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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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Abstract

Summary

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/ht2) 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/ht2, 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/ht2 compared with those within lower tertiles (p = 0.033), whereas subjects with higher tertiles of free T4 had lower ASM/ht2 compared with those within lower tertiles (p = 0.043). Subjects within higher tertiles of free T3/free T4 had higher ASM/ht2 (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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Funding

This work was supported by grants from the Korean Health Technology R&D Project, Ministry for Health, Welfare, & Family Affairs, Republic of Korea (Grant No. A092077).

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Author notes

  1. S.H. Kong and J.H. Kim equally contributed to this work.

Authors and Affiliations

  1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea

    S. H. Kong, J. H. Kim, Y. J. Park & C. S. Shin

  2. Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, South Korea

    J. H. Lee

  3. Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam, South Korea

    A. R. Hong

  4. Department of Preventive Medicine, Ajou University School of Medicine, Suwon, 443-721, Republic of Korea

    N. H. Cho

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  1. S. H. Kong
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Correspondence to N. H. Cho.

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Informed consent was obtained from all individual participants included in the study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Kong, S., Kim, J., Park, Y. et al. Low free T3 to free T4 ratio was associated with low muscle mass and impaired physical performance in community-dwelling aged population. Osteoporos Int 31, 525–531 (2020). https://doi.org/10.1007/s00198-019-05137-w

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