Correlation analysis of FT3/FT4 and frailty in elderly patients with coronary heart disease.

Endokrynologia Polska Pub Date : 2024-01-01 Epub Date: 2024-10-08 DOI:10.5603/ep.100711
Jiling Qu, Siqi Ji, Ting Zhou, Chuntao Wang, Yongbing Liu
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Abstract

Introduction: In previous studies on thyroid hormones and frailty, most of the target population were elderly, and there were relatively few studies on elderly patients with coronary heart disease (CHD). Inflammation, oxidative stress, and haemodynamic instability in cardiovascular disease (CVD) can influence fluctuations in thyroid hormone (TH) levels and increase the incidence of frailty. The purpose of the present study was to explore the effect of TH on the risk of frailty in elderly patients with CHD.

Material and methods: The Fried scale was used to assess the frailty of participants. The predictive value of TH for frailty was determined using the patient's operating characteristic curve. Multivariate logistic regression model was utilised to analyse the relationship between TH and frailty.

Results: A total of 277 elderly patients with CHD were included in the study, of whom 29.96% were in a state of frailty. Free triiodothyronine (FT3)/free thyroxine (FT4) predicted frailty with the largest area under the curve of 0.634. Unordered multinomial logistic regression analysis showed that a lower T3 level was a risk factor for pre-frailty (p < 0.05). Lower levels of T3, FT3, and FT3/FT4 were risk factors for frailty (p < 0.05) after adjusting for demographic variables and blood indexes.

Conclusion: The predictive value of FT3/FT4 for frailty was more accurate than that of a single index. Moreover, T3 ≤ 1.095 nmol/L, FT3 ≤ 4.085 pmol/L, and FT3/FT4 ≤ 0.336 were shown to be the influencing factors of frailty, while T3 ≤ 1.095 nmol/L is an independent risk factor pre-frailty. Clinicians should focus on timely identification of the risk of frailty in order to improve patient quality of life and to reduce the risk of complications.

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老年冠心病患者 FT3/FT4 与虚弱的相关性分析
简介在以往有关甲状腺激素与虚弱的研究中,大多数目标人群都是老年人,而针对冠心病(CHD)老年患者的研究相对较少。心血管疾病(CVD)中的炎症、氧化应激和血流动力学不稳定性会影响甲状腺激素(TH)水平的波动并增加虚弱的发生率。本研究旨在探讨甲状腺激素对心血管疾病老年患者虚弱风险的影响:采用弗里德量表评估参与者的虚弱程度。采用患者工作特征曲线确定 TH 对虚弱的预测值。采用多变量逻辑回归模型分析 TH 与虚弱之间的关系:研究共纳入了 277 名患有心脏病的老年患者,其中 29.96% 处于虚弱状态。游离三碘甲状腺原氨酸(FT3)/游离甲状腺素(FT4)预测虚弱的曲线下面积最大,为 0.634。无序多项式逻辑回归分析表明,较低的 T3 水平是虚弱前期的一个风险因素(P < 0.05)。在对人口统计学变量和血液指标进行调整后,较低的 T3、FT3 和 FT3/FT4 水平是导致虚弱的危险因素(p < 0.05):结论:FT3/FT4对虚弱的预测价值比单一指标更准确。此外,T3≤1.095 nmol/L、FT3≤4.085 pmol/L和FT3/FT4≤0.336被证明是体弱的影响因素,而T3≤1.095 nmol/L是体弱前的独立危险因素。临床医生应重视及时发现虚弱风险,以提高患者的生活质量,降低并发症风险。
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