Are thyroid hormone levels and sarcopenia in elderly patients associated with type 2 diabetes mellitus and euthyroidism?

Svetlana V Bulgakova,Irina S Chetverikova,Ekaterina V Treneva,Dmitrii P Kurmaev

doi:10.35693/2500-1388-2023-8-4-233-238

Svetlana V Bulgakova, Irina S Chetverikova + Show 2 more

Open Access

https://doi.org/10.35693/2500-1388-2023-8-4-233-238

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Abstract

Aim to study the relationship between thyroid function parameters (free T3 (FT3), free T4 (FT4), FT3/FT4 ratio), thyroid-stimulating hormone (TSH) and parameters characterizing sarcopenia (muscle mass and strength, physical performance) in patients with type 2 diabetes mellitus (T2DM) and euthyroidism. Material and methods. The study included 312 elderly patients with T2DM in a state of euthyroidism (mean age 65.39 2.28 years). In all participants the following parameters were measured: anthropometric parameters, thyroid hormones (FT3, FT4), TSH, fasting blood glucose, glycated hemoglobin (HbA1c), fasting C-peptide and insulin, lipid profile, body composition, handgrip strength, walking speed. Results. Sarcopenia was prevalent in 26.9% of T2DM patients with euthyroidism. A binary logistic regression analysis adjusted for age, gender, smoking and alcohol consumption, T2DM duration, hypertension, HbA1c level, eGFR, TG, HDL and fat mass fraction showed that the high-normal FT3 level (OR = 0.522, 95% CI: 0.3040.895, p = 0.018), a low-normal FT4 level (OR = 1.126, 95% CI: 1.0091.258, p = 0.034) and an increased FT3/FT4 ratio (OR = 0.923, 95% CI: 0.8790.969, p = 0.001) were associated with a low prevalence of sarcopenia. FT3 concentration was positively associated with muscle strength (OR = 0.525, 95% CI: 0.3050.902, p = 0.020) and walking speed (OR = 0.443, 95% CI: 0.2590.758, p = 0.003), while FT4 concentration was negatively associated with muscle mass (OR = 1.114, 95% CI: 1.0091.232, p = 0.036). The FT3/FT4 ratio was positively associated with muscle mass (OR = 0.943, 95% CI: 0.9050.981, p = 0.006), muscle strength (OR = 0.945, 95% CI: 0.9010.992, p = 0.021), and walking speed (OR = 0.934, 95% CI: 0.8940.975, p = 0.002). TSH levels were not associated with sarcopenia. Conclusion. The high FT3/FT4 ratio is significantly associated with a low risk of sarcopenia in T2DM patients with euthyroidism.

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