SynthesisThe lancet. Diabetes & endocrinology2023
The optimal healthy ranges of thyroid function defined by the risk of cardiovascular disease and mortality: systematic review and individual participant data meta-analysis.
Open access · greenAbstract readSystematic ReviewMeta-Analysis
In one paragraph
Synthesis in The lancet. Diabetes & endocrinology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 2 pooled it
10.7field-weighted citation impact, top 1% of its field
What it found
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The trial behind it
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Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Thyroid antibody status, thyroid function, and the risk of coronary heart disease and stroke: an individual participant data analysis from 14 cohorts.European journal of endocrinology · 2025Pooled it
- Defining Gestational Thyroid Dysfunction Through Modified Nonpregnancy Reference Intervals: An Individual Participant Meta-analysis.The Journal of clinical endocrinology and metabolism · 2024Pooled it
- Association between central thyroid hormone dysregulation and chronic kidney disease in type 2 diabetes: a cross-sectional study.Renal failure · 2026Article
- Endocrine-Metabolic Crosstalk Between Diabetes Mellitus and Hypothyroidism: From Network Mechanisms to Translational Stratification.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2026Review
- Baseline TSH within reference range and incident thyroid dysfunction in cancer patients: a retrospective cohort study.Hormones (Athens, Greece) · 2026Article
- Super-Resolution 3D Imaging Reveals Disarray of Dyadic Calcium Ion Channels in Failing Hearts Expressing Low Thyroid Hormone Function.International journal of molecular sciences · 2026Article
- Thyroid function tests and resting heart rate in Graves' disease: a prospective longitudinal study.Endocrine connections · 2026Article
- Natural history of thyroid function in ageing: an individual participant data analysis of 137 488 participants from 31 prospective cohort studies.The lancet. Diabetes & endocrinology · 2026Article
- Thyroid hormone therapy in a population cohort over two decades indicates persistent overtreatment.European thyroid journal · 2026Article
- Hypothyroidism, atherosclerosis and cardiovascular risk prevention.Nature reviews. Endocrinology · 2026Review
- Old and new pituitary biomarkers: evidence for sex-specificity.Pituitary · 2026Review
- Associations of Multimarkers of Metabolic Malnutrition and Inflammation With All-Cause Mortality and Their Interplay With Thyroid Function.Endocrinology, diabetes & metabolism · 2026Article
- Cardiovascular Risk Determinants in Euthyroid Patients with Obesity: The Strange Case of TSH in Primary Prevention.Journal of clinical medicine · 2026Article
- Association between impaired peripheral thyroid hormone sensitivity and coronary heart disease in type 2 diabetes: the potential mediating role of albumin.Frontiers in endocrinology · 2026Article
- Genetics of Thyroid Function: Relevance for Biology and Disease Management.The Journal of clinical endocrinology and metabolism · 2025Review
- Thyroid dysfunction in ageing populations.Endocrine connections · 2025Review
- Hyperthyroidism with reference to elevated serum FT3 and FT4 levels in patients with ischemic stroke.Biomedical reports · 2025Article
- Lower Thyroid Function and Higher Plasma Choline: Effect Modification by Metabolic Dysfunction-Associated Steatotic Liver Disease.International journal of molecular sciences · 2025Article
- Article
- Thyroid Disorders and Their Impact on Metabolic Syndrome and Cardiovascular Risk: A Narrative Review.Cureus · 2025Review
Corrections and comments
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Authors and funding
50 authors at 20 institutions in 14 countries.
Yanning XuDepartment of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
Arash DerakhshanDepartment of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands.
Ola HysajInstitute of Primary Health Care, University of Bern, Bern, Switzerland.
Lea WildisenInstitute of Primary Health Care, University of Bern, Bern, Switzerland.
Till IttermannInstitute for Community Medicine, Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research, Partner site Greifswald, Greifswald, Germany.
Alessandro PingitoreNational Research Council Institute of Clinical Physiology, Pisa, Italy.
Nazanin AbolhassaniInstitute of Primary Health Care, University of Bern, Bern, Switzerland.
Marco MediciDepartment of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands.
Lambertus A L M KiemeneyRadboud University Medical Center, Radboud Institute for Health Sciences, Department for Health Evidence, Nijmegen, Netherlands.
Niels P RiksenDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands.
