This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by van den Beld, A. W. Articles by Lamberts, S. W. J. Search for Related Content PubMed PubMed Citation Articles by van den Beld, A. W. Articles by Lamberts, S. W. J. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Seniors' Health Related Collections Thyroid Cardiovascular Endocrinology

Thyroid Hormone Concentrations, Disease, Physical Function, and Mortality in Elderly Men

Department of Internal Medicine (A.W.v.d.B., T.J.V., R.A.F., S.W.J.L.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; and Julius Center for Patient Oriented Research (D.E.G.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands

Address all correspondence and requests for reprints to: A. W. van den Beld, M.D., Ph.D., Department of Internal Medicine, Room Bd230, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. E-mail: a.vandenbeld{at}erasmusmc.nl.

Context: Physiological changes in thyroid hormone concentrations might be related to changes in the overall physical function in the elderly.

Objective: We determined to what extent thyroid hormone concentrations are related to physical function and mortality in elderly men.

Design: A longitudinal population study (the Zoetermeer study) was conducted. Mortality was registered in the subsequent 4 yr.

Participants: Four hundred three independently and ambulatory living men (aged 73–94 yr) participated.

Main Outcome Measures: The study examined the association between serum thyroid hormones and parameters of physical function as well as the association with mortality.

Methods: TSH, free T₄ (FT4) total T₄, T₃, rT₃, and T₄-binding globulin were measured. Physical function was estimated by the number of problems in activities of daily living, a measure of physical performance score (PPS), leg extensor strength and grip strength, bone density, and body composition.

Results: Serum rT₃ increased significantly with age and the presence of disease. Sixty-three men met the biochemical criteria for the low T₃ syndrome (decreased serum T₃ and increased serum rT₃). This was associated with a lower PPS, independent of disease. Furthermore, higher serum FT4 (within the normal range of healthy adults) and rT₃ (above the normal range of healthy adults) were related with a lower grip strength and PPS, independent of age and disease. Isolated low T₃ was associated with a better PPS and a higher lean body mass. Low FT4 was related to a decreased risk of 4-yr mortality.

Conclusions: In a population of independently living elderly men, higher FT4 and rT₃ concentrations are associated with a lower physical function. High serum rT₃ may result from a decreased peripheral metabolism of thyroid hormones due to the aging process itself and/or disease and may reflect a catabolic state. Low serum FT4 is associated with a better 4-yr survival; this may reflect an adaptive mechanism to prevent excessive catabolism.

This article has been cited by other articles:

				G. Atzmon, N. Barzilai, J. G. Hollowell, M. I. Surks, and I. Gabriely Extreme Longevity Is Associated with Increased Serum Thyrotropin J. Clin. Endocrinol. Metab., April 1, 2009; 94(4): 1251 - 1254. [Abstract] [Full Text] [PDF]

				B. Goichot, R. Sapin, and J. L. Schlienger Subclinical Hyperthyroidism: Considerations in Defining the Lower Limit of the Thyrotropin Reference Interval Clin. Chem., March 1, 2009; 55(3): 420 - 424. [Abstract] [Full Text] [PDF]

				E Forestier, S Vinzio, R Sapin, J L Schlienger, and B Goichot Increased reverse triiodothyronine is associated with shorter survival in independently-living elderly: the Alsanut study Eur. J. Endocrinol., February 1, 2009; 160(2): 207 - 214. [Abstract] [Full Text] [PDF]

				J. Heeringa, E. H. Hoogendoorn, W. M. van der Deure, A. Hofman, R. P. Peeters, W. C. J. Hop, M. den Heijer, T. J. Visser, and J. C. M. Witteman High-Normal Thyroid Function and Risk of Atrial Fibrillation: The Rotterdam Study Arch Intern Med, November 10, 2008; 168(20): 2219 - 2224. [Abstract] [Full Text] [PDF]

				P. Haentjens, A. Van Meerhaeghe, K. Poppe, and B. Velkeniers Subclinical thyroid dysfunction and mortality: an estimate of relative and absolute excess all-cause mortality based on time-to-event data from cohort studies Eur. J. Endocrinol., September 1, 2008; 159(3): 329 - 341. [Abstract] [Full Text] [PDF]

				S. Mariotti Mild Hypothyroidism and Ischemic Heart Disease: Is Age the Answer? J. Clin. Endocrinol. Metab., August 1, 2008; 93(8): 2969 - 2971. [Full Text] [PDF]

				S. Razvi, A. Shakoor, M. Vanderpump, J. U. Weaver, and S. H. S. Pearce The Influence of Age on the Relationship between Subclinical Hypothyroidism and Ischemic Heart Disease: A Metaanalysis J. Clin. Endocrinol. Metab., August 1, 2008; 93(8): 2998 - 3007. [Abstract] [Full Text] [PDF]

				N. Ochs, R. Auer, D. C. Bauer, D. Nanchen, J. Gussekloo, J. Cornuz, and N. Rodondi Meta-analysis: Subclinical Thyroid Dysfunction and the Risk for Coronary Heart Disease and Mortality Ann Intern Med, June 3, 2008; 148(11): 832 - 845. [Abstract] [Full Text] [PDF]

				B. Biondi and D. S. Cooper The Clinical Significance of Subclinical Thyroid Dysfunction Endocr. Rev., February 1, 2008; 29(1): 76 - 131. [Abstract] [Full Text] [PDF]

				H. Volzke, C. Schwahn, H. Wallaschofski, and M. Dorr The Association of Thyroid Dysfunction with All-Cause and Circulatory Mortality: Is There a Causal Relationship? J. Clin. Endocrinol. Metab., July 1, 2007; 92(7): 2421 - 2429. [Abstract] [Full Text] [PDF]

				M. D. Gammage, F. Osman, M. C. Sheppard, and J. A. Franklyn Reply J. Am. Coll. Cardiol., June 5, 2007; 49(22): 2229 - 2230. [Full Text] [PDF]

				H. Volzke Hyperthyroidism and Mortality J. Am. Coll. Cardiol., June 5, 2007; 49(22): 2228 - 2229. [Full Text] [PDF]

				M. D. Gammage, J. V. Parle, R. L. Holder, L. M. Roberts, F. D. R. Hobbs, S. Wilson, M. C. Sheppard, and J. A. Franklyn Association Between Serum Free Thyroxine Concentration and Atrial Fibrillation Arch Intern Med, May 14, 2007; 167(9): 928 - 934. [Abstract] [Full Text] [PDF]

				P. Saravanan, T. J. Visser, and C. M. Dayan Psychological Well-Being Correlates with Free Thyroxine But Not Free 3,5,3'-Triiodothyronine Levels in Patients on Thyroid Hormone Replacement J. Clin. Endocrinol. Metab., September 1, 2006; 91(9): 3389 - 3393. [Abstract] [Full Text] [PDF]

				S. Mariotti Editorial: Thyroid Function and Aging: Do Serum 3,5,3'-Triiodothyronine and Thyroid-Stimulating Hormone Concentrations Give the Janus Response? J. Clin. Endocrinol. Metab., December 1, 2005; 90(12): 6735 - 6737. [Full Text] [PDF]