Risk Factors Associated with the Activity and Severity of Graves’ Ophthalmopathy among Patients at the University of the Philippines Manila-Philippine General Hospital

Lat, Annabelle Marie; Jauculan, Maria Cristina; Sanchez, Charisse Ann; Jimeno, Cecilia; Sison-Peña, Cherrie Mae; Pe-Yan, Mary Rose; Pagkatipunan, Paulo Ma.; Suller, Armida; Cena, Marianne

doi:10.15605/jafes.03.02.09

Cited by 4 publications

(7 citation statements)

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“…The level of antibodies to thyroid-stimulating hormone receptors is statistically significantly higher in moderately severe endocrine ophthalmopathy 21.6 IU/l in comparison with mild endocrine ophthalmopathy 12.9 IU/l (p=0.001), which corresponds to the results of most researchers [6,10,12,13,14].…”

Section: Results Of the Research And Discussionsupporting

confidence: 83%

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Clinical Significance of Antibodies to Thyrotropic Hormone Receptor as a Biomarker of Graves Disease Activity

Tsurkan¹,

Lushchik²,

Makeeva³

2022

EJNH

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Objective: to study the clinical significance of antibodies to thyroid-stimulating hormone receptors as a biomarker of Graves' disease activity in patients in the Voronezh region. A retrospective study of 76 patients with Graves' disease treated at Voronezh Regional Clinical Hospital #1 from 2018 to 2021 was carried out. Qualitative and quantitative indicators were assessed: anamnestic data, features of the clinical picture, the results of laboratory and instrumental research methods at the first visit, in 6 and 12 months after antithyroid therapy. During the study, 3 groups were formed: group 1 -patients with Graves' disease -35 people, group 2 -patients with Graves' disease in combination with previously untreated endocrine ophthalmopathy -41 people, group 3 -control group of 15 people without thyroid disease. Our study found that male gender, smoking, free triiodothyronine levels, the severity of thyrotoxicosis and the presence of endocrine ophthalmopathy had a positive correlation with high levels of antibodies to thyroid-stimulating hormone receptors. Measurement of the level of antibodies to thyroid-stimulating hormone receptors in the blood in patients with Graves' disease helps to assess the course of Graves' disease complicated by endocrine ophthalmopathy and allows to determine the risk of activity and severity of endocrine ophthalmopathy. Determining the level of antibodies to thyroid-stimulating hormone receptors is recommended not only for rapid diagnosis, differential diagnosis, but also for monitoring the adequacy of treatment of patients with Graves' disease.

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Section: Results Of the Research And Discussionsupporting

confidence: 83%

“…The titer of antibodies to thyroid-stimulating hormone receptors positively correlated with the degree of activity of endocrine ophthalmopathy (r = 0.41). Our results do not contradict the studies of domestic and foreign scientists [6,10,11,12].…”

Section: Results Of the Research And Discussionsupporting

confidence: 70%

Clinical Significance of Antibodies to Thyrotropic Hormone Receptor as a Biomarker of Graves Disease Activity

Tsurkan¹,

Lushchik²,

Makeeva³

2022

EJNH

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“…Lat et al . [ 36 ] revealed that on multivariate analysis, male gender and elevated TRAb were found to be associated with severe disease (odds ratio [OR] 3.71, P = 0.041) and (OR 1.02, P = 0.007), respectively. A study in an Asian population failed to identify any relationship between T3 or T4 levels and GO.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with severity of orbitopathy in patients with Graves' disease

