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Hu X, Zhang L, Zhang M, Mi W, Sun Y, Wang Y, Zou H, Liu C, Xu S. Correlation of subclinical hypothyroidism with sarcopenia and its components in the Chinese older adults. Endocrine 2024; 84:1030-1039. [PMID: 38151629 DOI: 10.1007/s12020-023-03654-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/09/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE To identify the correlation of thyroid function and subclinical hypothyroidism (SCH) with sarcopenia and its components in the older Chinese adults. METHODS Older adults were recruited and divided into SCH group and non-SCH group. Free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured by electrochemiluminescence. Appendicular skeletal muscle mass (ASM) was measured, and skeletal muscle index (SMI) was further calculated. Grip strength was measured. Physical performance was graded by the Short Physical Performance Battery (SPPB) scores of the gait speed test, chair stand test and balance test. RESULTS Of the 240 older adults included, 48 (20.00%) presented with SCH. The prevalence of sarcopenia in SCH group was higher than that in non-SCH group (33.33% v.s. 18.75%). Grip strength was significantly lower in patients with SCH than those without sarcopenia. In terms of physical performance, 6-meter gait speed and SPPB score were lower in subjects with SCH than those without SCH, while 5 sit-to-stand movements was longer score in subjects with SCH than those without SCH. SCH was significantly correlated with sarcopenia, while FT3, FT4, and TSH levels were not. SCH was significantly correlated with low muscle strength and low muscle mass, but not with low physical performance. FT3 level was positively correlated with grip strength and SMI. TSH level was negatively correlated with grip strength, 6-meter gait speed, and SPPB score, but positively correlated with the time of 5 sit-to-stand movements. CONCLUSION SCH is a risk factor for sarcopenia in the older adults and correlated with low muscle strength and low muscle mass, but not with low physical performance. FT3, FT4 and TSH levels are associated with sarcopenia components, but not with sarcopenia.
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Affiliation(s)
- Xin Hu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Lina Zhang
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Mengjie Zhang
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Weinuo Mi
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Yu Sun
- Department of Endocrinology, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Yan Wang
- Department of Geriatrics, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China.
| | - Huiling Zou
- Department of Endocrinology, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Chao Liu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
- Key Laboratory of TCM Syndrome and Treatment of Yingbing (Thyroid Disease) of State Administration of Traditional Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Shuhang Xu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China.
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Sheng Y, Zhu X, Wei L, Zou Y, Qi X, Shi R, Xu W, Wang X, Ding G, Duan Y. Aberrant expression of thyroidal hormone receptor α exasperating mitochondrial dysfunction induced sarcopenia in aged mice. Aging (Albany NY) 2024; 16:7141-7152. [PMID: 38643465 PMCID: PMC11087121 DOI: 10.18632/aging.205748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 03/18/2024] [Indexed: 04/22/2024]
Abstract
Disrupted mitochondrial dynamics and mitophagy contribute to functional deterioration of skeletal muscle (SM) during aging, but the regulatory mechanisms are poorly understood. Our previous study demonstrated that the expression of thyroid hormone receptor α (TRα) decreased significantly in aged mice, suggesting that the alteration of thyroidal elements, especially the decreased TRα, might attenuate local THs action thus to cause the degeneration of SM with aging, while the underlying mechanism remains to be further explored. In this study, decreased expression of myogenic regulators Myf5, MyoD1, mitophagy markers Pink1, LC3II/I, p62, as well as mitochondrial dynamic factors Mfn1 and Opa1, accompanied by increased reactive oxygen species (ROS), showed concomitant changes with reduced TRα expression in aged mice. Further TRα loss- and gain-of-function studies in C2C12 revealed that silencing of TRα not only down-regulated the expression of above-mentioned myogenic regulators, mitophagy markers and mitochondrial dynamic factors, but also led to a significant decrease in mitochondrial activity and maximum respiratory capacity, as well as more mitochondrial ROS and damaged mitochondria. Notedly, overexpression of TRα could up-regulate the expression of those myogenic regulators, mitophagy markers and mitochondrial dynamic factors, meanwhile also led to an increase in mitochondrial activity and number. These results confirmed that TRα could concertedly regulate mitochondrial dynamics, autophagy, and activity, and myogenic regulators rhythmically altered with TRα expression. Summarily, these results suggested that the decline of TRα might cause the degeneration of SM with aging by regulating mitochondrial dynamics, mitophagy and myogenesis.
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Affiliation(s)
- Yunlu Sheng
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China
| | - Xiaoxia Zhu
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China
| | - Lijun Wei
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China
| | - Yuxin Zou
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China
| | - Xinyu Qi
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China
| | - Runqing Shi
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China
| | - Wenli Xu
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China
| | - Xiaodong Wang
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China
| | - Guoxian Ding
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China
| | - Yu Duan
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People’s Republic of China
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Hata S, Okada H, Minamida M, Hironaka J, Hasegawa Y, Kondo Y, Nakajima H, Kitagawa N, Okamura T, Hashimoto Y, Osaka T, Kitagawa N, Majima S, Senmaru T, Ushigome E, Nakanishi N, Asano M, Hamaguchi M, Fukui M. Associations between thyroid hormones and appendicular skeletal muscle index, and hand grip strength in people with diabetes: The KAMOGAWA-A study. Diabetes Res Clin Pract 2024; 209:111573. [PMID: 38346590 DOI: 10.1016/j.diabres.2024.111573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
AIM To assess the effects of thyroid hormones on appendicular skeletal muscle index (SMI) and hand grip strength (HGS) in people with diabetes. METHODS This cross-sectional cohort included 1,135 participants with diabetes admitted to 3 hospitals in Japan. Multiple regression analysis was performed to determine the associations among thyroid hormone levels, SMI, and HGS. RESULTS Of the 1,135 participants, 480 were female. Their median (interquartile range) age, body mass index, durations of diabetes, and glycated haemoglobin levels were 68 years, 24.3 kg/m2, 10 years, and 7.6 %, respectively. The median (interquartile range) SMI (kg/m2) and hand grip strength of the cohort were 7.1 kg/m2 and 28.2 kg, respectively. Positive correlations between FT3 and the FT3/FT4 ratio with SMI and HGS was observed after adjusting for covariates in males. A negative correlation was found between the FT3/FT4 ratio and sarcopenia as a result of low SMI and low HGS in the male participants but not in females (p for interaction = 0.02). CONCLUSIONS FT3/FT4 ratios may impact skeletal muscles in people with diabetes-particularly in males. Assessments of FT3/FT4 ratios may represent key indicators of muscle mass and strength in males.
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Affiliation(s)
- Shinnosuke Hata
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan; Department of Endocrinology and Metabolism, Kyoto First Red Cross Hospital, Kyoto, Japan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan; Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi, Japan.
| | - Megumi Minamida
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Junya Hironaka
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Yuka Hasegawa
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Yuriko Kondo
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Hanako Nakajima
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Nobuko Kitagawa
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan; Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Takafumi Osaka
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan; Department of Diabetology, Kameoka Municipal Hospital, Kameoka, Japan
| | - Noriyuki Kitagawa
- Department of Endocrinology and Diabetology, Ayabe City Hospital, Ayabe, Japan
| | - Saori Majima
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Takafumi Senmaru
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Mai Asano
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan; Division of Metabolism and Rheumatology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan; Department of Endocrinology and Diabetology, Ayabe City Hospital, Ayabe, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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Dirim AB, Sezer GE, Uzun E, Yilmaz M. Temporary hypothyroidism in severe crush syndrome: a potential novel entity. Hormones (Athens) 2023; 22:603-609. [PMID: 37596376 DOI: 10.1007/s42000-023-00475-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/31/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND Thyroid hormone synthesis is a complex process in the human body. Although the thyroid gland is essential for thyroid hormone synthesis, skeletal muscles also have crucial roles in thyroid hormone metabolism due to the deiodinase activities of the muscle cells. Hypothyroidism-related myopathy is a well-known entity. However, systemic effects of acute myopathies, such as rhabdomyolysis, on thyroid hormone metabolism have not to date been fully clarified. METHODS Fifty-three earthquake victims were evaluated retrospectively. We investigated the thyroid function tests (TFTs) among patients with creatine kinase (CK) levels higher than 10.000 U/L at admission. Fifteen patients had CK levels higher than 10.000 U/L and 12 of them had data of TFTs, including thyroid stimulating hormone (TSH), free T4 (FT4), and free T3 (FT3) during hospitalization. These patients were evaluated. RESULTS TSH levels were increased in all seven patients who required HD due to severe crush syndrome. Decreased FT4 levels were detected in 71.4% of them. None of the five non-HD patients had increased TSH levels or reduced FT4 levels. During follow-up, all patients survived. Renal and thyroid functions were normalized during follow-up without thyroxin replacement in patients with no prior history of hypothyroidism. Moreover, TFTs were normalized in two patients with history of hypothyroidism under thyroxine treatment without dose adjustments. CONCLUSIONS In severe forms of crush syndrome, temporary hypothyroidism might be seen. The exact mechanism underlying this entity is not well-known. Further clinical and experimental trials should be conducted to illuminate the mechanism of disrupted thyroid hormonogenesis in crush syndrome victims.
