Abstract
Sarcopenia is prevalent in postmenopausal women but is inconclusive in total thyroidectomy and under levothyroxine replacement. We aim to analyze the determinants of sarcopenia and investigate the early detection of sarcopenia in this group. Fifty postmenopausal women with total thyroidectomy were measured for body composition via Dual-energy X-ray Absorptiometry (DXA) and Appendicular Skeletal Muscle mass divided by the height square (ASM/ht2). Handgrip strength and gait speed and Geriatric Nutritional Risk Index (GNRI) were calculated. Eight determinants associated with sarcopenia include GNRI (β, 0.042; 95% confidence interval (CI), 0.021 to 0.064), femoral neck BMD (β, 0.989; 95% CI, 0.049 to 1.929), TSH (β, 0.192; 95% CI, 0.027 to 0.357), and thyroglobulin Ab (0.657; 95% CI, 0.210 to 1.103) for ASM/height2; menopausal years (β, −3.112; 95% CI, −5.661 to −0.563) and ASM/height2 (β, 2.669; 95% CI, 1.073 to 4.265) for handgrip strength; and GNRI (β, 0.062; 95% CI, 0.019 to 0.105), T3 (β, −3.541; 95% CI, −7.019 to −0.063), and age (β, 0.043; 95% CI, 0.003 to 0.084) for gait speed. Our study confirmed a high prevalence of low skeletal muscle mass index in postmenopausal women with total thyroidectomy and revealed a number of determinants that could help early diagnosis and management this disease in daily clinical practice.
Highlights
Sarcopenia, or low relative skeletal muscle index, is characterized by the age-related loss of skeletal muscle mass and strength and/or a reduction in physical performance [1]
Previous studies have confirmed that overt thyroid dysfunction, regardless of whether it involves hypothyroidism or hyperthyroidism, has a harmful impact on muscle health [5,6], as thyroid hormones play a role in skeletal muscle formation and function [7]
We identified eight determinants that were associated with sarcopenia in postmenopausal women who had undergone total thyroidectomy, of which Geriatric Nutritional Risk Index (GNRI) was the only determinant to affect both muscle mass and physical function
Summary
Sarcopenia, or low relative skeletal muscle index, is characterized by the age-related loss of skeletal muscle mass and strength and/or a reduction in physical performance [1]. It has attracted increasing attention worldwide as it has been shown to affect both motility and mortality [2]. Sarcopenia is more frequently observed in postmenopausal women [8], and current menopausal management guidelines state that hormone replacement therapy combined with exercise may be beneficial to prevent the loss of muscle mass, performance, and strength [9]. A decrease in estrogen has been associated with muscle apoptosis and myosin dysfunction, possibly due to an increase in proinflammatory cytokines [10]
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