{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,15]],"date-time":"2026-11-15T00:07:32Z","timestamp":1794701252390,"version":"4.9.1"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2004,4,22]],"date-time":"2004-04-22T00:00:00Z","timestamp":1082592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2004,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold><jats:sc>background\u2002<\/jats:sc><\/jats:bold> Thyroid\u2010associated ophthalmopathy (TAO) occurs in 25\u201350% of patients with Graves\u2019 disease (GD) and is occasionally seen in hypothyroid Hashimoto's disease or euthyroid individuals. The link between TAO and hyperthyroidism remains unclear. We hypothesized that qualitative or quantitative differences in thyroid antibodies might determine individual predisposition to these features.<\/jats:p><jats:p><jats:bold><jats:sc>methods\u2002<\/jats:sc><\/jats:bold> In a prospective study over 3\u00a0years, thyroid antibody levels were measured in all patients diagnosed at the Singapore National Eye Centre to have GD. These patients had no known history of thyroid disease, presented with eye complaints and diagnosis was made by an ophthalmologist. A total of 31 patients were identified. Antibody levels were compared against 71 consecutive patients referred to a thyroid clinic (TC) for thyrotoxic symptoms in whom the diagnosis of GD was confirmed by a thyroidologist.<\/jats:p><jats:p><jats:bold><jats:sc>findings\u2002<\/jats:sc><\/jats:bold> Thyroid autoantibody profiles of patients diagnosed at the ophthalmology centre (OC) and TC differed markedly. OC patients had significantly higher TSI (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7003) but lower TPOAb (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7008) and TgAb levels (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001). In contrast, TC patients had higher free T4 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7048) and higher TBII levels (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001). Antibody levels were correlated with four parameters of ophthalmopathy \u2013 chronic lid retraction, lid swelling, proptosis and extraocular myopathy (EOM). On univariate logistic regression analysis, TSI was a positive predictor and TPOAb and TgAb negative predictors of all four features. In the absence of TgAb, the odds ratios for individual TAO features ranged from 2\u00b78 to 7\u00b79, with corresponding values of 3\u00b79\u201310\u00b72 when TPOAb was absent. In stepwise logistic regression analysis, TSI was the strongest independent predictor of all aspects studied: lid fullness <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7001, proptosis <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7001, lid retraction <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7008, EOM <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7009. Among smokers, TPOAb were significantly lower (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7044) but no association between smoking and the other antibodies was observed.<\/jats:p><jats:p><jats:bold><jats:sc>interpretation\u2002<\/jats:sc><\/jats:bold> The study demonstrates markedly different thyroid autoantibody profiles in newly diagnosed GD patients with ophthalmic dominant as opposed to thyroid dominant features. It suggests differing antibody patterns are associated with predisposition to hyperthyroidism and orbitopathy. In addition, an association between smoking and low TPOAb levels was noted.<\/jats:p>","DOI":"10.1111\/j.1365-2265.2004.02033.x","type":"journal-article","created":{"date-parts":[[2004,12,21]],"date-time":"2004-12-21T23:11:30Z","timestamp":1103670690000},"page":"600-607","source":"Crossref","is-referenced-by-count":64,"title":["Thyroid autoantibody profiles in ophthalmic dominant and thyroid dominant Graves\u2019 disease differ and suggest ophthalmopathy is a multiantigenic disease"],"prefix":"10.1111","volume":"60","author":[{"given":"S. Y.","family":"Goh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. C.","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. L.","family":"Seah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. S.","family":"Fong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. H. 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