Arush Bansal, Jagmeet Singh, Naveen Pahal, Harshdeep Singh, Atul Verma, Sakshi Dahmiwal, Prabh Simranpal
Introduction Subclinical hypothyroidism (SCH) is characterized by elevated serum thyroid-stimulating hormone (TSH) levels with normal circulating thyroid hormones and has been associated with metabolic and renal abnormalities. Reduced glomerular filtration rate in hypothyroidism has been proposed to impair uric acid excretion, which may contribute to elevated serum uric acid levels. However, the relationship between serum uric acid levels and thyroid function in SCH remains inconclusive. This study aimed to evaluate serum uric acid levels and their correlation with thyroid hormone parameters in patients with SCH. Materials and methods This hospital-based cross-sectional observational study was conducted in the Department of General Medicine, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Himachal Pradesh, from January 2023 to June 2024. Eighty adults with confirmed SCH (TSH 6.0-9.9 µIU/mL with normal T3 and T4) were enrolled. Serum uric acid was measured using the Roche COBAS c311 clinical chemistry analyzer, while T3, T4, and TSH were estimated using the Roche COBAS e411 immunoassay analyzer. Statistical analysis was performed using SPSS version 26. Independent samples t-test, Chi-square test, and Pearson's correlation analysis were applied, with p<0.05 considered statistically significant. Results The mean age of participants was 47.98±14.07 years, and 53 (66.3%) were women. The mean serum T3, T4, TSH, creatinine, and uric acid levels were 1.28±0.32 ng/mL, 6.95±1.23 µg/dL, 6.68±0.56 µIU/mL, 0.75±0.20 mg/dL, and 5.71±1.49 mg/dL, respectively. Hyperuricemia was observed in 24 (30.0%) patients. Weak negative correlations were found between T3 and serum uric acid (r=-0.019) and creatinine (r=-0.063). T4 demonstrated a weak positive correlation with serum uric acid (r=0.110) and a weak negative correlation with creatinine (r=-0.030). TSH showed weak positive correlations with serum uric acid (r=0.017) and creatinine (r=0.078). None of these correlations reached statistical significance (all p>0.05). Conclusion Elevated serum uric acid levels were observed in a subset of patients with subclinical hypothyroidism, whereas most participants had normal serum creatinine levels. Although weak correlations were observed between thyroid hormone parameters and renal biochemical markers, none reached statistical significance. Therefore, this study did not detect evidence of a statistically significant linear association between thyroid hormone parameters and renal biochemical markers. Further large-scale multicenter prospective studies incorporating euthyroid controls and adjustment for potential confounding factors are warranted to clarify the clinical significance of these findings.