Graves Disease Is Associated With Endometriosis: A 3-Year Population-Based Cross-Sectional Study

Abstract

The aim of this cross-sectional study was to compare the prevalence of thyroid diseases between women with and without endometriosis.We established the endometriosis group according to diagnosis codes, surgery codes, and gonadotropin-releasing hormone agonist codes using the Korean Health Insurance Review and Assessment Service-National Inpatients Sample (HIRA-NIS) from 2009 to 2011. Four controls were randomly matched to each endometriosis case. Thyroid disease cases were selected using the thyroid disease diagnosis code (E0X).Among the 1,843,451 women sampled, 5615 had endometriosis; 22,460 controls were matched to the endometriosis cases. After adjustment for age and sampling year, Graves disease was associated with endometriosis (odds ratio [OR]: 2.52; 95% CI: 1.30-4.88; P < 0.01), while hypothyroidism was not (OR: 1.17; 95% CI: 0.90-1.52; P = 0.25). Autoimmune hypothyroidism was also not associated with endometriosis (OR: 1.61; 95% CI: 0.88-2.94; P = 0.12).This study revealed an association between Graves disease and endometriosis.

FIGURE 1

Flow chart representing the selection procedure based on the HIRA sample from 2009 to 2011. ^aSurgery codes: R4122, R4160, R4165, R4166, R4170, R4181, R4182, R4183, R4331, R4332, R4341, R4342, R4345, R4421, R4430, and R4435. ^bGnRH agonist codes: 182602BIJ, 182604BIJ, 244902BIJ, 167202BIJ, 167201BIJ, 198501CSI, 140301ACH, and 140302ACH. GnRH = gonadotropin-releasing hormone, HIRA = Health Insurance Review and Assessment Service.