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Affiliation(s)
- Ahmet Burak Dirim
- Department of Nephrology, University of Health Sciences, Bakırkoy Dr. Sadi Konuk Education and Research Hospital, Zuhuratbaba, Tevfik Sağlam Avenue, No: 11, Bakırkoy, 34147, Istanbul, Turkey.
| | - Gamze Ergun Sezer
- Department of Nephrology, University of Health Sciences, Bakırkoy Dr. Sadi Konuk Education and Research Hospital, Zuhuratbaba, Tevfik Sağlam Avenue, No: 11, Bakırkoy, 34147, Istanbul, Turkey
| | - Emine Uzun
- Department of Nephrology, University of Health Sciences, Bakırkoy Dr. Sadi Konuk Education and Research Hospital, Zuhuratbaba, Tevfik Sağlam Avenue, No: 11, Bakırkoy, 34147, Istanbul, Turkey
| | - Murvet Yilmaz
- Department of Nephrology, University of Health Sciences, Bakırkoy Dr. Sadi Konuk Education and Research Hospital, Zuhuratbaba, Tevfik Sağlam Avenue, No: 11, Bakırkoy, 34147, Istanbul, Turkey
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Tarantino G, Sinatti G, Citro V, Santini SJ, Balsano C. Sarcopenia, a condition shared by various diseases: can we alleviate or delay the progression? Intern Emerg Med 2023; 18:1887-1895. [PMID: 37490203 PMCID: PMC10543607 DOI: 10.1007/s11739-023-03339-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/01/2023] [Indexed: 07/26/2023]
Abstract
Sarcopenia is a severe condition common to various chronic diseases and it is reckoned as a major health problem. It encompasses many different molecular mechanisms that have been for a while discovered but not definitely clarified. Although sarcopenia is a disability status that leads to serious health consequences, the scarcity of suitable animal models has curtailed research addressing this disorder. Another limitation in the field of clinical investigation of sarcopenic patients is the lack of a generally accepted definition coupled with the difficulty of adopting common diagnostic criteria. In fact, both do not permit to clarify the exact prevalence rate and consequently limit physicians to establish any kind of therapeutical approach or, when possible, to adopt preventive measures. Unfortunately, there is no standardized cure, apart from doing more physical activity and embracing a balanced diet, but newly discovered substances start being considered. In this review, authors try to give an overview addressing principal pathways of sarcopenia and offer critical features of various possible interventions.
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Affiliation(s)
- Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy
| | - Gaia Sinatti
- Department of Life, Health and Environmental Sciences‑MESVA, School of Emergency‑Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy
| | - Vincenzo Citro
- Department of General Medicine, "Umberto I" Hospital, Nocera Inferiore, SA, Italy
| | - Silvano Jr Santini
- Department of Life, Health and Environmental Sciences‑MESVA, School of Emergency‑Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy
- Francesco Balsano Foundation, Via Giovanni Battista Martini 6, 00198, Rome, Italy
| | - Clara Balsano
- Department of Life, Health and Environmental Sciences‑MESVA, School of Emergency‑Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy.
- Francesco Balsano Foundation, Via Giovanni Battista Martini 6, 00198, Rome, Italy.
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Turimov Mustapoevich D, Kim W. Machine Learning Applications in Sarcopenia Detection and Management: A Comprehensive Survey. Healthcare (Basel) 2023; 11:2483. [PMID: 37761680 PMCID: PMC10531485 DOI: 10.3390/healthcare11182483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
This extensive review examines sarcopenia, a condition characterized by a loss of muscle mass, stamina, and physical performance, with a particular emphasis on its detection and management using contemporary technologies. It highlights the lack of global agreement or standardization regarding the definition of sarcopenia and the various techniques used to measure muscle mass, stamina, and physical performance. The distinctive criteria employed by the European Working Group on Sarcopenia in Older People (EWGSOP) and the Asian Working Group for Sarcopenia (AWGSOP) for diagnosing sarcopenia are examined, emphasizing potential obstacles in comparing research results across studies. The paper delves into the use of machine learning techniques in sarcopenia detection and diagnosis, noting challenges such as data accessibility, data imbalance, and feature selection. It suggests that wearable devices, like activity trackers and smartwatches, could offer valuable insights into sarcopenia progression and aid individuals in monitoring and managing their condition. Additionally, the paper investigates the potential of blockchain technology and edge computing in healthcare data storage, discussing models and systems that leverage these technologies to secure patient data privacy and enhance personal health information management. However, it acknowledges the limitations of these models and systems, including inefficiencies in handling large volumes of medical data and the lack of dynamic selection capability. In conclusion, the paper provides a comprehensive summary of current sarcopenia research, emphasizing the potential of modern technologies in enhancing the detection and management of the condition while also highlighting the need for further research to address challenges in standardization, data management, and effective technology use.
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Affiliation(s)
| | - Wooseong Kim
- Department of Computer Engineering, Gachon University, Sujeong-gu, Seongnam-si 461-701, Gyeonggi-do, Republic of Korea;
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Greco F, Moulton C, Antinozzi C, Lista M, Di Luigi L, Dimauro I, Sgrò P. Relationship between Euthyroidism and Muscle Mass and Strength: A Systematic Review. Int J Sports Med 2023; 44:704-710. [PMID: 37429319 DOI: 10.1055/a-2093-2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Thyroid hormones play a crucial role in skeletal muscle development, suggesting that thyroid function may influence muscle mass and muscle strength, which are both fundamental health-related indicators of several age-related consequences. However, whether there is a relationship between thyroid hormones, muscle mass, and muscle strength in individuals without thyroid dysfunctions is still unknown. Therefore, this systematic review aims to investigate whether thyroid hormones are related to muscle mass and strength parameters in euthyroid individuals. Three databases were searched (PubMed, Scopus, Web of Science) up to February 14, 2022, for peer-reviewed papers published in English. The search results were conducted independently by two different reviewers. The review included 13 studies with a total of 241,044 participants. All studies were observational: twelve studies measured thyroid stimulating hormone, ten and thirteen studies measured free triiodothyronine and free thyroxine, four studies analyzed the thyroid hormone ratio. The assessment methods for muscle mass were computed tomography, dual-energy X-ray absorptiometry and bioimpedance analysis, whereas hand dynamometer for muscle strength. Low levels within the normal range of free triiodothyronine, high levels within the normal range of free thyroxine, and lower thyroid hormone ratio may contribute to a reduced muscle function, which seems more evident in older males.
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Affiliation(s)
- Francesca Greco
- Department of Human Movement Sciences and Health, University of Rome 'Foro Italico', Roma, Italy
| | - Chantalle Moulton
- Department of Human Movement Sciences and Health, University of Rome 'Foro Italico', Roma, Italy
| | - Cristina Antinozzi
- Department of Human Movement Sciences and Health, University of Rome 'Foro Italico', Roma, Italy
| | - Marco Lista
- Department of Human Movement Sciences and Health, University of Rome 'Foro Italico', Roma, Italy
| | - Luigi Di Luigi
- Department of Human Movement Sciences and Health, University of Rome 'Foro Italico', Roma, Italy
| | - Ivan Dimauro
- Department of Human Movement Sciences and Health, University of Rome 'Foro Italico', Roma, Italy
| | - Paolo Sgrò
- Department of Human Movement Sciences and Health, University of Rome 'Foro Italico', Roma, Italy
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Chen J, Wei L, Zhu X, Xu W, Zou Y, Qi X, Fang J, Wang X, Shi X, Sheng Y, Ding G, Ouyang X, Duan Y. TT3, a More Practical Indicator for Evaluating the Relationship Between Sarcopenia and Thyroid Hormone in the Euthyroid Elderly Compared with FT3. Clin Interv Aging 2023; 18:1285-1293. [PMID: 37560750 PMCID: PMC10408719 DOI: 10.2147/cia.s420558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/22/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND AND AIMS Sarcopenia is a common disease in the elderly, and the thyroid hormone (TH) might participate in the pathogenesis of sarcopenia. However, the results of previous studies were not completely consistent. We performed this study to investigate the association between THs and sarcopenia in a Chinese elderly euthyroid population. SUBJECTS AND METHODS A total of 309 Chinese elderly euthyroid subjects with an average age of 85.19 ± 7.8 years were enrolled. Participants were divided into four groups (non-sarcopenia, possible sarcopenia, sarcopenia and serve sarcopenia) according to the consensus update of AWGS in 2019. Serum levels of TT3, FT3, TT4, FT4, TSH, rT3 and TBG were measured. Muscle mass was measured by multifrequency bioelectrical impedance analysis, hand grip (HG) was represented by spring-type dynamometer, and gait speed (GS) was determined by 6-metre walk test. The FRAIL scale was used to assess frailty. RESULTS Compared to the non-sarcopenia group, the sarcopenia group showed a significant increase in age and FRIAL score, while FT3 and TT3 levels decreased significantly. Partial correlation analysis (adjusted by age, gender and the scores of FRIAL scale) indicated that FT3, TT3 and TSH had significant positive correlations with HG, and there also was a significant positive correlation between TT3 and GS. In addition, after adjusting for age, gender, BMI, ALT, sCr, and score on the FRAIL scale, the multivariate linear regression analysis showed that TT3 was positively associated with muscle strength and negatively associated with sarcopenia risk. CONCLUSION There is an association between the low TT3 level and sarcopenia. Therefore, maintaining higher T3 concentrations within the normal range appears to be beneficial for sarcopenia in the elderly. In addition, due to the fluctuation of FT3, TT3 is a more stable and practical indicator to evaluate the relationship between sarcopenia and thyroid hormone in the elderly euthyroid population.
