Associations between Thyroid Stimulating Hormone Levels and Both Severity and Early Outcome of Patients with Ischemic Stroke

• Published in: European neurology Vol. 76; no. 3-4; p. 125
• Main Authors: Delpont, Benoit, Aboa-Eboulé, Corine, Durier, Jérôme, Petit, Jean-Michel, Daumas, Anaïs, Legris, Nicolas, Daubail, Benoit, Giroud, Maurice, Béjot, Yannick
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.2016
• Subjects: Acute Disease; Aged; Aged, 80 and over; Cerebral Infarction - blood; Cerebral Infarction - diagnosis; Cerebral Infarction - therapy; Disability Evaluation; Female; Humans; Male; Middle Aged; Prognosis; Severity of Illness Index; Thyrotropin - blood; Treatment Outcome
• ISSN: 1421-9913
• DOI: 10.1159/000449055

We aimed to investigate associations between serum thyroid stimulating hormone (TSH) levels and both severity and outcome after ischemic stroke (IS). A total of 731 patients consecutive IS patients were enrolled (mean age 69.4 ± 15.4, 61.6% men), and serum TSH levels were measured at admission and analyzed according to the tertiles of their distribution (<0.822 vs. 0.822-1.6 vs. >1.6 mUI/l). Associations between TSH and both severity at admission (National Institutes of Health Stroke Scale (NIHSS) scores <5 vs. ≥5) and functional outcome at discharge assessed by the modified Rankin Scale were analyzed using logistic regression and ordinal logistic regression models, respectively. High TSH levels were independently associated with both a decreased risk of NIHSS score ≥5 at admission (prevalence proportion ratio = 0.62; 95% CI 0.41-0.94, p = 0.024 for tertile 3 vs. tertile 1). In addition, patients with high TSH levels had a better functional outcome at discharge (OR 0.43; 95% CI 0.30-0.60, p < 0.001 for tertile 2 vs. tertile 1; OR 0.39; 95% CI 0.27-0.56, p < 0.001 for tertile 3 vs. tertile 1). The mechanisms underlying these associations and their potential exploitation in terms of therapeutic strategies need to be explored.