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Author Asvold, B.O.; Vatten, L.J.; Midthjell, K.; Bjoro, T. url  doi
  Title Serum TSH within the reference range as a predictor of future hypothyroidism and hyperthyroidism: 11-year follow-up of the HUNT Study in Norway Type Journal Article
  Year 2012 Publication The Journal of Clinical Endocrinology and Metabolism Abbreviated Journal J Clin Endocrinol Metab  
  Volume 97 Issue 1 Pages 93-99  
  Keywords Asymptomatic Diseases; Cohort Studies; Diagnostic Techniques, Endocrine/*standards; Female; Follow-Up Studies; Humans; Hyperthyroidism/blood/*diagnosis/etiology; Hypothyroidism/blood/*diagnosis/etiology; Male; Middle Aged; Norway; Prognosis; Reference Values; Risk Factors; Thyrotropin/*blood; Time Factors  
  Abstract CONTEXT: Serum TSH in the upper part of the reference range may sometimes be a response to autoimmune thyroiditis in early stage and may therefore predict future hypothyroidism. Conversely, relatively low serum TSH could predict future hyperthyroidism. OBJECTIVE: The objective of the study was to assess TSH within the reference range and subsequent risk of hypothyroidism and hyperthyroidism. DESIGN AND SETTING: This was a prospective population-based study with linkage to the Norwegian Prescription Database. SUBJECTS: A total of 10,083 women and 5,023 men without previous thyroid disease who had a baseline TSH of 0.20-4.5 mU/liter and who participated at a follow-up examination 11 yr later. MAIN OUTCOME MEASURES: Predicted probabilities of developing hypothyroidism or hyperthyroidism during follow-up, by categories of baseline TSH, were estimated. RESULTS: During 11 yr of follow-up, 3.5% of women and 1.3% of men developed hypothyroidism, and 1.1% of women and 0.6% of men developed hyperthyroidism. In both sexes, the baseline TSH was positively associated with the risk of subsequent hypothyroidism. The risk increased gradually from TSH of 0.50-1.4 mU/liter [women, 1.1%, 95% confidence interval (CI) 0.8-1.4; men, 0.3%, 95% CI 0.1-0.6] to a TSH of 4.0-4.5 mU/liter (women, 31.5%, 95% CI 24.6-39.3; men, 14.7%, 95% CI 7.7-26.2). The risk of hyperthyroidism was higher in women with a baseline TSH of 0.20-0.49 mU/liter (3.9%, 95% CI 1.8-8.4) than in women with a TSH of 0.50-0.99 mU/liter (1.4%, 95% CI 0.9-2.1) or higher ( approximately 1.0%). CONCLUSION: TSH within the reference range is positively and strongly associated with the risk of future hypothyroidism. TSH at the lower limit of the reference range may be associated with an increased risk of hyperthyroidism.  
  Address Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Postboks 8905 MTFS, N-7491 Trondheim, Norway. bjorn.o.asvold@ntnu.no  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0021-972X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:22049180 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1507  
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Author Gabin, J.M.; Tambs, K.; Saltvedt, I.; Sund, E.; Holmen, J. url  doi
  Title Association between blood pressure and Alzheimer disease measured up to 27 years prior to diagnosis: the HUNT Study Type Journal Article
  Year 2017 Publication Alzheimer's Research & Therapy Abbreviated Journal Alzheimers Res Ther  
  Volume 9 Issue 1 Pages 37  
  Keywords Age Distribution; Aged; Aged, 80 and over; Alzheimer Disease/*diagnosis/*epidemiology; Asymptomatic Diseases/*epidemiology; Blood Pressure Determination/statistics & numerical data; Comorbidity; Dementia/diagnosis/epidemiology; Disease Progression; Female; Humans; Hypertension/*diagnostic imaging/*epidemiology; Incidence; Longitudinal Studies; Male; Middle Aged; Norway/epidemiology; Prevalence; Reproducibility of Results; Risk Factors; Sensitivity and Specificity; Sex Distribution; Alzheimer disease; Blood pressure; Epidemiology; Prospective case cohort; Risk factors; Vascular dementia  
  Abstract BACKGROUND: A lot of attention has been paid to the relationship of blood pressure and dementia because epidemiological research has reported conflicting evidence. Observational data has shown that midlife hypertension is a risk factor for cognitive decline and dementia later in life, whereas there is evidence that low blood pressure is predictive in later life. The aim of the present study was to examine the association between dementia and blood pressure measured up to 27 years (mean 17.6 years) prior to ascertainment. METHODS: In Nord-Trondelag County, Norway, incident dementia data were collected during 1995-2011, and the diagnoses were validated by a panel of experts in the field. By using the subjects' personal identification numbers, the dementia data were linked to data from the Nord-Trondelag Health Study (the HUNT Study), a large, population-based health study performed in 1984-1986 (HUNT 1) and 1995-1997 (HUNT 2). A total of 24,638 participants of the HUNT Study were included in the present study, 579 of whom were diagnosed with Alzheimer disease, mixed Alzheimer/vascular dementia, or vascular dementia. Multiple logistic regression analyses were conducted to analyze the association between dementia and blood pressure data from HUNT 1 and HUNT 2. RESULTS: Over the age of 60 years, consistent inverse associations were observed between systolic blood pressure and all-cause dementia, mixed Alzheimer/vascular dementia, and Alzheimer disease, but not with vascular dementia, when adjusting for age, sex, education, and other relevant covariates. This was observed for systolic blood pressure in both HUNT 1 and HUNT 2, regardless of antihypertensive medication use. There was an adverse association between systolic blood pressure, pulse pressure, and Alzheimer disease in individuals treated with antihypertensive medication under the age of 60 years. CONCLUSIONS: Our data are in line with those in previous studies demonstrating an inverse association between dementia and systolic blood pressure in individuals over the age of 60 years. We cannot exclude a survival effect, however. Among middle-aged subjects (<60 years), elevated systolic blood pressure and pulse pressure were associated with eventual Alzheimer disease in individuals who reported using antihypertensive medication.  
  Address HUNT Research Centre, Faculty of Medicine and Health Sciences , Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Forskningsveien 2, 7600, Levanger, Norway  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1758-9193 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28569205; PMCID:PMC5452294 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1900  
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