Sohn Seo Young, Ahn Jiyeon, Lee Min Kyung, Lee Jae Hyuk, Kwon Ji-Won, Kweon Ji-Min, Lee Ju-Yeun
Division of Endocrinology, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea.
Department of Ophthalmology, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea.
Rheumatology (Oxford). 2025 Jan 1;64(1):303-309. doi: 10.1093/rheumatology/kead708.
Graves' disease (GD) is a major autoimmune thyroid disorder and is associated with non-thyroidal autoimmune disease (NTAD). We aimed to investigate the risk of NTAD in patients with GD compared with age- and sex-matched controls and to evaluate whether the risk differs between individuals with or without Graves' ophthalmopathy (GO).
This was a retrospective cohort study using data from the Korean National Health Claims database. We included 77 401 patients with GD (2310 with GO) and 77 401 age- and sex-matched controls. Risk of NTAD were compared between the entire cohort and within the GD cohort.
During a mean follow-up period of 9 years, NTAD developed in 12 341 (16.1%) patients in the GD cohort. Risk for SLE [adjusted hazard ratio (aHR) 1.15, 95% CI 1.02-1.29], vitiligo (aHR 1.24, 95% CI 1.10-1.40) and alopecia areata (aHR 1.11, 95% CI 1.04-1.20) were higher in the GD cohort than in the control cohort. In the GD cohort, risk for SLE (aHR 1.60, 95% CI 1.11-2.33), SS (aHR 1.89, 95% CI 1.30-2.74) and AS (aHR 1.53, 95% CI 1.08-2.17) were higher in the GO group than in the non-GO group.
This study demonstrated an increased risk of SLE, vitiligo and alopecia areata in patients with GD. In the GD cohort, patients with GO had an increased risk of SLE, SS and AS. These findings suggest the importance of implementing a strategy for early detection of NTAD based on the presence of GO.
格雷夫斯病（GD）是一种主要的自身免疫性甲状腺疾病，与非甲状腺自身免疫性疾病（NTAD）相关。我们旨在调查与年龄和性别匹配的对照组相比，GD患者发生NTAD的风险，并评估患有或未患有格雷夫斯眼病（GO）的个体之间风险是否存在差异。
这是一项回顾性队列研究，使用了韩国国家健康保险索赔数据库中的数据。我们纳入了77401例GD患者（2310例患有GO）和77401例年龄和性别匹配的对照。比较了整个队列以及GD队列中NTAD的风险。
在平均9年的随访期内，GD队列中有12341例（16.1%）患者发生了NTAD。GD队列中系统性红斑狼疮（SLE）[调整后风险比（aHR）1.15，95%置信区间（CI）1.02 - 1.29]、白癜风（aHR 1.24，95% CI 1.10 - 1.40）和斑秃（aHR 1.11，95% CI 1.04 - 1.20）的风险高于对照队列。在GD队列中，GO组的SLE（aHR 1.60，95% CI 1.11 - 2.33）、干燥综合征（SS）（aHR 1.89，95% CI 1.30 - 2.74）和强直性脊柱炎（AS）（aHR 1.53，95% CI 1.08 - 2.17）风险高于非GO组。
本研究表明GD患者发生SLE、白癜风和斑秃的风险增加。在GD队列中，患有GO的患者发生SLE、SS和AS的风险增加。这些发现提示了基于GO的存在实施NTAD早期检测策略的重要性。
