Study concept and design: Blum, Bauer, Westendorp, Khaw, Langhammer, Ferrucci, Gussekloo, Rodondi.
Acquisition, analysis, or interpretation of data: Blum, Bauer, Collet, Fink, Cappola, de Costa, Wirth, Peeters, Åsvold, Elzen, Luben, Imaizumi, Bremner, Gogakos, Eastell, Kearney, Strotmeyer, Wallace, Hoff, Ceresini, Rivadeneira, Uitterlinden, Stott, Westendorp, Khaw, Langhammer, Ferrucci, Gussekloo, Williams, Walsh, Jüni, Aujesky, Rodondi.
Drafting of the manuscript: Blum, Rodondi.
Critical revision of the manuscript for important intellectual content: Blum, Bauer, Collet, Fink, Cappola, de Costa, Wirth, Peeters, Åsvold, Elzen, Luben, Imaizumi, Bremner, Gogakos, Eastell, Kearney, Strotmeyer, Wallace, Hoff, Ceresini, Rivadeneira, Uitterlinden, Stott, Westendorp, Khaw, Langhammer, Ferrucci, Gussekloo, Williams, Walsh, Jüni, Aujesky.
Statistical analysis: Blum, de Costa, Gogakos, Jüni, Rodondi.
Obtained funding: Peeters, Ceresini, Uitterlinden, Stott, Westendorp, Khaw, Gussekloo, Williams, Walsh, Rodondi.
Administrative, technical, or material support: Blum, Peeters, Elzen, Luben, Kearney, Wallace, Uitterlinden, Khaw, Langhammer, Gussekloo, Aujesky, Rodondi.
Study supervision: Bauer, Hoff, Rivadeneira, Uitterlinden, Westendorp, Ferrucci, Jüni, Rodondi.
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Collet reports receipt of grants from the Swiss National Science Foundation during the conduct of the study. Dr Peeters reports receipt of personal fees from Genzyme B.V. outside of the submitted work. Dr Eastell reports receipt of grants from Amgen, AstraZeneca, Immunodiagnostic Systems, Canadian Institutes of Health Research, National Osteoporosis Society, Arthritis Research United Kingdom/Medical Research Council Centre of Excellence in Musculoskeletal Ageing Research, National Institute for Health Research, Cancer Research UK, and Medical Research Council/AstraZeneca Mechanisms of Disease Call during the conduct of the study; and personal fees from Novartis, Roche, Alexion, Otsuka, Teijan Pharma Limited, Institute of Biomedical Science, Merck, Amgen, Eli Lilly, Foundation for the National Institutes of Health (NIH), Endocrine Society, Johnson & Johnson, SPD Development, Fonterra Brands, Janssen Research, Ono Pharma, Immunodiagnostic Systems, Alere (Unipath), Chronos, GlaxoSmithKline Nutrition, Radius Health, European Calcified Tissue Society, Efficacy and Mechanism Evaluation Board of the Medical Research Council, and the International Osteoporosis Foundation Committee of Scientific Advisors, all outside of the submitted work. Dr Strotmeyer reports receipt of grants from the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR), and the University of Pittsburgh Claude D. Pepper Older Americans Independence Center during the conduct of the study, all outside of the submitted work. Dr Rodondi reports receipt of funding for a randomized controlled trial on subclinical hypothyroidism (TRUST trial) from the European Commission FP7-HEALTH-2011, Specific Programme “Cooperation” – Theme “Health” Investigator-driven clinical trials for therapeutic interventions in elderly populations (proposal: 278148-2). No other conflicts were reported.
