Graves' ophthalmopathy in relation to cigarette smoking and ethnic origin

Clin Endocrinol (Oxf). 1992 Mar;36(3):291-4. doi: 10.1111/j.1365-2265.1992.tb01445.x.


Objective: We aimed to study the effect of cigarette smoking on the prevalence and severity of Graves' ophthalmopathy (GO).

Patients: One hundred and fifty-five newly diagnosed patients with Graves' disease (GD) were diagnosed clinically and by routine biochemical methods. Twenty-five per cent (39) were of Asian origin.

Methods: Eye signs were classified according to the American Thyroid Association Classification. A detailed smoking questionnaire and data from hospital notes were used to calculate an index of cigarette consumption.

Results: Thirty-four per cent of all patients had Graves' ophthalmopathy, and the prevalence in males (26%) and females (36%) did not differ significantly. There was a prevalence of 42% among Europeans compared to 7.7% in Asians (P = 0.0002). The overall risk for Europeans for developing Graves' ophthalmopathy was 6.4 (1.78-22.7 confidence interval) times higher than for Asians. Corrected for the ethnic factor the increased risk from smoking for Europeans was 2.4 (1.12-5.18, 95% confidence interval) times higher. There was a significant dose effect (P = 0.008).

Conclusions: The present findings confirm an effect of cigarette smoking on Graves' ophthalmopathy and in addition show that Europeans have a substantially greater risk of developing Graves' ophthalmopathy than have Asians.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Asia / ethnology
  • Child
  • Female
  • Graves Disease / epidemiology*
  • Graves Disease / ethnology
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Smoking / adverse effects*
  • United Kingdom / epidemiology