Familial Risk of Graves Disease Among First-Degree Relatives and Interaction With Smoking: A Population-Based Study
Authors' conclusion
A gene-environment interaction can be suggested between smoking and GD-associated genetic factors, which diminishes after smoking cessation. Smokers with a positive family history should be considered a high-risk group and smoking cessation should be advised.
Study context
- Population
- Individuals with first-degree relatives (FDRs) in the National Health Insurance database
- Participants
- 5,524,403 individuals
- Exposure
- Individuals with vs without affected FDRs
- Outcome
- GD (familial risk)
Methodological detailsNational Health Insurance database
- National Health Insurance database
Main finding
As reported in the abstract
GD
Each group vs no affected FDRHazard ratio (95% CI)
Affected FDRs
3.39(3.30–3.48)
Affected twin
36.53(23.85–53.54)
Affected brother
5.26(4.89–5.66)
Affected sister
4.12(3.88–4.38)
Affected father
3.34(3.16–3.54)
Affected mother
2.63(2.53–2.74)
Observational data: associations, not effects.
Further findings
Graves disease (GD): interaction of family history and smoking (additive scale)
- Positive family history and smoking, HR
- 4.68
- RERI, smoking × family history
- 0.94 (95% CI, 0.74-1.19)
- Heavy smokers with positive family history: nearly 6-fold increased risk, higher than moderate smoking (dose-response interaction pattern)
GD: interaction of current or former smoking with family history
- RERI, current smoking × family history
- 0.52 (95% CI, 0.22-0.82)
- No significant interaction for former smoking
Original publication
Familial Risk of Graves Disease Among First-Degree Relatives and Interaction With Smoking: A Population-Based Study. J Clin Endocrinol Metab. Published 21 February 2023. doi:10.
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