{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:05:14Z","timestamp":1790064314556,"version":"4.0.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thyroid dysfunction is a risk factor for cardiovascular disease through its effects on lipid metabolism and arterial wall remodelling. However, the relative contributions of thyroid autoimmunity versus hormone deficiency to dyslipidaemia and atherosclerotic disease remain incompletely characterised in ageing populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the independent associations between thyroid dysfunction (overt hypothyroidism, subclinical hypothyroidism, overt hyperthyroidism, and subclinical hyperthyroidism) and early atherosclerotic markers, including lipid profiles, carotid intima-media thickness (CIMT), and to identify key predictors of hypercholesterolemia in an adult Indian population with thyroid dysfunctions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross-sectional observational study enrolled 82 consecutive adult patients with thyroid dysfunction from a tertiary care centre in eastern India. Patients receiving active thyroid hormone supplementation, antithyroid medication, or lipid-lowering treatment, including current statin therapy, were excluded. Thyroid and lipid measurements were performed using routine automated clinical laboratory methods, and participants underwent carotid ultrasound assessment. Multivariable binary logistic regression was performed to identify exploratory predictors of elevated total cholesterol (&amp;gt;200 mg\/dL), with odds ratios, 95% confidence intervals and the area under the receiver operating characteristic curve (AUC) used to describe internal model performance. Consecutive eligible patients were recruited over a prespecified 12-month feasibility period; the sample size was based on available recruitment and supported by a\n                      <jats:italic>post-hoc<\/jats:italic>\n                      power\/precision assessment for the principal correlation analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overt hypothyroidism was associated with higher CIMT and a greater burden of abnormal CIMT categories than the other thyroid-status groups. Total cholesterol was highest in the overt hypothyroid group, and TSH was positively correlated with CIMT in the overall cohort (Spearman rho = 0.65; p &amp;lt; 0.001). Peak systolic velocity was also highest in overt hypothyroidism. In exploratory multivariable logistic regression, log10(Anti-TPO) was associated with hypercholesterolaemia (OR 13.629, 95% CI: 1.174-190.489; p = 0.0421), whereas log10(TSH) was not independently associated after adjustment (OR 1.243, p = 0.6904). The wide confidence interval indicates substantial imprecision and the finding requires external validation. The internally assessed logistic model showed acceptable discrimination (AUC 0.834, 95% CI: 0.748-0.920), and Anti-TPO was positively correlated with CIMT (rho = 0.60; p &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Overt hypothyroidism was associated with early atherosclerotic changes and dyslipidaemia in this exploratory single-centre cohort. Anti-TPO antibodies correlated with CIMT and were associated with elevated total cholesterol in an adjusted model, but the imprecision of the estimate and cross-sectional design mean that these findings should be considered hypothesis-generating and require prospective external validation before clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1814468","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:22:02Z","timestamp":1786076522000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of atherosclerosis and dyslipidaemia among patients with thyroid disease: a cross-sectional analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Pronit","family":"Roy","sequence":"first","affiliation":[{"name":"Department of Tropical Medicine, School of Tropical Medicine","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arindam","family":"Naskar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Nutrition and Metabolic Diseases, School of Tropical Medicine","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehebubar","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine, School of Tropical Medicine","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saikat","family":"Mandal","sequence":"additional","affiliation":[{"name":"Translational Medical Sciences, School of Medicine, University of Nottingham","place":["Nottingham, United Kingdom"]},{"name":"NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust","place":["Nottingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arkadeep","family":"Dhali","sequence":"additional","affiliation":[{"name":"Academic Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust","place":["Sheffield, United Kingdom"]},{"name":"Faculty of Health, Imperial College","place":["London, England, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anindya","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Cardiology, Mid Yorkshire Teaching NHS Trust","place":["Wakefield, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Saafan","sequence":"additional","affiliation":[{"name":"Internal Medicine, Hull University Teaching Hospitals NHS Trust","place":["Hull, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2018.18","article-title":"Global epidemiology of hyperthyroidism and hypothyroidism","volume":"14","author":"Taylor","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1093\/bmb\/ldr030","article-title":"The epidemiology of thyroid disease","volume":"99","author":"Vanderpump","year":"2011","journal-title":"Br Med Bull"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.eprac.2023.08.006","article-title":"Prevalence and trends of thyroid disease among adults, 1999-2018","volume":"29","author":"Zhang","year":"2023","journal-title":"Endocr Pract"},{"key":"B4","doi-asserted-by":"publisher","first-page":"76","DOI":"10.2174\/1874192401105010076","article-title":"Effects of thyroid dysfunction on lipid profile","volume":"5","author":"Rizos","year":"2011","journal-title":"Open Cardiovasc Med J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1515\/hmbci-2013-0059","article-title":"Thyroid hormones and the heart","volume":"18","author":"Vargas-Uricoechea","year":"2014","journal-title":"Horm Mol Biol