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Increased reverse triiodothyronine is associated with shorter survival in independently-living elderly: the Alsanut study.

Abstract：

OBJECTIVE:Increased reverse tritiodothyronine (T(3)) used to be described as a part of euthyroid sick syndrome (ESS). It was demonstrated to be associated with increased mortality in acutely ill patients. It can also be found with low or normal T(3) in non-severely ill subjects but its significance remains unclear. PATIENTS AND DESIGN:The Alsanut study included a representative sample of 440 independently-living subjects aged 65 or over constituted between January 1988 and September 1989. Past and current medical history and nutritional data were collected at inclusion. Baseline thyroid hormone (TSH, FT(4), FT(3) and rT(3)) serum levels were measured. Life status was determined on 1 December 2005. RESULTS:Of the 374 elderly subjects included in the final analysis, 52 had abnormal TSH (43 with hyperthyroidism, nine with hypothyroidism) and 80.7% had died by 1 December 2005. There was no statistical difference in survival between subjects according to thyroid function (P=0.54). Of the 322 elderly subjects with normal TSH, mortality rate was 81.1%. ESS was found in 3.4%, whereas 8.1% of the participants displayed elevated rT(3) with normal FT(3). Time to death was strongly related to rT(3) (P<0.0001) and FT(3) (P<0.0001) in a univariate analysis. After adjusting for other confounding variables, rT(3) was the only thyroid hormone associated with shorter survival (P=0.014). CONCLUSIONS:RT(3) was the only thyroid hormone associated with shorter survival in a representative population of independently-living elderly. In these subjects, isolated elevated rT(3) might be an equivalent of ESS, reflecting declining health.

journal_name

Eur J Endocrinol

journal_title

European journal of endocrinology

authors

Forestier E,Vinzio S,Sapin R,Schlienger JL,Goichot B

doi

10.1530/EJE-08-0519

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

207-14

issue

2

eissn

0804-4643

issn

1479-683X

pii

EJE-08-0519

journal_volume

160

pub_type

杂志文章

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