Low triiodothyronine is associated with high risk of malnutrition and poor functional status in subacute stroke patients

被引：0
作者：
Di Vincenzo, Olivia [1 ]
Pagano, Ermenegilda [2 ]
Cervone, Mariarosaria [2 ]
Acampora, Lucia [3 ]
Dentice, Monica [3 ]
Gheri, Chiara Francesca [4 ]
Pasanisi, Fabrizio [3 ]
Scalfi, Luca [1 ,2 ]
机构：
[1] Univ Naples Federico II, Dept Publ Hlth, via Sergio Pansini,5, I-80131 Naples, Italy
[2] Santa Maria Pozzo Hosp, via Pomigliano 40, I-80049 Naples, Italy
[3] Univ Naples Federico II, Dept Clin Med & Surg, Via Sergio Pansini 5, I-80131 Naples, Italy
[4] IRCCS Fdn Don Carlo Gnocchi ONLUS Firenze, I-50143 Florence, Italy
来源：
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES | 2025年 / 35卷 / 02期
关键词：
Stroke; Thyroid hormone; Nutritional screening; Nutritional risk; Malnourished; Rehabilitation; THYROID-HORMONE; RELIABILITY; VALIDITY;
D O I：
10.1016/j.numecd.2024.09.008
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Background and aims: Stroke patients may exhibit low thyroid hormone (TH) levels and disease-related malnutrition, both potentially affecting clinical status; their relationships remain unexplored. This study aimed to evaluate TH concentrations in subacute stroke patients and investigate the relationships between TH levels, nutritional risk, and functional status. Methods and results: Early subacute stroke patients admitted to a rehabilitation unit were assessed using various nutritional screening tools (Geriatric Nutritional Risk Index-GNRI, Prognostic Nutritional Index-PNI, and Controlling Nutritional Status-CONUT score) and with the Global Leadership Initiative on Malnutrition (GLIM) criteria. Thyroid-Stimulating Hormone (TSH), free Tetraiodothyronine-Thyroxine (fT4) and free Triiodothyronine (fT3) levels were determined. Functional and cognitive status was evaluated using different scales. Associations between altered THs and nutritional status were examined through univariate/multivariate analyses and ROC analyses. Among 264 patients (age 72.0 +/- 10.5 yrs), significant correlations emerged between fT3 and nutritional risk and functional tests (mostly p < 0.001). The prevalence of high nutritional risk determined by GNRI, PNI and CONUT increased from higher to lower fT3 tertiles. Lower fT3 levels were observed in patients at high nutritional risk and with GLIM-based malnutrition. fT3 exhibited reasonable predictive power for high nutritional risk (particularly PNI: AUC 0.769, 95%CI 0.702-0.836, p < 0.001). Multivariate logistic regression identified nutritional risk (p < 0.001) and time from stroke onset as predictors of low fT3 values. Conclusion: Altered fT3 levels in early subacute stroke patients correlate with high nutritional risk and poor functional status. Low fT3 values upon admission for stroke rehabilitation may serve as a further parameter to be considered in patients at high nutritional risk.
引用
收藏
页数：7
相关论文
共 41 条
[1]   Relation of Low Triiodothyronine Syndrome Associated With Aging and Malnutrition to Adverse Outcome in Patients With Acute Heart Failure [J].
Asai, Kuniya ;
Shirakabe, Akihiro ;
Kiuchi, Kazutaka ;
Kobayashi, Nobuaki ;
Okazaki, Hirotake ;
Matsushita, Masato ;
Shibata, Yusaku ;
Goda, Hiroki ;
Shigihara, Shota ;
Asano, Kazuhiro ;
Tani, Kenichi ;
Okajima, Fumitaka ;
Hata, Noritake ;
Shimizu, Wataru .
AMERICAN JOURNAL OF CARDIOLOGY, 2020, 125 (03) :427-435
[2]   Outcomes validity and reliability of the modified Rankin scale: Implications for stroke clinical trials - A literature review and synthesis [J].
Banks, Jamie L. ;
Marotta, Charles A. .
STROKE, 2007, 38 (03) :1091-1096
[3]   Agreed definitions and a shared vision for new standards in stroke recovery research: The Stroke Recovery and Rehabilitation Roundtable taskforce [J].
Bernhardt, Julie ;
Hayward, Kathryn S. ;
Kwakkel, Gert ;
Ward, Nick S. ;
Wolf, Steven L. ;
Borschmann, Karen ;
Krakauer, John W. ;
Boyd, Lara A. ;
Carmichael, S. Thomas ;
Corbett, Dale ;
Cramer, Steven C. .
INTERNATIONAL JOURNAL OF STROKE, 2017, 12 (05) :444-450
[4]   T3 as predictor of mortality in any cause non-critically ill patients [J].
Biegelmeyer, Erika ;
Scanagata, Iury ;
Alves, Laura ;
Reveilleau, Murilo ;
Schwengber, Fernando Pereira ;
Wajner, Simone Magagnin .
ENDOCRINE CONNECTIONS, 2021, 10 (08) :852-860
[5]   Beyond Low Plasma T3: Local Thyroid Hormone Metabolism during Inflammation and Infection [J].
Boelen, Anita ;
Kwakkel, Joan ;
Fliers, Eric .
ENDOCRINE REVIEWS, 2011, 32 (05) :670-693
[6]   Impact of Thyroid Hormone Levels on Functional Outcome in Neurological and Neurosurgical Early Rehabilitation Patients [J].
Boltzmann, Melanie ;
Schmidt, Simone B. ;
Rollnik, Jens D. .
BIOMED RESEARCH INTERNATIONAL, 2017, 2017
[7]   ESPEN guidelines on definitions and terminology of clinical nutrition [J].
Cederholm, T. ;
Barazzoni, R. ;
Austin, P. ;
Ballmer, P. ;
Biolo, G. ;
Bischoff, S. C. ;
Compher, C. ;
Correia, I. ;
Higashiguchi, T. ;
Hoist, M. ;
Jensen, G. L. ;
Malone, A. ;
Muscaritoli, M. ;
Nyulasi, I. ;
Pirlich, M. ;
Rothenberg, E. ;
Schindler, K. ;
Schneider, S. M. ;
de van der Schueren, M. A. E. ;
Sieber, C. ;
Valentini, L. i ;
Yu, J. C. ;
Van Gossum, A. ;
Singer, P. .
CLINICAL NUTRITION, 2017, 36 (01) :49-64
[8]  
Cederholm T, 2019, CLIN NUTR, V38, P1, DOI [10.1016/j.clnu.2018.08.002, 10.1016/j.clnu.2019.02.033, 10.1002/jcsm.12383, 10.1002/jpen.1440]
[9]   Low Tri-iodothyronine Syndrome Is Associated With Cognitive Impairment in Patients With Acute Ischemic Stroke: A Prospective Cohort Study [J].
Che, Huijun ;
wu, Yuemin ;
Huang, Guiqian ;
He, Weilei ;
Lin, Shasha ;
Zhang, Xingru ;
He, Jincai .
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY, 2018, 26 (12) :1222-1230
[10]   Low triiodothyronine syndrome is associated with stroke-associated pneumonia [J].
Chen, Huijun ;
Xu, Minjie ;
Huang, Yezhi ;
He, Jincai ;
Ren, Wenwei .
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, 2022, 52 (11)
12345