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Type 2 diabetic patients with Graves' disease have more frequent and severe Graves' orbitopathy.
Nutr Metab Cardiovasc Dis. 2015 May; 25(5):452-7.NM

Abstract

BACKGROUND AND AIMS

Due to the worldwide increasing prevalence of diabetes (DM), patients with both diabetes and Graves' disease (GD) have become more frequent. Sporadic reports indicate that Graves' orbitopathy (GO), a GD complication that affects orbital soft tissues, can be severe in DM patients. The relationship between these diseases is not well understood. This study aims at evaluating the association of GD and GO with autoimmune and non-autoimmune diabetes (DM) and to assess diabetic features that influence GD and GO prevalence and severity.

METHODS AND RESULTS

This retrospective study evaluated GD, GO and DM association in 1211 consecutive GD patients (447 with GO and 77 with DM). A case-control study was carried out to evaluate DM relationship with GO severity by comparing at 1:2 ratio GO patients with or without DM. A strong association was found between GD and T1DM (p = 0.01) but not T2DM. Instead, the presence of GO was strongly associated with T2DM (p = 0.01). Moreover, GO was more frequently severe in GD patients with T2DM (11/30 or 36.6%) than in those without T2DM (1/60 or 1.7%, p = 0.05). T2DM was the strongest risk factor for severe GO (OR = 34.1 vs. 4.4 p < 0.049 in cigarette smokers). DM duration, obesity and vascular complications, but not metabolic control were significant determinants of GO severity.

CONCLUSIONS

GD is associated with T1DM but not with T2DM, probably because of the common autoimmune background. GO, in contrast, is more frequent and severe in T2DM, significantly associated with obesity, diabetes duration and diabetic vasculopathy but not metabolic control.

Authors+Show Affiliations

Department of Clinical and Molecular Biomedicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Via Palermo 636, 95100 Catania, Italy. Electronic address: rlemoli@unict.it.Department of Clinical and Molecular Biomedicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Via Palermo 636, 95100 Catania, Italy.Department of Clinical and Molecular Biomedicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Via Palermo 636, 95100 Catania, Italy.Department of Clinical and Molecular Biomedicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Via Palermo 636, 95100 Catania, Italy.Department of Clinical and Molecular Biomedicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Via Palermo 636, 95100 Catania, Italy.Department of Clinical and Molecular Biomedicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Via Palermo 636, 95100 Catania, Italy.Department of Clinical and Molecular Biomedicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Via Palermo 636, 95100 Catania, Italy.Department of Clinical and Molecular Biomedicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Via Palermo 636, 95100 Catania, Italy.Department of Clinical and Molecular Biomedicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Via Palermo 636, 95100 Catania, Italy; National Research Council (CNR), Department of Biostructures and Bioimmaging, Catania, Italy.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25746910

Citation

Le Moli, R, et al. "Type 2 Diabetic Patients With Graves' Disease Have More Frequent and Severe Graves' Orbitopathy." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 25, no. 5, 2015, pp. 452-7.
Le Moli R, Muscia V, Tumminia A, et al. Type 2 diabetic patients with Graves' disease have more frequent and severe Graves' orbitopathy. Nutr Metab Cardiovasc Dis. 2015;25(5):452-7.
Le Moli, R., Muscia, V., Tumminia, A., Frittitta, L., Buscema, M., Palermo, F., Sciacca, L., Squatrito, S., & Vigneri, R. (2015). Type 2 diabetic patients with Graves' disease have more frequent and severe Graves' orbitopathy. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 25(5), 452-7. https://doi.org/10.1016/j.numecd.2015.01.003
Le Moli R, et al. Type 2 Diabetic Patients With Graves' Disease Have More Frequent and Severe Graves' Orbitopathy. Nutr Metab Cardiovasc Dis. 2015;25(5):452-7. PubMed PMID: 25746910.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Type 2 diabetic patients with Graves' disease have more frequent and severe Graves' orbitopathy. AU - Le Moli,R, AU - Muscia,V, AU - Tumminia,A, AU - Frittitta,L, AU - Buscema,M, AU - Palermo,F, AU - Sciacca,L, AU - Squatrito,S, AU - Vigneri,R, Y1 - 2015/01/28/ PY - 2014/10/24/received PY - 2015/01/09/revised PY - 2015/01/18/accepted PY - 2015/3/10/entrez PY - 2015/3/10/pubmed PY - 2016/1/7/medline KW - Diabetes KW - Graves' KW - Ophthalmopath severity SP - 452 EP - 7 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 25 IS - 5 N2 - BACKGROUND AND AIMS: Due to the worldwide increasing prevalence of diabetes (DM), patients with both diabetes and Graves' disease (GD) have become more frequent. Sporadic reports indicate that Graves' orbitopathy (GO), a GD complication that affects orbital soft tissues, can be severe in DM patients. The relationship between these diseases is not well understood. This study aims at evaluating the association of GD and GO with autoimmune and non-autoimmune diabetes (DM) and to assess diabetic features that influence GD and GO prevalence and severity. METHODS AND RESULTS: This retrospective study evaluated GD, GO and DM association in 1211 consecutive GD patients (447 with GO and 77 with DM). A case-control study was carried out to evaluate DM relationship with GO severity by comparing at 1:2 ratio GO patients with or without DM. A strong association was found between GD and T1DM (p = 0.01) but not T2DM. Instead, the presence of GO was strongly associated with T2DM (p = 0.01). Moreover, GO was more frequently severe in GD patients with T2DM (11/30 or 36.6%) than in those without T2DM (1/60 or 1.7%, p = 0.05). T2DM was the strongest risk factor for severe GO (OR = 34.1 vs. 4.4 p < 0.049 in cigarette smokers). DM duration, obesity and vascular complications, but not metabolic control were significant determinants of GO severity. CONCLUSIONS: GD is associated with T1DM but not with T2DM, probably because of the common autoimmune background. GO, in contrast, is more frequent and severe in T2DM, significantly associated with obesity, diabetes duration and diabetic vasculopathy but not metabolic control. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/25746910/Type_2_diabetic_patients_with_Graves'_disease_have_more_frequent_and_severe_Graves'_orbitopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(15)00019-8 DB - PRIME DP - Unbound Medicine ER -