Silent Thyroid, Loud Lipids: The Hidden Link in Asymptomatic Adults

Background: Subclinical thyroid dysfunction is usually asymptomatic, but it potentially disrupts lipid metabolism and increases the risk of cardiovascular disease. We used standardised questionnaires to measure clinical parameters, including subclinical thyroid dysfunction and its relationship with cardiovascular risk in asymptomatic adults. Methods: A cross-sectional survey was conducted on 501 asymptomatic individuals attending the outpatient clinics from March to August 2025. Data were measured with the Billewicz Clinical Scoring Index (BCSI) for symptoms related to thyroid disease, and the INTERHEART Modifiable Risk Score (IHMRS) was derived to estimate cardiovascular disease risk. Statistical analysis was carried out with the SPSS version 26 (Spearman correlation, Mann-Whitney U and Kruskal-Wallis tests, multivariate linear regression). Results: There was a moderate positive correlation between BCSI and IHMRS (ρ = 0.382, p < 0.001), with higher mean thyroid-related symptom scores associated with increased cardiovascular risk. Males have significantly higher BCSI scores, and females have substantially greater IHMRS values (p < 0.001). Both scores were associated with older age and higher BMI (p < 0.001). Regression analysis revealed that BCSI, age, female sex, BMI, comorbidities, and medication use were significant positive predictors of IHMRS, while physical activity was inversely associated (p = 0.004). Conclusions: Subclinical thyroid dysfunction is significantly associated with higher CV risk in asymptomatic adults. Older age, being female, obesity and low physical activity strengthen this relationship. Primary prevention and screening at an earlier age, followed by targeted lifestyle intervention, are essential to avoid future cardiometabolic sequelae.