Thyroid-Stimulating hormone and metabolic cardiovascular risk markers from weighted two-wave analyses of india with an exploratory Chinese inpatient comparison

Evidence on thyroid-stimulating hormone (TSH) and metabolic cardiovascular risk markers in South Asian older adults is limited. We examined cross-sectional and two-wave associations in Harmonized LASI-DAD and conducted a cautiously interpreted Chinese inpatient comparison. We analysed Harmonized LASI-DAD Version B1 ( n = 6,168; Wave 1 collected 2017–2019 and Wave 2 collected 2022–2024). TSH was log-transformed. Weighted Wave 1 and Wave 2 models used biomarker weights; two-wave models used the longitudinal respondent weight and adjusted for the baseline value of the continuous outcome. The primary model adjusted for age, sex, body mass index (BMI), education, marital status, and rural/urban residence, where applicable. Benjamini–Hochberg false-discovery-rate (FDR) values were reported across outcomes within each model family. An ancillary retrospective, de-identified, same-visit inpatient electronic medical record (EMR) analysis from Jilin University First Hospital included 251 records after one pre-specified TSH plausibility exclusion. At Wave 1, higher log(TSH) was associated with LDL cholesterol (β = 2.26 mg/dL, 95% CI 0.53 to 4.00; nominal p = 0.0105; FDR p = 0.063) and total cholesterol (β = 2.68 mg/dL, 0.71 to 4.64; p = 0.0077; FDR p = 0.063). These associations persisted in a multiple-imputation sensitivity analysis (LDL β = 2.43, 0.93 to 3.94; total cholesterol β = 2.83, 1.06 to 4.59; both FDR p = 0.0025). Wave 2 and two-wave primary estimates for these outcomes were imprecise and included the null. Jilin estimates were also imprecise (LDL β = 0.90, − 3.90 to 5.71; total cholesterol β = 1.41, − 4.91 to 7.74; BMI β = 0.49, − 0.25 to 1.23). The weighted Wave 1 findings provide modest, cross-sectional evidence of positive TSH–lipid associations in this LASI-DAD analytic sample. The results do not establish cardiovascular-event risk, longitudinal persistence, causality, or independent external validation.