Colloid goiter and atherosclerosis.

THE RELATIONSHIP of the thyroid gland to the severity of atheroselerosis in experimental animals has been clearly established,1 and the effects of hypothyroidism on cholesterol metabolism in man are well known.2 Although commonly affirmed in textbooks,3-5 there is still insufficient evidence that hypothyroidism in man aggravates the severity of atherosclerosis.6 Complementary evidence would be obtained if any disease of the thyroid gland could be correlated with the severity of atherosclerosis in the human. Colloid goiter is an easily recognized abnormality of the thyroid gland that may be associated with either hypothyroidism, hyperthyroidism, or euthyroidism. One report from an area of endemic goiter (Finland) has shown a positive correlation between goiter and death from coronary artery disease.7 However, other geographic areas in which goiter is frequent, such as Guatemala,8 have a very low incidence of morbidity and mortality from coronary heart disease, and the average level of advanced atherosclerotic lesions in the same population is very low.10 Such conflicting data demand further investigation. A unique opportunity for testing this suspected relationship arose in a study of the thyroid gland in the local population while a study of the natural history of atheroselerotic arterial lesions was in progress. A series of cases became available in which detailed evaluation of the thyroid gland had been carried out by one investigator, and an independent and detailed evaluation of atheroselerotic lesions had been made by two others. The results to be reported here show no consistent relationship between goiter and atheroselerosis.