Smoking and Risk of Graves' Disease

作者：Mark F. Prummel · 发表于：JAMA · 年份：1993 · DOI：10.1001/jama.1993.03500040045034 · 被引用次数：465 · 研究领域：Ophthalmology and Eye Disorders、Thyroid Disorders and Treatments、Glaucoma and retinal disorders

OBJECTIVE: To assess if smoking is associated with Graves' disease and, if so, to ascertain whether this association persists when controlling for confounding factors. DESIGN: Consecutive entry case-control study with two age- and sex-matched control subjects from two different populations per case patient. SETTING: University hospital. PATIENTS: Five groups were studied: (1) Graves' ophthalmopathy and Graves' hyperthyroidism (n = 100; divided in four subgroups according to the severity of the eye disease); (2) Graves' hyperthyroidism without clinical eye involvement (n = 100); (3) sporadic nontoxic goiter (n = 100); (4) autoimmune hypothyroidism (n = 75); and (5) toxic nodular goiter (n = 75). The study comprised 200 subjects from a hospital-based population, and 200 from a population-based group served as control subjects. MAIN OUTCOME MEASURE: Smoking status was determined from a questionnaire at the time of onset of the disease to exclude any effect of the disease itself on smoking. RESULTS: Smoking greatly increased the risk for Graves' ophthalmopathy (odds ratio, 7.7; 95% confidence interval, 4.3 to 13.7), but patients with Graves' hyperthyroidism alone were also more often smokers than control subjects (odds ratio, 1.9; 95% confidence interval, 1.1 to 3.2). Smoking was not associated with the other thyroid diseases studied. Essentially similar results were obtained after adjustment for differences in education between case patients and control subjects. Among the patie...