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Low TSH Is Associated With Frailty in an Older Veteran Population Independent of Other Thyroid Function Tests
Low TSH is associated with frailty in the older adult. We studied whether low TSH is an independent marker of frailty or is an indicator of subclinical hyperthyroidism, which in turn predicts frailty. Of outpatient veterans seen between January 2005 and December 2016, we identified 100 patients aged...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7797567/ https://www.ncbi.nlm.nih.gov/pubmed/33457463 http://dx.doi.org/10.1177/2333721420986028 |
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author | Bhalla, Nalini S Vinales, Karyne Lima Li, Ming Bhattarai, Richa Fawcett, Janet Harman, Sherman Mitchell |
author_facet | Bhalla, Nalini S Vinales, Karyne Lima Li, Ming Bhattarai, Richa Fawcett, Janet Harman, Sherman Mitchell |
author_sort | Bhalla, Nalini S |
collection | PubMed |
description | Low TSH is associated with frailty in the older adult. We studied whether low TSH is an independent marker of frailty or is an indicator of subclinical hyperthyroidism, which in turn predicts frailty. Of outpatient veterans seen between January 2005 and December 2016, we identified 100 patients aged ≥60 years with two low TSH (<0.5 µIU/ml) and one fT3 measurement and 50 matched controls (TSH 0.5–5.0 µIU/ml). We used a deficit accumulation approach to create a frailty index (FI). The higher the FI, the more likely (p<0.001) that patients had expired. Patients with low (0.31 ± 0.11 µIU/mL) versus normal (1.84 ± 0.84 µIU/mL) TSH had higher mean FI compared to controls (0.25 ± 0.12 vs. 0.15 ± 0.07, p < .001). Low TSH was significantly associated with frailty (p < .001), independent of age. However, lower TSH was not associated with higher fT3 or fT4 levels. There was a nonsignificant inverse association of fT3 levels with FI (p = .13), which disappeared when adjusted for age. Similar to prior studies, low TSH was associated with frailty. However, neither fT3 nor fT4 predicted low TSH or FI, suggesting that the association of low TSH with frailty is not due to subclinical hyperthyroidism, but perhaps to effects of comorbidities on TSH secretion. |
format | Online Article Text |
id | pubmed-7797567 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-77975672021-01-15 Low TSH Is Associated With Frailty in an Older Veteran Population Independent of Other Thyroid Function Tests Bhalla, Nalini S Vinales, Karyne Lima Li, Ming Bhattarai, Richa Fawcett, Janet Harman, Sherman Mitchell Gerontol Geriatr Med Article Low TSH is associated with frailty in the older adult. We studied whether low TSH is an independent marker of frailty or is an indicator of subclinical hyperthyroidism, which in turn predicts frailty. Of outpatient veterans seen between January 2005 and December 2016, we identified 100 patients aged ≥60 years with two low TSH (<0.5 µIU/ml) and one fT3 measurement and 50 matched controls (TSH 0.5–5.0 µIU/ml). We used a deficit accumulation approach to create a frailty index (FI). The higher the FI, the more likely (p<0.001) that patients had expired. Patients with low (0.31 ± 0.11 µIU/mL) versus normal (1.84 ± 0.84 µIU/mL) TSH had higher mean FI compared to controls (0.25 ± 0.12 vs. 0.15 ± 0.07, p < .001). Low TSH was significantly associated with frailty (p < .001), independent of age. However, lower TSH was not associated with higher fT3 or fT4 levels. There was a nonsignificant inverse association of fT3 levels with FI (p = .13), which disappeared when adjusted for age. Similar to prior studies, low TSH was associated with frailty. However, neither fT3 nor fT4 predicted low TSH or FI, suggesting that the association of low TSH with frailty is not due to subclinical hyperthyroidism, but perhaps to effects of comorbidities on TSH secretion. SAGE Publications 2021-01-07 /pmc/articles/PMC7797567/ /pubmed/33457463 http://dx.doi.org/10.1177/2333721420986028 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Bhalla, Nalini S Vinales, Karyne Lima Li, Ming Bhattarai, Richa Fawcett, Janet Harman, Sherman Mitchell Low TSH Is Associated With Frailty in an Older Veteran Population Independent of Other Thyroid Function Tests |
title | Low TSH Is Associated With Frailty in an Older Veteran Population Independent of Other Thyroid Function Tests |
title_full | Low TSH Is Associated With Frailty in an Older Veteran Population Independent of Other Thyroid Function Tests |
title_fullStr | Low TSH Is Associated With Frailty in an Older Veteran Population Independent of Other Thyroid Function Tests |
title_full_unstemmed | Low TSH Is Associated With Frailty in an Older Veteran Population Independent of Other Thyroid Function Tests |
title_short | Low TSH Is Associated With Frailty in an Older Veteran Population Independent of Other Thyroid Function Tests |
title_sort | low tsh is associated with frailty in an older veteran population independent of other thyroid function tests |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7797567/ https://www.ncbi.nlm.nih.gov/pubmed/33457463 http://dx.doi.org/10.1177/2333721420986028 |
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