Correlation of Serum Fetuin A with hs-CRP Levels and Lipid Profile in Assessment of Cardiovascular Risk in Hypothyroid Pregnant Females: A Cross-sectional Study

Introduction: Pregnancy is associated with multiple metabolic and hormonal alterations. In India, hypothyroidism is substantially prevalent endocrinal disorder seen in pregnant women. Fetuin A is a carrier plasma glycoprotein synthesised by the liver and its reduced levels result in increased risk of peripheral arterial disease, Coronary Artery Disease (CAD) in patients with type 2 diabetes mellitus and in dialysis patients. Reduced fetuin A levels have been seen in hypothyroid females. However higher levels of proinflammatory marker high sensitivity C-Reactive Protein (hs-CRP) have been associated with hypothyroidism and also with cardiovascular disease risk. Aim: To analyse and correlate serum Thyroid Stimulating Hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4) and Anti-Thyroid Peroxidase antibodies (Anti TPO antibody), lipid profile, hs-CRP and fetuin A level in pregnant females. Materials and Methods: This cross-sectional study was conducted in Kalpana Chawla Government Medical College, Karnal, Haryana, India, from September 2022 to December 2023. The study included 160 pregnant females without any chronic disease who were investigated for TSH, fT3, fT4 and Anti TPO antibody, Lipid profile, fetuin A and hs-CRP. Statistical analysis was done using t-test, Mann-Whitney U test and Pearson correlation coefficient with p-value <0.05 as significant and p-value <0.001 as highly significant. Results: The median gestational age was 22 weeks (with IQR 11.50-32.0) in cases and 16 weeks (IQR 11.50-27.0) in controls. Fetuin A levels were lower in case group with median value of 4.98 ng/mL (IQR 2.28-10.35) versus control group with median value 5.44 ng/mL (IQR 2.75-12.24). hs-CRP levels were also higher in pregnant hypothyroid females (case group) with median value 2.89 mg/dL ( IQR 1.74-6.10) as compared to controls (median 2.32 IQR 1.74-6.46). Conclusion: There was no significant correlation of fetuin A with hs-CRP, but triglycerides, Very Low Density Lipoprotein (VLDL) and Atherogenic Index of Plasma (AIP) showed a statistically significant negative correlation with fetuin A.