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Hyperthyroid patients without Graves' orbitopathy are not at increased risk of developing glaucoma: a nationwide Danish register-based case-control study

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Abstract

Purpose

Graves' disease (GD) and toxic nodular goiter (TNG) are associated with various comorbidities. However, it is unclarified whether TNG and GD without orbitopathy are associated with glaucoma.

Methods

This was a case-control study using record-linkage data from nationwide Danish health registers. 28,461 patients with GD and 17,283 with TNG were included. Each case was age and sex matched with four non-hyperthyroid controls and followed over a mean period of 8 years. Data on glaucoma was obtained by record linkage within the National Danish Patient Register and/or the Danish National Prescription Registry. Logistic and Cox regression models were used to assess the risk of glaucoma before and after the diagnosis of GD and TNG.

Results

Compared to controls, there was a significantly increased frequency of glaucoma in patients with GD (4.6 vs. 4.2%, P = 0.006) and in patients with TNG (6.2 vs. 5.7%, P = 0.003). Prior to the diagnosis of hyperthyroidism, the odds ratio (OR) for glaucoma was non-significant in GD (1.09, 95% CI: 1.00–1.18) but slightly increased in TNG (1.13, 95% CI: 1.02–1.24). However, in TNG the OR attenuated completely when only including patients without co-morbidity in the analysis (1.03, 95% CI: 0.93–1.14). After adjustment for pre-existing co-morbidity, the hazard ratio (HR) for glaucoma following GD and TNG was not significantly increased (HR 1.08, 95% CI: 0.98–1.18 and HR 1.10, 95% CI: 0.99–1.21, respectively).

Conclusions

Neither prior to nor following the diagnosis of GD and TNG had any significant association with glaucoma.

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Abbreviations

GD:

Graves' disease

TNG:

Toxic nodular goiter

GO:

Graves' orbitopathy

CI:

Confidence interval

OR:

Odds ratio

HR:

Hazard ratio

CS:

Charlson score

DCRS:

The Danish Civil Registration System

DDB:

The Danish Demographic Database

DNPR:

The Danish National Patient Registry

DNPrR:

The Danish National Prescription Registry

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Funding

F. Brandt has received funding from the European 392 Thyroid Association (ETA).

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Hospital of Southern Jutland, Sydvang 1, 6400, Sønderborg, Denmark

    F. Brandt

  2. Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 6, 5000, Odense, Denmark

    F. Brandt, M. Thvilum, L. Hegedüs & T. H. Brix

Authors
  1. F. Brandt
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  2. M. Thvilum
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  3. L. Hegedüs
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  4. T. H. Brix
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Correspondence to F. Brandt.

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Brandt, F., Thvilum, M., Hegedüs, L. et al. Hyperthyroid patients without Graves' orbitopathy are not at increased risk of developing glaucoma: a nationwide Danish register-based case-control study. Endocrine 59, 137–142 (2018). https://doi.org/10.1007/s12020-017-1485-0

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  • DOI: https://doi.org/10.1007/s12020-017-1485-0

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