{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T09:01:13Z","timestamp":1790758873207,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"SNUH Research Fund","award":["0320250220"],"award-info":[{"award-number":["0320250220"]}]},{"DOI":"10.13039\/501100024853","name":"BK21 FOUR","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100024853","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Graves\u2019 disease (GD) is the predominant cause of hyperthyroidism and a multifactorial autoimmune disorder in which genetic susceptibility interacts with environmental exposures. Although gut microbiota alterations have been reported in GD, the association between antibiotic exposure and GD risk remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This population-based retrospective cohort study used the Korean National Health Insurance Service database and included 311 911 adults aged \u226540 years who underwent health screening in 2005-2006.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cumulative antibiotic prescriptions during the 5 years before the index date were categorized as none, 1-14, 15-60, and \u226561 days. The number of distinct antibiotic classes prescribed (0, 1, 2, 3, and \u22654) was also evaluated. Cox proportional hazards regression estimated adjusted hazard ratios (aHRs) and 95% CIs after adjustment for various covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Longer cumulative antibiotic exposure was associated with higher GD risk (P for trend &amp;lt; .0001). Compared with non-users, aHRs (95% CIs) for 1-14, 15-60, and \u226561 days of antibiotic exposure were 1.23 (1.03-1.47), 1.43 (1.20-1.70), and 1.43 (1.18-1.73), respectively. Exposure to \u22654 antibiotic classes was also associated with higher GD risk (aHR, 1.50; 95% CI, 1.25-1.80; P for trend &amp;lt; .0001). The incidence rate increased from 4.6 per 10 000 person-years among non-users to 6.3, 8.1, and 8.2 per 10 000 person-years for 1-14, 15-60, and \u226561 days, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prolonged antibiotic exposure and exposure to a greater number of antibiotic classes were associated with a modest relative increase in subsequent GD risk, although absolute differences were small. These observational findings do not establish causality and warrant confirmation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvag170","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T19:22:48Z","timestamp":1788204168000},"page":"478-487","source":"Crossref","is-referenced-by-count":0,"title":["Association between antibiotic use and Graves\u2019 disease: a cohort study"],"prefix":"10.1093","volume":"195","author":[{"given":"Yaejin","family":"Son","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, Seoul National University College of Medicine , Seoul 03080 ,","place":["Republic of Korea"]},{"name":"Department of Medicine and Surgery, Universit\u00e0 Cattolica del Sacro Cuore , Rome 00168 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8205-9556","authenticated-orcid":false,"given":"Sun 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