Sex-specific risk factors associated with graves’ orbitopathy in Korean patients with newly diagnosed graves’ disease

• Published in: Eye (London) 2023-11, Vol.37 (16), p.3382-3391
• Main Authors: Lee, Jooyoung, Kang, Jinmo, Ahn, Hwa Young, Lee, Jeong Kyu
• Format: Article
• Language: English
• Subjects: 692/499; 692/699/2743/1841; Anemia; Autoimmune diseases; Body mass index; Cholesterol; Codes; Cohort analysis; Diabetes; Drug dosages; Female; Gender differences; Graves disease; Graves Disease - complications; Graves Disease - diagnosis; Graves Disease - epidemiology; Graves Ophthalmopathy - complications; Graves Ophthalmopathy - diagnosis; Graves Ophthalmopathy - epidemiology; Humans; Hyperthyroidism; Laboratory Medicine; Male; Medicine; Medicine & Public Health; National health insurance; Ophthalmology; Pharmaceutical Sciences/Technology; Republic of Korea - epidemiology; Retrospective Studies; Risk Factors; Statins; Surgery; Surgical Oncology; Thyroid gland; Variables; Womens health
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/s41433-023-02513-z

Objective To assess sex-specific risk factors for Graves’ orbitopathy (GO) in newly diagnosed Graves’ disease (GD) patients. Methods A retrospective cohort study was conducted using the National Health Insurance Service’s sample database, which consisted of 1,137,861 subjects from 2002 to 2019. The international classification of disease-10 codes was used to identify those who developed GD (E05) and GO (H062). A multivariable Cox proportional hazards model was used to estimate the effect of risk factors on GO development. Results Among 2145 male and 5047 female GD patients, GO occurred in 134 men (6.2%) and 293 women (5.8%). A multivariable Cox regression model revealed that GO development was significantly associated with younger age (HR = 0.84, 95% CI = 0.73–0.98), low income (HR = 0.55, 95% CI = 0.35–0.86), and heavy drinking (HR = 1.79, 95% CI = 1.10–2.90) in men, and with younger age (HR = 0.89, 95% CI = 0.81–0.98), lower body mass index (HR = 0.55, 95% CI = 0.33–0.90), high total cholesterol (HR = 1.04, 95% CI = 1.01–1.06), hyperlipidaemia (HR = 1.37, 95% CI = 1.02–1.85), and lower statin dose (HR = 0.37, 95% CI = 0.22–0.62) in women. There was no association between smoking and GO development in both men and women. Conclusions The risk factors for GO development were sex-dependent. These results show the need for more sophisticated attention and support considering sex characteristics in GO surveillance.