title: Graves' hyperthyroidism and moderate alcohol consumption: evidence for disease prevention.
abstract: BACKGROUND
  We recently demonstrated that moderate alcohol consumption is associated with a considerable reduction in the risk of autoimmune hypothyroidism, similar to findings in other autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. We aimed to study a possible association between alcohol intake and autoimmune Graves' hyperthyroidism.
  
  
  METHODS
  This is a population-based, case-control study.
  
  
  METHODS
  In a well-defined Danish population (2,027,208 person-years of observation), we prospectively identified patients with new overt thyroid dysfunction and studied 272 patients with Graves' hyperthyroidism. For each patient, we recruited four age-gender-region-matched controls with normal thyroid function (n = 1088).
  
  
  METHODS
  Participants gave detailed information on current and previous alcohol intake as well as other factors to be used for analyses. The association between alcohol intake and development of hyperthyroidism was analysed in conditional multivariate Cox regression models.
  
  
  RESULTS
  Graves' patients had a lower reported alcohol consumption than controls (median units of alcohol (12 g) per week: 2 vs 4, P < 0·001). In a multivariate regression model, alcohol consumption was associated with a dose-dependent reduction in risk for development of overt Graves' hyperthyroidism. Odds ratios (95% confidence interval) compared with the reference group with a recent (last year) consumption of 1-2 units of alcohol per week were as follows: 0 units/week 1·73 (1·17-2·56), 3-10 units/week 0·56 (0·39-0·79), 11-20 units/week 0·37 (0·21-0·65), ≥21 units/week 0·22 (0·08-0·60). Similar results were found for maximum previous alcohol consumption during a calendar year. No interaction was found with the type of alcohol consumed (wine vs beer), smoking habit, age, gender or region of inhabitancy.
  
  
  CONCLUSIONS
  Moderate alcohol consumption is associated with a considerable reduction in the risk of Graves' disease with hyperthyroidism--irrespective of age and gender. Autoimmune thyroid disease seems to be much more dependent on environmental factors than hitherto anticipated.
authors.affiliation: Department of Endocrinology and Medicine, Aalborg Hospital, Aalborg, Denmark. carle@dadlnet.dk
authors.forename: Allan
authors.initials: A
authors.lastname: Carlé
authors.forename: Inge
authors.initials: I
authors.lastname: Bülow Pedersen
authors.forename: Nils
authors.initials: N
authors.lastname: Knudsen
authors.forename: Hans
authors.initials: H
authors.lastname: Perrild
authors.forename: Lars
authors.initials: L
authors.lastname: Ovesen
authors.forename: Lone Banke
authors.initials: LB
authors.lastname: Rasmussen
authors.forename: Torben
authors.initials: T
authors.lastname: Jørgensen
authors.forename: Peter
authors.initials: P
authors.lastname: Laurberg
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000503:physiopathology*; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D016022:Case-Control Studies; D003718:Denmark; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000503:physiopathology* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
chemical_list: D000891:Anti-Infective Agents, Local; D014284:Triiodothyronine; D000431:Ethanol; D013972:Thyrotropin; D013974:Thyroxine