Correlation between Subclinical Hypothyroidism and Metabolic Syndrome: A Retrospective Study

Salhah Saleh Alsulami; Mukhtiar Baig; Atheer Hameed Albeladi; Shahad Bandar Alyoubi; Shahad Alhumaidi Alsubaie; Samah Abdulsalam Albeladi; Kholoud Alawi Ghamri; Abeer Mohammed Saeed Alraiqi; Safa Mobarak Alyoubi; Wesam Aied Almutairi

doi:10.4103/sjmms.sjmms_225_22

Correlation between Subclinical Hypothyroidism and Metabolic Syndrome: A Retrospective Study

Saudi J Med Med Sci. 2023 Jul-Sep;11(3):250-256. doi: 10.4103/sjmms.sjmms_225_22. Epub 2023 Jul 15.

Affiliations

¹ Department of Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.
² Department of Internal Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
³ Department of Biochemistry, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.
⁴ Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

Abstract

Background: Several studies worldwide have studied the correlation between subclinical hypothyroidism (SCH), and metabolic syndrome (MetS), but have reported inconsistent findings.

Objectives: To assess the correlation between SCH and MetS in a population from Saudi Arabia.

Methods: This retrospective study was conducted at King Abdulaziz University Hospital and analyzed all thyroid function tests conducted between January 1, 2019, to December 31, 2021. A predesigned checklist was used to collect data about patients' characteristics such as age, gender, nationality, TSH, FT4 level, and MetS components.

Results: A total of 41,519 thyroid function tests were conducted during the study period. From this, 1303 (3.1%) patients were found to have SCH, with the majority being females (74.4%). The prevalence did not differ according to gender but increased to 3.5% among those aged >60 years. MetS components between mildly and markedly elevated TSH were significant for total cholesterol (P < 0.001) and high-density lipoprotein cholesterol (P < 0.05). Male patients with SCH were at a higher risk of developing diabetes (P < 0.001) and hypertension (P < 0.02), than female patients with SCH. After adjusting for age, in the multiple stepwise linear regression analysis, a significant association was found between TSH levels and ALT (odds ratio: 0.77) and SBP (odds ratio: 0.35).

Conclusion: The study demonstrated that the prevalence of SCH is similar between both genders but increases with age. MetS components were abnormal in patients aged >50 years and in males with SCH. SCH and MetS components were found to be correlated, and thus monitoring these variables in patients with SCH is advisable.

Keywords: Body mass index; cardiovascular risk factors; diabetes; dyslipidemia; hypertension; metabolic syndrome; obesity; subclinical hypothyroidism.