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Graves’ disease more common in blacks, Asians
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Findings from a study that examined rates of Graves’ disease and Hashimoto’s thyroiditis in US service personnel showed that Graves’ disease is more prevalent in black and Asian/Pacific Islander adults.
Previous findings show that Hashimoto’s thyroiditis is more prevalent in whites than in blacks. This study data confirmed that Hashimoto’s thyroiditis is more common in whites, and also demonstrated differences in Graves’ disease among black men and women and Asian/Pacific Islander men and women.
“The differences in incidence by race/ethnicity may be due to different environmental exposures, genetics, or a combination of both,” Donald S. A. McLeod, FRACP, MPH, of the Royal Brisbane Hospital in Australia, and colleagues wrote. “Our results are not easily attributable to the strongest known environmental risk factor, cigarette smoking.”
Smoking is associated with an increased risk for Graves’ disease and a decreased risk for Hashimoto’s thyroiditis, according to the researchers.
They examined Defense Medical Surveillance System (DMSS) data, which contain a record of all impatient and outpatient care provided to active duty US military service personnel. DMSS data included thyroid-related diagnoses for 20,270,688 participants (85.8% male) aged 20 to 54 years who self-reported race at the time of study enrollment. A person with a specific diagnosis of Graves’ disease or Hashimoto’s thyroiditis cannot enlist in the military, so a diagnosis of either was considered the incident date, all of which occurred from 1997 to 2011.
Data showed there were 1,378 cases of Graves’ disease in women and 1,388 cases in men; there were 758 cases of Hashimoto’s thyroiditis in women and 548 cases in men.
Compared with whites, the incidence rate ratio (IRR) of Graves’ disease was significantly elevated in black women (IRR=1.92; 95% CI, 1.56-2.37) and men (IRR=2.53; 95% CI, 2.01-3.18) and Asian/Pacific Islander women (IRR=1.78; 95% CI, 1.2-2.66) and men (IRR=3.36; 95% CI, 2.57-4.4).
In keeping with previous estimates, Hashimoto’s thyroiditis incidence was highest in whites; incidence was lowest in black women (IRR=0.33; 95% CI, 0.21-0.51) and men (IRR=0.22; 95% CI, 0.11-0.47) and Asian/Pacific Islander women (IRR=0.31; 95% CI, 0.17-0.56) and men (IRR=0.23; 95% CI, 0.07-0.72).
“We cannot rule out military-specific exposures affecting the pattern of autoimmune thyroid disease, which could limit the generalizability of our findings,” the researchers said.
Disclosure: One researcher reports financial ties with UptoDate.
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