{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:11:23Z","timestamp":1787235083743,"version":"build-2736575974"},"reference-count":33,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Statin use is associated with a reduced risk of Graves\u2019 orbitopathy (GO). However, whether the timing of initiating statin treatment after the diagnosis of Graves\u2019 disease (GD) affects the association between statin and GO risk remains unclear. This study aims to evaluate the risk of GO based on varying intervals of statin initiation following GD diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This nationwide, population-based retrospective cohort study used data of all beneficiaries aged &gt;40 years diagnosed with GD from Taiwan\u2019s National Health Insurance Research Database (2009\u20132019). We excluded patients with incomplete data, follow-up &lt;6 months, with a diagnosis of GO, or on medication for hyperlipidemia before GD diagnosis. We performed 1:4 matching based on age, sex, and the duration between GD diagnosis and the index day for statin users and nonusers. GO patients were further classified as having mild or moderate-to-severe GO according to the type of treatment received.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 47,424 patients were categorized into Group A (&lt;1 year, 4649 statin users; 18,584 nonusers), Group B (1\u20132 years, 3060 statin users; 12,349 nonusers), and Group C (2\u20133 years, 1752 statin users; 7030 nonusers) by the duration between GD diagnosis and the index date. Cox regression showed that statin users in Group A had a significantly lower risk of total GO (adjusted hazard ratio [HR]: 0.66, confidence interval [CI]: 0.47\u20130.94,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.023) and moderate-to-severe GO (adjusted HR: 0.39, CI: 0.19\u20130.80,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.010), but not mild GO (adjusted HR: 0.84, CI: 0.56\u20131.25,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.385) than nonusers. However, no significant associations were found in Groups B and C. The risk of GO was not statistically different among users of various types or intensities of statins in any group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Initiating statin treatment within one year after being diagnosed with GD was associated with 34% and 61% reduction in total and moderate-to-severe GO risk, respectively. For patients whose treatment was initiated more than one year after GD was diagnosed, statin use was not related to the risk of total, mild, and moderate-to-severe GO. These findings suggest that the timing of statin initiation may influence the risk of GO, which warrants further confirmation through prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256251364782","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T14:43:11Z","timestamp":1757688191000},"page":"1052-1062","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Early Statin Use Following Diagnosis of Graves\u2019 Disease Is Associated with a Reduced Risk of Moderate-to-Severe Graves\u2019 Orbitopathy in Middle-Aged Adults: Evidence from a Nationwide Taiwanese Cohort"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9505-2230","authenticated-orcid":false,"given":"Yu-Tsung","family":"Chou","sequence":"first","affiliation":[{"name":"Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan."},{"name":"Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Chieh","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan."},{"name":"Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Yi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan."},{"name":"Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan."},{"name":"Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Chen","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Tung","family":"Huang","sequence":"additional","affiliation":[{"name":"National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Lin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan."},{"name":"The Preparation Office of the Geriatric Hospital, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Hsuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deng-Chi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan."},{"name":"School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan."},{"name":"Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, 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