Robin P F DullaartDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Stella TrompetDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, the Netherlands.
Marcus DörrGerman Centre for Cardiovascular Research, Partner site Greifswald, Greifswald, Germany; Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.
Suzanne J BrownDepartment of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
Börge SchmidtInstitute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Dagmar Führer-SakelDepartment of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Mark P J VanderpumpThe Physicians' Clinic, London, England, UK.
Axel MuendleinVorarlberg Institute for Vascular Investigation and Treatment, Feldkirch, Austria.
Heinz DrexelVorarlberg Institute for Vascular Investigation and Treatment, Feldkirch, Austria; Private University of the Principality of Liechtenstein, Triesen, Liechtenstein; Drexel University College of Medicine, Philadelphia, PA, USA.
Howard A FinkGeriatric Research Education and Clinical Center, VA Healthcare System, Minneapolis, MN, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
M Kamran IkramDepartment of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Neurology, Erasmus University Medical Center, Rotterdam, Netherlands.
Maryam KavousiDepartment of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
Connie M RheeHarold Simmons Center for Chronic Disease Research and Epidemiology, University of California Irvine School of Medicine, Orange, CA, USA.
Isabela M BensenorDepartment of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil.
Fereidoun AziziEndocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Graeme J HankeyThe University of Western Australia, Perth, WA, Australia; Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.
Massimo IacovielloCardiology Unit, Cardiothoracic Department, University Polyclinic Hospital of Bari, Bari, Italy.
Misa ImaizumiDepartment of Clinical Studies, Radiation Effects Research Foundation, Nagasaki, Japan.
Graziano CeresiniDepartment of Medicine and Surgery, Unit of Internal Medicine and Onco-Endocrinology, University Hospital of Parma, Parma, Italy.
Luigi FerrucciLongitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA.
José A SgarbiDivision of Endocrinology and Metabolism, Faculdade de Medicina de Marília, Marília, Brazil.
Douglas C BauerDepartments of Medicine, Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
Nick WarehamMedical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK.
Kristien BoelaertInstitute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Stephan J L BakkerDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
J Wouter JukemaDepartment of Cardiology, Leiden University Medical Center, the Netherlands; Netherlands Heart Institute, Utrecht, Netherlands.
Bert VaesDepartment of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium.
Giorgio IervasiNational Research Council Institute of Clinical Physiology, Pisa, Italy.
Bu B YeapThe University of Western Australia, Perth, WA, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia.
Rudi G J WestendorpDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.
Tim I M KorevaarDepartment of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands.
Henry VölzkeInstitute for Community Medicine, Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research, Partner site Greifswald, Greifswald, Germany.
Salman RazviTranslational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Jacobijn GusseklooDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, the Netherlands; Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands.
John P WalshDepartment of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; The University of Western Australia, Perth, WA, Australia.
Anne R CappolaDivision of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Nicolas RodondiInstitute of Primary Health Care, University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, University of Bern, Switzerland.
Robin P PeetersDepartment of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands.
Layal ChakerDepartment of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands. Electronic address: l.chaker@erasmusmc.nl.
