title: Increased depression, diabetes and diabetic complications in Graves' disease patients in Asia.
abstract: BACKGROUND
  This study aimed to evaluate the risk of depression and other cardiovascular comorbidities in Graves' disease (GD) patients in Asia.
  
  
  METHODS
  The study patients were all newly diagnosed with GD [International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) 242.0] from January 1998 to December 2008. Patients aged <20 years or those with preexisting mental disorder (ICD-9-CM 290-319) were excluded from analyses. Control patients were randomly selected for the non-GD cohort, 1:4 frequency matched to the GD cohort according to sex, age and index year. The same exclusion criteria applied to the GD cohort were applied to the non-GD cohort. The GD cohort contained 4195 patients and the non-GD cohort contained 16 780 patients.
  
  
  RESULTS
  The GD patients were more likely to have diabetes (8.03% vs. 4.48%, P < 0.0001), hypertension (18.1% vs. 13.5%, P < 0.0001), hyperlipidemia (11.9% vs. 9.09%, P < 0.0001) and coronary artery disease (10.3% vs. 5.86%, P < 0.0001) than the control patients were. The GD patients were also associated with significantly higher risk of depression than the control patients were (hazard ratio = 1.69, 95% confidence interval = 1.45-1.96).
  
  
  CONCLUSIONS
  GD and GD treatment are associated with increased risk of depression diabetes and diabetic complications in Asian patients.
authors.affiliation: From the Institute of Medicine, Chung Shan Medical University, Taichung, Division of Metabolism & Endocrinology, Changhua Christian Hospital, Changhua, Nantou Christian Hospital, Nantou, Asia University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan From the Institute of Medicine, Chung Shan Medical University, Taichung, Division of Metabolism & Endocrinology, Changhua Christian Hospital, Changhua, Nantou Christian Hospital, Nantou, Asia University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan From the Institute of Medicine, Chung Shan Medical University, Taichung, Division of Metabolism & Endocrinology, Changhua Christian Hospital, Changhua, Nantou Christian Hospital, Nantou, Asia University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: H-H
authors.initials: HH
authors.lastname: Chen
authors.affiliation: From the Institute of Medicine, Chung Shan Medical University, Taichung, Division of Metabolism & Endocrinology, Changhua Christian Hospital, Changhua, Nantou Christian Hospital, Nantou, Asia University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan From the Institute of Medicine, Chung Shan Medical University, Taichung, Division of Metabolism & Endocrinology, Changhua Christian Hospital, Changhua, Nantou Christian Hospital, Nantou, Asia University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: S-Y
authors.initials: SY
authors.lastname: Yeh
authors.affiliation: From the Institute of Medicine, Chung Shan Medical University, Taichung, Division of Metabolism & Endocrinology, Changhua Christian Hospital, Changhua, Nantou Christian Hospital, Nantou, Asia University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: C-L
authors.initials: CL
authors.lastname: Lin
authors.affiliation: From the Institute of Medicine, Chung Shan Medical University, Taichung, Division of Metabolism & Endocrinology, Changhua Christian Hospital, Changhua, Nantou Christian Hospital, Nantou, Asia University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: S-N
authors.initials: SN
authors.lastname: Chang
authors.affiliation: From the Institute of Medicine, Chung Shan Medical University, Taichung, Division of Metabolism & Endocrinology, Changhua Christian Hospital, Changhua, Nantou Christian Hospital, Nantou, Asia University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan From the Institute of Medicine, Chung Shan Medical University, Taichung, Division of Metabolism & Endocrinology, Changhua Christian Hospital, Changhua, Nantou Christian Hospital, Nantou, Asia University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan d10040@mail.cmuh.org.tw.
authors.forename: C-H
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D013956:Antithyroid Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D048909:Diabetes Complications / Q000453:epidemiology / Q000209:etiology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D013956:Antithyroid Agents; D011433:Propranolol