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Affiliation(s)
- Jihai Chen
- Department of Geriatric, Geriatric Hospital of Nanjing Medical University, Nanjing, 210024, People’s Republic of China
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Lijun Wei
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Xiaoxia Zhu
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Wenli Xu
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Yuxin Zou
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Xinyu Qi
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Jia Fang
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Xiaodong Wang
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Xiaolan Shi
- Department of Geriatric, Geriatric Hospital of Nanjing Medical University, Nanjing, 210024, People’s Republic of China
| | - Yunlu Sheng
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Guoxian Ding
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Xiaojun Ouyang
- Department of Geriatric, Geriatric Hospital of Nanjing Medical University, Nanjing, 210024, People’s Republic of China
| | - Yu Duan
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
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Zhang L, Tu YY, Zhao Z, Jin J, Tao J, Zhang XY. Lower serum FT3 within the reference range is associated with mortality for older adults over 80 years of age with sarcopenia. BMC Geriatr 2023; 23:77. [PMID: 36747122 PMCID: PMC9900526 DOI: 10.1186/s12877-023-03783-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 01/30/2023] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE Thyroid hormones stimulate myogenesis and muscle contraction and regulate skeletal muscle cell metabolism. However, the association between thyroid hormone levels and mortality in sarcopenic older adults remains elusive. The aim of this study was to investigate the relationship between thyroid hormones and all-cause mortality in people over 80 years of age with sarcopenia. METHODS This study was performed on 264 sarcopenic patients aged 80 years and older. Serum levels of thyroid hormone, including free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) were tested to evaluate thyroid status. Sarcopenia was defined using the criteria of the European Working Group on Sarcopenia in Older People. Mortality data were available for up to 38 months of follow-up. The correlation between FT3 and calf circumference (CC) or handgrip strength (HGS) was determined by Pearson correlation analysis. Kaplan-Meier analysis was used to compare the differences between FT3 tertile groups. Cox regression was used to analyze the mortality risk ratio of patients with different FT3 tertiles. RESULTS During the follow-up period, 88 older adults died. Non-Survivors had lower serum FT3 levels (3.7 ± 0.5 vs. 3.9 ± 0.7, P = 0.001) than the Survivor. Serum FT3 was positively associated with CC and HGS (r = 0.29, P < 0.001, r = 0.21, P = 0.002, respectively). The Kaplan-Meier curve analysis demonstrated a difference in mortality among the FT3 tertile groups (log-rank test, χ2 = 11.83, P = 0.003). The high FT3 group had lower mortality compared with the low FT3 group (the adjusted HRs were 0.63 (95%CI: 0.41-0.96 P = 0.031). CONCLUSION Lower FT3 within the reference range is associated with higher mortality in adults over 80 years with sarcopenia and euthyroid. Routine assessment of FT3 may be an easy way to identify high-risk older adults with sarcopenia.
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Affiliation(s)
- Li Zhang
- grid.16821.3c0000 0004 0368 8293Department of Geriatrics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yi Shan road, Shanghai, 200233 China
| | - You-Yi Tu
- grid.16821.3c0000 0004 0368 8293Department of Geriatrics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yi Shan road, Shanghai, 200233 China
| | - Zhe Zhao
- grid.16821.3c0000 0004 0368 8293Department of Geriatrics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yi Shan road, Shanghai, 200233 China
| | - Jun Jin
- grid.16821.3c0000 0004 0368 8293Department of Geriatrics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yi Shan road, Shanghai, 200233 China
| | - Jun Tao
- grid.16821.3c0000 0004 0368 8293Department of Geriatrics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yi Shan road, Shanghai, 200233 China
| | - Xiao-Yan Zhang
- Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yi Shan road, Shanghai, 200233, China.
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10
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Ibad HA, Mammen JS, Simonsick EM, Kwoh CK, Guermazi A, Demehri S. Higher thyroid hormone has a negative association with lower limb lean body mass in euthyroid older adults: Analysis from the Baltimore Longitudinal study of aging. FRONTIERS IN AGING 2023; 4:1150645. [PMID: 37114095 PMCID: PMC10126399 DOI: 10.3389/fragi.2023.1150645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/30/2023] [Indexed: 04/29/2023]
Abstract
Background: Hyperthyroidism is associated with lower lean body mass, as a result of catabolic actions of thyroid hormone. Therefore, higher thyroid hormone levels could be a factor in the development of sarcopenia and age associated functional decline. The relationship between thyroid hormone and muscle mass in ambulatory, euthyroid older adults is not known. Method: We used mixed-effects models to estimate the cross-sectional relationships (accounting for inter-person variability) between thyroid axis hormone measures and lower limb composition or sarcopenia at visits in the Baltimore Longitudinal Study of Aging (BLSA) at which DEXA scans were available and both thyrotropin (TSH) and free thyroxine (FT4) were in the reference range. Analyses were adjusted for levothyroxine use, age, race, sex, BMI, smoking, alcohol intake, cholesterol, and systolic blood pressure. Results: 1442 euthyroid participants (median age 68, 50% female, and 69% white) contributed to 5306 visits from 2003 to 2019. FT4 was negatively associated with lower limb lean mass (beta: 88.49; 95% Confidence Interval (CI): 122.78, -54.20; p < 0.001) and positively associated with sarcopenia (OR: 1.11%, 95% CI: 1.01, 1.22) in the whole cohort. Additionally, higher FT4 was associated with lower leg lean mass (beta: 66.79; 95% CI: 102.24, -31.33; p < 0.001) and sarcopenia (OR:1.09%, 95% CI:1.01, 1.18) in older adults, but not in younger adults alone. Conclusion: In euthyroid older adults, higher FT4 is associated with lower leg lean mass and higher odds of sarcopenia. Understanding the relationship between thyroid hormone and sarcopenia is needed to improve clinical decision-making and avoid functional decline from excess thyroid hormone use in older adults.
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Affiliation(s)
- Hamza Ahmed Ibad
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jennifer S. Mammen
- The Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- *Correspondence: Jennifer S. Mammen,
| | | | - C. Kent Kwoh
- Division of Rheumatology, The University of Arizona, Tucson, AZ, United States
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, United States
| | - Shadpour Demehri
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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11
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Pang S, Qi H, Chen S, Liu J, Sheng Y. Muscle Strength, but Not Muscle Mass, Is Associated with Left Ventricular Diastolic Function during Aging in Chinese. Int Heart J 2022; 63:1115-1120. [DOI: 10.1536/ihj.22-140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Sisi Pang
- Division of Geriatric Cardiology, The First Affiliated Hospital of Nanjing Medical University
| | - Hanmei Qi
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University
| | - Shu Chen
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University
| | - Jin Liu
- Clinical Medicine Research Institution, The First Affiliated Hospital of Nanjing Medical University
| | - Yunlu Sheng
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University
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12
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Yang Y, Zhang Q, He C, Chen J, Deng D, Lu W, Wang Y. Prevalence of sarcopenia was higher in women than in men: a cross-sectional study from a rural area in eastern China. PeerJ 2022; 10:e13678. [PMID: 35935249 PMCID: PMC9354735 DOI: 10.7717/peerj.13678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/13/2022] [Indexed: 01/17/2023] Open
Abstract
Background There were limited studies specifically evaluating whether the difference of the prevalence of sarcopenia exists in men and women in older adults from rural areas in China. The aim of this study was to compare the prevalence of sarcopenia between men and women in a rural area in eastern China and to explore the underlying causes. Methods This study included 1,105 participants aged 60-89 years. Muscle mass was measured by bio-electrical impedance analysis. Hand grip strength was measured by Jamar Hydraulic Hand Dynamometer. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia-2019 Consensus. Data were analyzed using log-binomial and linear regression. Results The prevalence of sarcopenia was 21.7% in women and 12.9% in men among the study cohort. After adjusting for age, education level, number of diseases, income level, smoking, drinking, and eating habits, proportion of people with sarcopenia was 1.49-fold greater in women than in men (PR = 1.49, 95% CI [1.01-2.26], P = 0.055). Conclusions The prevalence of sarcopenia in elderly women in this rural area of eastern China is higher than in men, suggesting that women in rural areas in China seem to be more vulnerable for sarcopenia, thus early screening and prevention need to be provided for them to address such gender disparity in health.
