ASSESSMENT OF CARDIOVASCULAR RISK IN SUBCLINICAL HYPOTHYROIDISM USING LIPID PROFILE AND HIGH-SENSITIVE C-REACTIVE PROTEIN

Abstract

Introduction: Subclinical hypothyroidism (SCH), characterized by elevated thyroid-stimulating hormone (TSH) with normal thyroxine (fT4), has garnered clinical attention due to its potential association with dyslipidemia and cardiovascular morbidity. High-sensitivity C-reactive protein (hs-CRP), a sensitive marker of low-grade systemic inflammation, has been proposed as a mediator linking SCH with atherosclerosis.

 Aims & Objectives: The primary aim of this study was to assess the alterations in lipid profile and hs-CRP levels in patients with subclinical hypothyroidism compared to healthy controls.

Methodology: A hospital-based cross-sectional comparative study was conducted at three tertiary care public sector hospitals in Lahore: Mayo Hospital, Sir Ganga Ram Hospital, and Jinnah Hospital. A total of 203 individuals were enrolled, comprising 153 patients diagnosed with subclinical hypothyroidism and 50 samples select as healthy controls. Blood samples were collected to analyze serum TSH, free T4, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and hs-CRP. Statistical analysis was performed using SPSS. Independent sample t-tests and Pearson correlation coefficients were used to compare means and assess associations between variables.

Results & Findings: The mean serum TSH levels were significantly higher in the SCH group (7.8 ± 1.6 mIU/L) compared to controls (2.3 ± 0.9 mIU/L; p < 0.001). Subclinical hypothyroid patients exhibited significantly elevated levels of TC (218.4 ± 34.5 mg/dL vs. 178.6 ± 28.2 mg/dL), LDL-C (146.7 ± 29.4 mg/dL vs. 108.2 ± 25.7 mg/dL), and hs-CRP (3.92 ± 1.01 mg/L vs. 1.26 ± 0.72 mg/L) compared to controls (p < 0.001 for all). HDL-C levels were slightly lower in SCH but did not reach statistical significance. A moderate positive correlation was observed between TSH and hs-CRP (r = 0.44, p < 0.01) and between TSH and LDL-C (r = 0.39, p < 0.01), indicating a link between thyroid dysfunction, inflammation, and lipid abnormalities.

 Conclusion: This study demonstrates that subclinical hypothyroidism is significantly associated with dyslipidemia and elevated hs-CRP levels, suggesting an increased predisposition to cardiovascular risk in affected individuals. Early screening and management of lipid and inflammatory markers in SCH patients may serve as a preventative measure against the CVD risk.