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Cited by 60Nutrition and Health in AgingThyroid Disorders and TreatmentsHormonal and reproductive studies

Thyroid Function and Sarcopenia: Results from the ELSA-Brasil Study

Szlejf, Claudia, Suemoto, Claudia K., Janovsky, Carolina C.P.S., Barreto, Sandhi M., Diniz, Maria de Fátima H.S., Lotufo, Paulo A., Bensenor, Isabela M.·2020·Journal of the American Geriatrics Society
DOI 10.1111/jgs.16416
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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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  • In older adults, subclinical hyperthyroidism is not associated with low muscle mass and/or strength.

    “However, in older adults, subclinical hyperthyroidism was not associated with low muscle mass and/or strength (121–123)”

    From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [123]

  • The association between TSH and low muscle strength is U-shaped.

    “but the association between TSH and low muscle strength was found to be U-shaped (123).”

    From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [123]

  • 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 [123]

  • Some studies found negative 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 [123]

  • 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 [123]

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Authors
Szlejf, C., Suemoto, C. K., Janovsky, C. C. P. S., Barreto, S. M., Diniz, M. D. F. H. S., Lotufo, P. A., & Bensenor, I. M.
Affiliations
  • Center for Clinical and Epidemiological Research Hospital Universitário, University of São Paulo São Paulo Brazil
  • Universidade de São Paulo (BR)
  • Universidade Federal de Minas Gerais (BR)
ORCID
Venue
Journal of the American Geriatrics Society
Publisher
Wiley
Published
2020-03-13
Volume
68
Issue
7
Pages
1545-1553
ISSN
  • 0002-8614 (ISSN-L)
  • 1532-5415
DOI
10.1111/jgs.16416
OpenAlex
W3010846774
Cited by
60
References
32
Citations by year
2026: 5 · 2025: 9 · 2024: 14 · 2023: 10 · 2022: 9 · 2021: 11 · 2020: 2
FWCI
4.81
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of the American Geriatrics Society (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico
  • Financiadora de Estudos e Projetos
  • Ministério da Saúde
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
sarcopenia, subclinical hypothyroidism, subclinical hyperthyroidism, thyroid function, thyroid-stimulating hormone, free triiodothyronine, free thyroxine, muscle mass, muscle strength, grip strength, older adults, middle-aged adults, community-dwelling adults, ELSA-Brasil, U-shaped relationship
MeSH terms
Brazil, Cross-Sectional Studies, Female, Humans, Hyperthyroidism, Hypothyroidism, Male, Middle Aged, Thyroid Function Tests, Thyrotropin, Triiodothyronine, Hand Strength, Sarcopenia

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