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Affiliation(s)
- Yichen Yang
- Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China,Key Laboratory of Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qin Zhang
- Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China,Key Laboratory of Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Caihong He
- Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China,Key Laboratory of Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jing Chen
- Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China,Key Laboratory of Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Danfeng Deng
- Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China,Key Laboratory of Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenwen Lu
- Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China,Key Laboratory of Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yuming Wang
- Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China,Key Laboratory of Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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13
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Liu QQ, Xie WQ, Luo YX, Li YD, Huang WH, Wu YX, Li YS. High Intensity Interval Training: A Potential Method for Treating Sarcopenia. Clin Interv Aging 2022; 17:857-872. [PMID: 35656091 PMCID: PMC9152764 DOI: 10.2147/cia.s366245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/14/2022] [Indexed: 11/23/2022] Open
Abstract
Sarcopenia, an age-related disease characterized by loss of muscle strength and muscle mass, has attracted the attention of medical experts due to its severe morbidity, low living quality, high expenditure of health care, and mortality. Traditionally, persistent aerobic exercise (PAE) is considered as a valid way to attenuate muscular atrophy. However, nowadays, high intensity interval training (HIIT) has emerged as a more effective and time-efficient method to replace traditional exercise modes. HIIT displays comprehensive effects on exercise capacity and skeletal muscle metabolism, and it provides a time-out for the recovery of cardiopulmonary and muscular functions without causing severe adverse effects. Studies demonstrated that compared with PAE, HIIT showed similar or even higher effects in improving muscle strength, enhancing physical performances and increasing muscle mass of elder people. Therefore, HIIT might become a promising way to cope with the age-related loss of muscle mass and muscle function. However, it is worth mentioning that no study of HIIT was conducted directly on sarcopenia patients, which is attributed to the suspicious of safety and validity. In this review, we will assess the effects of different training parameters on muscle and sarcopenia, summarize previous papers which compared the effects of HIIT and PAE in improving muscle quality and function, and evaluate the potential of HIIT to replace the status of PAE in treating old people with muscle atrophy and low modality; and point out drawbacks of temporary experiments. Our aim is to discuss the feasibility of HIIT to treat sarcopenia and provide a reference for clinical scientists who want to utilize HIIT as a new way to cope with sarcopenia.
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Affiliation(s)
- Qian-Qi Liu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, 410083, People’s Republic of China
| | - Wen-Qing Xie
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
| | - Yu-Xuan Luo
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, 410083, People’s Republic of China
| | - Yi-Dan Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, 410083, People’s Republic of China
| | - Wei-Hong Huang
- Mobile Health Ministry of Education - China Mobile Joint Laboratory, Xiangya Hospital Central South University, Changsha, Hunan, 410008, People’s Republic of China
| | - Yu-Xiang Wu
- Department of Health and Kinesiology, School of Physical Education, Jianghan University, Wuhan, Hubei, 430056, People’s Republic of China
- Yu-Xiang Wu, Department of Health and Kinesiology, School of Physical Education, Jianghan University, No. 8, Sanjiaohu Road, Wuhan, Hubei, 430056, People’s Republic of China, Tel +86 27 8422 6921, Email
| | - Yu-Sheng Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- Correspondence: Yu-Sheng Li, Department of Orthopedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, 410008, People’s Republic of China, Tel +86-13975889696, Email
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14
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Priyadarsini N, Nanda P, Devi S, Mohapatra S. Sarcopenia: An Age-Related Multifactorial Disorder. Curr Aging Sci 2022; 15:209-217. [PMID: 35249518 DOI: 10.2174/1874609815666220304194539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/22/2021] [Accepted: 12/28/2021] [Indexed: 11/22/2022]
Abstract
Sarcopenia is an emerging clinical entity characterized by a gradual decline in skeletal muscle mass and strength that accompanies the normal aging process. It has been noted that sarcopenia is associated with various adverse health outcomes in the geriatric population like prolonged hospital admission, disability, poor quality of life, frailty, and mortality. Factors involved in the development of age-related sarcopenia include anorexia, alteration in the hormone levels, decreased neural innervation, low blood flow to the muscles, cytokine dysregulation, altered mitochondrial activity, genomic instability, intracellular proteolysis, and insulin resistance. Understanding the mechanism may help develop efficient preventive and therapeutic strategies which can improve the quality of life in elderly individuals. Thus, the objective of the present article is to review the literature regarding the mechanism involved in the development of sarcopenia in aged individuals.
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Affiliation(s)
- Nibedita Priyadarsini
- Department of Physiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Pranati Nanda
- Department of Physiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Sujata Devi
- Department of Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Subarna Mohapatra
- Department of Physiology, All India Institute of Medical Sciences, Bhubaneswar, India
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15
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Wang K, Zhang D, Cao G, Wang C, Wang L, Zhao R, He Q, Hou X, Gong L, Chen L. A Low Free T3 to Free T4 Ratio Is Associated with Sarcopenia in Euthyroid Patients with Type 2 Diabetes Mellitus. J Diabetes Res 2022; 2022:2305156. [PMID: 36034587 PMCID: PMC9402295 DOI: 10.1155/2022/2305156] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/16/2022] [Accepted: 08/03/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This research evaluated the link between normal thyroid hormone levels and sarcopenia in patients with type 2 diabetes mellitus (T2DM). METHODS This cross-sectional study enrolled 312 euthyroid patients with T2DM from Qilu Hospital of the Shandong University, China. Body composition, grip strength, and physical performance were assessed as per the 2019 consensus guidelines of the Asian Working Group for Sarcopenia. Binary logistic regression was used to examine the correlation between thyroid hormone levels and sarcopenia and its components. RESULTS The prevalence of sarcopenia was 26.9%. Following adjustments for potential confounders, a high-normal serum free triiodothyronine (FT3) level (odds ratio (OR) = 0.522, 95% confidence interval (CI): 0.304-0.895, P = 0.018), a low-normal serum free thyroxine (FT4) level (OR = 1.126, 95% CI: 1.009-1.258, P = 0.034), and a heightened FT3/FT4 ratio (OR = 0.923, 95% CI: 0.879-0.969, P = 0.001) were linked to a low prevalence of sarcopenia. Considering the components of sarcopenia, FT3 concentration was positively associated with muscle strength (OR = 0.525, 95% CI: 0.305-0.902, P = 0.020) and physical performance (OR = 0.443, 95% CI: 0.259-0.758, P = 0.003), while FT4 concentration was negatively linked to muscle mass (OR = 1.114, 95% CI: 1.009-1.232, P = 0.036). The FT3/FT4 ratio was positively linked to muscle mass (OR = 0.943, 95% CI: 0.905-0.981, P = 0.006), muscle strength (OR = 0.945, 95% CI: 0.901-0.992, P = 0.021), and physical performance (OR = 0.934, 95% CI: 0.894-0.975, P = 0.002). Nevertheless, thyroid-stimulating hormone concentration was not associated with sarcopenia. CONCLUSION A high FT3/FT4 ratio was significantly linked to a lowered risk of sarcopenia in euthyroid patients with T2DM.
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Affiliation(s)
- Kewei Wang
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan 250012, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan 250012, China
| | - Di Zhang
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan 250012, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan 250012, China
| | - Guanglei Cao
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan 250012, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan 250012, China
| | - Chuan Wang
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan 250012, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan 250012, China
| | - Lingshu Wang
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan 250012, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan 250012, China
| | - Ruxing Zhao
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan 250012, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan 250012, China
| | - Qin He
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan 250012, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan 250012, China
| | - Xinguo Hou
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan 250012, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan 250012, China
| | - Lei Gong
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan 250012, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan 250012, China
| | - Li Chen
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan 250012, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan 250012, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan 250012, China
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16
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Guligowska A, Chrzastek Z, Pawlikowski M, Pigłowska M, Pisarek H, Winczyk K, Kostka T. Gonadotropins at Advanced Age - Perhaps They Are Not So Bad? Correlations Between Gonadotropins and Sarcopenia Indicators in Older Adults. Front Endocrinol (Lausanne) 2021; 12:797243. [PMID: 35002975 PMCID: PMC8739969 DOI: 10.3389/fendo.2021.797243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/09/2021] [Indexed: 12/02/2022] Open
Abstract
Many hormones fluctuate during the aging process. It has been suggested that gonadotropins, which increase with age, contribute to the occurrence of many diseases and syndromes in older life, such as cardiovascular diseases, obesity, frailty syndrome and osteoporosis. This study aims to assess the relationship between circulating gonadotropins and other hormones potentially contributing to age-related functional decline and sarcopenia indicators in 39 male and 61 female community-dwelling seniors, mean age 80 years. According to the definition developed by the second European Working Group on Sarcopenia in Older People (EWGSOP2), the following indicators of the sarcopenia were assessed: bioimpedance-measured body composition, gait speed, handgrip strength, timed up and go test (TUG), chair stand test, Short Physical Performance Battery (SPPB). Blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, dehydroepiandrosterone sulphate (DHEAS) and cortisol were also measured. In the men, FSH and partially LH correlated positively with muscle mass percentage, gait speed, handgrip strength and SPPB, and negatively with percent body fat. Additionally, testosterone and DHEAS correlated negatively with the percentage of fat mass in men. Whereas in the women, FSH and LH were mainly negatively associated with body mass and adipose tissue measures. Cortisol did not show any relationship with the examined indicators. The study shows that the indicators of sarcopenia are strongly associated with levels of gonadotropins, sex hormones and DHEAS, especially in older men. The obtained results, after being confirmed in a larger group, may modify prevention and treatment strategies of sarcopenia.
