Cigarette smoking and risk of clinically overt thyroid disease - A population-based twin case-control study
Cigarette smoking and risk of clinically overt thyroid disease - A population-based twin case-control study
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DOI：
10.1001/archinte.160.5.661
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发表时间：
2000-03-13
影响因子：
--
通讯作者：
Hegedus, L
中科院分区：
文献类型：
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作者：
Brix, TH;Hansen, PS;Hegedus, L
背景：吸烟对甲状腺的影响已被研究多年。目的：探讨吸烟对临床显性甲状腺疾病发病的影响。方法：对132对(264人)临床显性甲状腺疾病的同性双胞胎进行配对病例对照研究。结果：总体上，吸烟与发生临床显性甲状腺疾病的风险增加相关(优势比为3.0；95%可信区间为1.4~6.6；P=0.003)。这种关联在单合子和双合子疾病-不协调配对中仍然具有统计学意义。吸烟的影响在纯合子对和双合子对中更明显(优势比，5.0比2.5；两者P=0.04)。在将双胞胎对细分为临床显性自身免疫性甲状腺疾病(49对)和非自身免疫性甲状腺疾病(83对)不一致的组后，获得了基本上相似的结果。在符合吸烟的双胞胎中，患有临床显性自身免疫性甲状腺疾病的先证者吸烟的比例显著高于他们的健康双胞胎(17对；P=.03)，而非自身免疫性甲状腺疾病先证者与他们的健康同卵双胞胎之间的吸烟差异无统计学意义(34对；P=.20)。结论：吸烟与发生临床显性甲状腺疾病的风险增加有关。此外，我们的数据表明，累积吸烟是一个风险因素，在自身免疫性甲状腺疾病中最为明显。
Background: The effects of cigarette smoking on the thyroid gland have been studied for years. However, the effect of smoking on thyroid function and size is still controversial.Objective: To determine the impact of cigarette smoking on the development of clinically overt thyroid disease.Methods: Matched case-control study of 132 same-sex twin pairs (264 individuals) discordant for clinically overt thyroid disease, ascertained from a population-based nationwide twin register. Information on thyroid disease and smoking habits was gathered by questionnaire, and the patients' endocrinologist or general practitioner verified the diagnosis.Results: Overall, smoking was associated with an increased risk of developing clinically overt thyroid disease (odds ratio,3.0; 95% confidence interval, 1.4-6.6; P =.003). This association remained statistically significant in monozygotic and dizygotic disease-discordant pairs. The effect of smoking was more pronounced in,monozygotic vs dizygotic pairs (odds ratio, 5.0 vs 2.5; P=.04 for both). Essentially similar results were obtained after subdividing the twin pairs into groups discordant for clinically overt autoimmune (49 pairs) and nonautoimmune (83 pairs) thyroid disease. Among twin pairs concordant for smoking, probands with clinically overt autoimmune thyroid disease smoked significantly more than did their healthy co-twins (17 pairs; P=.03), whereas no difference was found between probands with nonautoimmune thyroid disease and their healthy co-twins (34 pairs; P=.20).Conclusions: Smoking is associated with an increased risk of developing clinically overt thyroid disease. Furthermore, our data suggest that cumulative cigarette consumption is a risk factor, most pronounced in autoimmune thyroid disease.