Funding/Support: This project was supported by grants from the Swiss National Science Foundation (SNSF 320030-138267 and 320030-150025) and partially supported by a grant from the Swiss Heart Foundation (Dr Rodondi). The Cardiovascular Health Study was supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) (HHSN268201200036C, HHSN268200800007C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086; and grant U01HL080295) with an additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by the NIA (R01AG023629). The thyroid measurements in the Cardiovascular Health Study were supported by an American Heart Association Grant-in-Aid (Dr Fried). The Health, Aging, and Body Composition Study was supported by the NIA (contract numbers: N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106; and grant R01-AG028050); and an NINR grant (R01-NR012459). The NIA funded the Health, Aging, and Body Composition Study, reviewed the manuscript, and approved its publication. This research was supported in part by the NIA. The EPIC (European Prospective Investigation of Cancer)-Norfolk Study was supported by research grants from the Medical Research Council UK and Cancer Research UK. The Osteoporotic Fractures in Men (MrOS) Study is supported by NIH funding. The following institutes provided support: the NIA, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and NIH Roadmap for Medical Research (grant numbers: U01AG027810, U01AG042124, U01AG042139, U01AG042140, U01AG042143, U01AG042145, U01AG042168, U01AR066160, and UL1TR000128). The Nord-Trøndelag Health Study (HUNT Study) is a collaborative effort of the Faculty of Medicine, Norwegian University of Science and Technology; the Norwegian Institute of Public Health; and the Nord-Trøndelag County Council. Thyroid function testing in the HUNT Study was financially supported by Wallac Oy (Turku, Finland). The Leiden 85-plus Study was partly funded by the Dutch Ministry of Health, Welfare and Sports. The original PROSPER study was supported by an unrestricted, investigator-initiated grant from Bristol-Myers Squibb. The Rotterdam Study is funded by Erasmus MC and Erasmus University, Rotterdam, the Netherlands; the Netherlands Organisation for Scientific Research (NWO); the Netherlands Organisation for the Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE); the Ministry of Education, Culture and Science; the Dutch Ministry for Health, Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam. The original OPUS study was supported by sanofi-aventis, Eli Lilly, Novartis, Pfizer, Procter & Gamble Pharmaceuticals, and Roche. Dr Westendorp is supported by the Netherlands Organization for Scientific Research (NGI/NWO 911-03-016). Dr Collet reports receipt of research support from grants from the Swiss National Science Foundation and the Swiss Foundation for Grants in Biology and Medicine (PBLAP3-145870, P3SMP3-155318).
Role of the Funder/Sponsor: None of the sponsors had any role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication; except: (1) The NIA, which funded the Health, Aging, and Body Composition Study, reviewed the manuscript and approved its publication; (2) the Cardiovascular Health Study, which reviewed this manuscript for scientific content and consistency of data interpretation with previous Cardiovascular Health Study publications; and (3) the Radiation Effects Research Foundation, which funded the Nagasaki Adult Health Study and reviewed the manuscript and approved its publication.
Participating Studies of the Thyroid Studies Collaboration: United States: Cardiovascular Health Study; Health, Aging, and Body Composition Study; and the Osteoporotic Fractures in Men (MrOS) Study. United Kingdom: EPIC-Norfolk Study; and the Sheffield Study. United Kingdom/France/Germany: Osteoporosis and Ultrasound Study (OPUS). Norway: Nord-Trøndelag Health Study (HUNT Study). the Netherlands: Leiden 85-Plus Study; and the Rotterdam Study. the Netherlands/Ireland/Scotland: PROSPER Study. Italy: Invecchiare in Chianti (InCHIANTI) Study. Australia: Busselton Health Study. Japan: Nagasaki Adult Health Study.
Group Information: A full list of principal Cardiovascular Health Study investigators and institutions can be found at CHS-NHLBI.org. The HUNT Research Centre and the Department for Research and Development at Nord-Trøndelag Hospital Trust provided the data for the HUNT Study. The OPUS study was designed and conducted by David M. Reid, MD, FRCPEdin, FRCPLon, Division of Applied Medicine, University of Aberdeen, United Kingdom; Claus C. Glüer, PhD, Universitätsklinikum Schleswig-Holstein, Kiel, Germany; Dieter Felsenberg, MD, PhD, Free University of Berlin, Germany; Christian Roux, MD, PhD, Paris Descartes University, France; and Richard Eastell and Graham R. Williams.
Disclaimer: Dr Cappola, a JAMA Associate Editor, was not involved in the review of or decision to publish this work.
Additional Contributions: The contribution of inhabitants, general practitioners, and pharmacists of the Ommoord district to the Rotterdam Study is gratefully acknowledged.