title: Graves' ophthalmopathy in relation to cigarette smoking and ethnic origin.
abstract: OBJECTIVE
  We aimed to study the effect of cigarette smoking on the prevalence and severity of Graves' ophthalmopathy (GO).
  
  
  METHODS
  One hundred and fifty-five newly diagnosed patients with Graves' disease (GD) were diagnosed clinically and by routine biochemical methods. Twenty-five per cent (39) were of Asian origin.
  
  
  METHODS
  Eye signs were classified according to the American Thyroid Association Classification. A detailed smoking questionnaire and data from hospital notes were used to calculate an index of cigarette consumption.
  
  
  RESULTS
  Thirty-four per cent of all patients had Graves' ophthalmopathy, and the prevalence in males (26%) and females (36%) did not differ significantly. There was a prevalence of 42% among Europeans compared to 7.7% in Asians (P = 0.0002). The overall risk for Europeans for developing Graves' ophthalmopathy was 6.4 (1.78-22.7 confidence interval) times higher than for Asians. Corrected for the ethnic factor the increased risk from smoking for Europeans was 2.4 (1.12-5.18, 95% confidence interval) times higher. There was a significant dose effect (P = 0.008).
  
  
  CONCLUSIONS
  The present findings confirm an effect of cigarette smoking on Graves' ophthalmopathy and in addition show that Europeans have a substantially greater risk of developing Graves' ophthalmopathy than have Asians.
authors.affiliation: Medical Research Council, Northwick Park Hospital, Harrow, Middlesex, UK.
authors.forename: M
authors.initials: M
authors.lastname: Tellez
authors.forename: J
authors.initials: J
authors.lastname: Cooper
authors.forename: C
authors.initials: C
authors.lastname: Edmonds
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia / Q000208:ethnology; D002648:Child; D005260:Female; D006111:Graves Disease / Q000453:epidemiology* / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D006113:United Kingdom / Q000453:epidemiology