Epidemiological Study On The Etiology Of Pretibial Myxedema

objective:Up to now,the etiology of pretibial myxedema is not clear,and no epidemiological investigation on the etiology of pretibial myxedema has been reported.To determine the etiology of pretibial myxedema(PTM),we designed and conducted a large case-control study.Patients and methods:From July 2013 to September 2018,we conducted a retrospective case-control study analysis of patients who visited the outpatient department of nuclear industry 416 hospital according to the experimental design method of 1:2 case-control study,Criteria for inclusion in the case group: PTM diagnostic criteria were met;First visit to our department for diagnosis and treatment;The control group was divided into internal control group and external control group.The inclusion criteria of the internal control group were: meeting the diagnostic criteria of GD or HT without PTM;Between 0 and80 years old;The ratio of men to women is 1:3;Inclusion criteria of the external control group: met the definition of healthy people;Between 0 and 80 years old;3)the ratio of male to female is 1:1;Rule out unwilling to cooperate and do not meet the inclusion criteria,a total of 1200 people into the object,the demographic characteristics(age,sex,occupation,smoking,drinking,local skin trauma,history of AITD,exophthalmos,acropachy,I-131 treatment,postures,thyroid function(T3,T4,FT3,FT4,TSH),serum thyroid autoantibodies(TRAb,TPOAb and TgAb)19 factors do more than single factor and logistic factors analysis,and serum TRAb concentration-response relationship between concentration and skin lesions.Result:PTM,210 cases(52.5%)were male and 190 cases(47.5%)were female,aged between 16 and 86(mean 45.73 12.18 years).In the univariate analysis of the three groups,gender,age,trauma,exophthalmosis,finger clubbing,and i-131 treatment,AITD history,body position,serum thyroid autoantibody,and serum TSH showed statistically significant differences among the three groups.In the logistic multivariateanalysis of the three groups,TRAb was the main risk factor for PTM(OR=42.88,P=0.000),TRAb=129.151 165.948IU/L,and there was a dosage-effect relationship between TRAb and skin lesions.TRAb concentration in nodules was the lowest(61.5296.93),TRAb concentration in elephant legs was the highest(225.5 280.9).In addition,PTM is unrelated to thyroid function(P>0.05),that is,it can occur when thyroid function is normal,hyperthyroidism or hypothyroidism.Conclusion:In age,sex,occupation,living habits,trauma,history of AITD and thyroid stimulating hormone,thyroid autoantibodies,I-131 treatment,exophthalmos,and acropachy,19 factors,only gender,age,position,TRAb and trauma,five factors associated with PTM,its associated intensity is strong to the weak sequence TRAb,postures,trauma,age,gender,is one of the most relevant TRAb.