3 years ago

SERUM HIGH CHOLESTEROL IS A NOVEL RISK FACTOR FOR GRAVES' ORBITOPATHY (GO): RESULTS OF A CROSS-SECTIONAL STUDY.

Claudio Marcocci, Barbara Mazzi, Michele Marino, Giamberto Casini, Paolo Vitti, Marenza Leo, Teresa Mautone, Maria Antonietta Profilo, Francesca Menconi, Roberto Rocchi, Marco Nardi, Ilaria Ionni, Elena Sabini
Background Limited data suggest that treatment with statins is associated with a reduced risk of Graves' orbitopathy (GO) in patients with Graves' disease (GD), attributed to the anti-inflammatory rather than to the hypolipemic effects of these medications. The aim of the present study was to investigate whether there is an association between high cholesterol and GO. The primary outcome was the relation between GO and low-density lipoprotein (LDL)-cholesterol. The secondary outcomes were the relation between severity or activity [the clinical activity score (CAS)] of GO and LDL-cholesterol. Methods We conducted a cross-sectional investigation in consecutive patients with GD who came to our observation to undergo radioiodine treatment, a stratification aimed at forming two distinct groups of patients under the same conditions. We enrolled 250 patients, 133 with and 117 without GO. Ophthalmological assessments and serum lipids measurements were performed. Results In multivariate analyses with correction for the duration of hyperthyroidism, a variable that differed between patients with respect to the presence or absence of GO, a correlation between the presence of GO and both total (P=0.01) and LDL-cholesterol (P=0.02) was observed. In patients with hyperthyroidism lasting <44 months, total and LDL-cholesterol were higher (P=0.01 and P=0.008, respectively) among GO patients. In this subgroup, based on the presence/absence of GO, we established cut-off values for total (191 mg/dl) and LDL-cholesterol (118.4 mg/dl), above which an increased risk of GO was observed (total cholesterol RR: 1.47; P=0.03; LDL-cholesterol RR: 1.28; P=0.03). GO severity and CAS did not correlate with serum lipids. However, CAS was found to be higher (P=0.02) in patients with high total cholesterol. When the analysis was restricted to untreated GO patients, we found a correlation between CAS and both total (P=0.04) and LDL-cholesterol (P=0.03), after adjustment for GO duration. Conclusions In patients with a short duration of hyperthyroidism, total and LDL-cholesterol correlate with the presence of GO, suggesting a role of cholesterol in the development of GO. Depending on GO duration, total and LDL-cholesterol correlate with GO activity, suggesting a role of cholesterol in the clinical expression of GO.

Publisher URL: http://doi.org/10.1089/thy.2017.0430

DOI: 10.1089/thy.2017.0430

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