老年住院患者队列中甲状腺激素水平与衰弱的关联：一项横断面研究。

Association between thyroid hormone levels and frailty in an older inpatient cohort: a cross-sectional study.

作者信息

Liu Yang, Sun Qin, Zhang Min, Ren Min, Chen Ping, Liang Ting

机构信息

Department of Geriatrics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Ann Palliat Med. 2021 Jun;10(6):6678-6686. doi: 10.21037/apm-21-1102.

DOI:10.21037/apm-21-1102

PMID:34237971

Abstract

BACKGROUND

Frailty is a common biological syndrome in elderly people, and the aging process regulates thyroid function. The present study aimed to determine the prevalence of frailty in an older inpatient cohort using the FRAIL scale and to evaluate the association of frailty with thyroid hormone levels.

METHODS

This cross-sectional study was performed in the Department of Geriatrics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China. From November 2019 to April 2020, 146 inpatients aged ≥65 years were recruited for the study and demographic data, frailty, geriatric assessment, and thyroid hormone levels were evaluated. Frailty was determined by the FRAIL scale, and geriatric assessment was based on activities of daily living (ADL) and instrumental activities of daily living (IADL). The data were analyzed using appropriate parametric and nonparametric statistical tests.

RESULTS

At enrollment, 31 (21.23%) of the total participants were robust, 31 (21.23%) were pre-frail, and 84 (57.53%) were frail. The frail patients were significantly older than the robust patients and pre-frail patients (P<0.001 for both). The percentages of ADL disability differed significantly among the patients for frail versus robust, frail versus pre-frail, and pre-frail versus robust, as did the percentages of IADL disability among patients for frail versus robust and frail versus pre-frail (P<0.01 for all). In binary logistic regression analyses adjusted for age, sex, body mass index, HbA1c (%), and smoking, frailty was significantly associated with serum thyroid stimulating hormone (TSH) concentration [odds ratio (OR): 1.704], T3 concentration (OR: 0.102), ADL score (OR: 0.793), and IADL score (OR: 0.413).

CONCLUSIONS

In our study population, the prevalence of frailty was higher in older geriatric inpatients in China than other studies. Inpatients with high TSH levels were at increased risk of frailty. Conduction of future longitudinal studies is warranted to determine the relationship between thyroid hormone levels and frailty.

摘要

背景

衰弱是老年人常见的生物学综合征，且衰老过程会调节甲状腺功能。本研究旨在使用衰弱量表确定老年住院患者队列中衰弱的患病率，并评估衰弱与甲状腺激素水平的关联。

方法

本横断面研究在中国电子科技大学附属四川省人民医院老年医学科进行。2019年11月至2020年4月，招募了146名年龄≥65岁的住院患者进行研究，并对其人口统计学数据、衰弱情况、老年评估和甲状腺激素水平进行了评估。通过衰弱量表确定衰弱情况，老年评估基于日常生活活动能力（ADL）和工具性日常生活活动能力（IADL）。使用适当的参数和非参数统计检验对数据进行分析。

结果

入组时，总参与者中31人（21.23%）身体健壮，31人（21.23%）为衰弱前期，84人（57.53%）为衰弱。衰弱患者的年龄显著高于身体健壮患者和衰弱前期患者（两者P均<0.001）。衰弱患者与身体健壮患者、衰弱患者与衰弱前期患者、衰弱前期患者与身体健壮患者之间的ADL残疾百分比差异显著，衰弱患者与身体健壮患者、衰弱患者与衰弱前期患者之间的IADL残疾百分比差异也显著（所有P均<0.01）。在对年龄、性别、体重指数、糖化血红蛋白（HbA1c）（%）和吸烟进行校正的二元逻辑回归分析中，衰弱与血清促甲状腺激素（TSH）浓度[比值比（OR）：1.704]、T3浓度（OR：0.102）、ADL评分（OR：0.793）和IADL评分（OR：0.413）显著相关。