SERUM URIC ACID AS A PREDICTOR OF METABOLIC DYSFUNCTION IN PATIENTS WITH SUBCLINICAL HYPOTHYROIDISM

Background: Subclinical hypothyroidism (SCH) is a prevalent endocrine disorder associated with subtle but clinically significant metabolic derangements1.Serum uric acid (SUA),a byproduct of purine metabolism,has been implicated in endothelial dysfunction, cardiovascular disease, and chronic kidney disease2.Its role in metabolic dysfunction among patients with SCH remains underexplored3. Objective: To evaluate serum uric acid levels in patients with subclinical hypothyroidism and assess its potential as a predictor of metabolic dysfunction. Methods: This cross-sectional study included 102 patients with thyroid disorders attending a tertiary care hospital.Based on thyroid function tests (TSH,T3, T4), participants were classified into euthyroid, overt hypothyroid, hyperthyroid, and SCH. Serum uric acid, urea, and creatinine levels were estimated. Statistical analysis included chi-square tests, Kruskal-Wallis test, and Spearman's correlation to determine associations between SUA and thyroid status. Results: Out of 102 participants, 39 were hypothyroid,20 hyperthyroid,and 43 euthyroid.Among hypothyroid patients,25.6% demonstrated elevated SUA levels compared to only 2.3% in euthyroid and none in hyperthyroid patients (p < 0.001). Mean SUA levels were significantly higher in SCH/hypothyroid patients (6.28 ± 1.32 mg/dl) compared to euthyroid (4.77 ± 1.07 mg/dl) and hyperthyroid (2.74 ± 0.57 mg/dl). SUA correlated positively with TSH (r = 0.42,p < 0.01) and with serum urea/creatinine, suggesting early metabolic dysfunction. Conclusion: Serum uric acid is significantly elevated in patients with subclinical hypothyroidism and may serve as an early marker of metabolic dysfunction. Routine monitoring of SUA in SCH could help in risk stratification and prevention of cardiovascular and renal complications.