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Does smoking increase relapse rates in Graves' disease?
L E Kimball1, E Kulinskaya, B Brown
1The Department of Endocrinology, Hemel Hempstead General Hospital, United Kingdom.
Journal of Endocrinological Investigation
|April 4, 2002
Summary
Smoking significantly increases Graves' disease relapse risk in males treated with anti-thyroid drugs (ATD). This finding highlights smoking as a key risk factor for Graves' disease outcomes, particularly in male patients.
Area of Science:
- Endocrinology
- Clinical Medicine
- Public Health
Background:
- Graves' disease is a common cause of hyperthyroidism.
- Treatment with thionamide anti-thyroid drugs (ATD) aims for remission.
- Factors influencing relapse rates require further investigation.
Purpose of the Study:
- To investigate the impact of smoking on Graves' hyperthyroidism relapse rates.
- To identify other clinical factors associated with disease remission.
- To assess the interaction between smoking and sex in Graves' disease outcomes.
Main Methods:
- Retrospective analysis of clinical and laboratory data from 221 Graves' disease patients.
- Patients treated with ATD for at least one year.
- Remission defined as biochemical euthyroidism for at least 6 months post-ATD discontinuation.
Main Results:
- Smoking showed a marginally significant deleterious effect on remission (p=0.081).
- The negative impact of smoking on remission was highly significant in males (OR, 11.1).
- Goiter (OR, 3.8) and Thyroid Associated Ophthalmopathy (TAO) (OR, 1.8) were associated with lower remission chances; shorter time to euthyroidism predicted better remission.
Conclusions:
- Cigarette smoking increases the likelihood of Graves' disease recurrence in males treated with ATD.
- Smoking is an important risk factor in Graves' disease pathogenesis and outcomes, especially in males.
- Goiter, TAO, and time to euthyroidism are also significant predictors of Graves' disease remission.