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Maja Hjelm Lundgaard Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Allan Carlé Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Ulla Birgitte Christiansen Department of Gynaecology and Obstetrics, Aalborg University Hospital, Aalborg, Denmark

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Anne Sørensen Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Gynaecology and Obstetrics, Aalborg University Hospital, Aalborg, Denmark

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Søren Risom Kristensen Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Stine Linding Andersen Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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biochemical evaluation with the measurement of thyroid-stimulating hormone (TSH). Results revealed an elevated plasma level of TSH (>100 mIU/L). Simultaneous measurements of total thyroxine (T4) as well as total triiodothyronine (T3) showed that the plasma

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Stine Linding Andersen Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Niels Henrik Bruun Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark

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Peter Astrup Christensen Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Simon Lykkeboe Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Aase Handberg Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Annebirthe Bo Hansen Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Maja Hjelm Lundgaard Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Louise Knøsgaard Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Nanna Maria Uldall Torp Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Allan Carlé Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Jesper Karmisholt Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Inge Bülow Pedersen Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Peter Vestergaard Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark

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Stig Andersen Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Geriatrics, Aalborg University Hospital, Aalborg, Denmark

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Kristensen SR Bülow Pedersen I Vestergaard P . Pregnancy week-specific reference ranges for thyrotropin and free thyroxine in the North Denmark region pregnancy cohort . Thyroid 2019 29 430 – 438 . ( https://doi.org/10.1089/thy.2018.0628 ) 15

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Zhongli Chen Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus University Medical Center Rotterdam, The Netherlands

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Robin P Peeters Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus University Medical Center Rotterdam, The Netherlands

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Wesley Flach Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus University Medical Center Rotterdam, The Netherlands

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Linda J de Rooij Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus University Medical Center Rotterdam, The Netherlands

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Sena Yildiz Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus University Medical Center Rotterdam, The Netherlands

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Alexander Teumer Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany

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Matthias Nauck DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany

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Rosalie B T M Sterenborg Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus University Medical Center Rotterdam, The Netherlands
Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands

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Joost H W Rutten Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands

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Marco Medici Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus University Medical Center Rotterdam, The Netherlands
Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands

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W Edward Visser Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus University Medical Center Rotterdam, The Netherlands

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Marcel E Meima Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus University Medical Center Rotterdam, The Netherlands

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Reagents Nonradioactive 3,3’-diiodothyronine (3,3’-T2), 3,3’,5’-triiodothyronine (rT3), 3,3’,5-triiodothyronine (T3) and thyroxine (T4) were purchased from Sigma-Aldrich (Zwijndrecht, the Netherlands). [ 125 I]-3,3’-T2, [ 125 I]-rT3, [ 125 I]-T3, [ 125 I

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Tetsuya Hiraiwa Hiraiwa Thyroid Clinic, Ibaraki City
Department of Internal Medicine (I), Osaka Medical College, Takatsuki City

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Naoyuki Tsujimoto Department of Internal Medicine (I), Osaka Medical College, Takatsuki City

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Keiji Tanimoto Department of Internal Medicine (I), Osaka Medical College, Takatsuki City

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Jungo Terasaki Department of Internal Medicine (I), Osaka Medical College, Takatsuki City

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Nobuyuki Amino Kuma Hospital, Kobe, Japan

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Toshiaki Hanafusa Department of Internal Medicine (I), Osaka Medical College, Takatsuki City

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laboratory tests showing high values of free thyroxine (FT 4 ) and free tri-iodothyronine (FT 3 ), low levels of thyrotropin-stimulating hormone (TSH), increased TSH receptor antibody (TRAb) titer and/or thyroid-associated ophthalmopathy. PT was diagnosed by

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Shinsuke Shinkai Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan

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Kenji Ohba Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
Medical Education Center, Hamamatsu University School of Medicine, Shizuoka, Japan

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Kennichi Kakudo Department of Pathology and Thyroid Disease Center, Izumi City General Hospital, Osaka, Japan

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Takayuki Iwaki Department of Pharmacology, Hamamatsu University School of Medicine, Shizuoka, Japan

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Yoshihiro Mimura Department of Internal Medicine, American Hospital of Paris, Neuilly sur Seine, France

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Akio Matsushita Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan

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Go Kuroda Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan

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Yuki Sakai Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan

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Nobuhiko Nishino Department of Surgery, Maruyama Hospital, Shizuoka, Japan

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Kazuo Umemura Medical Education Center, Hamamatsu University School of Medicine, Shizuoka, Japan
Department of Pharmacology, Hamamatsu University School of Medicine, Shizuoka, Japan

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Takafumi Suda Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan

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Shigekazu Sasaki Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan

