{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T02:46:11Z","timestamp":1790304371506,"version":"4.1.0"},"reference-count":48,"publisher":"Japan Endocrine Society","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endocr J"],"published-print":{"date-parts":[[2026]]},"DOI":"10.1507\/endocrj.ej25-0334","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T22:07:25Z","timestamp":1764194845000},"page":"449-459","source":"Crossref","is-referenced-by-count":1,"title":["Impacts of physical, metabolic, and immunological factors on the exophthalmometry values of a contemporary Japanese population with\/without Graves\u2019 disease"],"prefix":"10.1507","volume":"73","author":[{"given":"Erika","family":"Nakaji","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3430-5796","authenticated-orcid":false,"given":"Ichiro","family":"Horie","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5291-968X","authenticated-orcid":false,"given":"Hiroshi","family":"Yano","sequence":"additional","affiliation":[{"name":"Clinical Research Support Center, Kagawa University Hospital, Kagawa 761-0793, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinpei","family":"Nishikido","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Nakaji","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka","family":"Sako","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Niri","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai","family":"Haraguchi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Akazawa","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiro","family":"Usa","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"},{"name":"Takashi Nagai Memorial International Hibakusha Medical Center, Nagasaki University Hospital, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akari","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Uematsu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"386","reference":[{"key":"1","doi-asserted-by":"crossref","unstructured":"1 Bartalena L, Kahaly GJ, Baldeschi L, Dayan CM, Eckstein A, et al. (2021) The 2021 European Group on Graves\u2019 orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves\u2019 orbitopathy. Eur J Endocrinol 185: G43\u2013G67.","DOI":"10.1530\/EJE-21-0861"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2 Cheung JJC, Chang DL, Chan JC, Choy BNK, Shih KC, et al. (2019) Exophthalmometry values in the Hong Kong Chinese adult population from a population-based study. Medicine (Baltimore) 98: e17993.","DOI":"10.1097\/MD.0000000000017993"},{"key":"3","doi-asserted-by":"crossref","unstructured":"3 Werner SC (1977) Modification of the classification of the eye changes of Graves\u2019 disease. Am J Ophthalmol 83: 725\u2013727.","DOI":"10.1016\/0002-9394(77)90140-4"},{"key":"4","doi-asserted-by":"crossref","unstructured":"4 Inoue Y, Inoue T (1977) Study on dysthyroid ophthalmopathy. Proceedings of the 3rd International Symposium on Orbital Disorders, Amsterdam: 349\u2013355.","DOI":"10.1007\/978-94-009-9978-7_66"},{"key":"5","doi-asserted-by":"crossref","unstructured":"5 Amino N, Yuasa T, Yabu Y, Miyai K, Kumahara Y (1980) Exophthalmos in autoimmune thyroid disease. J Clin Endocrinol Metab 51: 1232\u20131234.","DOI":"10.1210\/jcem-51-6-1232"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6 Burch HB, Perros P, Bednarczuk T, Cooper DS, Dolman PJ, et al. (2022) Management of thyroid eye disease: a consensus statement by the American Thyroid Association and the European Thyroid Association. Eur Thyroid J 11: e220189.","DOI":"10.1530\/ETJ-22-0189"},{"key":"7","doi-asserted-by":"crossref","unstructured":"7 Sabini E, Mazzi B, Profilo MA, Mautone T, Casini G, et al. (2018) High serum cholesterol is a novel risk factor for Graves\u2019 orbitopathy: results of a cross-sectional study. Thyroid 28: 386\u2013394.","DOI":"10.1089\/thy.2017.0430"},{"key":"8","doi-asserted-by":"crossref","unstructured":"8 Lanzolla G, Vannucchi G, Ionni I, Campi I, Sileo F, et al. (2019) Cholesterol serum levels and use of statins in Graves\u2019 orbitopathy: a new starting