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The effect of thyroid hormone therapy on muscle function, strength and mass in older adults with subclinical hypothyroidism—an ancillary study within two randomized placebo controlled trials

Title: The effect of thyroid hormone therapy on muscle function, strength and mass in older adults with subclinical hypothyroidism—an ancillary study within two randomized placebo controlled trials
Authors: Netzer, Seraina; Chocano-Bedoya, Patricia; Feller, Martin; Janett-Pellegri, Camilla; Wildisen, Lea; Büchi, Annina E; Moutzouri, Elisavet; Gonzalez Rodriguez, Elena; Collet, Tinh-Hai; Poortvliet, Rosalinde K E; Mc Carthy, Vera J C; Aeberli, Daniel; Aujesky, Drahomir; Westendorp, Rudi; Quinn, Terence J; Gussekloo, Jacobijn; Kearney, Patricia M; Mooijaart, Simon; Bauer, Douglas C; Rodondi, Nicolas
Contributors: Swiss National Science Foundation; ZonMw programme Evidence-based Medicine in Old age
Source: Age and Ageing ; volume 52, issue 1 ; ISSN 0002-0729 1468-2834
Publisher Information: Oxford University Press (OUP)
Publication Year: 2023
Description: Background loss of skeletal muscle function, strength and mass is common in older adults, with important socioeconomic impacts. Subclinical hypothyroidism is common with increasing age and has been associated with reduced muscle strength. Yet, no randomized placebo-controlled trial (RCT) has investigated whether treatment of subclinical hypothyroidism affects muscle function and mass. Methods this is an ancillary study within two RCTs conducted among adults aged ≥65 years with persistent subclinical hypothyroidism (thyrotropin (TSH) 4.60–19.99 mIU/l, normal free thyroxine). Participants received daily levothyroxine with TSH-guided dose adjustment or placebo and mock titration. Primary outcome was gait speed at final visit (median 18 months). Secondary outcomes were handgrip strength at 1-year follow-up and yearly change in muscle mass. Results we included 267 participants from Switzerland and the Netherlands. Mean age was 77.5 years (range 65.1–97.1), 129 (48.3%) were women, and their mean baseline TSH was 6.36 mIU/l (standard deviation [SD] 1.9). At final visit, mean TSH was 3.8 mIU/l (SD 2.3) in the levothyroxine group and 5.1 mIU/l (SD 1.8, P < 0.05) in the placebo group. Compared to placebo, participants in the levothyroxine group had similar gait speed at final visit (adjusted between-group mean difference [MD] 0.01 m/s, 95% confidence interval [CI] −0.06 to 0.09), similar handgrip strength at one year (MD −1.22 kg, 95% CI −2.60 to 0.15) and similar yearly change in muscle mass (MD −0.15 m2, 95% CI −0.49 to 0.18). Conclusions in this ancillary analysis of two RCTs, treatment of subclinical hypothyroidism did not affect muscle function, strength and mass in individuals 65 years and older.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/ageing/afac326
Availability: https://doi.org/10.1093/ageing/afac326; https://academic.oup.com/ageing/article-pdf/52/1/afac326/48944591/afac326.pdf
Rights: https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model
Accession Number: edsbas.100BE0BF
Database: BASE