TY - JOUR
T1 - Favorable influence of subclinical hypothyroidism on the functional outcomes in stroke patients
AU - Baek, Jang Hyun
AU - Chung, Pil Wook
AU - Kim, Yong Bum
AU - Moon, Heui Soo
AU - Suh, Bum Chun
AU - Jin, Dong Kwan
AU - Kim, Byung Moon
AU - Rhee, Eun Jung
AU - Lee, Yong Taek
AU - Park, Kwang Yeol
PY - 2010
Y1 - 2010
N2 - Subclinical hypothyroidism (SCH) is thought to have an influence on stroke outcomes. However, few reports demonstrate a favorable relationship between the two. We evaluated this association in acute ischemic stroke. From Jan 2005 to Jun 2008, 756 acute ischemic stroke patients were recruited within seven days of onset. The patients with overt hypothyroidism/hyperthyroidism or other medical conditions that may affect thyroid function were excluded. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels were measured within two days. Patients were divided into two groups: the SCH group (TSH > 5.0 μU/mL and normal FT4 levels) and the control group. Stroke outcomes were assessed using two different criteria. In the first outcome model, favorable outcomes [I] were simply defined by modified Rankin Scale (mRS) scores (≦ 1), while the favorable outcomes [II] were defined as follows: a) a mRS score of 0, if the baseline National Institute of Health Stroke Scale (NIHSS) scores were < 8, b) a mRS score of 0 or 1, if the NIHSS scores were 8-14, c) a mRS score 0-2, if the NIHSS scores were >14. The changes in mRS scores and the proportion of patients with favorable outcomes [I] or [II] at the 30th and 90 th day were compared between the two patient groups. Of the 756 patients, 31 (4.1%) were patients with SCH. More patients from the SCH group showed improvement in NIHSS scores on the 30th day compared to the control group (48.4% vs. 25.3%, p=0.006). In addition, the proportion of patients who exhibited favorable outcomes [I] was significantly higher in the SCH group on the 90th day (74.2% vs. 55.3%, p=0.027) and that trend was seen as early as the 30th day (p=0.102). Similarly, the proportion of the patients with favorable outcomes [II] was significantly greater in the SCH group both on the 30th (29.0% vs. 14.6%, p=0.039) and 90th day (58.0% vs. 31.0%, p=0.003). We found that acute ischemic stroke patients with SCH at admission were more likely to show favorable functional outcomes than those without SCH. We can suggest preconditioning before the stroke combined with a reduced response to stress as a possible protective mechanism.
AB - Subclinical hypothyroidism (SCH) is thought to have an influence on stroke outcomes. However, few reports demonstrate a favorable relationship between the two. We evaluated this association in acute ischemic stroke. From Jan 2005 to Jun 2008, 756 acute ischemic stroke patients were recruited within seven days of onset. The patients with overt hypothyroidism/hyperthyroidism or other medical conditions that may affect thyroid function were excluded. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels were measured within two days. Patients were divided into two groups: the SCH group (TSH > 5.0 μU/mL and normal FT4 levels) and the control group. Stroke outcomes were assessed using two different criteria. In the first outcome model, favorable outcomes [I] were simply defined by modified Rankin Scale (mRS) scores (≦ 1), while the favorable outcomes [II] were defined as follows: a) a mRS score of 0, if the baseline National Institute of Health Stroke Scale (NIHSS) scores were < 8, b) a mRS score of 0 or 1, if the NIHSS scores were 8-14, c) a mRS score 0-2, if the NIHSS scores were >14. The changes in mRS scores and the proportion of patients with favorable outcomes [I] or [II] at the 30th and 90 th day were compared between the two patient groups. Of the 756 patients, 31 (4.1%) were patients with SCH. More patients from the SCH group showed improvement in NIHSS scores on the 30th day compared to the control group (48.4% vs. 25.3%, p=0.006). In addition, the proportion of patients who exhibited favorable outcomes [I] was significantly higher in the SCH group on the 90th day (74.2% vs. 55.3%, p=0.027) and that trend was seen as early as the 30th day (p=0.102). Similarly, the proportion of the patients with favorable outcomes [II] was significantly greater in the SCH group both on the 30th (29.0% vs. 14.6%, p=0.039) and 90th day (58.0% vs. 31.0%, p=0.003). We found that acute ischemic stroke patients with SCH at admission were more likely to show favorable functional outcomes than those without SCH. We can suggest preconditioning before the stroke combined with a reduced response to stress as a possible protective mechanism.
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U2 - 10.1507/endocrj.K09E-206
DO - 10.1507/endocrj.K09E-206
M3 - Article
C2 - 19823001
AN - SCOPUS:76049130349
VL - 57
SP - 23
EP - 29
JO - Endocrine Journal
JF - Endocrine Journal
SN - 0918-8959
IS - 1
ER -