point for the therapy. Front Endocrinol (Lausanne) 10: 933.","DOI":"10.3389\/fendo.2019.00933"},{"key":"9","doi-asserted-by":"crossref","unstructured":"9 Cardo C, Bernardo Santos R, Pinotti Pedro Miklos AB, Barbosa Jaconis S, Romaldini JH, et al. (2025) The relationship between cholesterol levels and thyroid eye disease. Eur Thyroid J 14: e240133.","DOI":"10.1530\/ETJ-24-0133"},{"key":"10","doi-asserted-by":"crossref","unstructured":"10 Revankar S, Mehta A (2022) Determination of exophthalmometry values in the North Indian population. Indian J Ophthalmol 70: 3083\u20133087.","DOI":"10.4103\/ijo.IJO_489_22"},{"key":"11","doi-asserted-by":"crossref","unstructured":"11 Chan W, Madge SN, Senaratne T, Senanayake S, Edussuriya K, et al. (2009) Exophthalmometric values and their biometric correlates: The Kandy Eye Study. Clin Exp Ophthalmol 37: 496\u2013502.","DOI":"10.1111\/j.1442-9071.2009.02087.x"},{"key":"12","doi-asserted-by":"crossref","unstructured":"12 Karti O, Selver OB, Karahan E, Zengin MO, Uyar M (2015) The effect of age, gender, refractive status and axial length on the measurements of hertel exophthalmometry. Open Ophthalmol J 9: 113\u2013115.","DOI":"10.2174\/1874364101509010113"},{"key":"13","unstructured":"13  (2019) National Health and Nutrition Survey in Japan: Data from 1970 to 2019. Ministry of Health, Labour and Welfare, Japan. https:\/\/www.mhlw.go.jp\/bunya\/kenkou\/kenkou_eiyou_chousa.html accessed on August 15, 2025 (in Japanese)."},{"key":"14","unstructured":"14 (2019) School Health Statistics Survey in Japan: Data from 1984 to 2019. Ministry of Education, Culture, Sports, Science and Technology, Japan. https:\/\/www.mext.go.jp\/b_menu\/toukei\/chousa05\/hoken\/1268826.htm accessed on August 15, 2025 (in Japanese)."},{"key":"15","unstructured":"15 The Japan Thyroid Association (ed) (2020) Guidelines for the Management of Thyroid Eye Disease. Medical Review Co, Ltd., Tokyo, Japan (in Japanese)."},{"key":"16","doi-asserted-by":"crossref","unstructured":"16 Lam AK, Lam CF, Leung WK, Hung PK (2009) Intra-observer and inter-observer variation of Hertel exophthalmometry. Ophthalmic Physiol Opt 29: 472\u2013476.","DOI":"10.1111\/j.1475-1313.2008.00617.x"},{"key":"17","doi-asserted-by":"crossref","unstructured":"17 Koo TK, Li MY (2016) A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 15: 155\u2013163.","DOI":"10.1016\/j.jcm.2016.02.012"},{"key":"18","doi-asserted-by":"crossref","unstructured":"18 Okui T (2021) An age-period-cohort analysis of prevalence and consultation rate for dyslipidemia in Japan. Asia Pac J Public Health 33: 46\u201352.","DOI":"10.1177\/1010539520963643"},{"key":"19","doi-asserted-by":"crossref","unstructured":"19 Fujiyoshi A, Kohsaka S, Hata J, Hara M, Kai H, et al. (2024) JCS 2023 Guideline on the primary prevention of coronary artery disease. Circ J 88: 763\u2013842.","DOI":"10.1253\/circj.CJ-23-0285"},{"key":"20","doi-asserted-by":"crossref","unstructured":"20 Beden U, Ozarslan Y, Ozt\u00fcrk HE, S\u00f6nmez B, Erkan D, et al. (2008) Exophthalmometry values of Turkish adult population and the effect of age, sex, refractive status, and Hertel base values on Hertel readings. Eur J Ophthalmol 18: 165\u2013171.","DOI":"10.1177\/112067210801800201"},{"key":"21","doi-asserted-by":"publisher","unstructured":"21 Kim IT, Choi JB (2001) Normal range of exophthalmos values on orbit computerized tomography in Koreans. Ophthalmologica 215: 156\u2013162.","DOI":"10.1159\/000050850"},{"key":"22","doi-asserted-by":"crossref","unstructured":"22 Wu D, Liu X, Wu D, Di X, Guan H, et al. (2015) Normal values of Hertel exophthalmometry in a Chinese Han population from Shenyang, Northeast China. Sci Rep 5: 8526.","DOI":"10.1038\/srep08526"},{"key":"23","doi-asserted-by":"crossref","unstructured":"23 Kahn DM, Shaw RB Jr (2008) Aging of the bony orbit: a three-dimensional computed tomographic study. Aesthet Surg J 28: 258\u2013264.","DOI":"10.1016\/j.asj.2008.02.007"},{"key":"24","unstructured":"24 Bartley GB (1994) The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota. Trans Am Ophthalmol Soc 92: 477\u2013588."