JCEM:外周甲状腺脱碘程度与老年住院患者的虚弱程度及长期预后有何相关?

2018-03-13 MedSci MedSci原创

尽管FT3低和不良结局之间的关联已在文献中广泛报道,但外周甲状腺素脱碘的程度及其与住院老年患者的虚弱和存活的关系尚未完全建立。近日在JCEM上发表的一篇文章则旨在评估FT3 / FT4比率减少(甲状腺毒素脱碘损伤的间接标志物)与住院老年患者的脆弱状态和生存率之间的可能相关性。

尽管FT3低和不良结局之间的关联已在文献中广泛报道,但外周甲状腺素脱碘的程度及其与住院老年患者的虚弱和存活的关系尚未完全建立。近日在JCEM上发表的一篇文章则旨在评估FT3 / FT4比率减少(甲状腺毒素脱碘损伤的间接标志物)与住院老年患者的脆弱状态和生存率之间的可能相关性。

研究人员连续招收老年患者,住院在比萨大学的老年病房。入院时,对所有患者进行多维老年评估(MGA)和多预后指数(MPI),这是一种脆弱性的间接测量方法。记录住院原因和谵妄发生率。过夜禁食后抽取血液样本进行FT3,FT4和TSH值评估。

研究共纳入例如643例患者(83.8±7.4岁,53%的女性)。 FT3呈负相关且强相关,而FT4与MGA参数,MPI评分(分别为p <0.001和p <0.05)和存活(分别为p <0.001和p = 0.09)呈中度正相关。即使在FT3没有低的患者中,FT3 / FT4比率下降与MGA(p <0.001)和MPI评分(p <0.0001)差异高度相关。在最终的多变量Cox回归模型中纳入FT3证实了FT3 / FT4比值在预测生存率方面的独立作用(p = 0.005)。

上述研究结果表明FT3 / FT4比率降低(外周甲状腺素脱碘的替代指标)和虚弱之间的强相关性。此外,FT3 / FT4比值作为生存的独立标志物出现,即使FT3值正常的患者也是如此。

原始出处:

Giuseppe Pasqualetti.et al. Degree of peripheral thyroxin deiodination, frailty and long-term survival in hospitalized older patients. J Clin Endocrinol Metab. 2018.

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    2018-05-24 achengzhao
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    2018-05-16 smallant2015
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    2018-03-15 yfjms

    学习

    0

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    2018-03-14 changjiu

    学习一下谢谢

    0