Triglycerides as a predictor of activity and severity in thyroid eye disease: a multicentre study

Background This study investigated the association between dyslipidaemia and thyroid eye disease (TED) activity and severity using a multicentre dataset from South Korea. Methods A retrospective, multicentre study included adult patients (aged ≥19 years) with TED and elevated thyroid autoantibody levels, including thyroid-stimulating immunoglobulin >140%and thyroid-stimulating hormone-binding inhibitory immunoglobulin >1.5IU/L. Patients previously treated with systemic steroids were excluded. TED activity was defined by a Clinical Activity Score, and severity was categorised as mild or marked based on the NOSPECS classification. Logistic regression analyses identified associations between lipid profiles and TED activity/severity. Subgroup analysis excluded statin users. Receiver operating characteristic curves determined optimal triglyceride (TG) cut-off values. Results Of 330 patients (71.2%women; mean age, 45.7±13.2 years), elevated TG levels were independently associated with TED activity (OR=1.005, 95%CI 1.001 to 1.008, p=0.011) and severity (OR=1.004, 95%CI 1.001 to 1.007, p=0.014). Optimal TG cut-off values were 104mg/dL for active TED and 108mg/dL for marked severity. These associations remained consistent in non-statin users with similar cut-off values. Elevated intraocular pressure and smoking were significantly associated with increased disease severity. Subgroup analysis excluding statin users revealed significant associations of total cholesterol and low-density lipoprotein cholesterol with TED activity. Conclusions Elevated TG levels are significantly associated with TED activity and severity, highlighting the potential clinical value of measuring TG for risk stratification and disease management. Further studies should explore whether TG-lowering interventions improve TED outcomes.