Evaluation of Alterations in Serum Uric Acid Levels in Newly Diagnosed Overt Thyroid Dysfunction: A Prospective Observational Study From a Tertiary Care Center.

BACKGROUND

Thyroid dysfunction is widely recognized to affect metabolic regulation and renal handling of uric acid and creatinine, but historical clinical findings have remained inconsistent. This study evaluates biochemical profiles and diagnostic markers across control, hyperthyroid, and hypothyroid cohorts to establish clear correlations and diagnostic thresholds.

OBJECTIVES

To comprehensively analyze baseline demographic characteristics, thyroid profiles (T3, T4, TSH (thyroid stimulating hormone)), and renal parameters (uric acid, creatinine) across patient cohorts; to explore Pearson correlations among these metrics; and to conduct receiver operating characteristic (ROC) curve analysis to determine the diagnostic utility and optimal cutoffs for serum uric acid and creatinine as biomarkers for thyroid dysfunction.

METHODS

A comprehensive cross-sectional analysis was performed on a study population of N = 300 participants, split into a control group (n = 150) and a thyroid dysfunction group (n = 150, comprising 50 hyperthyroid and 100 hypothyroid patients) at a tertiary care center over 12 months. Detailed biochemical profiling, Pearson correlation coefficients, and ROC curve analyses with sensitivity/specificity calculations were performed to assess marker efficacy.

RESULTS

The overall mean age was 33.10 ± 13.65 years, with a balanced distribution across cohorts (p = 0.137). Significant discrepancies in T3 (p = 0.004) and TSH (p < 0.001) were confirmed. Serum uric acid was significantly elevated in thyroid dysfunction compared with controls (5.62 ± 2.28 vs. 4.46 ± 1.13 mg/dL, p < 0.001), showing a strong positive correlation with TSH (r = 0.197, p = 0.001). Conversely, serum creatinine was modestly but significantly lower in the thyroid dysfunction group (0.86 ± 0.16 vs. 0.92 ± 0.22 mg/dL, p = 0.010), showing a significant negative correlation with TSH (r = -0.176, p = 0.002). ROC analysis revealed significant diagnostic accuracy for uric acid (area under the curve (AUC) = 0.642, p < 0.001), with an optimal screening cutoff of 4.05 mg/dL (71.3% sensitivity), whereas creatinine demonstrated poor discriminatory performance (AUC = 0.441, p = 0.076).

CONCLUSION

Serum uric acid demonstrates highly significant alterations and predictable diagnostic value in thyroid dysfunction, closely correlating with TSH levels. Creatinine shows a reverse metabolic association and poor diagnostic accuracy. Routine screening of serum uric acid, but not necessarily creatinine, is clinically indicated in newly diagnosed thyroid dysfunction cases to guide metabolic risk stratification.