游离三碘甲状腺原氨酸水平低与 2 型糖尿病老年患者衰弱的风险相关。
Low free triiodothyronine levels are associated with risk of frailty in older adults with type 2 diabetes mellitus.
机构信息
Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
出版信息
Exp Gerontol. 2020 Sep;138:111013. doi: 10.1016/j.exger.2020.111013. Epub 2020 Jun 23.
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 [25(OH) D], 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) D 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.
目的
随着全球人口老龄化，衰弱的情况越来越普遍，因此需要尽早识别出处于衰弱风险中的人群。甲状腺激素水平与 2 型糖尿病（T2DM）患者衰弱之间的关系尚不清楚。本研究的目的是评估老年 T2DM 患者中甲状腺激素浓度与衰弱之间的关系。
方法
根据衰弱表型标准，将 240 名老年 T2DM 患者分为三组：强壮组（n=94）、虚弱前期组（n=110）和虚弱组（n=36）。测定游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和促甲状腺激素（TSH）、25-羟维生素 D[25（OH）D]、高敏 C 反应蛋白（hs-CRP）和白细胞介素 6（IL-6）的浓度。使用 Jamar 握力计测量握力。通过步速和计时起立行走（TUG）测试评估身体功能。进行逻辑回归分析以评估 FT3 与衰弱之间的关系。
结果
虚弱患者的 FT3 水平最低（2.56±0.42pg/mL），其次是虚弱前期患者（2.73±0.38pg/mL），强壮患者的 FT3 水平最高（2.83±0.43pg/mL）。FT3 水平与握力和步速呈正相关（R=0.313，P<0.001；R=0.250，P<0.001），与 TUG 时间呈负相关（R=-0.276，P<0.001）。在校正年龄、性别、TSH、25（OH）D 和估计肾小球滤过率（eGFR）后，逻辑回归显示，低 FT3 与衰弱风险增加显著相关（优势比（OR）：4.53；95%置信区间（CI）：1.89-10.83；P=0.001）。
结论
在老年 T2DM 患者中，低 FT3 水平与衰弱风险增加相关。测量 FT3 可能有助于识别衰弱风险较高的人群。
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