Relationship Between Cholesterol Serum Levels And The Presence And Activity Of Graves’ Ophthalmopathy

ObjectiveTo confirm the relationship between cholesterol serum levels and the presence and activity of Graves’ ophthalmopathy(GO),providing new evidence for the prevention of GO presence and treatment of active-phase GO.To evaluate the efficacy of different combinations of cholesterol to predict the presence and activity of GO,proposing new indicators for GO presence and GO active phase.MethodsA total of 620 diagnosed Graves’ disease(GD)patients,aged 18-86 years,was collected from the inpatient wards of Fujian Provincial Hospital From January 2012 to December 2020.148 GD patients with Graves’ ophthalmopathy were included in the GO group.Other 472 GD patients without Graves’ ophthalmopathy were included in the control group(GD group).According to the GO clinical activity score(CAS),CAS points ≥ 3 is in the active phase,and CAS points <3 is in the inactive phase.58 GO patients in the active phase were included in the active-phase GO group,and Other 90 GO patients in the inactive phase were included in the control group(inactive-phase GO group).According to the stratification of thyroid status,the differences in basic clinical data and blood lipids between GO group and GD group,active-phase GO group and inactive-phase GO group were compared respectively.Confirm the relationship between cholesterol serum levels and GO presence,stage and clinical activity score.The ROC curve was used to evaluate the efficacy of different cholesterol combinations in predicting GO presence and GO in the active phase.Results1.A total of 620 GD patients were studied,including 225 males and 395 females,with a male-female ratio of about 1:2.The median age of all study subjects was50.00(37.00-60.00)years old,and the median duration of GD was 12.00(2.00-72.00)months.2.Serum levels of total cholesterol,Low-density Lipoprotein(LDL)-Cholesterol and Non-High-Density Lipoprotein(Non-HDL)-Cholesterol were significantly higher in patients with GO compared with those without GO In the hyperthyroidism and euthyroidism stratification(P<0.05).The proportions of high total cholesterol(≥5.2mmol/L),high LDL-cholesterol(≥3.4mmol/L)and high Non-HDL-cholesterol(≥4.1mmol/L)were significantly greater in patients with GO than those without GO after stratification of thyroid status(P<0.05).3.Logistic regression analysis shows that total cholesterol,LDL-cholesterol and Non-HDL-cholesterol were risk factors for GO development.The ROC curve indicated that when the probability is equal to 0.169,the combination of total cholesterol,LDL-Cholesterol and Non-HDL-Cholesterol has the best efficiency for predicting GO development with a sensitivity of 85.8% and a specificity of 52.1%.4.Serum levels of triglycerides,total cholesterol,LDL-cholesterol and Non-HDL-cholesterol were significantly higher in active-phase GO patients compared with those in inactive phase In the hyperthyroidism stratification(P<0.05).The proportions of high total cholesterol(≥5.2mmol/L),high LDL-cholesterol(≥3.4mmol/L)and high Non-HDL-cholesterol(≥4.1mmol/L)were significantly greater in active-phase GO patients than those in inactive phase after stratification of thyroid status(P<0.05).5.Spearman correlation analysis and Partial correlation analysissuggested that there were positive correlations between triglycerides,total cholesterol,LDL-cholesterol,Non-HDL-cholesterol and Clinical activity score.6.Logistic regression analysis shows that triglycerides,total cholesterol,LDL-cholesterol and Non-HDL-cholesterol were risk factors for GO activities.The ROC curve indicated that when the probability is equal to 0.391,Non-HDL-Cholesterol has the best efficiency for monitoring GO in the active-phase with a sensitivity of 81.0% and a specificity of 68.9%.ConclusionsHypercholesterolemia is a risk factor for the presence and activity of GO,which proposes new evidence for the prevention of GO presence and treatment of active-phase GO.For GD patients and GO patients with hypercholesterolemia,it is necessary to monitor cholesterol serum levels and actively carry out cholesterol management to reduce the presence and activities of GO.Non-HDL-Cholesterol is highly effective in predicting GO occurrence and evaluating GO activity period,and may be a new indicator for GO occurrence prediction and activity period evaluation.