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Treatment outcomes in patients with relapsed Graves' disease.

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Low-dose Methimazole in the Long-term Management of Graves' Disease: Small Doses, Big Benefits.

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The relationship between cholesterol levels and thyroid eye disease.

Caroline Cardo1, Roberto Bernardo Santos2, Ana Beatriz Pinotti Pedro Miklos3

  • 1Postgraduate Course Internal Medicine, Campinas State University, Campinas. Brazil. Endocrinology and Metabolism, Hospital PUC-Campinas, Campinas, Brazil.

European Thyroid Journal
|January 17, 2025
PubMed
Summary

Elevated LDL cholesterol and smoking are linked to more active and severe thyroid eye disease (TED). These findings suggest LDL cholesterol may indicate TED risk, warranting further investigation into lipid-lowering therapies.

Keywords:
Graves’ diseasecholesterolhyperthyroidismthyroid eye disease

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Area of Science:

  • Endocrinology
  • Ophthalmology
  • Cardiology

Background:

  • Thyroid eye disease (TED) is the most common extrathyroidal manifestation of Graves' disease (GD).
  • Emerging evidence indicates a connection between high total and low-density lipoprotein (LDL) cholesterol levels and TED.
  • This study investigated this correlation within the Brazilian population.

Purpose of the Study:

  • To examine the association between lipid profiles and thyroid eye disease (TED) in Brazilian patients with Graves' disease (GD).
  • To determine if cholesterol levels correlate with the activity and severity of TED.
  • To explore the role of smoking and lipid levels in TED development and progression.

Main Methods:

  • Retrospective analysis of data from GD patients treated with methimazole between 1999 and 2021.
  • Exclusion of patients receiving treatments other than methimazole.
  • Analysis of laboratory results, smoking habits, statin use, and lipid-modifying medications during the euthyroid state.

Main Results:

  • Elevated LDL cholesterol and active smoking were significantly associated with increased TED activity and severity.
  • Logistic regression showed correlations between higher LDL cholesterol, total cholesterol, and increased clinical activity scores and disease severity.
  • Multiple regression confirmed significant correlations between TED activity and LDL cholesterol and smoking status; disease severity was associated with reduced HDL cholesterol, elevated LDL cholesterol, and active smoking.

Conclusions:

  • Elevated LDL cholesterol may be a potential indicator for thyroid eye disease (TED).
  • Further research is required to ascertain if lipid-lowering interventions can mitigate TED risk or enhance its management.
  • Smoking cessation and lipid management strategies may be crucial in managing TED.