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Background <p>Dyslipidemia is a major modifiable risk factor for cardiovascular disease (CVD). While thyroid dysfunction is a well-established secondary cause of dyslipidemia, the strength and nature of this association in individuals with pre-existing, significant dyslipidemia remain less clear. This study aimed to investigate the association between thyroid parameters Thyroid Stimulating Hormone and Thyroxine (TSH and T4) and the lipid profile in a dyslipidemia population.</p> Methods <p>This cross-sectional analysis was conducted using baseline data from the Kerman Coronary Artery Disease Risk Factors Study (KERCADRS), an ongoing population-based prospective cohort study carried out in Kerman, southeastern Iran, from 2009, involving 303 dyslipidemia adults. In this study, we included adults with dyslipidemia, defined as meeting at least three of the four standard lipid criteria (TC ≥ 220&#xa0;mg/dL, TG ≥ 200&#xa0;mg/dL, HDL-C &lt; 40&#xa0;mg/dL in men or &lt; 50&#xa0;mg/dL in women, LDL-C ≥ 130&#xa0;mg/dL). Serum T4 and TSH levels were measured by ELISA. Participants were stratified by thyroid status. Multivariable linear regression was used to assess the independent associations between thyroid hormones and a comprehensive panel of lipid parameters, adjusted for age, sex, Body Mass Index (BMI), and fasting blood sugar (FBS).</p> Results <p>Most participants with dyslipidemia were euthyroid (77.9%). Subclinical hypothyroidism was the most common thyroid disorder (13.53%). A key finding was the lack of significant differences in conventional lipid parameters or advanced atherogenic indices across different thyroid status groups. In regression models, a higher serum T4 level was independently associated with lower levels of TC (βa: -2.44, <i>p</i> = 0.007), LDL-C (βa: -1.97, <i>p</i> = 0.012), and HDL-C (βa: -0.74, <i>p</i> = 0.020). TSH showed a significant inverse association only with TC (βa: -0.80, <i>p</i> = 0.027). No significant differences in conventional lipid parameters (TC, TG, HDL-C, LDL-C) or advanced atherogenic indices (AIP, AI, LCI, TG/HDL ratio, TyG and its variants) across thyroid status groups. In this dyslipidemia population, thyroid status categories did not differentiate lipid levels, and the independent effects of T4 and TSH were small relative to the dominant impact of established dyslipidemia.</p> Conclusion <p>In the participants characterized by significant dyslipidemia, variations in thyroid status were not a primary determinant of the lipid profile. The findings suggest that the influence of thyroid dysfunction on lipids may be attenuated in patients with severe dyslipidemia, shifting the clinical focus towards managing the dyslipidemia itself as the dominant risk factor. The independent role of T4 warrants further investigation.</p> Clinical trial number <p>Not applicable.</p>

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The association between T4 and TSH with lipid profile is attenuated in patients with established dyslipidemia

  • 期刊论文

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  • 发表日期：

    2026年4月29日

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  • Mahdis Rahimi Naiini,
  • Alireza Jafari,
  • Beydolah Shahouzehi

摘要

Background

Dyslipidemia is a major modifiable risk factor for cardiovascular disease (CVD). While thyroid dysfunction is a well-established secondary cause of dyslipidemia, the strength and nature of this association in individuals with pre-existing, significant dyslipidemia remain less clear. This study aimed to investigate the association between thyroid parameters Thyroid Stimulating Hormone and Thyroxine (TSH and T4) and the lipid profile in a dyslipidemia population.

Methods

This cross-sectional analysis was conducted using baseline data from the Kerman Coronary Artery Disease Risk Factors Study (KERCADRS), an ongoing population-based prospective cohort study carried out in Kerman, southeastern Iran, from 2009, involving 303 dyslipidemia adults. In this study, we included adults with dyslipidemia, defined as meeting at least three of the four standard lipid criteria (TC ≥ 220 mg/dL, TG ≥ 200 mg/dL, HDL-C < 40 mg/dL in men or < 50 mg/dL in women, LDL-C ≥ 130 mg/dL). Serum T4 and TSH levels were measured by ELISA. Participants were stratified by thyroid status. Multivariable linear regression was used to assess the independent associations between thyroid hormones and a comprehensive panel of lipid parameters, adjusted for age, sex, Body Mass Index (BMI), and fasting blood sugar (FBS).

Results

Most participants with dyslipidemia were euthyroid (77.9%). Subclinical hypothyroidism was the most common thyroid disorder (13.53%). A key finding was the lack of significant differences in conventional lipid parameters or advanced atherogenic indices across different thyroid status groups. In regression models, a higher serum T4 level was independently associated with lower levels of TC (βa: -2.44, p = 0.007), LDL-C (βa: -1.97, p = 0.012), and HDL-C (βa: -0.74, p = 0.020). TSH showed a significant inverse association only with TC (βa: -0.80, p = 0.027). No significant differences in conventional lipid parameters (TC, TG, HDL-C, LDL-C) or advanced atherogenic indices (AIP, AI, LCI, TG/HDL ratio, TyG and its variants) across thyroid status groups. In this dyslipidemia population, thyroid status categories did not differentiate lipid levels, and the independent effects of T4 and TSH were small relative to the dominant impact of established dyslipidemia.

Conclusion

In the participants characterized by significant dyslipidemia, variations in thyroid status were not a primary determinant of the lipid profile. The findings suggest that the influence of thyroid dysfunction on lipids may be attenuated in patients with severe dyslipidemia, shifting the clinical focus towards managing the dyslipidemia itself as the dominant risk factor. The independent role of T4 warrants further investigation.

Clinical trial number

Not applicable.