Nabi¹,

Rafiq

2020

Taiwan J Ophthalmol

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PURPOSE: Graves' orbitopathy (GO) is one of the most frequent orbital disorders and is the most common cause of proptosis in adults. GO is described as chronic inflammation of orbital and periorbital tissues. This study aimed to evaluate the risk factors for severe GO in patients with Graves' disease (GD). MATERIALS AND METHODS: This was a prospective cross-sectional study done on 52 newly diagnosed patients of GD with GO documented by thyroid 99m Technetium-pertechnetate scan at our center between May 2016 and May 2019. All patients underwent a comprehensive ophthalmological examination and laboratory and hormonal analysis. Clinical Activity Score (CAS) and severity were estimated as per the European Group on Graves Orbitopathy. Thirty-four patients with mild GO were compared with 18 patients with moderate-to-severe GO (severe) for baseline risk parameters. RESULTS: Majority of the patients had mild orbitopathy (34 [65.4%]) followed by moderate to severe (18 [34.6%]). CAS was active in 13.5% of the study group. There was a statistically significant male preponderance in severe GO. Current smoking increased the risk of severe GO ( P = 0.003). Duration of GD symptoms at presentation was statistically significantly longer in severe GO patients than mild GO ( P = 0.004). Thyrotropin receptor antibody (TRAb) titer significantly increased in severe GO group (6.2 ± 2.4 IU/L) when compared to mild GO (3.2 ± 1.6 IU/L) ( P < 0.001). TRAb positivity was similar between groups. Braley's sign, i.e., the differential intraocular pressure (IOP) of >6 mmHg, was statistically significantly higher in severe GO ( P < 0.001). Male gender, current smoking, TRAb >2 upper limit of normal (ULN), and differential IOP >6 mmHg were found to be associated with severe GO. CONCLUSION: Approximately 35% of the patients with GO have severe disease, with a higher risk in men. This study identified male gender, current smoking, TRAb >2 ULN, and differential IOP >6 mmHg to be associated with severe GO.

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“…37 In our series, duration of thyroid disease before/after the eye involvement was similar among the 3 groups, and this was in agreement with the findings of previous studies. 39,41 Male gender has been found to be an important risk factor of moderate-to-severe TED/DON development in many western reports, 9,30 but the impact of gender in predicting risk of GO progression has varied in previous Asian studies. 6,41,42 Lat et al reported that being male carried a four times higher risk of GO severity in a region of the Philippines 41 ; conversely, in Korean populations, female sex was found to be a potential risk factor of severe TED.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors of development of dysthyroid optic neuropathy among individuals with thyroid-eye disease

Kemchoknatee,

Thongsawangchai,

Srisombut

et al. 2023

European Journal of Ophthalmology

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Purpose Dysthyroid optic neuropathy (DON) is a severe visual loss condition in thyroid eye disease (TED). This study aimed to identify factors affecting moderate-to-severe TED or DON in Thai populations. Methods We retrospectively reviewed the records of 230 TED patients at Rajavithi Hospital between January 1, 2017, and October 31, 2022. Results Mild, moderate-to-severe TED, and DON were found in 60.43%, 22.61%, and 16.96% of participants, respectively. Female predominance was noted in all groups. The proportion of older age, hyperthyroidism, current smokers, and type 2 diabetes mellitus (T2DM) participants were significantly higher in the DON group. Multivariable logistic-regression analysis revealed that hyperthyroidism and current smoking significantly increased the risk of developing moderate-to-severe TED (OR = 3.001, p = 0.010, and OR = 4.153, p = 0.015, respectively). Exophthalmos was the strongest predictor (OR = 6.834, p < 0.001). Regarding DON risk factors, older age (≥55 years) had OR = 3.206 ( p = 0.003), hyperthyroidism had OR = 3.228 ( p = 0.005), and being a current smoker had OR = 3.781 ( p = 0.011). T2DM posed the greatest risk of DON development (OR = 4.111, p = 0.004). Conclusions Hyperthyroidism and current smoking are significant risk factors for moderate-to-severe TED and DON. TED patients with diabetes mellitus or older age should be closely monitored and informed about their risk of developing DON.

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Risk Factors Associated with the Activity and Severity of Graves’ Ophthalmopathy among Patients at the University of the Philippines Manila-Philippine General Hospital

Abstract: Background. Asians with Graves' ophthalmopathy (GO) may have earlier compressive features due to narrower orbital apex and increased orbital volume.

Cited by 4 publications

References 1 publication

Clinical Significance of Antibodies to Thyrotropic Hormone Receptor as a Biomarker of Graves Disease Activity

Clinical Significance of Antibodies to Thyrotropic Hormone Receptor as a Biomarker of Graves Disease Activity

Factors associated with severity of orbitopathy in patients with Graves' disease

Predictive factors of development of dysthyroid optic neuropathy among individuals with thyroid-eye disease

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