title: Serum thyrotropin concentration is an early marker of normalization of low triiodothyronine syndrome in aged hospitalized patients after discharge.
abstract: OBJECTIVE
  To assess short-term spontaneous evolution of alterations in thyroid function tests in aged hospitalized patients after discharge.
  
  
  METHODS
  A group of 146 patients (mean age±SD 85.9±6.2 yr) was studied. Serum concentrations of TSH, free T4 (FT4), and free T3 (FT3) were evaluated in every patient both after admission and 1 month after discharge.
  
  
  RESULTS
  At entry, both serum TSH [median (interquartile range), 2.19mU/l (0.89-2.31)] and FT4 (mean±SD, 16.7±3.4 pmol/l) concentrations were into the normal range, whereas serum FT3 concentrations were low (3.3±0.7 pmol/l). After discharge TSH and FT4 concentrations remained normal and FT3 low. However, both serum TSH [2.53 mU/l (1.24-3.33); p<0.01] and FT3 (3.7±1.0 pmol/l; p<0.001) concentrations significantly increased. Most patients (no.=124, 84.9%) showed the euthyroid sick syndrome (ESS). After discharge, ESS diminished to 76 (52.1%) subjects. Patients who normalized thyroid function tests showed significantly lower TSH values at entry compared with those who persisted with altered thyroid function tests [1.27 mU/l (0.69-1.89) vs 1.69mU/l (0.96-2.91), p<0.05]. Logistic regression analysis showed that serum levels of TSH at admission was the only variable negatively related to normalization of thyroid function [odds ratio 0.730; confidence interval 95%, 0.567-0.940; p=0.01).
  
  
  CONCLUSIONS
  About 35%of aged patients hospitalized for acute illness spontaneously normalize their thyroid function tests 1 month after discharge, mainly due to the correction of ESS. Serum TSH levels at admission seem to be the only variable negatively related to normalization of thyroid function at this time.
authors.affiliation: Department of Endocrinology, General Hospital, Segovia, Spain. piglo65@gmail.com
authors.forename: P
authors.initials: P
authors.lastname: Iglesias
authors.forename: A
authors.initials: A
authors.lastname: Muñoz
authors.forename: F
authors.initials: F
authors.lastname: Prado
authors.forename: M T
authors.initials: MT
authors.lastname: Guerrero
authors.forename: M C
authors.initials: MC
authors.lastname: Macías
authors.forename: E
authors.initials: E
authors.lastname: Ridruejo
authors.forename: P
authors.initials: P
authors.lastname: Tajada
authors.forename: C
authors.initials: C
authors.lastname: García-Arévalo
authors.forename: J J
authors.initials: JJ
authors.lastname: Díez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005067:Euthyroid Sick Syndromes / Q000097:blood* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010351:Patient Discharge; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000032:analysis / Q000097:blood*; D013997:Time Factors; D014284:Triiodothyronine / Q000097:blood
chemical_list: D015415:Biomarkers; D014284:Triiodothyronine; D013972:Thyrotropin