目的 分析高龄老人中甲状腺激素(THs)与身体虚弱及虚弱表征五个组分(疲劳、抵抗力、行走能力、疾病数目和体重减轻)的相关性。方法 选取≥80岁的社区老年居民487例。基于FRAIL量表(疲劳、抵抗、行走、疾病、体重下降)对虚弱明确诊断,记录每个虚弱子域的阳性得分。记录人口统计学信息(年龄、性别、婚姻状况和教育状况)、合并症及参与者生活方式等。测定血清THs,包括游离三碘甲状腺素(fT3)、三碘甲状腺素(T3)、游离甲状腺素(fT4)、甲状腺素(T4)及促甲状腺激素(TSH)水平。对数据进行logistic回归分析,筛选出虚弱及其子域的潜在风险因素。结果 487名受试者中,有60例(12.23%)被诊断为亚临床甲状腺功能减退症,110例(22.59%)虚弱评分为阳性。对所有潜在混杂因素进行调整后的Logistic回归分析显示,虚弱与血清TSH浓度(OR=1.06)、fT3浓度(OR=0.54)和亚临床甲状腺功能减退症(OR=2.18)有显著关联,fT4和虚弱间没有关联,而fT3/fT4则与虚弱相关。结论 亚临床甲状腺功能减退症、较高的TSH水平、较低的fT3水平和fT3/fT4比值的降低都与社区高龄老人虚弱程度相关。未来的纵向研究需要继续确定甲状腺功能紊乱与高龄老人虚弱之间的关联。
Abstract
Objective To analyze the relationship between thyroid hormones (THs), frailty and the five components of frailty phenotype (fatigue, resistance, walking ability, number of illnesses, and weight loss) in the elderly. Methods Cross-sectional study with 487 community-dwelling elderly residents aged ≥80 years was conducted. A clear diagnosis of frailty was made based on the FRAIL scale (fatigue, resistance, walking, disease, and weight loss), and positive scores were recorded for each frailty subdomain. Demographic information (age, sex, marital status and education), comorbidities, and details of the participants’ lifestyles were also recorded. Laboratory tests were performed to determine serum THs, including free triiodothyronine (fT3), triiodothyronine (T3), free thyroxine (fT4), and thyroxine (T4), and thyroid stimulating hormone (TSH) levels. logistic regression of the data was performed to screen out potential risk factors for frailty and its subdomains. Results Of the 487 subjects enrolled, 60 (12.23%) were diagnosed with subclinical hypothyroidism, and 110 (22.59%) had a positive frailty score. Logistic regression analysis adjusted for all potential confounders showed that frailty was significantly associated with serum TSH concentration (OR:1.06), fT3 concentration (OR:0.54), and subclinical hypothyroidism (OR:2.18).The study showed no association between fT4 and frailty, whereas fT3/fT4 was associated with frailty. Conclusions Subclinical hypothyroidism, higher TSH levels, lower fT3 levels, and lower fT3/fT4 ratio are all associated with frailty as assessed by the FRAIL scale in community-dwelling elderly. Future longitudinal studies are needed to continue to determine the association between thyroid dysfunction and frailty in the elderly.
关键词
甲状腺功能减退 /
虚弱 /
老龄化 /
甲状腺激素 /
促甲状腺激素
Key words
hypothyroidism /
frailty /
aging /
thyroid hormone /
thyroid stimulating hormone
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基金
军队某课题资助;国家老年疾病临床医学研究中心开放课题(NCRCG-PLAGH-2022004)
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