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Exp Clin Endocrinol Diabetes 2011; 119(3): 139-143
DOI: 10.1055/s-0030-1267918
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Low Free Triiodothyronine Levels are Related to Poor Prognosis in Acute Ischemic Stroke

W. Ambrosius1 , 2 , R. Kazmierski3 , V. Gupta1 , A. Wencel Warot2 , D. Adamczewska-Kociałkowska3 , A. Błazejewska1 , K. Ziemnicka4 , W. L. Nowinski1
  • 1Biomedical Imaging Lab, Agency for Science Technology and Research, Singapore
  • 2Department of Neurology, Poznan University of Medical Sciences, H. Swiecicki Hospital, Poznan, Poland
  • 3Department of Neurology and Cerebrovascular Disorders, Poznan University of Medical Sciences, L. Bierkowski Hospital, Poznan, Poland
  • 4Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
Further Information

Publication History

received 13.05.2010 first decision 05.08.2010

accepted 01.10.2010

Publication Date:
17 November 2010 (online)

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Abstract

Background: Neuroendocrine changes are important processes which accompany critical illness, however, the number of clinical studies concentrating on the role of thyroid gland hormones in stroke pathogenesis is relatively small. The aim of this prospective study was to investigate the relation between free triiodothyronine (fT3) levels and the prognosis of patients with stroke.

Methods: The prospective study included 387 patients with acute (<24 h of symptoms onset) ischemic stroke consecutively admitted to Stroke Units. The subjects with known conditions that could interfere with thyroid gland metabolism were excluded. We analyzed: the routine blood tests, fT3, free thyroxine (fT4), thyroid-stimulating hormone (TSH) levels, unenhanced CT scans, initial clinical status (NIH Stroke Scale, NIHSS), 30- and 360- days outcome (modified Rankin Scale-mRS) and calculated the survival rate.

Results: A higher NIHSS score was in the 1st fT3 levels tertile, whereas a lower in the 3rd fT3 levels tertile (p=0.006). The 30- and 360-days mRS scores showed that patients in the lowest fT3 tertile had more severe neurological impairment than those in the highest tertile (p=0.001 and p=0.03, respectively). A 1-year mortality of the patients with the first tertile fT3 levels was significantly higher than that of the patients with the third tertile hormone levels (p=0.008). Additionally, subjects with fT3 level in the lowest tertile demonstrated higher WBC counts and the ventricular system on Computed Tomography of head performed on admission to hospital was statistically more frequent compressed than that in the patients with fT3 level in the highest tertile (p=0.02 and p=0.03, respectively).

Conclusion: In acute stroke patients lower free T3 levels are an important factor related to unfavorable outcome, i. e., severe disability and death.

Key words

triiodothyronine - nonthyroidal illness syndrome - cerebrovascular disease

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Correspondence

W. Ambrosius

Department of Neurology

Poznan University of Medical

Sciences

Przybyszewskiego St. 49

60–355 Poznan

Poland

Phone: +48/61/869 1535

Fax: +48/61/869 1697

Email: wambrosius@amp.edu.pl

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