Author:
Wang Jing,Chen Zhichao,Carru Ciriaco,Capobianco Giampiero,Sedda Stefania,Li Zhi
Abstract
Abstract
Background
The effect of stress on Graves’ disease (GD) is controversial. Our purpose was to quantify the impacts of stress on patients with Graves’ disease.
Methods
Systematic searches of PubMed, MEDLINE, Embase, Web of Science, Scopus, Cochrane Library and PsycInfo were conducted from inception to 1 January 2023. Studies comparing the incidence of stressful life events (SLEs) that occurred before diagnosis and during drug therapy in cases diagnosed with GD and controls were included in the final analysis.
Results
Nine case-control studies and four cohort studies enrolling 2892 participants (1685 [58%] patients) were included. Meta-analysis revealed a high and significant effect-size index in a random effect model (d = 1.81, P = 0.01), indicating that stress is an important factor in the onset of GD. The relationship between SLEs and GD was stronger in studies with higher proportions of female patients (β = 0.22, P < 0.01) and weaker in studies with older patients with GD (β =−0.62, P < 0.01). However, stress did not significantly affect the outcome of antithyroid drug therapy for GD (d = 0.32, P = 0.09).
Conclusions
The results of this meta-analysis suggest that stress is one of the environmental triggers for the onset of GD. Therefore, we recommend stress management assistance for individuals genetically susceptible to GD, especially for young females.
Funder
Basic and Applied Basic Research Foundation of Guangdong Province
Publisher
Springer Science and Business Media LLC
Subject
General Medicine,Endocrinology, Diabetes and Metabolism