heterogeneity (12 >25%). Results: Five hundred and forty-seven articles were obtained after screening of databases. After checking over the titles and abstracts, five trials were included which covered 380 patients and complied with inclusion criteria. According to results of analysis, there was no significant relationship between postoperative atrial fibrillation and thyroid stimulating hormone (SMD: 0.38, 95%CI -0.46-1.23, p=0.375), and also thyroxine (SMD: 0.006, 95% CI -0.29-0.30, p=0.966). However, tri-iodothyronine (SMD: -1.06, 95% CI -2.08- -0.03, p=0.04) was correlated with development of atrial fibrillation. Heterogeneity was observed in three parameters (I-2; for TSH: 92.45%, for T3: 93.08% and for T4: 31.78%). Conclusion: Preoperative levels of tri-iodothyronine was an effective parameter for predicting postoperative atrial fibrillation after cardiac surgery, but there was a need of larger trials for eliminating heterogeneity for all of the parameters of thyroid function tests.