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Affiliation(s)
- Agnieszka Guligowska
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Zuzanna Chrzastek
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Marek Pawlikowski
- Department of Immunoendocrinology, Medical University of Lodz, Lodz, Poland
| | - Malgorzata Pigłowska
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Hanna Pisarek
- Department of Neuroendocrinology, Chair of Laboratory and Molecular Diagnostics, Medical University of Lodz, Lodz, Poland
| | - Katarzyna Winczyk
- Department of Neuroendocrinology, Chair of Laboratory and Molecular Diagnostics, Medical University of Lodz, Lodz, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
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17
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Vanhorebeek I, Derese I, Gunst J, Wouters PJ, Hermans G, Van den Berghe G. Persisting neuroendocrine abnormalities and their association with physical impairment 5 years after critical illness. Crit Care 2021; 25:430. [PMID: 34915907 PMCID: PMC8675467 DOI: 10.1186/s13054-021-03858-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/06/2021] [Indexed: 11/10/2022] Open
Abstract
Background Critical illness is hallmarked by neuroendocrine alterations throughout ICU stay. We investigated whether the neuroendocrine axes recover after ICU discharge and whether any residual abnormalities associate with physical functional impairments assessed 5 years after critical illness.
Methods In this preplanned secondary analysis of the EPaNIC randomized controlled trial, we compared serum concentrations of hormones and binding proteins of the thyroid axis, the somatotropic axis and the adrenal axis in 436 adult patients who participated in the prospective 5-year clinical follow-up and who provided a blood sample with those in 50 demographically matched controls. We investigated independent associations between any long-term hormonal abnormalities and physical functional impairments (handgrip strength, 6-min walk distance, and physical health-related quality-of-life) with use of multivariable linear regression analyses. Results At 5-year follow-up, patients and controls had comparable serum concentrations of thyroid-stimulating hormone, thyroxine (T4), triiodothyronine (T3) and thyroxine-binding globulin, whereas patients had higher reverse T3 (rT3, p = 0.0002) and lower T3/rT3 (p = 0.0012) than controls. Patients had comparable concentrations of growth hormone, insulin-like growth factor-I (IGF-I) and IGF-binding protein 1 (IGFBP1), but higher IGFBP3 (p = 0.030) than controls. Total and free cortisol, cortisol-binding globulin and albumin concentrations were comparable for patients and controls. A lower T3/rT3 was independently associated with lower handgrip strength and shorter 6-min walk distance (p ≤ 0.036), and a higher IGFBP3 was independently associated with higher handgrip strength (p = 0.031). Conclusions Five years after ICU admission, most hormones and binding proteins of the thyroid, somatotropic and adrenal axes had recovered. The residual long-term abnormality within the thyroid axis was identified as risk factor for long-term physical impairment, whereas that within the somatotropic axis may be a compensatory protective response. Whether targeting of the residual abnormality in the thyroid axis may improve long-term physical outcome of the patients remains to be investigated. Trial registration ClinicalTrials.gov: NCT00512122, registered on July 31, 2007 (https://www.clinicaltrials.gov/ct2/show/NCT00512122). Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13054-021-03858-1.
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Affiliation(s)
- Ilse Vanhorebeek
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Inge Derese
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Jan Gunst
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.,Department of Intensive Care Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Pieter J Wouters
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.,Department of Intensive Care Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Greet Hermans
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.,Medical Intensive Care Unit, Department of General Internal Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Greet Van den Berghe
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Leuven, Belgium. .,Department of Intensive Care Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. .,Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
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18
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Li P, Ding L, Zhen J, Hu J, Fan Y, Liu M. Association of subtle alterations in thyroid function with presarcopenia in patients with type 2 diabetes mellitus. J Diabetes Investig 2021; 13:696-705. [PMID: 34704391 PMCID: PMC9017640 DOI: 10.1111/jdi.13703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/07/2021] [Accepted: 10/26/2021] [Indexed: 11/27/2022] Open
Abstract
Aims/Introduction To investigate the association of subtle alterations in thyroid function with presarcopenia among patients with type 2 diabetes mellitus. Materials and Methods A total of 1,865 adult patients with type 2 diabetes mellitus were enrolled in this cross‐sectional study, excluding patients with overt thyroid dysfunction. Skeletal muscle mass measured by dual energy X‐ray absorptiometry was used to assess presarcopenia. Logistic regression models were used to estimate the effects of thyroid hormones on presarcopenia, and subgroup analyses were carried out in different strata of age, sex and body mass index, respectively. Results Compared with the euthyroid group (Euthy), the subclinical hyperthyroidism group had an increased odds of presarcopenia (multivariate‐adjusted odds ratio 1.99, 95% confidence interval 1.09–3.63), but the subclinical hypothyroidism group did not (P > 0.05). In the subclinical hyperthyroidism group, age and body mass index <24 kg/m2 were independent risk factors for presarcopenia. In the overall Euthy group, an increased odds of presarcopenia was correlated with the elevated free thyroxine : free triiodothyronine ratio (all P for trend <0.05), whereas not with increment in free triiodothyronine level (P for trend >0.05). Additionally, in Euthy subgroup analyses stratified by middle‐age, sex and body mass index, a similar association was noted (all P for trend <0.05), but not in the older‐aged patients (P for trend >0.05). Conclusions Subclinical hyperthyroidism was an independent risk factor for presarcopenia in patients with type 2 diabetes mellitus, but subclinical hypothyroidism was not. In the Euthy group with type 2 diabetes mellitus, a high free thyroxine : free triiodothyronine ratio was a good index of presarcopenia in addition to older age.
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Affiliation(s)
- Ping Li
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Ding
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinyang Zhen
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingxin Hu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuxin Fan
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Liu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
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19
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De Stefano MA, Ambrosio R, Porcelli T, Orlandino G, Salvatore D, Luongo C. Thyroid Hormone Action in Muscle Atrophy. Metabolites 2021; 11:metabo11110730. [PMID: 34822388 PMCID: PMC8625289 DOI: 10.3390/metabo11110730] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 12/19/2022] Open
Abstract
Skeletal muscle atrophy is a condition associated with various physiological and pathophysiological conditions, such as denervation, cachexia, and fasting. It is characterized by an altered protein turnover in which the rate of protein degradation exceeds the rate of protein synthesis, leading to substantial muscle mass loss and weakness. Muscle protein breakdown reflects the activation of multiple proteolytic mechanisms, including lysosomal degradation, apoptosis, and ubiquitin-proteasome. Thyroid hormone (TH) plays a key role in these conditions. Indeed, skeletal muscle is among the principal TH target tissue, where TH regulates proliferation, metabolism, differentiation, homeostasis, and growth. In physiological conditions, TH stimulates both protein synthesis and degradation, and an alteration in TH levels is often responsible for a specific myopathy. Intracellular TH concentrations are modulated in skeletal muscle by a family of enzymes named deiodinases; in particular, in muscle, deiodinases type 2 (D2) and type 3 (D3) are both present. D2 activates the prohormone T4 into the active form triiodothyronine (T3), whereas D3 inactivates both T4 and T3 by the removal of an inner ring iodine. Here we will review the present knowledge of TH action in skeletal muscle atrophy, in particular, on the molecular mechanisms presiding over the control of intracellular T3 concentration in wasting muscle conditions. Finally, we will discuss the possibility of exploiting the modulation of deiodinases as a possible therapeutic approach to treat muscle atrophy.
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Affiliation(s)
- Maria Angela De Stefano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy;
| | - Raffaele Ambrosio
- Istituti di Ricovero e Cura a Carattere Scientifico, SDN, 80143 Naples, Italy;
| | - Tommaso Porcelli
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy;
| | | | - Domenico Salvatore
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy;
- Correspondence: (D.S.); (C.L.)
| | - Cristina Luongo
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy;
- Correspondence: (D.S.); (C.L.)
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20
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Liu Y, Shan Z. Expert consensus on diagnosis and treatment for elderly with thyroid diseases in China (2021). Aging Med (Milton) 2021; 4:70-92. [PMID: 34250426 PMCID: PMC8251868 DOI: 10.1002/agm2.12165] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/15/2023] Open
Abstract
In order to improve the diagnosis and treatment of senile thyroid diseases in China and to promote healthy aging, the Endocrine Metabolic Diseases Group of the Chinese Geriatrics Society, and the Thyroid Group of the Chinese Society of Endocrinology jointly drafted the "Expert consensus on diagnosis and treatment for Chinese elderly with thyroid diseases" (referred to as consensus). The Consensus consists of five parts that set 40 recommendations on main clinical issues. The consensus emphasizes clinical focus on the age-related changes of the hypothalamus-pituitary-thyroid axis in the elderly, and it recommends application of comprehensive geriatric assessment to thoroughly evaluate the impact of thyroid diseases and relevant intervention on overall health condition. Meanwhile, it recommends generalization of screening for hypothyroidism during admission to nursing institution or hospital, and routine health check-ups. Furthermore, it develops individualized stratified management on hyperthyroidism, hypothyroidism, thyroid nodules, and differentiated thyroid carcinoma in the elderly distinguished from the youngers, including treatment regimen, control ranges, and flowcharts for diagnosis and treatment. The Consensus will provide the basis for clinical decisions and health management of thyroid diseases in the elderly by geriatrician, endocrinologist, and general practitioners.
