Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2026
Integrating Fetuin-A and Lipid-Based Phenotyping as Markers of Cardiometabolic Risk in Subclinical Hypothyroidism.
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Abdallah Al Anoud N, Al-Sanabra Ola M
Аннотация
OBJECTIVE: The aims of the study were to evaluate fetuin-A (FA) as an integrative biomarker for cardiometabolic risk in subclinical hypothyroidism (SCH) and to investigate lipid-based metabolic heterogeneity.
SUBJECT AND METHODS: In this cross-sectional study, 192 participants (105 SCH, 87 controls) were evaluated for thyroid function, metabolic parameters, lipid profiles, FA, and high-sensitivity C-reactive protein (hs-CRP). Lipid phenotyping was performed using principal component analysis (PCA) and latent profile analysis (LPA). A composite cardiovascular disease risk index (CVDRI) incorporating FA and the atherogenic index of plasma (AIP) was calculated. Correlation, regression, and receiver operating characteristic (ROC) analysis were conducted.
RESULTS: SCH patients exhibited significantly elevated thyroid-stimulating hormone (TSH), insulin resistance, dyslipidemia, hs-CRP, and FA compared to controls (p < 0.0001). FA showed strong correlations with TSH, lipid parameters, insulin resistance, and CVDRI (ρ = 0.60-0.77, p < 0.001). PCA and LPA identified three distinct SCH phenotypes, each showing progressively adverse metabolic and inflammatory profiles. ROC analysis showed excellent discriminatory performance for FA and CVDRI (AUCs >95%), whereas lipid-derived indices distinguished high-risk phenotypes.
CONCLUSION: FA is a promising integrative biomarker linking thyroid dysfunction with cardiometabolic risk in SCH. Lipid-based phenotyping highlights disease heterogeneity and supports the use of composite biomarker strategies for early risk stratification and personalized management.
SUBJECT AND METHODS: In this cross-sectional study, 192 participants (105 SCH, 87 controls) were evaluated for thyroid function, metabolic parameters, lipid profiles, FA, and high-sensitivity C-reactive protein (hs-CRP). Lipid phenotyping was performed using principal component analysis (PCA) and latent profile analysis (LPA). A composite cardiovascular disease risk index (CVDRI) incorporating FA and the atherogenic index of plasma (AIP) was calculated. Correlation, regression, and receiver operating characteristic (ROC) analysis were conducted.
RESULTS: SCH patients exhibited significantly elevated thyroid-stimulating hormone (TSH), insulin resistance, dyslipidemia, hs-CRP, and FA compared to controls (p < 0.0001). FA showed strong correlations with TSH, lipid parameters, insulin resistance, and CVDRI (ρ = 0.60-0.77, p < 0.001). PCA and LPA identified three distinct SCH phenotypes, each showing progressively adverse metabolic and inflammatory profiles. ROC analysis showed excellent discriminatory performance for FA and CVDRI (AUCs >95%), whereas lipid-derived indices distinguished high-risk phenotypes.
CONCLUSION: FA is a promising integrative biomarker linking thyroid dysfunction with cardiometabolic risk in SCH. Lipid-based phenotyping highlights disease heterogeneity and supports the use of composite biomarker strategies for early risk stratification and personalized management.