{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:01:47Z","timestamp":1786118507001,"version":"build-2736575974"},"reference-count":30,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med Princ Pract"],"abstract":"<jats:p>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 &lt; 0.0001). FA showed strong correlations with TSH, lipid parameters, insulin resistance, and CVDRI (\u03c1 = 0.60\u20130.77, p &lt; 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 &gt;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.<\/jats:p>","DOI":"10.1159\/000553492","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T16:00:55Z","timestamp":1783612855000},"page":"1-11","source":"Crossref","is-referenced-by-count":0,"title":["Integrating Fetuin-A and Lipid-Based Phenotyping as Markers of Cardiometabolic Risk in Subclinical Hypothyroidism"],"prefix":"10.1159","author":[{"given":"Al Anoud N.","family":"Abdallah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9361-9077","authenticated-orcid":false,"given":"Ola M.","family":"Al-Sanabra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2018.18"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30703-1"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1709853"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-022-01166-5"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2018.0579"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.4158\/EP14421.RA"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/b978-0-12-394317-0.00010-8"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14176148"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1186\/s12944-019-1021-8"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1177\/03000605221082874"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines13092098"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-024-03310-y"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2015(02)05"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1007\/BF00280883"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3390\/ph16060839"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2003.022558"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-07504-6"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2023.2165811"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.17925\/EE.2014.10.02.157"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd11040098"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.26574\/maedica.2024.19.2.255"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1530\/EC-23-0302"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1186\/s12944-025-02740-1"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1106968"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1055\/a-2081-4599"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.33314\/jnhrc.v22i02.5383"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-021-03392-8"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.50848"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-48600-9"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03283-1"}],"container-title":["Medical Principles and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000553492","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T16:01:35Z","timestamp":1786032095000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000553492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,9]]},"references-count":30,"URL":"https:\/\/doi.org\/10.1159\/000553492","archive":["Portico"],"relation":{},"ISSN":["1011-7571","1423-0151"],"issn-type":[{"value":"1011-7571","type":"print"},{"value":"1423-0151","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,9]]}}}