},{"key":"25","doi-asserted-by":"crossref","unstructured":"25 Bartalena L, Piantanida E, Gallo D, Lai A, Tanda ML (2020) Epidemiology, natural history, risk factors, and prevention of Graves\u2019 orbitopathy. Front Endocrinol (Lausanne) 11: 615993.","DOI":"10.3389\/fendo.2020.615993"},{"key":"26","doi-asserted-by":"crossref","unstructured":"26 Kuo PC, Kuo SC, Teng YS, Lai CC (2025) Association of obesity with orbital fat expansion in thyroid eye disease. BMC Ophthalmol 25: 2.","DOI":"10.1186\/s12886-024-03824-9"},{"key":"27","doi-asserted-by":"crossref","unstructured":"27 Tsui S, Naik V, Hoa N, Hwang CJ, Afifiyan NF, et al. (2008) Evidence for an association between thyroid-stimulating hormone and insulin-like growth factor 1 receptors: a tale of two antigens implicated in Graves\u2019 disease. J Immunol 181: 4397\u20134405.","DOI":"10.4049\/jimmunol.181.6.4397"},{"key":"28","doi-asserted-by":"crossref","unstructured":"28 Wei YH, Liao SL, Wang SH, Wang CC, Yang CH (2020) Simvastatin and ROCK inhibitor Y-27632 inhibit myofibroblast differentiation of Graves\u2019 ophthalmopathy-derived orbital fibroblasts <i>via<\/i> RhoA-Mediated ERK and p38 signaling pathways. Front Endocrinol (Lausanne) 11: 607968.","DOI":"10.3389\/fendo.2020.607968"},{"key":"29","doi-asserted-by":"publisher","unstructured":"29 Morgan IG, Ohno-Matsui K, Saw SM (2012) Myopia. Lancet 379: 1739\u20131748.","DOI":"10.1016\/S0140-6736(12)60272-4"},{"key":"30","doi-asserted-by":"crossref","unstructured":"30 Liang J, Pu Y, Chen J, Liu M, Ouyang B, et al. (2025) Global prevalence, trend and projection of myopia in children and adolescents from 1990 to 2050: a comprehensive systematic review and meta-analysis. Br J Ophthalmol 109: 362\u2013371.","DOI":"10.1136\/bjo-2024-325427"},{"key":"31","doi-asserted-by":"crossref","unstructured":"31 Prummel MF, Wiersinga WM (1993) Smoking and risk of Graves\u2019 disease. JAMA 269: 479\u2013482.","DOI":"10.1001\/jama.1993.03500040045034"},{"key":"32","doi-asserted-by":"crossref","unstructured":"32 Bartalena L (2012) Prevention of Graves\u2019 ophthalmopathy. Best Pract Res Clin Endocrinol Metab 26: 371\u2013379.","DOI":"10.1016\/j.beem.2011.09.004"},{"key":"33","doi-asserted-by":"crossref","unstructured":"33 Smith BR (2025) Autoantibodies to the TSH Receptor-from discovery to understanding the mechanisms of action and to new therapeutics. Endocr J 72: 1163\u20131174.","DOI":"10.1507\/endocrj.EJ25-0127"},{"key":"34","doi-asserted-by":"crossref","unstructured":"34 Kampmann E, Diana T, Kanitz M, Hoppe D, Kahaly GJ (2015) Thyroid stimulating but not blocking autoantibodies are highly prevalent in severe and active thyroid-associated orbitopathy: a prospective study. Int J Endocrinol 2015: 678194.","DOI":"10.1155\/2015\/678194"},{"key":"35","doi-asserted-by":"crossref","unstructured":"35 Koizumi T, Tanaka T, Umeda K, Komiyama D, Obata H (2024) Correlation between extraocular muscle enlargement and thyroid autoantibodies in thyroid eye disease. Jpn J Ophthalmol 68: 250\u2013258.","DOI":"10.1007\/s10384-024-01061-7"},{"key":"36","doi-asserted-by":"publisher","unstructured":"36 Noh JY, Hamada N, Inoue Y, Abe Y, Ito K, et al. (2000) Thyroid-stimulating antibody is related to Graves\u2019 ophthalmopathy, but thyrotropin-binding inhibitor immunoglobulin is related to hyperthyroidism in patients with Graves\u2019 disease. Thyroid 10: 809\u2013813.","DOI":"10.1089\/thy.2000.10.809"},{"key":"37","doi-asserted-by":"crossref","unstructured":"37 Noh JY, Watanabe N, Ito K, Tsuiki M, Ishihara Y, et al. (2025) Safety, pharmacokinetics, and potential benefits of TSH-receptor-specific monoclonal autoantibody K1-70(TM) in Japanese Graves\u2019 disease patients: results of a phase 1 trial. Endocr J 72: 897\u2013909.","DOI":"10.1507\/endocrj.EJ25-0043"},{"key":"38","doi-asserted-by":"crossref","unstructured":"38 Ryder M, Wentworth M, Algeciras-Schimnich A, Morris JC, Garrity J, et al. (2021) Blocking the thyrotropin receptor with K1-70 in a patient with follicular thyroid