학술논문
Long-Term Outcome of Graves' Disease: A Gender Perspective.
Document Type
Academic Journal
Author
Calissendorff J; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.; Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden.; Cramon PK; Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.; Hallengren B; Department of Endocrinology, Skåne University Hospital, Malmö, Sweden.; Department of Clinical Sciences, Lund University, Lund, Sweden.; Khamisi S; Department of Endocrinology, Uppsala University Hospital, Uppsala, Sweden.; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.; Lantz M; Department of Endocrinology, Skåne University Hospital, Malmö, Sweden.; Department of Clinical Sciences, Lund University, Lund, Sweden.; Planck T; Department of Endocrinology, Skåne University Hospital, Malmö, Sweden.; Department of Clinical Sciences, Lund University, Lund, Sweden.; Sjölin G; Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden.; Wallin G; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.; Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden.; Holmberg M; ANOVA, Karolinska University Hospital, Stockholm, Sweden.; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
Source
Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 101768931 Publication Model: eCollection Cited Medium: Internet ISSN: 2688-4844 (Electronic) Linking ISSN: 26884844 NLM ISO Abbreviation: Womens Health Rep (New Rochelle) Subsets: PubMed not MEDLINE
Subject
Language
English
Abstract
Introduction: In gender-skewed conditions such as Graves' disease (GD), the outcome naturally becomes dominated by the majority. This may lead to gender-biased misunderstandings regarding treatment outcomes. This especially holds true when complications, such as depression, are unevenly distributed. We have, therefore, studied the long-term outcome of GD from a gender perspective.
Materials and Methods: A cohort of 1186 patients with GD was included in a follow-up 6-10 years after inclusion. Choice of treatment, the feeling of recovery, long-term treatment, comorbidity, and quality of life were investigated with questionnaires. All results were studied sex-divided.
Results: We included 973 women and 213 men. There was no difference between men and women in the choice of treatment. At follow-up, women scored significantly worse in the general questionnaire 36-item Short-Form Health Status (SF-36) domain bodily pain and in the thyroid-specific Thyroid-Related Patient-Reported Outcome (ThyPRO) domains depression, impaired sex life, and cosmetic complaints, all p < 0.05. Women were twice as likely (29.5%) to be treated with levothyroxine after successful treatment with antithyroid drugs (ATD) compared with men (14.9%, p < 0.05).
Conclusion: After treatment for GD, women were more affected by depression, impaired sex life, cosmetic issues, and bodily pain despite successful cure of hyperthyroidism. The prevalence of hypothyroidism was also doubled in women. Whether these observed gender differences reflect a worse outcome of GD in women or a natural consequence of a higher prevalence of these symptoms and autoimmunity in the female population is difficult to disentangle. Nevertheless, several years after GD, women reveal more persistent symptoms.
Competing Interests: The authors declare no competing financial interests.
(© Jan Calissendorff et al., 2023; Published by Mary Ann Liebert, Inc.)
Materials and Methods: A cohort of 1186 patients with GD was included in a follow-up 6-10 years after inclusion. Choice of treatment, the feeling of recovery, long-term treatment, comorbidity, and quality of life were investigated with questionnaires. All results were studied sex-divided.
Results: We included 973 women and 213 men. There was no difference between men and women in the choice of treatment. At follow-up, women scored significantly worse in the general questionnaire 36-item Short-Form Health Status (SF-36) domain bodily pain and in the thyroid-specific Thyroid-Related Patient-Reported Outcome (ThyPRO) domains depression, impaired sex life, and cosmetic complaints, all p < 0.05. Women were twice as likely (29.5%) to be treated with levothyroxine after successful treatment with antithyroid drugs (ATD) compared with men (14.9%, p < 0.05).
Conclusion: After treatment for GD, women were more affected by depression, impaired sex life, cosmetic issues, and bodily pain despite successful cure of hyperthyroidism. The prevalence of hypothyroidism was also doubled in women. Whether these observed gender differences reflect a worse outcome of GD in women or a natural consequence of a higher prevalence of these symptoms and autoimmunity in the female population is difficult to disentangle. Nevertheless, several years after GD, women reveal more persistent symptoms.
Competing Interests: The authors declare no competing financial interests.
(© Jan Calissendorff et al., 2023; Published by Mary Ann Liebert, Inc.)