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Incidence and clinical presentation of moderate to severe graves' orbitopathy in a Danish population before and after iodine fortification of salt.
J Clin Endocrinol Metab. 2012 Jul; 97(7):2325-32.JC

Abstract

CONTEXT

Population-based data on the incidence and clinical presentation of moderate to severe Graves' orbitopathy (GO) are scarce, and virtually nothing is known on the effect of an iodization program on the incidence and presentation of GO.

OBJECTIVE

The objective of the study was to characterize incident moderate to severe GO in North Jutland County, Denmark, during the period 1992-2009, before and after the Danish salt iodization program.

DESIGN AND PATIENTS

The design of the study was a prospective register of patients with incident moderate to severe GO in a population during 8.9 million persons × years of observation.

SETTING

The study was conducted at a thyroid-eye clinic of university hospital.

MAIN OUTCOME MEASURES

Clinical presentation and incidence before and after the year 2000 initiation of the mandatory Danish iodization of salt were measured. The incidence of GO was related to the incidence of Graves' hyperthyroidism (GH) in the same population.

RESULTS

The incidence rate of moderate to severe GO was 16.1/million per year (women: 26.7; men: 5.4), with no change associated with iodization of salt. The moderate to severe GO incidence was 4.9% of the incidence of GH. The incidence rate ratio between women and men with GO (4.9) was not different from the ratio in GH. Compared with GH, only a few patients (<2%) suffered from moderate and severe GO below the age of 40 yr, whereas GO was relatively common in age groups 40-60 yr (∼8%).

CONCLUSIONS

Approximately 5% of the patients with Graves' disease develop moderate to severe GO, with a similar risk in women and men with Graves' disease. The risk of GO is much higher in patients aged 40-60 yr than in young patients with Graves' disease. Salt iodization was not associated with a change in the incidence of GO.

Authors+Show Affiliations

Department of Endocrinology, Aalborg Hospital, Aarhus University Hospital, DK-9000 Aalborg, Denmark. peter.laurberg@rn.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22518849

Citation

Laurberg, Peter, et al. "Incidence and Clinical Presentation of Moderate to Severe Graves' Orbitopathy in a Danish Population Before and After Iodine Fortification of Salt." The Journal of Clinical Endocrinology and Metabolism, vol. 97, no. 7, 2012, pp. 2325-32.
Laurberg P, Berman DC, Bülow Pedersen I, et al. Incidence and clinical presentation of moderate to severe graves' orbitopathy in a Danish population before and after iodine fortification of salt. J Clin Endocrinol Metab. 2012;97(7):2325-32.
Laurberg, P., Berman, D. C., Bülow Pedersen, I., Andersen, S., & Carlé, A. (2012). Incidence and clinical presentation of moderate to severe graves' orbitopathy in a Danish population before and after iodine fortification of salt. The Journal of Clinical Endocrinology and Metabolism, 97(7), 2325-32. https://doi.org/10.1210/jc.2012-1275
Laurberg P, et al. Incidence and Clinical Presentation of Moderate to Severe Graves' Orbitopathy in a Danish Population Before and After Iodine Fortification of Salt. J Clin Endocrinol Metab. 2012;97(7):2325-32. PubMed PMID: 22518849.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence and clinical presentation of moderate to severe graves' orbitopathy in a Danish population before and after iodine fortification of salt. AU - Laurberg,Peter, AU - Berman,Dalia C, AU - Bülow Pedersen,Inge, AU - Andersen,Stig, AU - Carlé,Allan, Y1 - 2012/04/19/ PY - 2012/4/21/entrez PY - 2012/4/21/pubmed PY - 2012/9/27/medline SP - 2325 EP - 32 JF - The Journal of clinical endocrinology and metabolism JO - J. Clin. Endocrinol. Metab. VL - 97 IS - 7 N2 - CONTEXT: Population-based data on the incidence and clinical presentation of moderate to severe Graves' orbitopathy (GO) are scarce, and virtually nothing is known on the effect of an iodization program on the incidence and presentation of GO. OBJECTIVE: The objective of the study was to characterize incident moderate to severe GO in North Jutland County, Denmark, during the period 1992-2009, before and after the Danish salt iodization program. DESIGN AND PATIENTS: The design of the study was a prospective register of patients with incident moderate to severe GO in a population during 8.9 million persons × years of observation. SETTING: The study was conducted at a thyroid-eye clinic of university hospital. MAIN OUTCOME MEASURES: Clinical presentation and incidence before and after the year 2000 initiation of the mandatory Danish iodization of salt were measured. The incidence of GO was related to the incidence of Graves' hyperthyroidism (GH) in the same population. RESULTS: The incidence rate of moderate to severe GO was 16.1/million per year (women: 26.7; men: 5.4), with no change associated with iodization of salt. The moderate to severe GO incidence was 4.9% of the incidence of GH. The incidence rate ratio between women and men with GO (4.9) was not different from the ratio in GH. Compared with GH, only a few patients (<2%) suffered from moderate and severe GO below the age of 40 yr, whereas GO was relatively common in age groups 40-60 yr (∼8%). CONCLUSIONS: Approximately 5% of the patients with Graves' disease develop moderate to severe GO, with a similar risk in women and men with Graves' disease. The risk of GO is much higher in patients aged 40-60 yr than in young patients with Graves' disease. Salt iodization was not associated with a change in the incidence of GO. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/22518849/Incidence_and_clinical_presentation_of_moderate_to_severe_graves'_orbitopathy_in_a_Danish_population_before_and_after_iodine_fortification_of_salt_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2012-1275 DB - PRIME DP - Unbound Medicine ER -