Association Between TSH Level and Stroke Severity: A Cross-Sectional Study Using the mRS

Stroke is a major global health issue with numerous contributing risk factors. One of the most important risk factors of stroke is cardiovascular disease. Other risk factors include dyslipidemia, obesity, diabetes, and thyroid dysfunction which are known to increase the risk of cardiovascular disease. As dysfunction of the thyroid and its related hormones such as thyroid-stimulating hormone (TSH) are in correlation with cardiovascular disease, which may lead to stroke, investigating the correlation between TSH levels and the severity of stroke is worth attention.

This cross-sectional study was conducted in Imam Reza Hospital in Tabriz, Iran, from March 2021 to March 2023. In this study, 204 stroke patients whose TSH levels were evaluated were included. Data on age, gender, comorbidities, TSH levels, stroke subtype, and disability severity (measured by the modified Rankin scale [mRS] before admission, during admission, at discharge, and after 3 months) were analyzed using SPSS Version 22.

Out of 204 patients, TSH levels of 35 (17.2%) patients were below the range (TSH < 0.39), 154 (75.5%) patients within the range (TSH: 0.39-6.19), and 15 (7.4%) patients had TSH levels above the range (TSH > 6.19). There is a weak to moderate but statistically significant correlation between mRS and TSH level during admission (R = -0.25, p < 0.01) and at discharge (R = -0.28, p < 0.01). However, there is a nonsignificant correlation before admission (R = -0.10, p = 0.174) and 3 months after discharge (R = -0.12, p = 0.137). There is not a significant difference among TSH groups comparing their age, gender, type of stroke, and CT scan findings.

Elevated TSH levels may be associated with less severe stroke symptoms at both admission and discharge. Further studies with larger sample sizes are necessary to better understand the relationship between thyroid function and stroke.