In this cohort of euthyroid adults at high CV risk (hypertension and dyslipidemia), our key findings were as follows: upper-normal TSH (>2.16 mIU/L) was associated with significantly higher TG and Tg/HDL ratios, suggesting heightened insulin resistance; lower-normal TSH (0.5-2.16 mIU/L) was independently associated with a fivefold increased risk of stroke, even though these patients did not display marked differences in blood pressure, fasting glucose, or lipid parameters (beyond Tg). Here, TG is linked to metabolic syndrome.