Sex differences in thyroid hormone and ferritin levels and short-term functional outcomes in acute ischemic stroke

Abstract

Introduction: Acute ischemic stroke (AIS) is a major cause of death and disability worldwide. Thyroid hormones and ferritin are involved in neuronal recovery and iron metabolism after cerebral ischemia. However, their association with short-term functional outcomes in AIS, particularly potential sex-specific differences, remains unclear. This study investigated the relationship between thyroid hormone and ferritin levels and short-term functional prognosis in AIS patients.

Objective: This study aims to investigate the relationship between thyroid hormones and ferritin and the prognosis of patients with AIS, and to evaluate whether there is a sex-specific difference, which could provide a reference for predicting the short-term functional outcome of patients with AIS.

Methods: A total of 961 patients with AIS were recruited from January 2019 to December 2021. Patient demographic and clinical data were collected, and thyroid hormones (free triiodothyronine [FT3], free thyroxine, total triiodothyronine [TT3], and total thyroxine) and ferritin levels were measured on admission. Statistical methods, including t-test, chi-square test, logistic regression analysis, and correlation analysis, were used to analyze the predictive value of thyroid hormone and ferritin levels regarding short-term functional outcome in AIS patients stratified by sex.

Results: Lower FT3 and TT3 levels and higher ferritin levels were observed in patients with poor outcomes (p< 0.05). After adjustment for confounders, the findings revealed that TT3 was independently associated with poor short-term functional outcome (odds ratio = 0.405, 95% confidence interval: 0.203-0.807, p= 0.010). In sex-stratified analyses, TT3 levels were statistically correlated with poor outcomes among male patients, whereas free thyroxine, TT3, and ferritin were associated with poor outcomes in female patients. FT3 and TT3 were negatively correlated with modified Rankin Scale scores in both sexes, while ferritin showed a positive correlation with poor outcome only in female patients.

Conclusion: Thyroid hormone and ferritin levels can serve as potential predictors of short-term functional outcome in patients with AIS, and sex-specific differences exist in their effects.

Keywords

Acute ischemic stroke / Short-term functional outcome / Thyroid hormones / Iron metabolism / Ferritin

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