Cardo Caroline, Bernardo Santos Roberto, Pinotti Pedro Miklos Ana Beatriz, Barbosa Jaconis Sabrina, Romaldini João Hamilton, Villagelin Danilo
Eur Thyroid J. 2025 Feb 3;14(1). doi: 10.1530/ETJ-24-0133. Print 2025 Feb 1.
Thyroid eye disease (TED) is the most prevalent extrathyroidal manifestation of Graves' disease (GD). Emerging evidence suggests a relationship between elevated total and low-density lipoprotein (LDL) cholesterol levels and TED. This study aimed to investigate this correlation in the Brazilian population by analyzing data from two tertiary care centers.
Data were collected from GD patients treated with methimazole between 1999 and 2021, excluding those receiving other treatments. Laboratory results and information on smoking habits, statin use and medications affecting lipid profiles during the euthyroid state were analyzed.
Smoking and elevated LDL cholesterol levels were significantly associated with TED activity and severity. Logistic regression revealed correlations between higher LDL cholesterol, total cholesterol and increased clinical activity score (P < 0.01, OR: 1.012, 95% CI: 1.003-1.021; P < 0.01, OR: 1.010, 95% CI: 1.002-1.018). These were also associated with more severe disease forms as defined by EUGOGO (P < 0.01, OR: 1.015, 95% CI: 1.006-1.024; P < 0.005, OR: 1.011, 95% CI: 1.004-1.019). Multiple regression confirmed that TED activity was significantly correlated with LDL cholesterol (P < 0.01) and smoking status (P < 0.01). Disease severity was associated with reduced HDL cholesterol (P < 0.05, OR: 0.973, 95% CI: 0.948-0.999), elevated LDL cholesterol (P < 0.005, OR: 1.013, 95% CI: 1.004-1.023) and active smoking (P < 0.05, OR: 2.881, 95% CI: 1.190-6.971).
Elevated LDL cholesterol may serve as a potential indicator of TED. Further research is needed to determine whether lipid-lowering interventions could reduce TED risk or improve its management.
甲状腺眼病（TED）是格雷夫斯病（GD）最常见的甲状腺外表现。新出现的证据表明，总胆固醇和低密度脂蛋白（LDL）胆固醇水平升高与TED之间存在关联。本研究旨在通过分析来自两个三级医疗中心的数据，调查巴西人群中的这种相关性。
收集1999年至2021年期间接受甲巯咪唑治疗的GD患者的数据，排除接受其他治疗的患者。分析实验室结果以及关于吸烟习惯、他汀类药物使用情况和甲状腺功能正常状态下影响血脂谱的药物的信息。
吸烟和LDL胆固醇水平升高与TED的活动度和严重程度显著相关。逻辑回归显示，较高的LDL胆固醇、总胆固醇与临床活动评分增加之间存在相关性（P < 0.01，OR：1.012，95% CI：1.003 - 1.021；P < 0.01，OR：1.010，95% CI：1.002 - 1.018）。这些还与欧洲Graves眼病研究组（EUGOGO）定义的更严重疾病形式相关（P < 0.01，OR：1.015，95% CI：1.006 - 1.024；P < 0.005，OR：1.011，95% CI：1.004 - 1.019）。多元回归证实，TED活动度与LDL胆固醇（P < 0.01）和吸烟状态（P < 0.01）显著相关。疾病严重程度与高密度脂蛋白（HDL）胆固醇降低（P < 0.05，OR：0.973，95% CI：0.948 - 0.999）、LDL胆固醇升高（P < 0.005，OR：1.013，95% CI：1.004 - 1.023）和当前吸烟（P < 0.05，OR：2.881，95% CI：1.190 - 6.971）相关。
LDL胆固醇升高可能是TED的一个潜在指标。需要进一步研究以确定降脂干预措施是否可以降低TED风险或改善其管理。
