SynthesisFrontiers in endocrinology2026
Association between serum immunoglobulin G4 levels and Graves' ophthalmopathy: a meta-analysis.
Synthesis in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Graves' ophthalmopathy (GO) is a severe extrathyroidal manifestation of Graves' disease (GD) lacking simple and specific biomarkers. Immunoglobulin G4 (IgG4) has attracted increasing attention in autoimmune and fibrotic diseases. This study systematically evaluates the association of serum IgG4 levels with GO and clarifies the altered characteristics of serum IgG4 levels among GO individuals, as well as their association with GO risk and activity. Methods: Embase, Cochrane Library, PubMed, and Web of Science were searched from inception to December 2025. Two researchers independently performed literature screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Statistical analysis used Stata 18.0. Effect sizes were standardized mean difference (SMD) for continuous variables and odds ratio (OR) for dichotomous variables, both with 95% confidence intervals (CI). Either random- or fixed-effects models were applied based on heterogeneity (I² statistic). Sensitivity and subgroup analyses explored heterogeneity sources. Publication bias was evaluated via funnel plots and Egger's test using R. Results: Ten studies with 1, 221 subjects (patients with GO, those with GD without ophthalmopathy, and healthy controls) were included. Meta-analysis showed significantly elevated serum IgG4 levels in patients with GO, especially those with active GO, compared to healthy controls (SMD = 1.260, 95%CI:0.681-1.839) and GD patients without ophthalmopathy (SMD = 1.018, 95%CI:0.278-1.758). High IgG4 levels were associated with increased GO risk (OR = 2.808, 95%CI:1.150-6.859). Univariable analysis confirmed IgG4 as a potential risk factor for GO (ES = 4.735, 95%CI:1.582-14.171), but this association was not statistically significant in multivariable analysis after adjusting for confounders. Subgroup analyses showed higher serum IgG4 levels in active versus inactive GO (SMD = 0.911, 95%CI:0.363-1.460, p=0.001). Conclusion: Serum IgG4 levels are elevated in individuals with GO and closely associated with disease activity. High serum IgG4 levels represent a significant factor associated with increased GO risk. These findings suggest IgG4 may be involved in specific immunopathological processes underlying GO and could serve as a potential biomarker for auxiliary diagnosis, activity assessment, and risk identification. However, the influence of IgG4 on GO may be modulated by other factors, requiring further validation of its role as an independent risk factor. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251078723, identifier CRD420251078723.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.