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Affiliation(s)
- Youshuo Liu
- Department of Geriatrics and Geriatric EndocrinologyThe Second Xiangya Hospitaland the Institute of Aging and GeriatricsCentral South UniversityNational Clinical Research Center for Metabolic Diseases (The Second Xiangya Hospital)ChangshaChina
| | - Zhongyan Shan
- Department of Endocrinology and MetabolismThe Institute of EndocrinologyThe First Hospital of China Medical University, NHC Key Laboratory
Diagnosis and Treatment of Thyroid DiseasesShenyangChina
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21
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Hong K, Linton JA, Kim S, Song Y, Shin H. Analysis of thyroid hormones and sarcopenia: association of creatine kinase and thyroid hormones (thyroid‐stimulating hormone, triiodothyronine, and free thyroxine): a cross‐sectional study. JCSM CLINICAL REPORTS 2021. [DOI: 10.1002/crt2.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Ki‐Hong Hong
- Department of Family Medicine Severance Hospital, Yonsei University College of Medicine 50‐1 Yonsei‐ro, Seodaemun‐gu Seoul Korea
| | - John A. Linton
- International Health Care Center Severance Hospital, Yonsei University Health System 50‐1 Yonsei‐ro, Seodaemun‐gu Seoul 03722 Korea
| | - Sue Kim
- International Health Care Center Severance Hospital, Yonsei University Health System 50‐1 Yonsei‐ro, Seodaemun‐gu Seoul 03722 Korea
| | - Yu‐Hyeon Song
- Department of Family Medicine Severance Hospital, Yonsei University College of Medicine 50‐1 Yonsei‐ro, Seodaemun‐gu Seoul Korea
| | - Hye‐Jung Shin
- Biostatistics Collaboration Units, Department of Research Affairs Yonsei University College of Medicine, Seoul, Korea 50‐1 Yonsei‐ro, Seodaemun‐gu Seoul Korea
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22
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Wang L, Sheng Y, Xu W, Sun M, Lv S, Yu J, Wang X, Ding G, Duan Y. Mechanism of thyroid hormone signaling in skeletal muscle of aging mice. Endocrine 2021; 72:132-139. [PMID: 32720201 DOI: 10.1007/s12020-020-02428-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 07/18/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIM Skeletal muscle (SM) has been shown as a target of thyroid hormones (THs). However, the status of TH signaling in aged SM remains unclear. This study aimed to explore the mechanism of TH signaling in SM of aging mice. METHODS Thirty C57BL/6J male mice were divided into 6-, 15- and 22-month (6, 15 and 22M) groups according to different age. Physical parameters were evaluated by analytical balance, grip strength test and histological analysis. Thyroid function was detected by enzyme-linked immunosorbent assay. TH signaling was compared among the three groups by real-time PCR and western blotting analysis. RESULTS p16, p21, and p53 mRNA levels in SM increased in age-dependent manner. The muscle weight and strength decreased in 22M group compared to 6 and 15M groups. Concentrations of thyroid hormones, including free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) in 22 M mice were not shown significant difference compared to 6M or 15M mice, although FT3 showed slightly decrease and TSH appeared a mild increase accompanying with age. mRNA levels of TH transporters, including MCT8 and MCT10, as well as iodothyronine deiodinase type 2 (DIO2) and type 3 (DIO3), were higher in 22M, while TH receptor α (TRα) mRNA and protein expression was lower in 22M, compared to the other groups. Type-I myosin heavy chain (MyHC I), MyHC IIx, and MyHC IIa were upregulated and Type-IIb MyHC (MyHC IIb) was downregulated in SM with advancing age. CONCLUSIONS TH signaling in SM changes with aging.
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Affiliation(s)
- Li Wang
- Division of Geriatric Endocrinology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yunlu Sheng
- Division of Geriatric Endocrinology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Wenli Xu
- Division of Geriatric Endocrinology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Minne Sun
- Division of Geriatric Endocrinology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Shan Lv
- Division of Geriatric Endocrinology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Jing Yu
- Division of Geriatric Endocrinology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiaodong Wang
- Division of Geriatric Endocrinology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Guoxian Ding
- Division of Geriatric Endocrinology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
| | - Yu Duan
- Division of Geriatric Endocrinology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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23
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Effraimidis G, Watt T, Feldt-Rasmussen U. Levothyroxine Therapy in Elderly Patients With Hypothyroidism. Front Endocrinol (Lausanne) 2021; 12:641560. [PMID: 33790867 PMCID: PMC8006441 DOI: 10.3389/fendo.2021.641560] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/03/2021] [Indexed: 01/06/2023] Open
Abstract
Levothyroxine (L-T4) treatment of overt hypothyroidism can be more challenging in elderly compared to young patients. The elderly population is growing, and increasing incidence and prevalence of hypothyroidism with age are observed globally. Elderly people have more comorbidities compared to young patients, complicating correct diagnosis and management of hypothyroidism. Most importantly, cardiovascular complications compromise the usual start dosage and upward titration of L-T4 due to higher risk of decompensating cardiac ischemia and -function. It therefore takes more effort and care from the clinician, and the maintenance dose may have to be lower in order to avoid a cardiac incidence. On the other hand, L-T4 has a beneficial effect on cardiac function by increasing performance. The clinical challenge should not prevent treating with L-T4 should the patient develop e.g., cardiac ischemia. The endocrinologist is obliged to collaborate with the cardiologist on prophylactic cardiac measures by invasive cardiac surgery or medical therapy against cardiac ischemic angina. This usually allows subsequent successful treatment. Management of mild (subclinical) hypothyroidism is even more complex. Prevalent comorbidities in the elderly complicate correct diagnosis, since many concomitant morbidities can result in non-thyroidal illness, resembling mild hypothyroidism both clinically and biochemically. The diagnosis is further complicated as methods for measuring thyroid function (thyrotropin and thyroxine) vary immensely according to methodology and background population. It is thus imperative to ensure a correct diagnosis by etiology (e.g., autoimmunity) before deciding to treat. Even then, there is controversy regarding whether or not treatment of such mild forms of hypothyroidism in elderly will improve mortality, morbidity, and quality of life. This should be studied in large cohorts of patients in long-term placebo-controlled trials with clinically relevant outcomes. Other cases of hypothyroidism, e.g., medications, iodine overload or hypothalamus-pituitary-hypothyroidism, each pose specific challenges to management of hypothyroidism; these cases are also more frequent in the elderly. Finally, adherence to treatment is generally challenging. This is also the case in elderly patients, which may necessitate measuring thyroid hormones at individually tailored intervals, which is important to avoid over-treatment with increased risk of cardiac morbidity and mortality, osteoporosis, cognitive dysfunction, and muscle deficiency.
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Affiliation(s)
- Grigoris Effraimidis
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Torquil Watt
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Internal Medicine, Endocrine Section, Copenhagen University Hospital Herlev Gentofte, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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24
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Park YS, Chang Y, Lee Y, Shin H, Ryu S, Yoon KJ. The prospective relationship between low muscle mass and thyroid hormones among 198 069 euthyroid men and women; comparing different definitions of low muscle mass. Int J Clin Pract 2021; 75:e13710. [PMID: 32955783 PMCID: PMC7988611 DOI: 10.1111/ijcp.13710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/08/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The impact of thyroid hormones within normal range on muscle mass remains unknown. We examined the association between new onset of low muscle mass (LMM) and thyroid hormones among euthyroid men and women with three different definitions of LMM in prospective cohort study. METHODS We performed a cohort study of 198 069 Korean adults (mean age of 39.2 years), free of LMM at baseline, who participated in a repeated screening examination and were followed up annually or biennially for up to 6.3 years. Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxin (FT4) levels were measured by an electrochemiluminescent immunoassay. Muscle mass was assessed using a bioelectrical impedance analyser. LMM was defined as the appendicular skeletal muscle mass (ASM) by body weight (ASM/weight, LMM-W), height squared (ASM/height2 , LMM-H) and BMI (ASM/BMI, LMM-B) of one standard deviation below the sex-specific mean for young reference group. RESULTS During a median follow-up of 3.1 years (interquartile range, 2.0-4.1 years), new-onset LMM-W, LMM-H and LMM-B occurred in 17 856 (incident rate, 27.8 per 1000 person-years), 8307 (incident rate, 13.4 per 1000 person-years) and 13 990 participants (incident rate, 24.5 per 1000 person-years) in each. In euthyroid men, FT4 was inversely and FT3 positively associated with incident LMM-W in a dose-response manner. TSH and FT4 had inverse dose-response relationship with incident LMM-B. Incident LMM-H of euthyroid men has no apparent associations with any thyroid hormones. Euthyroid women had no dose-response relationship between thyroid hormones and any definition of LMM. CONCLUSIONS Among euthyroid men, FT4 had inverse dose-response association with new onset of LMM defined with weight (LMM-W) and BMI (LMM-B). Height squared LMM (LMM-H) had no apparent relationship with any thyroid hormones. Euthyroid women had no dose-responsive association between thyroid hormones and incident LMM.
