Sex-specific Risk Factors Associated with Graves’ Orbitopathy in Korean Patients with Newly Diagnosed Graves’ Disease

Abstract

Abstract Objective: To assess sex-specific risk factors for Graves’ orbitopathy (GO) in newly diagnosed Graves’ disease (GD) patients. Methods: In total, data for 7,192 diagnosed GD patients were obtained from the National Health Insurance Service’s sample database which consisted of 1,137,861 subjects from 2002 to 2019. A multivariable Cox proportional hazards model was used to estimate the effect of risk factors on GO development. Results: Among 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, p = 0.022), low income (HR = 0.55, 95% CI = 0.35–0.86, p= 0.009), and heavy drinking (HR = 1.79, 95% CI = 1.10–2.90, p = 0.019) in men, and with younger age (HR = 0.89, 95% CI = 0.81–0.98, p = 0.018), lower body mass index (BMI) (HR = 0.55, 95% CI = 0.33–0.90, p = 0.019), high total cholesterol (HR = 1.04, 95% CI = 1.01–1.06, p = 0.003), hyperlipidemia (HR = 1.37, 95% CI = 1.02–1.85, p = 0.039), and lower doses of statin in statin users (HR = 0.37, 95% CI = 0.22–0.62, p< 0.001).in women. Conclusions: GO development was associated with younger age, low income, and heavy drinking in men, and with younger age, low BMI, high total cholesterol, hyperlipidemia, and lower doses of statin in statin users in women. These results indicate that more attention and support are required in GO surveillance.