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of 0.01 mIU/L (reference range: 0.05–5.00), a free thyroxine level of 23.2 pmol/L (reference range: 11.6–21.9), and a free tri-iodothyronine level of 6.6 pmol/L (reference range: 3.5–6.2) as measured by ECLusys (Roche Diagnostics K.K., Tokyo, Japan

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Petros Perros Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, UK

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, Prange AJ Jr: Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism. N Engl J Med 1999;340:424–429. 3 Saravanan P, Chau WF, Roberts N, Vedhara K, Greenwood R, Dayan CM: Psychological well-being in

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David J. Stott University of Glasgow, Glasgow, UK

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Douglas C. Bauer University of California, San Francisco, Calif., USA

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Ian Ford University of Glasgow, Glasgow, UK

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Patricia Kearney University College of Cork, Cork, Ireland

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Jacobijn Gussekloo Leiden University Medical Centre, Leiden

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Terence J. Quinn University of Glasgow, Glasgow, UK

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Nicolas Rodondi Inselspital, Bern University Hospital, Bern, Switzerland

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Jan Smit Radboud University Medical Centre, Nijmegen, The Netherlands

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Rudi Westerdorp Leyden Academy on Vitality and Ageing, Leiden

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useful background and guidance, we suggest that the approach recommended there carries potential risks, with the likely outcome of an increase in the proportion of ‘younger' elderly patients treated for SCH and the withholding of thyroxine treatment in

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John H. Lazarus Centre for Endocrine and Diabetes Sciences, Cardiff School of Medicine, Cardiff

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Jonathan P. Bestwick Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, London, UK

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Nicholas J. Wald Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, London, UK

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statistically significant (p = 0.81). For both subgroups (high TSH and low FT4) the power was >90%. (3) We mentioned the possibility that thyroxine therapy was started too late in pregnancy, but a trend analysis on starting thyroxine treatment from 8 to 15

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Jeanette Carlqvist J Carlqvist, Department of Radiology, University of Gothenburg Institute of Clinical Sciences, Goteborg, Sweden

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Ulf Nyman U Nyman, Division of Medical Radiology, Lund University Department of Translational Medicine, Malmo, Sweden

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John Brandberg J Brandberg, Department of Radiology, University of Gothenburg Institute of Clinical Sciences, Goteborg, Sweden

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Helena Filipsson Nyström H Nyström, Department of Endocrinology, Sahlgrenska University Hospital, Goteborg, Sweden

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Mikael Hellström M Hellström, Department of Radiology, University of Gothenburg Institute of Clinical Sciences, Goteborg, Sweden

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Objectives: When exposed to iodine contrast medium (ICM), thyroid dysfunction may develop, due to excess amounts of iodide. The incidence of contrast-induced thyroid dysfunction has been difficult to interpret, because of the observational and retrospective designs of most previous studies. With the Swedish CArdioPulmonary bioImage Study (SCAPIS), where randomly selected individuals aged 50–65 years, underwent contrast-enhanced coronary CT angiography (CCTA), we were able to prospectively assess the incidence, magnitude and clinical impact of contrast-induced thyroid dysfunction.

Methods: In 422 individuals, thyroid hormone levels were analysed before and 4–12 weeks after CCTA. Thyroid-related patient-reported outcome questionnaires (ThyPRO) at the time of pre and post CCTA blood samplings were provided by 368 of those individuals. Thyroid peroxidase antibodies (TPOab) were analysed and ultrasound of the thyroid gland was performed to detect any thyroid nodules.

Results: There was a small statistically significant effect on thyroid hormone levels but no cases of overt hypo- or hyperthyroidism after ICM. Subclinical hypo- or hyperthyroidism or isolated low/high levels of free thyroxine (fT4) developed in 3.5% of the population with normal hormone levels pre-CCTA, but without any increased thyroid-related symptoms compared to the remaining cohort. Elevated TPOab and being born outside Sweden were risk factors of developing subclinical hypothyroidism. Presence of thyroid nodules was not associated with ICM-induced thyroid dysfunction.

Conclusion: The results of this prospective study support the notion that in iodine-sufficient countries, ICM associated thyroid dysfunction is rare, usually mild, self-limiting and oligo/asymptomatic in subjects aged 50–65 years.

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Linda M. Thienpont Mass Spectrometry Reference Laboratory, Laboratory for Analytical Chemistry, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium

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James D. Faix Clinical Chemistry and Immunology, Montefiore Medical Center, New York, N.Y., USA
Department of Pathology, Albert Einstein School of Medicine, New York, N.Y., USA

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Graham Beastall International Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy

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HA, Ronin C, Rottmann M, Thijssen JH, Toussaint B; International Federation of Clinical Chemistry and Laboratory Medicine (IFCC), Scientific Division Working Group for Standardization of Thyroid Function Tests (WG-STFT): Measurement of free thyroxine

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