AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO025520538
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ORIGINAL RESEARCH ARTICLE

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

Yang Li1,2,3† ,  Xiaofei Niu4† ,  Yaxin Zhang1,2,3 ,  Wenwen Wang5 ,  Ye Li1,2,3 ,  Yanan Wang1,2,3 ,  Xiaosu Guo1,2,3 ,  Zhi Yuan Shen1,2,3 ,  Yuan Xing1,2,3 ,  Shu Juan Tian1,2,3* ,  Xin Guo1,2,3*
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1 Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
2 Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China
3 Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, Hebei, China
4 Department of Traditional Chinese Medicine, Huanghua Municipal People’s Hospital, Cangzhou, Hebei, China
5 Department of Science Education, Huanghua Municipal People’s Hospital, Cangzhou, Hebei, China
†These authors contributed equally to this work.
EJMO, 025520538 https://doi.org/10.36922/EJMO025520538
Received: 23 December 2025 | Revised: 28 January 2026 | Accepted: 28 February 2026 | Published online: 14 April 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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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
Funding
This work was supported by the National Natural Science Foundation of China (No. 82301458), the Nature Science Foundation of Hebei Province (H2024206372), Hebei Province Government-funded Excellent Talents Project in Clinical Medicine (No. ZF2024147), the Medical Science Research Project of Hebei Province (No. 20230984 and 20240529), the Project of Traditional Chinese Medicine of Hebei Province (No. 2023064), and the “Spark” scientific research project of the First Hospital of Hebei Medical University (No. XH202314).
Conflict of interest
The authors declare they have no conflict of interest.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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