BackgroundSerum total sialic acid (TSA) concentration is regarded as an indicator of the risks of atherosclerosis and cardiovascular diseases. The association between SA levels and atherosclerosis risk factors has not been assessed in patients with thyroid diseases. MethodsSixty newly diagnosed treatment-naive hypothyroid patients, 35 with subclinical and 25 with overt hypothyroidism, and 30 euthyroid individuals were analyzed. SA was measured in fasting blood samples, as were routine biochemical parameters, some atherosclerosis markers and carotid artery intima media thickness (CIMT). ResultsMean SA (38.1 12.0 vs. 46.0 +/- 15.8; P = 0.019) and CIMT (0.57 +/- 0.06 vs. 0.62 +/- 0.12; P = 0.013) were found to be higher in the patient group compared with the control group. Mean sialic acid was higher in overt hypothyroidism patients compared with subclinical hypothyroidism patients and the control group. No difference was found between the subclinical hypothyroidism group and the control group. Sialic acid level and CIMT had a positive correlation in both the entire population and the hypothyroidism group. The linear regression model established for mean CIMT level in the entire population showed that risk factors of LDL (B +/- SE = 0.454 +/- 0.206; P = 0.030), uric acid (B +/- SE = 1.902 +/- 0.686; P = 0.007), hs-CRP (B +/- SE = 1.003 +/- 0.380; P =0.010), and SA (B +/- SE = 2.419 +/- 0.450; P < 0.001) were independent predictors of CIMT level. ConclusionSialic acid level is elevated in hypothyroid patients. However, this elevation is not related to thyroid hormone levels and autoantibodies. Correlations between SA and atherosclerosis indicators, such as CIMT, LDL, hs-CRP, and uric acid, in hypothyroid individuals suggest that SA may be an indicator of atherogenesis in these patients.