Low free T3 to free T4 ratio was associated with low muscle mass and impaired physical performance in community-dwelling aged population

Kong, S. H.; Kim, J. H.; Park, Y. J.; Lee, J. H.; Hong, A. R.; Shin, C. S.; Cho, N. H.

doi:10.1007/s00198-019-05137-w

Cited by 28Thyroid Disorders and TreatmentsNutrition and Health in AgingHormonal and reproductive studies

Low free T3 to free T4 ratio was associated with low muscle mass and impaired physical performance in community-dwelling aged population

Kong, S. H., Kim, J. H., Park, Y. J., Lee, J. H., Hong, A. R., Shin, C. S., Cho, N. H.·2020·Osteoporosis International

DOI 10.1007/s00198-019-05137-w

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Abstract

In aged population, the association of thyroid hormones on physical performance, especially within their normal range, has yet to be elucidated. In this study, individuals with low serum free T3/free T4 were likely to have low muscle mass and impaired physical performance.Purpose We aimed to evaluate the associations of muscle mass, strength, and physical performance with thyroid hormone in an aged euthyroid population from a community-based cohort.Methods We examined 918 men aged over 60 years and 1215 postmenopausal women from the Ansung cohort study. Appendicular skeletal muscle mass divided by square of height (ASM/ht 2) was used as the muscle mass index. Hand grip strength was measured using a hydraulic dynamometer. Physical performance was assessed using the short physical performance battery (SPPB).Results Participants with higher tertiles of free T3 and free T3/free T4 were younger and had higher ASM/ht 2, stronger hand grip strength, and higher SPPB scores than those in the lower tertiles. In adjusted models, men within higher tertiles of free T3 had higher ASM/ht 2 compared with those within lower tertiles (p = 0.033), whereas subjects with higher tertiles of free T4 had lower ASM/ht 2 compared with those within lower tertiles (p = 0.043). Subjects within higher tertiles of free T3/free T4 had higher ASM/ht 2 (p < 0.001) and better physical performance (p = 0.048) than those within lower tertiles after adjustments. However, free T3, free T4, or free T3/free T4 was not related to hand grip strength after adjustment for covariates.Conclusion Our results thus indicate that in an aged euthyroid population, low serum free T3/free T4 was a better index for low muscle mass and impaired physical performance than serum free T3 or free T4 alone.

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Data on the association between T3/fT3 and muscle mass are conflicting.
“Nevertheless, data on the association between T3/fT3 and muscle mass are conflicting and some studies found negative (35, 123), while others positive associations (124–126), with some differences between men and women.”
From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [125]
Other studies found positive associations between T3/fT3 and muscle mass.
“Nevertheless, data on the association between T3/fT3 and muscle mass are conflicting and some studies found negative (35, 123), while others positive associations (124–126), with some differences between men and women.”
From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [125]
There are some differences between men and women in the association between T3/fT3 and muscle mass.
“Nevertheless, data on the association between T3/fT3 and muscle mass are conflicting and some studies found negative (35, 123), while others positive associations (124–126), with some differences between men and women.”
From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [125]

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Authors: Kong, S. H., Kim, J. H., Park, Y. J., Lee, J. H., Hong, A. R., Shin, C. S., & Cho, N. H.
Affiliations: Seoul National University (KR)
Veterans Health Service Medical Center (KR)
Chonnam National University Hwasun Hospital (KR)
Ajou University (KR)
Corresponding author: Cho, N. H.
ORCID: Kong, S. H.
Kim, J. H.
Park, Y. J.
Lee, J. H.
Hong, A. R.
Shin, C. S.
Venue: Osteoporosis International
Publisher: Springer Science and Business Media LLC
Published: 2019-11-29
Volume: 31
Issue: 3
Pages: 525-531
ISSN: 0937-941X (ISSN-L)
1433-2965
DOI: 10.1007/s00198-019-05137-w
OpenAlex: W2990315394
Cited by: 28
References: 32
Citations by year: 2026: 3 · 2025: 5 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 7 · 2020: 2
FWCI: 2.64
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Osteoporosis International (publishedVersion)
PubMed (publishedVersion)
AJOU Open Repository (Ajou University) (submittedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords: free T3, free thyroxine, thyroid hormones, muscle mass, appendicular skeletal muscle mass, physical performance, grip strength, older adults, euthyroidism, postmenopausal women, community-dwelling older adults
MeSH terms: Physical Functional Performance, Aged, Female, Humans, Male, Middle Aged, Muscles, Cohort Studies, Muscle, Skeletal, Hand Strength, Independent Living

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Low free T3 to free T4 ratio was associated with low muscle mass and impaired physical performance in community-dwelling aged population

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