医学
优势比
内科学
置信区间
冲程(发动机)
亚临床感染
甲状腺功能
混淆
激素
胃肠病学
心脏病学
机械工程
工程类
作者
Jinjing Wang,Fengli Li,Lulu Xiao,Feng Peng,Wen Sun,Min Li,Dezhi Liu,Yanrui Jiang,Ruibing Guo,Hua Li,Wusheng Zhu,Gelin Xu,Xinfeng Liu
出处
期刊:Neurology
[Ovid Technologies (Wolters Kluwer)]
日期:2018-11-20
卷期号:91 (21)
被引量:24
标识
DOI:10.1212/wnl.0000000000006534
摘要
Objective
To investigate whether thyroid function profiles can predict poststroke fatigue (PSF) in patients with acute ischemic stroke. Methods
Patients with stroke were consecutively recruited within 3 days of onset in Jinling Hospital. Serum levels of thyroid hormones, thyroid antibodies, hematologic indexes, and biochemical indexes were measured on admission. Fatigue was scored using the Fatigue Severity Scale. Associations were analyzed with multivariate regression and restricted cubic splines. Results
Of the 704 patients with stroke, 292 (41.5%) were diagnosed with fatigue in the acute stage and 224 (35.3%) 6 months after the index stroke. The serum levels of thyroid-stimulating hormone (TSH) were inversely associated with the risk of PSF in both the acute phase and at follow-up evaluations after adjusting for potential confounders (odds ratio 0.30, 95% confidence interval 0.24–0.37 in the acute phase, and odds ratio 0.70, 95% confidence interval 0.58–0.84 at follow-up). The subgroup analysis indicated that in the acute phase of ischemic stroke, TSH was associated with severity of PSF in the groups with euthyroidism (β = −0.70, p < 0.001), subclinical hypothyroidism (β = −0.44, p < 0.001), and low-T3 syndrome (β = −0.34, p = 0.008). Higher TSH was associated with better Fatigue Severity Scale scores in patients with low-T3 syndrome 6 months after the index stroke (β = −0.35, p = 0.01). Furthermore, in the group with low-T3 syndrome, FT3 serum level could also indicate a higher risk of PSF (β = −2.54, p < 0.001 in the acute phase, and β = −2.67, p < 0.001 at follow-up). Conclusion
Thyroid function profiles may predict fatigue after acute ischemic stroke, suggesting that neuroendocrine responses could have a role in PSF.
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