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Affiliation(s)
- Young Sook Park
- Department of Physical & Rehabilitation MedicineSamsung Changwon HospitalSungkyunkwan University School of MedicineChangwonKorea
| | - Yoosoo Chang
- Center for Cohort StudiesTotal Healthcare CenterKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea
- Department of Occupational and Environmental MedicineKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea
- Department of Clinical Research Design & EvaluationSAIHSTSungkyunkwan UniversitySeoulKorea
| | - Yong‐Taek Lee
- Department of Physical & Rehabilitation MedicineKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea
| | - Hocheol Shin
- Center for Cohort StudiesTotal Healthcare CenterKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea
- Department of Family MedicineKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea
| | - Seungho Ryu
- Center for Cohort StudiesTotal Healthcare CenterKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea
- Department of Occupational and Environmental MedicineKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea
- Department of Clinical Research Design & EvaluationSAIHSTSungkyunkwan UniversitySeoulKorea
| | - Kyung Jae Yoon
- Department of Clinical Research Design & EvaluationSAIHSTSungkyunkwan UniversitySeoulKorea
- Department of Physical & Rehabilitation MedicineKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulKorea
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25
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Tsunekawa K, Matsumoto R, Ushiki K, Martha L, Shoho Y, Yanagawa Y, Ishigaki H, Yoshida A, Araki O, Nakajima K, Kimura T, Murakami M. Significance of serum branched-chain amino acid to tyrosine ratio measurement in athletes with high skeletal muscle mass. BMC Sports Sci Med Rehabil 2021; 13:1. [PMID: 33397493 PMCID: PMC7784282 DOI: 10.1186/s13102-020-00229-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/21/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Few nutritional markers reflect the hypermetabolic state of athletes with high levels of skeletal muscle. Although branched-chain amino acids (BCAA) play crucial roles in protein metabolism in skeletal muscle, the relationship between skeletal muscle mass and amino acid imbalances caused by the metabolism of BCAA and aromatic amino acids remains unclear. The aim of this study is to test the hypothesis that athletes with high levels of skeletal muscle mass have plasma amino acid imbalances, assessed by serum BCAA to tyrosine ratio (BTR) which can be measured conveniently. METHODS The study enrolled 111 young Japanese men: 70 wrestling athletes and 41 controls. None of them were under any medications, extreme dietary restrictions or intense exercise regimens. Each participant's body composition, serum concentrations of albumin and rapid turnover proteins including transthyretin and transferrin, BTR, and thyroid function were assessed. RESULTS Compared to the controls, the athletes had significantly higher skeletal muscle index (SMI) (p < 0.001), and lower serum albumin concentration (p < 0.001) and BTR (p < 0.001). Kruskal-Wallis tests showed that serum albumin concentration and BTR were significantly lower in the participants with higher SMI. Serum albumin concentration and BTR were inversely correlated with SMI by multiple regression analysis (logarithmic albumin, β = - 0.358, p < 0.001; BTR, β = - 0.299, p = 0.001). SMI was inversely and transthyretin was positively correlated with serum albumin (SMI, β = - 0.554, p < 0.001; transthyretin, β = 0.379, p < 0.001). Serum concentration of free 3,5,3'-triiodothyronine (FT3) was inversely correlated with BTR, and, along with SMI and albumin, was independent predictor of BTR (SMI, β = - 0.321, p < 0.001; FT3, β = - 0.253, p = 0.001; logarithmic albumin, β = 0.261, p = 0.003). However, FT3 was not correlated with SMI or serum albumin. Serum concentrations of rapid turnover proteins were not correlated with BTR. CONCLUSIONS Increased skeletal muscle mass enhances the circulating amino acid imbalances, and is independently facilitated by thyroid hormones. Serum BTR may be a useful biomarker to assess the hypermetabolic state of wrestling athletes with high levels of skeletal muscle.
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Affiliation(s)
- Katsuhiko Tsunekawa
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan.
| | - Ryutaro Matsumoto
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan.,Graduate School of Health and Sport Science, Nippon Sport Science University, Yokohama, 227-0033, Japan
| | - Kazumi Ushiki
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan
| | - Larasati Martha
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan
| | - Yoshifumi Shoho
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan.,Faculty of Education, Ikuei University, Takasaki, 370-0011, Japan
| | - Yoshimaro Yanagawa
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan.,Faculty of Education, Ikuei University, Takasaki, 370-0011, Japan
| | - Hirotaka Ishigaki
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan.,Department of Medical Technology, Faculty of Health Science, Gunma Paz University, Takasaki, 370-0006, Japan
| | - Akihiro Yoshida
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan
| | - Osamu Araki
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan
| | - Kiyomi Nakajima
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan
| | - Takao Kimura
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan
| | - Masami Murakami
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan
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26
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Priego T, Martín AI, González-Hedström D, Granado M, López-Calderón A. Role of hormones in sarcopenia. VITAMINS AND HORMONES 2021; 115:535-570. [PMID: 33706961 DOI: 10.1016/bs.vh.2020.12.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Aging involves numerous changes in body composition that include a decrease in skeletal muscle mass. The gradual reduction in muscle mass is associated with a simultaneous decrease in muscle strength, which leads to reduced mobility, fragility and loss of independence. This process called sarcopenia is secondary to several factors such as sedentary lifestyle, inadequate nutrition, chronic inflammatory state and neurological alterations. However, the endocrine changes associated with aging seem to be of special importance in the development of sarcopenia. On one hand, advancing age is associated with a decreased secretion of the main hormones that stimulate skeletal muscle mass and function (growth hormone, insulin-like growth factor 1 (IGFI), testosterone and estradiol). On the other hand, the alteration of the IGF-I signaling along with decreased insulin sensitivity also have an important impact on myogenesis. Other hormones that decline with aging such as the adrenal-derived dehydroepiandrosterone, thyroid hormones and vitamin D seem to also be involved in sarcopenia. Adipokines released by adipose tissue show important changes during aging and can affect muscle physiology and metabolism. In addition, catabolic hormones such as cortisol and angiotensin II can accelerate aged-induced muscle atrophy, as they are involved in muscle wasting and their levels increase with age. The role played by all of these hormones and the possible use of some of them as therapeutic tools for treating sarcopenia will be discussed.
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Affiliation(s)
- T Priego
- Departamento de Fisiología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - A I Martín
- Departamento de Fisiología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - D González-Hedström
- Departamento de Fisiología, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Pharmactive Biotech Products S.L. Parque Científico de Madrid. Avenida del Doctor Severo Ochoa, 37 Local 4J, 28108 Alcobendas, Madrid, Spain
| | - M Granado
- Departamento de Fisiología, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; CIBER Fisiopatología de la Obesidad y Nutrición. Instituto de Salud Carlos III, Madrid, Spain
| | - A López-Calderón
- Departamento de Fisiología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
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Abstract
Sarcopenia describes low muscle mass and strength associated with ageing, whilst reduced physical performance indicates the severity of the condition. It can happen independently of other medical conditions and can be a key feature of the frailty phenotype. Frailty is a syndrome of increased vulnerability to incomplete resolution of homeostasis, following a stressor event. Researchers have described the implications of hypothalamic pituitary dysregulation in the pathogenesis of both entities. This review summarizes the recent evidence in this area as well as other endocrine factors such as insulin resistance and vitamin D status and outlines current research priorities. We conducted searches to PubMed and Embase databases for articles, reviews and studies reporting new data on the interaction between hormones of the endocrine system and frailty and/ or sarcopenia in the last 5 years. Interventional studies, cohort studies, case-control studies and animal studies were included. Clinical trials register was also searched to identify ongoing relevant studies. Studies have given us insights into the complex relationships between factors such as anabolic hormones, glucocorticoids and vitamin D on muscle strength and performance and their involvement in ageing phenotypes. However, robust randomized controlled trials are needed to consolidate existing evidence in humans and inform clinical practice. Current evidence supports hormone replacement in patients with confirmed deficiencies, to optimize health and prevent complications. Hormone replacement has limited use for age-related conditions. Current interest is focused on muscle/bone/fat interactions and health outcomes in "sarcopenic obesity." A life-course approach to improving 'health-span' is advocated. Lifestyle factors such as nutrition and physical activity have important interactions with body composition, physical function and metabolic outcomes. Large-scale clinical trials will determine the efficacy and long-term safety of hormone supplementation in the management of sarcopenia and frailty.
