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Heleen I Jansen Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands

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Marijn M Bult Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands

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Peter H Bisschop Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam, The Netherlands

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Anita Boelen Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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Annemieke C Heijboer Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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Jacquelien J Hillebrand Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam UMC location University of Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam, The Netherlands

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the measurement of serum thyroid-stimulating hormone (TSH) concentration, possibly followed up with serum free thyroxine (fT4) concentration when TSH is above or below the reference interval. Once a thyroid disorder is diagnosed and treatment is

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Beibei Zhu School of Public Health, Anhui Medical University, Hefei, Anhui, China
Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China

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Yan Han School of Public Health, Anhui Medical University, Hefei, Anhui, China
Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China

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Fen Deng School of Public Health, Anhui Medical University, Hefei, Anhui, China
Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China

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Kun Huang School of Public Health, Anhui Medical University, Hefei, Anhui, China
Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China

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Shuangqin Yan Ma’anshan Maternal and Child Health Care Center, Ma’anshan, Anhui, China

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Jiahu Hao School of Public Health, Anhui Medical University, Hefei, Anhui, China
Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China

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Peng Zhu School of Public Health, Anhui Medical University, Hefei, Anhui, China
Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China

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Fangbiao Tao School of Public Health, Anhui Medical University, Hefei, Anhui, China
Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China

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glucose abnormality have been well established. However, previous studies mainly focused on thyroid-stimulating hormone (TSH), fT4 and T4. T3 has long been overlooked, even though T3 plays a significant role in glucose regulation ( 11 ). In recent years, T

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Till Ittermann Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

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Rehman Mehmood Khattak Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
Department of Zoology, Islamia College Peshawar (CU), Peshawar, Pakistan

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Marcello R P Markus Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany

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Jens-Peter Kühn Institute of Radiology, University Hospital, Carl-Gustav-Carus University, Dresden, Germany

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Marie-Luise Kromrey Department of Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany

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Giovanni Targher Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy

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Antje Steveling Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany

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

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Henry Völzke Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

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association was observed in another meta-analysis ( 2 ). Furthermore, some population-based studies showed an inverse association between serum free thyroxine (fT4) levels and NAFLD ( 4 , 5 ). However, in only one of these studies, a positive association of

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M von Wolff Division of Gynaecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Bern University Hospital, University of Bern, Bern, Switzerland

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C T Nakas University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
Laboratory of Biometry, University of Thessaly, Volos, Greece

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M Tobler Division of Gynaecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Bern University Hospital, University of Bern, Bern, Switzerland
Division of Pneumology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

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T M Merz Division of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

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M P Hilty Intensive Care Unit, University Hospital, Zurich, Switzerland

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J D Veldhuis Endocrine Research Unit, Department of Internal Medicine, Mayo School of Graduate Medical Education, Centre for Translational Science Activities, Mayo Clinic, Rochester, New York, USA

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A R Huber Centre for Laboratory Medicine, Cantonal Hospital, Aarau, Switzerland

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J Pichler Hefti Division of Pneumology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

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−80°C thereafter. Cortisol, prolactin, thyroid-stimulating hormone (TSH), free tetraiodothyronine (fT4), free triiodothyronine (fT3), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and total testosterone (testosterone) were analysed

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Laura van Iersel Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands

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Sarah C Clement Department of Pediatrics, Amsterdam University Medical Center, location VU University Medical Center, Amsterdam, The Netherlands

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Antoinette Y N Schouten-van Meeteren Department of Pediatric Oncology, Emma Children’s Hospital, Amsterdam University Medical Center, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

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Annemieke M Boot Department of Pediatric Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

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Hedi L Claahsen-van der Grinten Department of Pediatric Endocrinology, Amalia Children’s Hospital, Radboud University Medical Center, Nijmegen, The Netherlands

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Bernd Granzen Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands

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K Sen Han Department of Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands

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Geert O Janssens Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands

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Erna M Michiels Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands

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A S Paul van Trotsenburg Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Center, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

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W Peter Vandertop Neurosurgical Center Amsterdam, Amsterdam University Medical Center, location Academic Medical Center, University of Amsterdam and location VU University Medical Center, Amsterdam, The Netherlands

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Dannis G van Vuurden Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
Department of Pediatric Oncology/Hematology, Amsterdam University Medical Center, location VU University Medical Center, Amsterdam, The Netherlands

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Hubert N Caron Department of Pediatric Oncology, Emma Children’s Hospital, Amsterdam University Medical Center, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

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Leontien C M Kremer Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
Department of Pediatrics, Emma Children’s Hospital, Amsterdam University Medical Center, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

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Hanneke M van Santen Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands

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-dose cRT, with a prevalence ranging between 2.6 and 14.9% ( 4 ). Detection of central hypothyroidism may be challenging ( 5 ). Its diagnosis is generally based on plasma free thyroxine (FT4) concentrations below those of the reference range, in

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Qiankai Jin Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Guoqing Huang Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Xiaoqing Tian Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Yimeng Shu Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Ximisinuer Tusongtuoheti Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
School of Medicine, Ningbo University, Ningbo, China

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Yushan Mao Department of Endocrinology, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China

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between THs and MetS in the euthyroid population is still controversial. A survey of 20,053 euthyroid Korean adults found that neither serum thyroid stimulating hormone (TSH) nor free thyroxine (FT4) was significantly associated with MetS ( 6 ). Mehran et

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Nannan Bian Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Xiaomeng Sun Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Biao Zhou Departments of General Surgery and Obesity and Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China

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Lin Zhang Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Qiu Wang Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Yu An Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Xiaohui Li Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Yinhui Li Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Jia Liu Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Hua Meng Departments of General Surgery and Obesity and Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China

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Guang Wang Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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obese individuals after bariatric surgery ( 11 ). However, to our knowledge, there have been no studies on the association between thyroid function (TSH, FT3, free thyroxine (FT4) and FT3/FT4) and adipo-IR. Our study investigated the relationship between

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Leqi He Department of Clinical Laboratory Medicine, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Xiaoying Li Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Zaoping Chen Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Wei Wang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Kai Wang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Xinmei Huang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Qian Yang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Wencai Ke Department of Clinical Laboratory Medicine, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Jun Liu Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Bingbing Zha Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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secretion ( 3 , 4 ). Therefore, with the increase of hCG in early pregnancy, free thyroxine (FT4) also shows an increasing trend. Conversely, compared with normal pregnant women, FT4 decreased by 13% in the second trimester of pregnancy, while hCG level was

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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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Louise Knøsgaard Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, 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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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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Denmark Region, as previously described in detail ( 5 , 6 ). In 2017–2018, the samples were used for measurement of maternal thyroid-stimulating hormone (TSH), free T4 (fT4), free T3 (fT3), total T4 (TT4), total T3 (TT3), and T-uptake on a Cobas 8000

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Qian Yang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Wencai Ke Department of Clinical Laboratory Medicine, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China

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Fanfan Pan Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Xinmei Huang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Jun Liu Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Bingbing Zha Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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(free thyroxine (FT4), thyrotropin (TSH), TPO antibodies (TPOAb), TG antibodies (TGAb), and thyrotropin receptor antibodies (TRAb)), and RAIU (3 h RAIU and 24 h RAIU). A flowchart of the study is shown in Fig. 1 . Patients were excluded from the study

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