Polycystic ovary syndrom(PCOS) and the association of subsequent risk of
Graves’ Diseases: a population-based cohort study
Abstract
Objective: This study aimed to investigate the risk of Graves’ disease
in Polycystic ovary syndrome (PCOS) patients. Design: Population-based
retrospective cohort study. Setting: We utilized the medical records
randomly selected from the Taiwan National Health Insurance Research
Database (NHIRD) during period between 2000 and 2013. Population: We
included women aged between 20 and 50 who have no previous Graves’
disease diagnosis records. Methods: We matched the baseline
characteristics and the index date of the PCOS-free cohort to the PCOS
cohort at a ratio of 4:1 by propensity score matching method. Cox
proportional hazards model was used to estimate hazard ratios (HRs) and
95% confidence intervals (CIs). Main outcome measure: To analyze the
cumulative incidence and the hazard ratio of Graves’ disease events in
both PCOS group and PCOS-free cohort. Results: We identified 5927
patients as the PCOS cohort, and included 23708 patients as the
PCOS-free cohort. The PCOS group had a significant increased risk of
Graves’ disease with an adjusted hazard ratio (aHR) of 1.34 (95% CI=
1.00-1.81). The p-value was 0.03 in log-rank test. PCOS patients without
anxiety, chronic obstructive pulmonary disease, hypertension or
hyperlipidemia had a higher risk of Graves’ disease in the
stratification analysis. Conclusions: This study revealed a significant
association between PCOS and subsequent risk of developing Graves’
disease. Funding: Nil. Tweetable abstract: PCOS increase the risk of
Graves’ disease. Keywords: Polycystic ovary syndrome, PCOS, Graves’
disease, GD, hyperthyroidism, autoimmune thyroiditis, cohort, hazard
ratio, epidemiology, Taiwan National Health Insurance Research Database