Thyroid Studies Collaboration
Erasmus MC · NLUniversity of Bern · CHLeiden University Medical Center · NLRadboud University Nijmegen · NLThe University of Western Australia · AUUniversitätsmedizin Greifswald · DEIstituto di Fisiologia Clinica · ITUniversity Medical Center Groningen · NLUniversity of Duisburg-Essen · DEFaculdade de Medicina de Marília · BRKU Leuven · BENational Institute on Aging · USNewcastle University · GBPrivate University in the Principality of Liechtenstein · LIRadiation Effects Research Foundation · JPResearch Institute for Endocrine Sciences · IRSir Charles Gairdner Hospital · AUUniversidade de São Paulo · BRUniversity of Birmingham · GBUniversity of California, Irvine · US
Funding
Oregon Clinical and Translational Research Institute - The National COVID Cohort Collaborative (N3C)UL1TR002369 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI Cynthia D Morris, Christopher G. Slatore · 2017 to 2026
$78.4MLong term fracture risk and change in peripheral bone in the oldest old men: The MrOS studyR01AG066671 · NIA · CALIFORNIA PACIFIC MED CTR RES INSTITUTE · PI BOUXSEIN, MARY L, CAWTHON, PEGGY MANNEN · 2020 to 2024
$13.3MExceptional Survival: Trajectories to Functional Aging (CHS All Stars)R01AG023629 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NEWMAN, ANNE B. · 2004 to 2016
$9.5MOsteoporotic Fractures in Men (MrOS) - San Francisco Coordinating CenterU01AR066160 · NIAMS · CALIFORNIA PACIFIC MED CTR RES INSTITUTE · PI CUMMINGS, STEVEN RON · 2013 to 2017
$9.3MCARDIOVASCULAR HEALTH STUDY (CHS) - TASK AREA C, STUDY CLOSEOUT75N92021D00006 · NHLBI · UNIVERSITY OF WASHINGTON · PI PSATY, BRUCE · 2021 to 2024
$8.4MCHS research resources for the cardiovascular health of older adultsU01HL130114 · NHLBI · UNIVERSITY OF WASHINGTON · PI BURKE, GREGORY L, KRONMAL, RICHARD A · 2016 to 2019
$6.6MOsteoporotic Fractures in Men (MrOS) - MinneapolisU01AG042145 · NIA · UNIVERSITY OF MINNESOTA · PI ENSRUD, KRISTINE · 2013 to 2019
$5.3MOsteporotic Fractures in Men (MrOS)- Admin CenterU01AG027810 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 2006 to 2017
$5.1MCHS Events Follow-up StudyU01HL080295 · NHLBI · UNIVERSITY OF WASHINGTON · PI PSATY, BRUCE M · 2005 to 2008
$4.6MOxidative stress and the pathogenesis of sarcopenia and disability in older womenR01AG027012 · NIA · JOHNS HOPKINS UNIVERSITY · PI SEMBA, RICHARD D · 2005 to 2018
$3.6MPeripheral Nerve Function Decline in an Aged CohortR01AG028050 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI STROTMEYER, ELSA S. · 2007 to 2015
$3.5MOsteoporotic Fractures in Men (MrOS) - PortlandU01AG042124 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 2013 to 2019
$3.0MIntramural NIH HHS Z99 AG999999Medical Research Council MC_UU_00006/1NCATS NIH HHS UL1 TR002369NHLBI NIH HHS 75N92021D00006NHLBI NIH HHS HHSN268200800007CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS HHSN268201800001CNHLBI NIH HHS N01 HC055222NHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085080NHLBI NIH HHS N01 HC085081NHLBI NIH HHS N01 HC085082NHLBI NIH HHS N01 HC085083NHLBI NIH HHS N01 HC085086NHLBI NIH HHS U01 HL080295NHLBI NIH HHS U01 HL130114NIAMS NIH HHS U01 AR066160NIA NIH HHS K24 AG042765NIA NIH HHS R01 AG023629NIA NIH HHS R01 AG027012NIA NIH HHS R01 AG028050NIA NIH HHS R01 AG032317NIA NIH HHS R01 AG066671NIA NIH HHS U01 AG027810NIA NIH HHS U01 AG042124NIA NIH HHS U01 AG042139NIA NIH HHS U01 AG042140NIA NIH HHS U01 AG042143NIA NIH HHS U01 AG042145NIA NIH HHS U01 AG042168NINR NIH HHS R01 NR012459
Abstract
backgroundReference intervals of thyroid-stimulating hormone (TSH) and free thyroxine (FT
methodsThis systematic review and individual participant data (IPD) meta-analysis identified eligible prospective cohorts through the Thyroid Studies Collaboration, supplemented with a systematic search via Embase, MEDLINE (Ovid), Web of science, the Cochrane Central Register of Controlled Trials, and Google Scholar from Jan 1, 2011, to Feb 12, 2017 with an updated search to Oct 13, 2022 (cohorts found in the second search were not included in the IPD). We included cohorts that collected TSH or FT
findingsWe identified 3935 studies, of which 53 cohorts fulfilled the inclusion criteria and 26 cohorts agreed to participate. We included IPD on 134 346 participants with a median age of 59 years (range 18-106) at baseline. There was a J-shaped association of FT
interpretationThere was a J-shaped association of FT
fundingNone.
Indexed as
Cardiovascular DiseasesThyroid GlandAdolescentAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedPregnancyProspective StudiesThyroid Function TestsThyrotropinThyroxineYoung AdultThyrotropinThyroxine
Identifiers
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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.