Heterogeneity of Thyroid Function and Impact of Peripheral Thyroxine Deiodination in Centenarians and Semi-Supercentenarians: Association With Functional Status and Mortality
Heterogeneity of Thyroid Function and Impact of Peripheral Thyroxine Deiodination in Centenarians and Semi-Supercentenarians: Association With Functional Status and Mortality
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DOI：
10.1093/gerona/gly194
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发表时间：
2019-06-01
影响因子：
5.1
通讯作者：
Vitale, Giovanni
中科院分区：
文献类型：
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作者：
Ostan, Rita;Monti, Daniela;Vitale, Giovanni
甲状腺激素（FT3, FT4）和促甲状腺激素（TSH）在672个特征良好的意大利受试者（年龄范围：52-113岁）中进行了评估，其中包括前所未有的百岁老人，半超级百岁老人，以及百岁老人的后代和年龄匹配的老年人（分别为CENT， 105+， CENTOFF和CTRL）。结果表明，FT3水平和FT3/FT4比值呈年龄依赖性降低，FT4和TSH呈年龄依赖性升高。在CENT/105+中，较高的FT4水平和较低的FT3/FT4比值与功能状态受损和死亡率增加相关。聚类分析根据FT3、FT4和TSH水平确定了CENT/105+的三个聚类。第3组FT3和TSH较低，FT4较高，健康状况最差，生存期最短。因此，甲状腺激素的年龄相关变化延伸到最高龄，并且CENT/105+在甲状腺功能方面具有高度异质性。这种异质性与CENT/105+患者不同的健康、功能和认知状态以及生存/死亡率有关。最后，我们调查了大量的CENT/105+显示提示非甲状腺疾病综合征（NTIS）的甲状腺特征（从先前的分析中排除）。与未患NTIS的CENT/105+相比，NTIS CENT/105+患者的功能和认知状况更差，死亡率更高。
Thyroid hormones (FT3, FT4) and thyroid-stimulating hormone (TSH) were evaluated in a population of 672 well-characterized Italian subjects (age range: 52-113 years), including an unprecedented number of centenarians, semi-supercentenarians, as well as centenarian's offspring and age-matched elderly (CENT, 105+, CENTOFF, and CTRL, respectively). The results show that FT3 level and FT3/FT4 ratio decrease while FT4 and TSH increase in an age-dependent manner. In CENT/105+, higher FT4 level, and lower FT3/FT4 ratio are associated with an impaired functional status and an increased mortality. A cluster analysis identified three clusters of CENT/105+ based on their FT3, FT4, and TSH levels. Cluster 3, characterized by lower FT3 and TSH and higher FT4, shows the worst health status and the shortest survival. Thus, the age-related changes of thyroid hormones extend to the most advanced age, and CENT/105+ are highly heterogeneous regarding thyroid function. This heterogeneity is related to different health, functional and cognitive status, as well as with survival/mortality in CENT/105+. Finally, we investigated a remarkable number of CENT/105+ showing a thyroid profile suggestive of non-thyroidal illness syndrome (NTIS) (excluded from the previous analysis). NTIS CENT/105+ are characterized by a worse functional and cognitive status and an increased mortality with respect to CENT/105+ without NTIS.