title: [Influence of selected endogenous and environmental factors on the course and complications of Grave's disease].
abstract: Graves' disease (GD) is an autoimmune thyroid disease with complex and not fully established etiology. It occurs when environmental factors influence people genetically prone to this illness. The aim of this study was to determine the impact of selected factors (endogenous and environmental) on the course and complications of disease in patients with recurrent GD.
  
  
  METHODS
  Two hundred and four patients with relapsed GD, treated in the Clinical Department of Endocrinology in University Hospital in Cracow in years 2004-2006 and then in 2011 were retrospectively analyzed. Patients who agreed to participate in the study were sent questionnaire to complete. Demographic and clinical data were collected and entered into a database. Patient data included: gender, place of living, lifestyle (smoking), family history of autoimmune diseases, the course of the disease, its symptoms and the treatment strategy. Furthermore the medical documentation was analyzed. Descriptive statistical analyses were made.
  
  
  RESULTS
  The study showed a significant difference in the frequency of appearance of ophthalmopathy between men and women (80% and 37.14%, respectively, p = 0.041), between smokers and nonsmokers (61.9% and 21.05%, respectively, p = 0.022) and between the age of patients with positive and negative family history of autoimmune diseases (37.6 years and 50.5 years respectively, p = 0.002).
  
  
  CONCLUSIONS
  1. Male gender is a risk factor for ophthalmopathy in GD. 2. Cigarette smoking affects the risk of Graves' ophthalmopathy. 3. A positive family history of thyroid diseases and/or autoimmune diseases promotes the development of GD at a younger age.
authors.forename: Anna
authors.initials: A
authors.lastname: Kurzynska
authors.forename: Elwira
authors.initials: E
authors.lastname: Przybylik-Mazurek
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Węgrzynowicz
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Morzywołek
authors.forename: Agata
authors.initials: A
authors.lastname: Wieczorek
authors.forename: Maja
authors.initials: M
authors.lastname: Żarnowska
authors.forename: Alicja
authors.initials: A
authors.lastname: Hubalewska-Dydejczyk
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D001327:Autoimmune Diseases / Q000453:epidemiology; D015984:Causality; D015897:Comorbidity; D005260:Female; D020022:Genetic Predisposition to Disease; D006111:Graves Disease / Q000453:epidemiology* / Q000235:genetics*; D049970:Graves Ophthalmopathy / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland; D011159:Population Surveillance; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013959:Thyroid Diseases / Q000453:epidemiology