Evaluation of sarcopenia in patients with hyperthyroidism





Hyperthyroidism, Muscle, Sarcopenia


Background and aim: Sarcopenia is a generalized skeletal muscle disease and thyroid hormones have regulatory effects on skeletal muscle metabolism. This study aims to evaluate the association between hyperthyroidism and sarcopenia.

Methods: Thirteen patients with overt hyperthyroidism (OH), 13 patients with subclinical hyperthyroidism (SH) and 30 healthy volunteers were included. OH was defined as serum thyroid-stimulating hormone (TSH) <0.34 mU/L and free T4 (fT4) >1.12 ng/dL and/or free T3 (fT3) >4.37 ng/L; while SH was defined as TSH <0.34 when fT4 and fT3 were within the normal reference range (0.61–1.12 ng/dL for fT4; 2.6–4.37 ng/L for fT3). Handgrip strength (HGS) measurement and chair stand test were performed for muscle strength, while skeletal muscle mass index measurement with bioelectrical impedance analysis and calf circumference (CC) measurement were performed for muscle mass evaluation.

Results: The median age was 44.9 (21–76), and 16 (61.5%) were female. HGS and CC were found to be significantly lower in the OH and SH groups than in the control group (p=0.007; p=0.008, respectively). Sarcopenia was more common in the OH and SH groups than in the control group (p=0.007), and the risk of sarcopenia was higher in the OH group than in the SH group (OR: 2.44, 95% CI: 0.26–31.87). In hyperthyroid patients, a high fT4 increased the possibility of sarcopenia (OR: 6.0 95% CI: 0.59–79.23).

Conclusions: Sarcopenia is significantly more common in patients with hyperthyroidism.


Download data is not yet available.


Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and ageing 2019;48(1):16-31.

Bousquet-Santos K, Vaisman M, Barreto ND, Cruz-Filho RA, Salvador BA, Frontera WR, et al. Resistance training improves muscle function and body composition in patients with hyperthyroidism. Archives of physical medicine and rehabilitation 2006;87(8):1123-30.

Brennan MD, Powell C, Kaufman KR, Sun PC, Bahn RS, Nair KS. The impact of overt and subclinical hyperthyroidism on skeletal muscle. Thyroid : official journal of the American Thyroid Association 2006;16(4):375-80.

Malmstrom TK, Miller DK, Simonsick EM, Ferrucci L, Morley JE. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. Journal of cachexia, sarcopenia and muscle 2016;7(1):28-36.

Bahat G, Tufan A, Tufan F, Kilic C, Akpinar TS, Kose M, et al. Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition. Clinical nutrition (Edinburgh, Scotland) 2016;35(6):1557-63.

Iannuzzi-Sucich M, Prestwood KM, Kenny AM. Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women. The journals of gerontology Series A, Biological sciences and medical sciences 2002;57(12):M772-7.

Mitchell WK, Williams J, Atherton P, Larvin M, Lund J, Narici M. Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength; a quantitative review. Frontiers in physiology 2012;3:260.

Klein I, Ojamaa K. Thyroid (neuro)myopathy. Lancet (London, England) 2000;356(9230):614.

Bloise FF, Cordeiro A, Ortiga-Carvalho TM. Role of thyroid hormone in skeletal muscle physiology. The Journal of endocrinology 2018;236(1):R57-r68.

Milanesi A, Lee JW, Yang A, Liu YY, Sedrakyan S, Cheng SY, et al. Thyroid Hormone Receptor Alpha is Essential to Maintain the Satellite Cell Niche During Skeletal Muscle Injury and Sarcopenia of Aging. Thyroid : official journal of the American Thyroid Association 2017;27(10):1316-22.

Borba VZC, Costa TL, Moreira CA, Boguszewski CL. MECHANISMS OF ENDOCRINE DISEASE: Sarcopenia in endocrine and non-endocrine disorders. European journal of endocrinology 2019;180(5):R185-r99.

Taylor PN, Albrecht D, Scholz A, Gutierrez-Buey G, Lazarus JH, Dayan CM, et al. Global epidemiology of hyperthyroidism and hypothyroidism. Nature reviews Endocrinology 2018;14(5):301-16.

Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid : official journal of the American Thyroid Association 2016;26(10):1343-421.

Reginster JY, Burlet N. Osteoporosis: a still increasing prevalence. Bone 2006;38(2 Suppl 1):S4-9.

Berta E, Lengyel I, Halmi S, Zrínyi M, Erdei A, Harangi M, et al. Hypertension in Thyroid Disorders. Frontiers in endocrinology 2019;10:482.

Rizos CV, Elisaf MS, Liberopoulos EN. Effects of thyroid dysfunction on lipid profile. The open cardiovascular medicine journal 2011;5:76-84.






Original articles