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Long-Term Outcome of Graves’ Disease : A Gender Perspective

Calissendorff, Jan ; Cramon, Per Karkov ; Hallengren, Bengt LU ; Khamisi, Selwan ; Lantz, Mikael LU ; Planck, Tereza LU ; Sjölin, Gabriel ; Wallin, Göran and Holmberg, Mats (2023) In Women's Health Reports 4(1). p.487-496
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... (More)

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.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Graves disease, long-term follow-up, quality of life
in
Women's Health Reports
volume
4
issue
1
pages
10 pages
publisher
Mary Ann Liebert, Inc.
external identifiers
  • pmid:37818181
  • scopus:85177422354
ISSN
2688-4844
DOI
10.1089/whr.2023.0073
language
English
LU publication?
yes
id
37667843-09bd-4033-be63-9683beb0ce1b
date added to LUP
2024-01-04 13:30:22
date last changed
2024-04-19 09:46:03
@article{37667843-09bd-4033-be63-9683beb0ce1b,
  abstract     = {{<p>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 &lt; 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 &lt; 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.</p>}},
  author       = {{Calissendorff, Jan and Cramon, Per Karkov and Hallengren, Bengt and Khamisi, Selwan and Lantz, Mikael and Planck, Tereza and Sjölin, Gabriel and Wallin, Göran and Holmberg, Mats}},
  issn         = {{2688-4844}},
  keywords     = {{Graves disease; long-term follow-up; quality of life}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{1}},
  pages        = {{487--496}},
  publisher    = {{Mary Ann Liebert, Inc.}},
  series       = {{Women's Health Reports}},
  title        = {{Long-Term Outcome of Graves’ Disease : A Gender Perspective}},
  url          = {{http://dx.doi.org/10.1089/whr.2023.0073}},
  doi          = {{10.1089/whr.2023.0073}},
  volume       = {{4}},
  year         = {{2023}},
}