Relationship Between Thyroid Function and Post-stroke Fatigue

YU Guangzhen; MIN Lianqiu

doi:10.3969/j.issn.2096-305X.2025.02.011

Abstract：Objective To investigate the relationship between post-stroke fatigue,PSF and thyroid function in patients with acute ischemic stroke.Methods According to the inclusion criteria and exclusion criteria,the hospitalized patients from January 2021 to December 2022 in the Department of Neurology of the First Affiliated Hospital of Jinzhou Medical University were collected.Serum thyroid hormone and biochemical indexes were measured in enrolled patients,and general data,basic diseases and concomitant diseases were collected.The enrolled patients were scored with fatigue severity scale(FSS)at 2 weeks of onset.The patients with FSS score ≥4 were diagnosed with PSF.According to the results,they were divided into study group and control group.Patients in the study group were divided into the following subgroups according to the level of Thyroid function:(1)Normal thyroid function:Thyroid-stimulating hormone(TSH),free triiodotyrosine(FT3)and free tetraiodotyrosine(FT4)were all within the normal range;(2)subclinical hypothyroidism:TSH＞4.2 mIU/L,FT3 and FT4 were within the normal range;(3)low T3 syndrome:FT3＜3.1μmol/L,FT4 and TSH are within the normal range.The differences of serum thyroid hormone levels between the two groups were analyzed,and the correlation between serum thyroid hormone levels and FSS scores in the study group and subgroups of the study group was analyzed.Results A total of 201 patients meeting the inclusion criteria were collected,including 105 patients with PSF.According to the classification of thyroid function status,71 of the 105 patients in the study group had normal thyroid function,16 had subclinical hypothyroidism,and 18 had low T3 syndrome.Serum FT3,TSH and uric acid(UA)levels in the study group were significantly lower than those in the control group,with statistical significance(P＜0.05).Serum cholesterol FT4,total cholesterol(TC),fasting plasma glucose(FPG)and plasma homocysteine(Hcy)levels were significantly higher than those of control group,with statistical significance(P＜0.05).Logistic regression analysis showed that FT3,FT4,TSH and Hcy were related factors for PSF(P＜0.05).In the study group,FSS score was negatively correlated with serum TSH score(P＜0.05),and positively correlated with serum Hcy score(P＜0.05).Subgroup analysis showed that FSS score of subclinical hypothyroidism patients was negatively correlated with serum TSH level(P＜0.05),and positively correlated with serum FT4 level(P＜0.05).FSS scores in patients with low T3 syndrome were negatively correlated with serum FT3 and TSH levels(P＜0.05),and positively correlated with serum FT4 levels(P＜0.05).There was a negative correlation between FSS score and serum TSH level in patients with normal thyroid function(P＜0.05).Conclusion(1)In various thyroid function states,serum TSH level is negatively correlated with the risk of PSF in patients with ischemic stroke,that is,the lower the TSH level,the higher the fatigue score;TSH can be used as a protective factor and predictor for evaluating PSF.(2)There was a negative correlation between lower serum FT3 level and higher risk of PSF in patients with low T3 syndrome;there was a positive association between increased serum FT4 levels in patients with subclinical hypothyroidism and low T3 syndrome and a higher risk of PSF.