title: Low FT3: a possible marker of frailty in the elderly.
abstract: BACKGROUND
  Frailty is associated with a functional decline of multiple physiological systems, of which they may be a cause or consequence. The objective of the study was to evaluate the prevalence of thyroid hormone modifications in elderly frail subjects and its relationship with frailty.
  
  
  METHODS
  An observational study was carried out at the University Hospital "Tor Vergata" in Rome among ambulatory and hospitalized patients. The study population consisted of 112 elderly subjects: 62 were hospitalized following hip fracture and 50 control subjects were outpatients. Participating patients received a multidimensional geriatric evaluation. The Survey of Health, Ageing and Retirement in Europe Frailty Instrument (SHARE-FI) was used to assess the degree of frailty. Thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were measured to evaluate thyroid status.
  
  
  RESULTS
  FT3, but not FT4, was significantly correlated with Frailty score, both in patients with hip fracture and in patients from the control group. In the entire study population, FT3 under normal limits is effective in discriminating frail/prefrail subjects from nonfrail subjects.
  
  
  CONCLUSIONS
  The reduction in serum concentrations of FT3 is a clear manifestation of stress associated with fractures. Numerous preexisting factors, such as the fracture patients' nutritional status, sarcopenia, disability and comorbidities, which characterize the condition of frailty and influence its pathogenesis, are strongly correlated with FT3 values, suggesting the existence of latent nonthyroidal illness syndrome (NTIS).
  
  
  CONCLUSIONS
  We conclude that measuring FT3 can be a useful laboratory parameter in clinical assessment, which can play an important role in identifying vulnerable elderly subjects and in quantifying the condition of frailty.
authors.affiliation: Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Bertoli
authors.affiliation: Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Valentini
authors.affiliation: Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Maria Assunta
authors.initials: MA
authors.lastname: Cianfarani
authors.affiliation: Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Gasbarra
authors.affiliation: Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Tarantino
authors.affiliation: Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Federici
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D015897:Comorbidity; D005060:Europe; D005260:Female; D016330:Frail Elderly; D000073496:Frailty / Q000097:blood*; D015577:Geriatric Assessment / Q000379:methods; D006306:Health Surveys; D006620:Hip Fractures / Q000097:blood* / Q000453:epidemiology; D006801:Humans; D008297:Male; D013960:Thyroid Function Tests; D013963:Thyroid Hormones / Q000097:blood*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
chemical_list: D015415:Biomarkers; D013963:Thyroid Hormones; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine
keywords: FT3; NTIS; aging; frailty; hip fracture