Clinical Assessment of Hypothyroid Patients Using the Zulewski Score and the Correlation Between Thyroid and Lipid Parameters: A Tertiary Care Centre-Based Study From Central India.

Introduction: Clinical scores based on signs and symptoms have been used in thyroidology to identify individuals at high risk for hypothyroidism. The current study observes the signs and symptoms of patients with hypothyroidism who are positive for hypothyroidism according to the Zulewski clinical score, and determines associations between thyroid and lipid profiles.

Methods: The current prospective cohort study was conducted among newly diagnosed hypothyroid patients aged 18-65 years with a Zulewski score > 5 (indicative of hypothyroidism) and biochemically diagnosed as hypothyroid. Demographics, thyroid, and lipid profiles of the patients were recorded and analysed. A P < 0.05 was considered to be statistically significant.

Results: The current study included 100 patients with hypothyroidism (M:F = 1:1.94), with an average age of 40.9 ± 12.1 years. Slow movement and coarse skin were the most common signs among men (67.6%) and women (68.2%), respectively. Weight gain was the most common symptom (M: 91.2%; F: 87.9%). The TSH levels of patients significantly increased with higher Zulewski scores. A deranged lipid profile was observed in 86% of patients. A positive correlation was observed between total cholesterol and TSH (r = 0.275; P = 0.006), and between total cholesterol and T4 (r = -0.205; P = 0.041). A negative correlation was observed between T3 and cholesterol (r = -0.263; P = 0.008), and between T3 and triglycerides (r = -0.263; P = 0.008).

Conclusion: The current study highlights the reliability of the Zulewski score for early diagnosis and risk assessment in Indian patients with hypothyroidism. It could also serve as an indirect clinical measure to assess deranged lipid parameters and identify the risk of atherosclerosis among hypothyroid patients.