Thyroid hormones and frailty in older adults: systematic review and dose–response meta-analysis

Abstract Objective To investigate (1) whether the association of thyroid hormone with frailty risk is linear or nonlinear and (2) which range of thyroid hormones or thyroid stimulating hormone (TSH) is more associated with a higher risk of frailty in older adults. Design Systematic review and dose–r...

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Main Authors: Wen-Chun Chia, Yang-Ching Chen, Shuang-ling Xiu, Sen-Te Wang
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Geriatrics
Subjects:
Online Access:https://doi.org/10.1186/s12877-025-05748-5
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author Wen-Chun Chia
Yang-Ching Chen
Shuang-ling Xiu
Sen-Te Wang
author_facet Wen-Chun Chia
Yang-Ching Chen
Shuang-ling Xiu
Sen-Te Wang
author_sort Wen-Chun Chia
collection DOAJ
description Abstract Objective To investigate (1) whether the association of thyroid hormone with frailty risk is linear or nonlinear and (2) which range of thyroid hormones or thyroid stimulating hormone (TSH) is more associated with a higher risk of frailty in older adults. Design Systematic review and dose–response meta-analysis. Methods Medical electronic databases were searched for cross-sectional or longitudinal studies, published from database inception to February 2022. We focused on the relationship between TSH and frailty. Data on TSH reference range, TSH exposure categories, sample size of each exposure category, and adjusted odds ratios (ORs) for frailty with 95% confidence interval (CI) were extracted. In the dose–response meta-analysis, we set the OR for frailty as 1 at 0.3 mIU/L TSH. Results The systematic review included 10 studies, whereas the meta-analysis included 3 studies (n = 6388). TSH levels ranged from 0.3 to 4.8 mIU/L, and the dose–response meta-analysis revealed a significant J-shaped association (p = 0.0071). Frailty OR (95% CI) increased from 1.30 (1.06–1.59) for 2.7 mIU/L TSH to 2.06 (1.18–3.57) for 4.8 mIU/L TSH. Conclusions A significant nonlinear, J-shaped association was noted between TSH level and frailty. TSH levels within the upper half (2.7–4.8mIU/L) of reference range was noted to significantly higher risk of frailty; by contrast, those in the lower half (0.6–1.5 mIU/L) had a lower risk of frailty, though not significantly so. Trail registration This systematic review was registered with PROSPERO (registration number: CRD42022299214).
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spelling doaj-art-de303fb6ecfd499bacf5caf897196b282025-08-20T03:13:18ZengBMCBMC Geriatrics1471-23182025-02-0125111210.1186/s12877-025-05748-5Thyroid hormones and frailty in older adults: systematic review and dose–response meta-analysisWen-Chun Chia0Yang-Ching Chen1Shuang-ling Xiu2Sen-Te Wang3Department of Family Medicine, Taipei Medical University HospitalDepartment of Family Medicine, Wan Fang Hospital, Taipei Medical UniversityDepartment of Endocrinology, Xuanwu Hospital, Capital Medical UniversityLifestyle and Healthcare Management Center, Joyce ClinicAbstract Objective To investigate (1) whether the association of thyroid hormone with frailty risk is linear or nonlinear and (2) which range of thyroid hormones or thyroid stimulating hormone (TSH) is more associated with a higher risk of frailty in older adults. Design Systematic review and dose–response meta-analysis. Methods Medical electronic databases were searched for cross-sectional or longitudinal studies, published from database inception to February 2022. We focused on the relationship between TSH and frailty. Data on TSH reference range, TSH exposure categories, sample size of each exposure category, and adjusted odds ratios (ORs) for frailty with 95% confidence interval (CI) were extracted. In the dose–response meta-analysis, we set the OR for frailty as 1 at 0.3 mIU/L TSH. Results The systematic review included 10 studies, whereas the meta-analysis included 3 studies (n = 6388). TSH levels ranged from 0.3 to 4.8 mIU/L, and the dose–response meta-analysis revealed a significant J-shaped association (p = 0.0071). Frailty OR (95% CI) increased from 1.30 (1.06–1.59) for 2.7 mIU/L TSH to 2.06 (1.18–3.57) for 4.8 mIU/L TSH. Conclusions A significant nonlinear, J-shaped association was noted between TSH level and frailty. TSH levels within the upper half (2.7–4.8mIU/L) of reference range was noted to significantly higher risk of frailty; by contrast, those in the lower half (0.6–1.5 mIU/L) had a lower risk of frailty, though not significantly so. Trail registration This systematic review was registered with PROSPERO (registration number: CRD42022299214).https://doi.org/10.1186/s12877-025-05748-5FrailtyTSHThyroid hormone
spellingShingle Wen-Chun Chia
Yang-Ching Chen
Shuang-ling Xiu
Sen-Te Wang
Thyroid hormones and frailty in older adults: systematic review and dose–response meta-analysis
BMC Geriatrics
Frailty
TSH
Thyroid hormone
title Thyroid hormones and frailty in older adults: systematic review and dose–response meta-analysis
title_full Thyroid hormones and frailty in older adults: systematic review and dose–response meta-analysis
title_fullStr Thyroid hormones and frailty in older adults: systematic review and dose–response meta-analysis
title_full_unstemmed Thyroid hormones and frailty in older adults: systematic review and dose–response meta-analysis
title_short Thyroid hormones and frailty in older adults: systematic review and dose–response meta-analysis
title_sort thyroid hormones and frailty in older adults systematic review and dose response meta analysis
topic Frailty
TSH
Thyroid hormone
url https://doi.org/10.1186/s12877-025-05748-5
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