There is controversy regarding the clinical significance of subclinical hypothyroidism, and lipid changes are one of the abnormalities described in this disease. The authors evaluated alterations in the lipid profile in a group of patients with subclinical hypothyroidism. Fifty-two patients with subclinical hypothyroidism were compared with 98 healthy controls matched by body mass index, age, and sex. A third-generation thyroid-stimulating hormone assay and serum lipid levels-total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-c), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-c), apoprotein A, lipoprotein (a), apoprotein B (apo B), TC/HDL, and LDL/HDL ratio-were measured. Subclinical hypothyroid patients had higher (P Ͻ 0.05) TC, LDL-c, TG, apo B levels, TC/HDL and LDL/HDL ratio compared with the control group. There were no differences in relation to HDL-c, apoprotein A, and lipoprotein (a). There was an association between subclinical hypothyroidism and TC Ͼ200 and TG Ͼ200 mg/dL; 55.7% of the patients had hypercholesterolemia as compared with 34.6% in the control group (P ϭ 0.01) and 17.3% of patients had hypertriglyceridemia compared with 5.1% in the control group (P ϭ 0.01). The authors conclude that subclinical hypothyroidism is associated with elevated cholesterol and triglyceride levels and high total cholesterol/HDL and LDL/HDL ratios.S ubclinical hypothyroidism is defined as a symptom-free or minimally symptomatic state that is characterized by abnormally elevated serum concentrations of thyroid-stimulating hormone (TSH) and normal serum concentrations of free thyroxine. 1,2 Subclinical hypothyroidism is caused by the same disorders of the thyroid gland as those that cause overt hypothyroidism. Among these are autoimmune thyroiditis, use of antithyroid drugs, hypothyroidism following thyroid ablation with 131 I, and hypothyroidism after thyroid excision. It is important to remember that abnormally elevated serum concentrations of TSH can occur as a transient phenomenon, particularly in patients receiving certain drugs such as lithium, amiodarone, sulpiride, metoclopramide, haloperidol, and spironolactone. 1 In contrast to overt hypothyroidism, which affects 1% to 4% of the population, the prevalence of subclinical hypothyroidism ranges from 5% to 10%. 3 It affects 6% to 10% of women (approaching 15% in women over 60 years of age) and 2.4% to 3% of men. 4 One of the most important prospective, population-based studies (Whickham Study) conducted in England has found abnormally elevated levels of TSH in 7.5% of female subjects and in 2.8% of male subjects. 5 The largest study to assess the prevalence of thyroid dysfunction demonstrated that in 25,862 study subjects, 11.7% showed abnormal TSH levels and, of these, 9% had subclinical hypothyroidism. 6 There is considerable controversy regarding the morbidity and the clinical significance of subclinical hypothyroidism. 7,8 It can be a progressive condition, which leads to a series of metabolic consequences. Moreover, it is likely to...

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1. The appearance of meta-hemoglobin in pneumococcus cultures in blood media must be consequential to the formation of hydogen peroxide, according to the observation of several authors as well as of our own. 2. We emphasize the rôle of mucin in the production of hydrogen peroxide by pneumococcus, a circumstance which has been neglected by the authors who dealt with the matter. 3. In the metabolism of pneumococcus, the existence or formation of mucin is necessary for the maintenance of certain biological properties of the germ. 4. In cultures media containing blood and mucin, the production of meta-hemoglobin by pneumococcus is much larger than in those which contain no mucin. 5. We venture the hypothesis that mucin plays a very important rôle in the implantation of pneumonia, as in the periods preceeding this disease theres is an increase of bronchial secretion, and this secretion is almost entirely constintuted by mucin. 6. Mucin increases the pathogenic power of pneumococcus in mice according to the studies of several authors, which comes to favour our hypothesis.