Clin Investig"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M305417200","article-title":"Thyroid hormone regulation and cholesterol metabolism are connected through Sterol Regulatory Element-Binding Protein-2 (SREBP-2)","volume":"278","author":"Shin","year":"2003","journal-title":"J Biol Chem"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000022214","article-title":"Normal range of anti-thyroid peroxidase antibody (TPO-Ab) and atherosclerosis among eu-thyroid population: A cross-sectional study","volume":"99","author":"Shimizu","year":"2020","journal-title":"Med (Baltimore)"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030521","article-title":"Normal anti-thyroid peroxidase antibody (TPO-Ab) titers and active arterial wall thickening among euthyroid individuals: a prospective study","volume":"11","author":"Shimizu","year":"2022","journal-title":"J Clin Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2017.00600","article-title":"Oxidative stress-mediated atherosclerosis: Mechanisms and therapies","volume":"8","author":"Yang","year":"2017","journal-title":"Front Physiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1001\/jama.2012.9630","article-title":"Common carotid intima-media thickness measurements in cardiovascular risk prediction: a meta-analysis","volume":"308","author":"Den Ruijter","year":"2012","journal-title":"JAMA"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.628875","article-title":"Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis","volume":"115","author":"Lorenz","year":"2007","journal-title":"Circulation"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2015.05.007","article-title":"The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society","volume":"241","author":"Vlachopoulos","year":"2015","journal-title":"Atherosclerosis"},{"key":"B13","doi-asserted-by":"publisher","first-page":"4579","DOI":"10.1038\/s41598-018-22897-3","article-title":"Non-invasive markers of cardiovascular risk in patients with subclinical hypothyroidism: A systematic review and meta-analysis of 27 case control studies","volume":"8","author":"Yao","year":"2018","journal-title":"Sci Rep"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd11040098","article-title":"The relationship between subclinical hypothyroidism and carotid intima-media thickness as a potential marker of cardiovascular risk: a systematic review and a meta-analysis","volume":"11","author":"Isail\u0103","year":"2024","journal-title":"J Cardiovasc Dev Dis"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.4274\/jcrpe.2145","article-title":"Effects of thyroid autoimmunity on early atherosclerosis in euthyroid girls with Hashimoto's thyroiditis","volume":"8","author":"\u0130\u015fg\u00fcven","year":"2016","journal-title":"J Clin Res Pediatr Endocrinol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12227058","article-title":"Menopause predisposes women to increased risk of cardiovascular disease","volume":"12","author":"Kami\u0144ska","year":"2023","journal-title":"J Clin Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.18632\/aging.204352","article-title":"Sex differences in major cardiovascular outcomes and fractures in patients with subclinical thyroid dysfunction: a systematic review and meta-analysis","volume":"14","author":"Fang","year":"2022","journal-title":"Aging (Albany NY)"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1530\/EC-24-0601","article-title":"Is subclinical hypothyroidism associated with cardiovascular disease in the elderly","volume":"14","author":"Yamamoto","year":"2025","journal-title":"Endocr Connect"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1472752","article-title":"Association between thyroid hormone sensitivity and carotid plaque risk: a health examination cohort-based study","volume":"15","author":"Gong","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1002\/eji.200324413","article-title":"Autoantibodies in autoimmune thyroid disease promote immune complex formation with self antigens and increase B cell and CD4+ T cell proliferation in response to self antigens","volume":"34","author":"Nielsen","year":"2004","journal-title":"Eur J Immunol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.37.5.3883","article-title":"The effect of thyroid autoimmunity on dyslipidemia in patients with euthyroid Hashimoto thyroiditis","volume":"37","author":"Cengiz","year":"2021","journal-title":"Pak J Med Sci"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcz055","article-title":"Residual inflammatory risk after contemporary lipid lowering therapy","volume":"6","author":"Riaz","year":"2020","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"B23","article-title":"Practical use of the Framingham risk score in primary prevention: Canadian perspective","volume":"57","author":"Bosomworth","year":"2011","journal-title":"Can Fam Physician"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcrp.2022.200159","article-title":"A tool to help patients visualize ASCVD risk and the potential impact of risk-lowering interventions","volume":"15","author":"Mendez","year":"2022","journal-title":"Int J Cardiol Cardiovasc Risk Prev"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1809798","article-title":"Low-dose methotrexate for the prevention of atherosclerotic events","volume":"380","author":"Ridker","year":"2019","journal-title":"N Engl J Med"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD014741.pub2","article-title":"Interleukin-receptor antagonist and tumour necrosis factor inhibitors for the primary and secondary prevention of atherosclerotic cardiovascular diseases","volume":"9","author":"Mart\u00ed-Carvajal","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707914","article-title":"Antiinflammatory therapy with canakinumab for atherosclerotic disease","volume":"377","author":"Ridker","year":"2017","journal-title":"N Engl J Med"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1814468\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:22:03Z","timestamp":1786076523000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1814468\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":27,"alternative-id":["10.3389\/fendo.2026.1814468"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1814468","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]},"article-number":"1814468"}}