Sarfo-Kantanka Osei, Sarfo Fred Stephen, Ansah Eunice Oparebea, Kyei Ishmael
Endocrine and Diabetes Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Clin Med Insights Endocrinol Diabetes. 2018 Mar 21;11:1179551418759076. doi: 10.1177/1179551418759076. eCollection 2018.
Graves disease (GD) has increased in prevalence over the past decade in Africa. Despite this, the condition is not well described, especially in sub-Saharan Africa.
We have described the clinical characteristics and associated factors of GD in a cohort of patients attending a resource-limited setting tertiary hospital.
Patients were examined thoroughly and systematically tested for the degree of clinical and biochemical thyroid status. Thyroid volume, characteristics, and blood flow were assessed at presentation using ultrasonography. Factors associated with an inability to achieve clinical and biochemical thyroid remission were evaluated using multiple logistic regression analysis.
Overall, 182 patients were studied, 152 (83.5%) were women with a female:male ratio of 5.1:1.0. The mean age at presentation was 39.9 ± 14.7 years with women significantly older than men. Thyroid-associated orbitopathy (TAO) was observed in 56% of the participants and pretibial myxoedema in 6%. About 84% of the participants were hyperthyroid at presentation, 9% were euthyroid, 4% were hypothyroid, and 3% had subclinical hyperthyroidism. Inability to achieve biochemical and clinical remission at 24 months was associated with increased thyroid volume (odds ratio [OR]: 2.35, 95% confidence interval [CI]: 1.85-2.52, < .001), presence of TAO (OR: 2.15, 95% CI: 2.12-2.33, < .001), increased FT3/FT4 ratio (OR: 1.33, 95% CI: 1.24-2.56, = .004), and missed clinic appointment (OR: 5.2, 95% CI: 4.55-7.89, < .001).
Graves disease among Ghanaians is associated with significant signs at presentation. Inability to achieve remission within the first 24 months is associated with increased thyroid volume, TAO, an increased FT3/FT4 ratio, as well as missed clinic appointment.
在过去十年中，非洲格雷夫斯病（GD）的患病率有所上升。尽管如此，这种疾病的描述并不充分，尤其是在撒哈拉以南非洲地区。
我们描述了在一家资源有限的三级医院就诊的一组患者中GD的临床特征及相关因素。
对患者进行全面系统的检查，检测其临床和生化甲状腺状态的程度。就诊时使用超声评估甲状腺体积、特征和血流情况。采用多因素逻辑回归分析评估与无法实现临床和生化甲状腺功能缓解相关的因素。
总体而言，共研究了182例患者，其中152例（83.5%）为女性，男女比例为5.1:1.0。就诊时的平均年龄为39.9±14.7岁，女性明显比男性年龄大。56%的参与者有甲状腺相关眼病（TAO），6%有胫前黏液性水肿。就诊时约84%的参与者为甲状腺功能亢进，9%甲状腺功能正常，4%甲状腺功能减退，3%有亚临床甲状腺功能亢进。24个月时无法实现生化和临床缓解与甲状腺体积增大（比值比[OR]：2.35，95%置信区间[CI]：1.85 - 2.52，P <.001）、TAO的存在（OR：2.15，95%CI：2.12 - 2.33，P <.001）、FT3/FT4比值升高（OR：1.33，95%CI：1.24 - 2.56，P =.004）以及错过门诊预约（OR：5.2，95%CI：4.55 - 7.89，P <.001）有关。
加纳人中的格雷夫斯病在就诊时有明显体征。在最初24个月内无法实现缓解与甲状腺体积增大、TAO、FT3/FT4比值升高以及错过门诊预约有关。
