Background/Objectives: The aim of this study was to investigate whether there are relationships between obesity-related factors including body mass index (BMI), diabetes or prediabetes, hyperlipidemia, fasting plasma glucose, fasting plasma insulin, homeostasis model assessment-estimated insulin resistance (HOMA-IR), and high sensitive C-reactive protein (hs-CRP) and Graves’ orbitopathy (GO).

Subjects/Methods: Eighty-four patients with Graves’ disease (GD) (42 without GO and 42 with GO) were enrolled in this Cross-sectional cohort study. Sex, age, GD treatment history, height, body weight, waist circumference, smoking status, co-morbidities, and levels of free thyroxin, thyroid-stimulating hormone, thyroid-stimulating hormone receptor (TSHR) antibodies, fasting plasma glucose and insulin, and hs-CRP were recorded. Eye condition was evaluated using the NOSPECS classification and clinical activity score.

Results: BMI, fasting plasma insulin, and HOMA-IR were associated with the presence of GO after adjusting for age, sex, smoking, TSHR antibodies, and steroid usage (adjusted odd’s ratio〔OR〕1.182, 95% confidence interval (95% CI), 1.003-1.393, p=0.046; adjusted OR 1.165, 95% CI, 1.001-1.355, p=0.048; and adjusted OR 1.985, 95% CI, 1.046-3.764, p=0.036, respectively). In addition, BMI, fasting plasma glucose, fasting plasma insulin, HOMA-IR, and hs-CRP levels were positively correlated with the severity of GO (Spearman’s rho=0.285, p=0.009; Spearman’s rho=0.298, p=0.006; Spearman’s rho=0.243, p=0.026; Spearman’s rho=0.270, p=0.013; and Spearman’s rho=0.299, p=0.006, respectively).

Conclusion: The findings of this study suggest that obesity and obesity-related factors, and especially fasting plasma insulin and HOMA-IR are related to GO.

Eighty-four patients with Graves’ disease (GD) (42 without GO and 42 with GO) were enrolled in this Cross-sectional cohort study. Sex, age, GD treatment history, height, body weight, waist circumference, smoking status, co-morbidities, and levels of free thyroxin, thyroid-stimulating hormone, thyroid-stimulating hormone receptor (TSHR) antibodies, fasting plasma glucose and insulin, and hs-CRP were recorded. Eye condition was evaluated using the NOSPECS classification and clinical activity score.

BMI: body mass index

central obesity: 0= no, 1=yes

treatment period of GD(Graves' disease): years

DM(diabetes mellitus)+preDM: 0= no, 1=yes

H/T(hypertension): 0= no, 1=yes

TSH R Ab(thyroid-stimulating hormone receptor antibodies):%

thyroid-stimulating hormone receptor: mg/dL

insulin:uIU/mL

HOMA-IR(homeostasis model assessment-estimated insulin resistance)

hs-CRP(high sensitive C-reactive protein)

CAS(clinical activity score)

GO(Graves' ophthalmopathy)