School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia.
Clin Endocrinol (Oxf). 2012 May;76(5):741-8. doi: 10.1111/j.1365-2265.2011.04290.x.
Frailty is common in the elderly and predisposes to ill-health. Some symptoms of frailty overlap those of thyroid dysfunction, but it is unclear whether differences in thyroid status influence risk of frailty. We evaluated associations between thyroid status and frailty in older men.
Cross-sectional epidemiological study.
Community-dwelling men aged 70-89 years.
Circulating thyrotropin (TSH) and free thyroxine (FT(4) ) were assayed. Frailty was assessed as ≥3 of the Fatigue, Resistance, Ambulation, Illnesses and Loss (FRAIL) scale's 5 domains: fatigue; resistance (difficulty climbing flight of stairs); ambulation (difficulty walking 100 m); illness (>5); or weight loss (>5%), blinded to hormone results.
Of 3943 men, 27 had subclinical hyperthyroidism, 431 subclinical hypothyroidism and 608 were classified as being frail (15·4%). There was an inverse log-linear association of TSH with FT(4). There was no association between TSH and frailty. After adjusting for covariates, men with FT(4) in the highest two quartiles had increased odds of being frail (Q3:Q1, odds ratio [OR] = 1·32, 95% confidence interval [CI] = 1·01-1·73 and Q4:Q1, OR = 1·36, 95% CI = 1·04-1·79, P = 0·010 for trend). Higher FT(4) was associated with fatigue (P = 0·038) and weight loss (P < 0·001). The association between FT(4) and frailty remained significant when the analysis was restricted to euthyroid men.
High-normal FT(4) level is an independent predictor of frailty among ageing men. This suggests that even within the euthyroid range, circulating thyroxine may contribute to reduced physical capability. Further studies are needed to clarify the utility of thyroid function testing and the feasibility of preventing or reversing frailty in older men.
衰弱在老年人中很常见，并且容易导致健康状况不佳。衰弱的一些症状与甲状腺功能障碍重叠，但尚不清楚甲状腺状态的差异是否会影响衰弱的风险。我们评估了老年男性的甲状腺状态与衰弱之间的关系。
横断面流行病学研究。
年龄在 70-89 岁的社区居住男性。
检测循环促甲状腺激素（TSH）和游离甲状腺素（FT（4））。使用疲劳、抵抗力、活动能力、疾病和体重减轻（FRAIL）量表的 5 个领域中的≥3 个来评估衰弱：疲劳；抵抗力（难以爬楼梯）；活动能力（难以行走 100 米）；疾病（>5）；或体重减轻（>5%），激素结果为盲法。
在 3943 名男性中，27 人患有亚临床甲状腺功能亢进症，431 人患有亚临床甲状腺功能减退症，608 人被归类为衰弱（15.4%）。TSH 与 FT（4）呈负对数线性关系。TSH 与衰弱之间没有关联。在调整了混杂因素后，FT（4）处于最高两个四分位数的男性衰弱的可能性增加（Q3：Q1，比值比[OR] = 1.32，95%置信区间[CI] = 1.01-1.73；Q4：Q1，OR = 1.36，95%CI = 1.04-1.79，P = 0.010 趋势）。较高的 FT（4）与疲劳（P = 0.038）和体重减轻（P < 0.001）相关。当分析仅限于甲状腺功能正常的男性时，FT（4）与衰弱之间的关联仍然显著。
高正常 FT（4）水平是老年男性衰弱的独立预测因素。这表明，即使在甲状腺功能正常范围内，循环甲状腺素也可能导致身体能力下降。需要进一步的研究来阐明甲状腺功能测试的效用以及预防或逆转老年男性衰弱的可行性。
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