Medicina clinica · 2026
Association between serum free triiodothyronine (FT3) levels and ICU-acquired weakness: A prospective observational study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Tian Jie, Zeng Siyao, Guan Chunming, Li Haibo
Аннотация
BACKGROUND: Intensive care unit-acquired weakness (ICU-AW) is a common complication among critically ill patients. Existing evidence indicates that critically ill patients frequently develop low triiodothyronine syndrome (LT3S), and this thyroid hormone imbalance may disrupt muscle metabolic pathways and thereby promote the onset and progression of ICU-AW. However, the relationship between FT3 levels and ICU-AW remains inconclusive, and clinical research addressing this link remains limited. Accordingly, this study aims to examine the clinical relationship between FT3 levels and ICU-AW.
METHODS: We enrolled patients with mechanical ventilation in the ICU of the Second Affiliated Hospital of Harbin Medical University from June 2024 to December 2025, dividing them into low-T3 group (n=46, FT3<2.43pmol/L) and non-low T3 group (n=33, FT3≥2.43pmol/L) by admission FT3 levels. ICU-AW was defined as a Medical Research Council score≤48. We collected clinical data including demographics, comorbidities and laboratory results, compared baseline characteristics, and adopted correlation, regression and subgroup analyses to assess relevant associations.
RESULTS: Among 79 patients, 58.2% had reduced admission FT3, and its incidence decreased with increasing MRC scores. Spearman analysis showed FT3 levels were positively correlated with MRC scores. Fully adjusted logistic regression confirmed FT3 as a factor associated with ICU-AW (OR=0.31; 95% CI, 0.10-0.97; p=0.0447). ROC analysis indicated FT3 had good discrimination for ICU-AW (AUC=0.84).
CONCLUSIONS: Reduced FT3 levels are closely associated with the development of ICU-acquired weakness, with higher FT3 levels showing a positive correlation with higher MRC scores and a negative correlation with the risk of ICU-AW.
TRIAL REGISTRATION: The study has been registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2500100201, registration date: April 3, 2025). This study is a retrospective registration.
METHODS: We enrolled patients with mechanical ventilation in the ICU of the Second Affiliated Hospital of Harbin Medical University from June 2024 to December 2025, dividing them into low-T3 group (n=46, FT3<2.43pmol/L) and non-low T3 group (n=33, FT3≥2.43pmol/L) by admission FT3 levels. ICU-AW was defined as a Medical Research Council score≤48. We collected clinical data including demographics, comorbidities and laboratory results, compared baseline characteristics, and adopted correlation, regression and subgroup analyses to assess relevant associations.
RESULTS: Among 79 patients, 58.2% had reduced admission FT3, and its incidence decreased with increasing MRC scores. Spearman analysis showed FT3 levels were positively correlated with MRC scores. Fully adjusted logistic regression confirmed FT3 as a factor associated with ICU-AW (OR=0.31; 95% CI, 0.10-0.97; p=0.0447). ROC analysis indicated FT3 had good discrimination for ICU-AW (AUC=0.84).
CONCLUSIONS: Reduced FT3 levels are closely associated with the development of ICU-acquired weakness, with higher FT3 levels showing a positive correlation with higher MRC scores and a negative correlation with the risk of ICU-AW.
TRIAL REGISTRATION: The study has been registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2500100201, registration date: April 3, 2025). This study is a retrospective registration.