High Serum Cholesterol Is a Novel Risk Factor for Graves' Orbitopathy: Results of a Cross-Sectional Study

Sabini, Elena; Mazzi, Barbara; Profilo, Maria Antonietta; Mautone, Teresa; Casini, Giovanni; Rocchi, Roberto; Ionni, Ilaria; Menconi, Francesca; Leo, Marenza; Nardi, Marco; Vitti, Paolo; Marcocci, Claudio; Marinò, Michele

doi:10.1089/thy.2017.0430

Cited by 77 publications

(71 citation statements)

References 41 publications

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“…In total, 26,803 patients were included in the review and 10,667 were diagnosed with thyroid eye disease (TED). Articles included mainly originated from Europe (n = 28), 22‐49 Asia (n = 20), 50‐69 North America (n = 7), 70‐76 Oceania (n = 1) 77 and South America (n = 1) 78 . Table 1 summarizes the results of the meta‐analysis, and a summary of the included articles can be found in the appendix.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of thyroid eye disease in Graves’ disease: A meta‐analysis and systematic review

Chin

Lee

et al. 2020

Clinical Endocrinology

113

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Objective Thyroid eye disease (TED) is a debilitating condition that frequently manifests in patients suffering from Graves’ disease (GD). This study aims to analyse the prevalence of TED among GD patients, with a focus on geographical region‐specific rates. Methods Medline and Embase were searched for articles examining TED prevalence on April 2020, and articles were retrieved and sieved. Statistical analysis was performed after Freeman‐Tukey double arcsine transformation. Thereafter, results were pooled with random effects by DerSimonian and Laird model. Results Fifty‐seven articles involving 26,804 patients were included in the review. The overall pooled prevalence of TED was 40% (CI: 0.32 to 0.48) and by continent was 38% (CI: 0.31 to 0.46) for Europe, 44% (CI: 0.32 to 0.56) for Asia, 27% (CI: 0.06 to 0.56) for North America and 58% (CI: 0.55 to 0.61) for Oceania. The prevalence of TED in Southeast Asia was 35% (CI: 0.24 to 0.47) and Middle East 48% (CI: 0.19 to 0.78). Subgroup analysis showed regions with predominantly Caucasians (37%; CI: 0.28 to 0.46) had a lower prevalence of TED compared to Asians (45%; CI: 0.33 to 0.58). The pooled prevalence of lid retraction was 57% (CI: 0.39 to 0.74), proptosis 57% (CI: 0.48 to 0.65), diplopia 36% (CI: 0.24 to 0.48) and ocular hypertension 13% (CI: 0.06 to 0.19). Conclusion A substantial proportion of patients with GD have TED and often manifest as lid retraction, proptosis and diplopia. Early detection through active screening might help to mitigate the progression of TED and its associated complications.

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Section: Resultsmentioning

confidence: 99%

Prevalence of thyroid eye disease in Graves’ disease: A meta‐analysis and systematic review

Chin

Lee

et al. 2020

Clinical Endocrinology

113

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“…This finding highlights the importance of prompt restoration and stable maintenance of euthyroidism in the management of TAO patients, especially the meticulous control of TSH levels ≤5 μIU/mL.Most importantly, the present study reveals a relationship between the pretreatment triglyceride levels and the efficacy of IVMP therapy in TAO patients for the first time. A recent cross-sectional study suggests a significant correlation between cholesterol levels and the development, as well as activity, of Graves' orbitopathy in patients with recent-onset Graves' disease,23 which has been further supported by a retrospective investigation 24. This finding prompted the present exploration of a possible relationship between the levels of serum lipid fractions and the efficacy of IVMP therapy.…”

mentioning

confidence: 78%

Factors associated with the efficacy of intravenous methylprednisolone in moderate‐to‐severe and active thyroid‐associated ophthalmopathy: A single‐centre retrospective study

Wang

Zhang

et al. 2018

Clinical Endocrinology

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This study provides some novel insights into the factors associated with the efficacy of IVMP therapy. A multivariable prediction model has been established and validated to help determine the indication and prognosis of IVMP therapy. Moreover, several suggestions have been made in the management of TAO patients: early diagnosis and treatment (within 15 months); prompt restoration and maintenance of euthyroidism, especially meticulous control of TSH levels (≤5 μIU/mL); and regular monitoring of triglyceride levels.

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“…Cholesterol levels above these values were associated with a significantly increased risk of GO. Still in the former population, the percentage of patients with high total cholesterol was significantly greater in patients with GO (77). Overall, the fact that the relation between GO and cholesterol was restricted only to patients with GD of recent onset could be somehow anticipated.…”

Section: Cholesterol and Gomentioning

confidence: 84%

“…In addition to a possible direct action of statins on the eye by their pleiotropic effects, the effects of these drugs in GO may also reflect lowering of cholesterol serum level (77). In a recent cross-sectional study, a significant correlation was found between the occurrence of GO and both total and LDL-cholesterol, in patients with a GD of relatively recent onset, suggesting a role of cholesterol in the development of GO (77). Moreover, a correlation was found between CAS and total as well as LDLcholesterol in untreated GO patients depending on GO duration, indicating a role of cholesterol on GO activity.…”

Section: Cholesterol and Gomentioning

confidence: 99%

Cholesterol Serum Levels and Use of Statins in Graves' Orbitopathy: A New Starting Point for the Therapy

et al. 2020

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Graves' Orbitopathy (GO) is the most frequent extrathyroidal manifestation of Graves' disease (GD). Its ultimate cause remains unclear, but it is commonly considered an autoimmune disorder due to self recognition of autoantigens constitutively expressed by orbital fibroblasts (OFs), and thyroid epithelial cells. High dose intravenous glucocorticoids (ivGC) are the most commonly used treatment for moderately severe and active GO. However, based on the complex pathogenesis of GO, a number of factors may have a protective and maybe a therapeutic role. The use of other medications improving the effect of GC may increase the overall effectiveness of the therapy and reduce GC doses, thereby limiting side effects. Recently, a possible protective role of 3-hydroxy-3-methylglutaryl-coenzyme reductase inhibitors, the so-called statins, and perhaps of lowering cholesterol levels, has been proposed. Thus, statins have been reported to be associated with a reduced frequency of GO in GD patients and in recent cross-sectional and retrospective studies a significant correlation was found between the occurrence of GO and both total and LDL-cholesterol in patients with a GD of relatively recent onset, suggesting a role of cholesterol in the development of GO. Moreover, a correlation was found between the GO clinical activity score and total as well as LDL-cholesterol in untreated GO patients, depending on GO duration, indicating a role of cholesterol on GO activity. Therefore, statin treatment may be beneficial for GO. Here we review this subject, which offers new therapeutic perspectives for patients with GO.

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High Serum Cholesterol Is a Novel Risk Factor for Graves' Orbitopathy: Results of a Cross-Sectional Study

Cited by 77 publications

References 41 publications

Prevalence of thyroid eye disease in Graves’ disease: A meta‐analysis and systematic review

Prevalence of thyroid eye disease in Graves’ disease: A meta‐analysis and systematic review

Factors associated with the efficacy of intravenous methylprednisolone in moderate‐to‐severe and active thyroid‐associated ophthalmopathy: A single‐centre retrospective study

Cholesterol Serum Levels and Use of Statins in Graves' Orbitopathy: A New Starting Point for the Therapy

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