Assessment of Cardio Metabolic Profile in Newly Diagnoded Cases of Hypothyroism

Pandey S, Dhaneria S, Banzal S and Chouhan J

Published on: 2025-10-25

Abstract

Background: Hypothyroidism is associated with dyslipidaemia and cardiovascular involvement detectable on ECG and echocardiography, yet contemporary Indian data comparing overt and subclinical disease are limited.

Objectives: To assess the cardio-metabolic profile of newly diagnosed adults with hypothyroidism and compare ECG, echocardiographic abnormalities, and lipid parameters between overt and subclinical hypothyroidism.

Methods: Hospital-based cross-sectional study at a tertiary centre in central India (January–June 2025). Adults (≥18 years) with newly diagnosed primary hypothyroidism were enrolled after exclusions. Overt hypothyroidism was defined as TSH >10 µIU/mL with low T4; subclinical as TSH 4.2–10 µIU/mL with normal T4. All participants underwent 12-lead ECG, transthoracic echocardiography, and fasting lipid profile (TC, LDL-C, HDL-C, TG). Continuous variables were summarised as mean ± SD; categorical as n (%). Group differences used t-test/Mann-Whitney and χ²/Fisher’s exact tests; p<0.05 significant. Ethics approval and informed consent were obtained. 

Results: Of 100 participants, 66 had overt and 34 subclinical hypothyroidism; 72% were female. Diastolic dysfunction was present in 62% overall (mild 28%, moderate 24%, severe 10%), systolic dysfunction in 18%, and pericardial effusion in 20%. Diastolic dysfunction severity differed between groups (none: 57.6% overt vs 35.3% subclinical; p=0.007), whereas systolic dysfunction did not (15.2% vs 23.5%; p=0.155). Pericardial effusion trended higher in overt disease (24.2% vs 11.8%; p=0.065). “Any echocardiographic abnormality” was more frequent in overt than subclinical hypothyroidism (72.7% vs 52.9%; p=0.029). ECG changes were common-sinus bradycardia predominated-while lipid means (TC/LDL-C/HDL-C/TG) were comparable between groups (all p>0.60). 

Conclusion: Newly diagnosed hypothyroidism demonstrates prominent electrical and diastolic functional alterations, with a higher burden of echocardiographic abnormalities in overt disease. Lipid parameters were similar at baseline across types. Routine ECG and targeted echocardiography at diagnosis, with risk-stratified management—particularly for overt hypothyroidism-are supported by these findings.