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Affiliation(s)
- Vicky Kamwa
- Musculoskeletal Endocrinology Research Group, Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK - .,Academic Metabolic Bone Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK - .,Institute of Inflammation and Ageing, The University of Birmingham, Birmingham, UK -
| | - Carly Welch
- Institute of Inflammation and Ageing, The University of Birmingham, Birmingham, UK
| | - Zaki K Hassan-Smith
- Musculoskeletal Endocrinology Research Group, Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK.,Academic Metabolic Bone Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Ahn SH, Seo DH, Cho Y, Jung M, Kim SH, Hong S. Different Relationships Between Thyrotropin and Muscle Strength According to Sex and Age in Euthyroid Koreans (The 6th Korea National Health and Nutritional Examination Survey 2014-2015). Thyroid 2020; 30:1710-1717. [PMID: 32438894 DOI: 10.1089/thy.2019.0601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Changes in muscle mass and strength can be caused by multiple endocrine factors, including thyroid dysfunction. However, the relationship between thyroid function and muscle strength in euthyroid individuals is not clear. In the present study, we investigated the relationship between thyroid function and handgrip strength (HGS) in euthyroid Koreans, especially according to sex and age. Methods: This was a population-based, cross-sectional study from the 6th Korea National Health and Nutrition Examination Survey including 2894 Koreans (1487 men and 1407 women) aged ≥19 years. Serum thyrotropin (TSH) and free thyroxine (fT4) levels were measured. HGS was measured using a digital grip strength dynamometer. Results: Serum TSH level, but not serum fT4 level, was significantly associated with HGS in men, but neither TSH nor fT4 level was associated with HGS in women. Serum TSH showed a negative association with HGS in men aged <65 years (n = 1376; β = -0.566, p = 0.008), but a positive association in men aged ≥65 years (n = 111; β = 1.158, p = 0.010) after adjusting for confounders. HGS decreased as TSH tertile increased in men aged <65 years (p for trend = 0.010), but increased with TSH tertile in men aged ≥65 years (p for trend = 0.009) after adjusting for confounders. Odds ratios (ORs) for the lowest quartile of HGS increased in the highest tertile of TSH among men aged <65 years (OR = 1.657 [95% confidence interval {CI} 1.099-2.500], p = 0.006) and decreased in the highest tertile of TSH among men aged ≥65 years (OR = 0.176 [CI 0.032-0.966], p = 0.034) after adjusting for confounders. Conclusions: In euthyroid Koreans, serum TSH levels were significantly associated with HGS only in men and this relationship was found to depend significantly on age. These findings suggest that age has a distinct influence on the effect of even subtle change of thyroid function on muscle strength in men.
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Affiliation(s)
- Seong Hee Ahn
- Department of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Da Hea Seo
- Department of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Yongin Cho
- Department of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Mihye Jung
- Department of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - So Hun Kim
- Department of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Seongbin Hong
- Department of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
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Xiu S, Mu Z, Zhao L, Sun L. Low free triiodothyronine levels are associated with risk of frailty in older adults with type 2 diabetes mellitus. Exp Gerontol 2020; 138:111013. [PMID: 32590129 DOI: 10.1016/j.exger.2020.111013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/27/2020] [Accepted: 06/17/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES With aging populations around the world, frailty is becoming more prevalent increasing the need to early identify those at risk of frailty. The association between thyroid hormone levels and frailty in subjects with type 2 diabetes mellitus (T2DM) remains unclear. The objective of the study was to evaluate the relationship between thyroid hormone concentrations and frailty in older adults with T2DM. METHODS A total of 240 older adults with T2DM were divided into three groups according to the frailty phenotype criteria: robust group (n = 94), pre-frail (n = 110) and frail group (n = 36). Concentrations of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH), 25-hydroxyvitamin D3 [25(OH) D3], highly sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were determined. Handgrip strength was measured using a Jamar hand dynamometer. Physical function was assessed by gait speed and the timed go and up (TUG) test. Logistic regression analysis was performed to evaluate the association between FT3 and frailty. RESULTS The FT3 level was the lowest among frail people (2.56 ± 0.42 pg/mL), followed by pre-frail participants (2.73 ± 0.38 pg/mL), with the highest among the robust subjects (2.83 ± 0.43 pg/mL). FT3 level was positively correlated with handgrip strength and gait speed (R = 0.313, P < 0.001; R = 0.250, P < 0.001, respectively), while negatively correlated with TUG time (R = -0.276, P < 0.001). After adjusting for age, sex, TSH, 25(OH) D3 and estimate glomerular filtration rate (eGFR), logistic regression showed that low FT3 was significantly associated with an increased risk of frailty (odds ratio (OR): 4.53; 95% confidence interval (CI): 1.89-10.83; P = 0.001). CONCLUSION Low levels of FT3 were associated with an increased risk of frailty in older adults with T2DM. Measuring FT3 might be useful for identifying those at high risk of frailty.
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Affiliation(s)
- Shuangling Xiu
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
| | - Zhijing Mu
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Lei Zhao
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Lina Sun
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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30
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Functional Mechanisms of Mitochondrial Respiratory Chain Supercomplex Assembly Factors and Their Involvement in Muscle Quality. Int J Mol Sci 2020; 21:ijms21093182. [PMID: 32365950 PMCID: PMC7246575 DOI: 10.3390/ijms21093182] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/23/2020] [Accepted: 04/28/2020] [Indexed: 12/13/2022] Open
Abstract
Impairment of skeletal muscle function causes disabilities in elderly people. Therefore, in an aged society, prevention and treatment of sarcopenia are important for expanding healthy life expectancy. In addition to aging, adipose tissue disfunction and inflammation also contribute to the pathogenesis of sarcopenia by causing the combined state called ‘sarcopenic obesity’. Muscle quality as well as muscle mass contributes to muscle strength and physical performance. Mitochondria in the skeletal muscles affect muscle quality by regulating the production of energy and reactive oxygen species. A certain portion of the mitochondrial respiratory chain complexes form a higher-order structure called a “supercomplex”, which plays important roles in efficient energy production, stabilization of respiratory chain complex I, and prevention of reactive oxygen species (ROS) generation. Several molecules including phospholipids, proteins, and certain chemicals are known to promote or stabilize mitochondrial respiratory chain supercomplex assembly directly or indirectly. In this article, we review the distinct mechanisms underlying the promotion or stabilization of mitochondrial respiratory chain supercomplex assembly by supercomplex assembly factors. Further, we introduce regulatory pathways of mitochondrial respiratory chain supercomplex assembly and discuss the roles of supercomplex assembly factors and regulatory pathways in skeletal muscles and adipose tissues, believing that this will lead to discovery of potential targets for prevention and treatment of muscle disorders such as sarcopenia.
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Szlejf C, Suemoto CK, Janovsky CCPS, Barreto SM, Diniz MDFHS, Lotufo PA, Bensenor IM. Thyroid Function and Sarcopenia: Results from the ELSA-Brasil Study. J Am Geriatr Soc 2020; 68:1545-1553. [PMID: 32167571 DOI: 10.1111/jgs.16416] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 02/20/2020] [Accepted: 02/20/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVES We aimed to investigate the association of subclinical thyroid disease and thyroid hormone levels with sarcopenia and its defining components in community-dwelling middle-aged and older adults without overt thyroid dysfunction. DESIGN Cross-sectional study. SETTING Active and retired employees from public institutions located in six Brazilian cities. PARTICIPANTS A total of 6974 participants from the ELSA-Brasil study's second wave, aged 50 years and older, without overt thyroid dysfunction and with complete data for exposure, outcome, and covariates. METHODS Serum levels of thyrotropin (TSH), free thyroxine, and free triiodothyronine (FT3) were measured and divided in quintiles for the analyses. Participants were classified with euthyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism. Muscle mass was assessed by bioelectrical impedance analysis and muscle strength by handgrip strength. Sarcopenia was defined according to the Foundation for the National Institutes of Health criteria. Possible confounders included sociodemographic characteristics, clinical conditions, and lifestyle. Analyses were performed separately for middle-aged and older adults (≥65 y). RESULTS The frequencies of sarcopenia, low muscle mass, low muscle strength, subclinical hypothyroidism, and subclinical hyperthyroidism were 1.5%, 20.8%, 3.8%, 9.1%, and .9%, respectively. Subclinical thyroid dysfunction was not associated with sarcopenia and its defining components. Among older adults, TSH had a U-shaped association with sarcopenia and low muscle strength. The odds ratios (ORs) (95% confidence intervals [CIs]) for the associations of the first, second, fourth, and fifth quintile with sarcopenia, respectively, were 5.18 (1.47-18.28), 6.28 (1.82-21.73), 4.12 (1.15-14.76), and 4.81 (1.35-17.10), and with low muscle strength was (OR (95% CI) for the first, second, and fifth quintiles, respectively: 1.43 (1.16-5.07), 2.07 (1.24-4.70), and 2.18 (1.03-4.60). Additionally, FT3 had a negative association with muscle mass in both age strata. CONCLUSION Subtle thyroid hormone alterations are associated with sarcopenia or its defining components in middle-aged and older adults without overt thyroid dysfunction. J Am Geriatr Soc 68:1545-1553, 2020.
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Affiliation(s)
- Claudia Szlejf
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, Brazil
| | - Claudia K Suemoto
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, Brazil.,Division of Geriatrics, University of São Paulo Medical School, São Paulo, Brazil
| | - Carolina C P S Janovsky
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, Brazil
| | - Sandhi M Barreto
- Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | | | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, Brazil.,Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
| | - Isabela M Bensenor
- Center for Clinical and Epidemiological Research, Hospital Universitário, University of São Paulo, São Paulo, Brazil.,Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
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32
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Gu Y, Meng G, Wu H, Zhang Q, Liu L, Bao X, Wang Y, Zhang S, Sun S, Wang X, Zhou M, Jia Q, Song K, Niu K. Thyroid Function as a Predictor of Handgrip Strength Among Middle-Aged and Older Euthyroid Adults: The TCLSIH Cohort Study. J Am Med Dir Assoc 2019; 20:1236-1241. [DOI: 10.1016/j.jamda.2019.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/31/2019] [Accepted: 06/17/2019] [Indexed: 12/15/2022]
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