cancer, Graves\u2019 disease, and Graves\u2019 ophthalmopathy. Thyroid 31: 1597\u20131602.","DOI":"10.1089\/thy.2021.0053"},{"key":"39","doi-asserted-by":"crossref","unstructured":"39 Douglas RS, Kahaly GJ, Patel A, Sile S, Thompson EHZ, et al. (2020) Teprotumumab for the treatment of active thyroid eye disease. N Engl J Med 382: 341\u2013352.","DOI":"10.1056\/NEJMoa1910434"},{"key":"40","doi-asserted-by":"crossref","unstructured":"40 Hiromatsu Y, Ishikawa E, Kozaki A, Takahashi Y, Tanabe M, et al. (2025) A randomised, double-masked, placebo-controlled trial evaluating the efficacy and safety of teprotumumab for active thyroid eye disease in Japanese patients. Lancet Reg Health West Pac 55: 101464.","DOI":"10.1016\/j.lanwpc.2025.101464"},{"key":"41","doi-asserted-by":"crossref","unstructured":"41 Katahira M, Tsunekawa T, Mizoguchi A, Yamaguchi M, Tsuru K, et al. (2023) Clinical significance of thyroglobulin antibodies and thyroid peroxidase antibodies in Graves\u2019 disease: a cross-sectional study. Hormones (Athens) 22: 253\u2013261.","DOI":"10.1007\/s42000-023-00437-7"},{"key":"42","doi-asserted-by":"crossref","unstructured":"42 Schott M, Eckstein A, Willenberg HS, Nguyen TB, Morgenthaler NG, et al. (2007) Improved prediction of relapse of Graves\u2019 thyrotoxicosis by combined determination of TSH receptor and thyroperoxidase antibodies. Horm Metab Res 39: 56\u201361.","DOI":"10.1055\/s-2007-957347"},{"key":"43","doi-asserted-by":"crossref","unstructured":"43 Khamisi S, Lundqvist M, Emadi P, Almby K, Ljunggren \u00d6, et al. (2021) Serum thyroglobulin is associated with orbitopathy in Graves\u2019 disease. J Endocrinol Invest 44: 1905\u20131911.","DOI":"10.1007\/s40618-021-01505-8"},{"key":"44","doi-asserted-by":"crossref","unstructured":"44 Shanmuganathan T, Girgis C, Lahooti H, Champion B, Wall JR (2015) Does autoimmunity against thyroglobulin play a role in the pathogenesis of Graves\u2019 ophthalmopathy: a review. Clin Ophthalmol 9: 2271\u20132276.","DOI":"10.2147\/OPTH.S88444"},{"key":"45","doi-asserted-by":"crossref","unstructured":"45 Zawadzka-Starczewska K, Stasiak B, Wojciechowska-Durczy\u0144ska K, Lewi\u0144ski A, Stasiak M (2022) Novel insight into non-genetic risk factors of Graves\u2019 orbitopathy. Int J Environ Res Public Health 19: 16941.","DOI":"10.3390\/ijerph192416941"},{"key":"46","doi-asserted-by":"crossref","unstructured":"46 Watanabe N, Yoshimura Noh J, Kozaki A, Yoshimura R, Yoshihara A, et al. (2023) Incidence and risk factors for Graves\u2019 orbitopathy in patients who underwent anti-inflammatory and immunosuppressive treatment during medical treatment for Graves\u2019 disease: investigation of 1,553 cases with newly diagnosed Graves\u2019 disease and proposal of a predictive score. Endocr J 70: 1087\u20131096.","DOI":"10.1507\/endocrj.EJ23-0079"},{"key":"47","doi-asserted-by":"crossref","unstructured":"47 Constantinescu SM, Hospel J, Daumerie C, Alexopoulou O, Maiter D, et al. (2023) Significance of thyroperoxidase and thyroglobulin antibodies in medically treated Graves\u2019 disease. Eur Thyroid J 12: e230193.","DOI":"10.1530\/ETJ-23-0193"},{"key":"48","doi-asserted-by":"crossref","unstructured":"48 Eckstein AK, Plicht M, Lax H, Hirche H, Quadbeck B, et al. (2004) Clinical results of anti-inflammatory therapy in Graves\u2019 ophthalmopathy and association with thyroidal autoantibodies. Clin Endocrinol (Oxf) 61: 612\u2013618.","DOI":"10.1111\/j.1365-2265.2004.02143.x"}],"container-title":["Endocrine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/endocrj\/73\/3\/73_EJ25-0334\/_pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T03:50:44Z","timestamp":1772855444000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/endocrj\/73\/3\/73_EJ25-0334\/_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":48,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1507\/endocrj.ej25-0334","relation":{},"ISSN":["0918-8959","1348-4540"],"issn-type":[{"value":"0918-8959","type":"print"},{"value":"1348-4540","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"EJ25-0334"}}