Pattern of Serum Lipid Profile in Patients with Hypothyroidism at a Tertiary Care Center of Eastern Nepal

Abstract

Introduction: Hypothyroidism is a prevalent endocrine disorder that profoundly disrupts lipid metabolism, thereby increasing cardiovascular risk. Despite a growing burden of thyroid disorders and non communicable diseases in Nepal, region-specific data characterizing the serum lipid profile of hypothyroid patients from Eastern Nepal remain limited. The aim of the study was to assess the pattern of serum lipid profile and determine the prevalence of dyslipidemia among patients with hypothyroidism attending a tertiary care center in Eastern Nepal, and to evaluate the association between the type and severity of hypothyroidism and lipid abnormalities.

Materials and Methods: This hospital-based cross-sectional observational  study enrolled 208 adult patients with biochemically confirmed hypothyroidism attending the Medical Outpatient Department of a tertiary care hospital in Eastern Nepal. Sociodemographic and clinical data were collected using a structured questionnaire. Fasting lipid profile parameters were obtained from routine laboratory investigations. Data were analyzed using STATA version 14. Descriptive statistics, independent t-tests, Pearson’s correlation, and multivariate logistic regression were used.

Results: The mean age of participants was 48.7 ± 13.2 years, with female predominance (65.4%). Overt hypothyroidism was present in 67.8% and subclinical hypothyroidism in 32.2% of participants. The overall prevalence of dyslipidemia was 84.6%. Elevated total cholesterol (TC) was the most common abnormality (71.2%), followed by reduced HDL-C (58.7%), elevated LDL-C (66.8%), and hypertriglyceridemia (51.9%). Mean TC and LDL-C were significantly higher, and mean HDL-C significantly lower, in patients with overt compared to subclinical hypothyroidism (p<0.001 for all). Serum TSH showed a significant positive correlation with TC (r=+0.52), LDL-C (r=+0.49), and TG (r=+0.33), and a significant negative correlation with HDL-C (r=−0.41; all p<0.001). On multivariate logistic regression, independent predictors of dyslipidemia included overt hypothyroidism (adjusted OR 2.41; 95% CI 1.27–4.57; p=0.007), higher TSH levels (adjusted OR 1.47 per 5 mIU/L; 95% CI 1.17–1.85; p=0.001), obesity with BMI ≥25 kg/m² (adjusted OR 1.96; 95% CI 1.12–3.43; p=0.018), and disease duration >5 years(adjusted OR 1.78; 95% CI 1.01–3.15; p=0.048).

Conclusion: Dyslipidemia is highly prevalent among patients with hypothyroidism in Eastern Nepal and is significantly more severe in overt hypothyroidism. The strong positive correlation between TSH and atherogenic lipid fractions underscores the importance of routine lipid screening and early treatment optimization in hypothyroid patients to mitigate cardiovascular risk.