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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...

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Autores principales: Bhalla, Nalini S, Vinales, Karyne Lima, Li, Ming, Bhattarai, Richa, Fawcett, Janet, Harman, Sherman Mitchell
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
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.
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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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