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J Clin Endocrinol Metab. 2017 Nov 6. doi: 10.1210/jc.2017-01854. [Epub ahead of print]

High circulating free thyroxine levels may increase the risk of frailty: The Rotterdam Study.

Author information

1
Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
2
Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands.
3
Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
4
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
5
Section of Geriatric Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.

Abstract

Context:

Thyroid hormones affect metabolism in various tissues, organs and systems. However, the overall impact of thyroid function on an individual's vulnerability to adverse outcomes remains unclear.

Objective:

To investigate the cross-sectional and prospective association of thyroid function with frailty index, a well-established measure of overall health.

Design and Setting:

The Rotterdam Study, a population-based, prospective cohort study.

Participants and main outcome measurements:

Participants with baseline measurements of thyroid function and frailty index were eligible. Frailty index was measured at baseline and after a median follow-up time of 10.1 (interquartile range 5.7-10.8) years. A higher frailty index indicated a worse health state. We assessed the association of thyroid function with frailty at baseline, frailty at follow-up and frailty changes over time, adjusting for age, sex, cohort, smoking, alcohol and education.

Results:

We included 9640 participants (mean age 64.9 years). There was a U-shaped association of TSH (p 0.0003) and FT4 (p<0.0001) with frailty at baseline. There was no association of TSH, but a positive association of FT4 with frailty at follow-up and frailty changes over time (β, 1.22; CI, 0.73 to 1.72 per 1 unit FT4).

Conclusion:

In this population-based study, participants with low and high thyroid function were more likely to be frail than participants with normal thyroid function. However, only those with higher FT4 levels had an increased risk of becoming more frail over time. The identification of FT4 as a potential marker of health deterioration could have future implications regarding the prediction and prevention of frailty.

PMID:
29126162
DOI:
10.1210/jc.2017-01854
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