PREVALENCE OF SUBCLINICAL HYPOTHYROIDISM IN PATIENTS WITH METABOLIC SYNDROME-A CROSS-SECTIONAL STUDY

Background: Subclinical hypothyroidism (SCH), defined by elevated thyroid-stimulating hormone (TSH) with normal free thyroxine, is increasingly recognized for its metabolic implications. Metabolic syndrome (MetS), a cluster of cardiovascular risk factors, shares several pathophysiological overlaps with thyroid dysfunction. The coexistence of these two conditions may compound adverse health outcomes, yet local data remains limited. Objective: To determine the prevalence of subclinical hypothyroidism among patients diagnosed with metabolic syndrome and assess associated demographic and clinical risk factors. Methods: A cross-sectional study was conducted over eight months at a tertiary care hospital in Lahore, enrolling 270 adult patients with metabolic syndrome based on NCEP ATP III criteria. Data on demographics, anthropometric measurements, and lifestyle factors were collected. Biochemical assessments included fasting glucose, lipid profile, and thyroid function tests (TSH and free T4). Statistical analysis involved descriptive statistics, chi-square tests, and logistic regression using SPSS version 26, with p-values <0.05 considered significant. Results: Subclinical hypothyroidism was observed in 21.5% of metabolic syndrome patients. It was significantly more prevalent among females. Patients with SCH exhibited higher rates of individual metabolic components including elevated triglycerides (81.0%), low HDL cholesterol (67.2%), and increased fasting glucose (84.5%) compared to euthyroid individuals. Female sex emerged as an independent predictor of SCH (OR: 1.84; 95% CI: 1.03–3.29). Conclusion: Subclinical hypothyroidism is notably prevalent among patients with metabolic syndrome, with a greater clustering of metabolic abnormalities in affected individuals. These findings support routine thyroid screening in this high-risk group to facilitate early intervention and integrated management.