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De Rycke O, Védie AL, Guarneri G, Nin F, De Flori C, Hentic O, Idri S, Sauvanet A, Rebours V, Cros J, Couvelard A, Ruszniewski P, de Mestier L. O-positive blood type is associated with prolonged recurrence-free survival following curative resection of pancreatic neuroendocrine tumors. Pancreatology 2020; 20:1718-1722. [PMID: 33032924 DOI: 10.1016/j.pan.2020.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 09/11/2020] [Accepted: 09/19/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The ABO blood group may influence the development and progression of cancer. In particular, the prognosis of patients with blood type O is better for pancreatic adenocarcinoma, although this has not been extensively explored in pancreatic neuroendocrine tumors (PanNET). OBJECTIVE To assess the influence of the ABO and Rhesus blood types on the risk of recurrence in patients who underwent curative intent PanNET surgical resection. METHODS All consecutive patients operated on for well-differentiated panNET in an expert center from 2003 to 2018 were retrospectively included. Blood group, Rhesus system, demographic and clinical data were collected. The primary endpoint was recurrence free survival (RFS). Factors associated with RFS were explored using Cox proportional hazard models. RESULTS Overall, 300 patients (male 43%) were included, median age 54 years old (IQR 45-64). The ABO blood group distribution was similar to that of the French population. There was no association between blood group and tumor features. The median postoperative follow-up was 43.9 months (17.0-77.8). The 5- and 10-year RFS rates were 85 ± 4% and 71 ± 13% in O RhD + patients, versus 72 ± 4% and 63 ± 6% otherwise, respectively (p = 0.035). The O RhD + blood group was associated with a decreased risk of recurrence (HR 0.34, 95% CI [0.15-0.75]), p = 0.007 in multivariable analysis adjusted for age, ki67, functioning syndrome, resection margins, tumor size, lymph node status, oncogenetic syndrome. CONCLUSIONS After curative-intent surgical resection for PanNET, patients with a non-O RhD + blood group may have an increased risk of recurrence and could benefit from closer follow-up.
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Affiliation(s)
- Ophélie De Rycke
- Department of Gastroenterology and Pancreatology, ENETS Centre of Excellence, Beaujon University Hospital (APHP), Clichy, France; Université de Paris, France; INSERM U1149, Centre de Recherche sur l'Inflammation, Paris, France
| | - Anne-Laure Védie
- Department of Gastroenterology and Pancreatology, ENETS Centre of Excellence, Beaujon University Hospital (APHP), Clichy, France; Université de Paris, France
| | - Giovanni Guarneri
- Department of Hepato-Bilio-Pancreatic Surgery, ENETS Centre of Excellence, Beaujon University Hospital (APHP), Clichy, France
| | - Frédéric Nin
- Établissement Français du Sang Ile de France, Beaujon University Hospital (APHP), Clichy, France
| | - Céline De Flori
- INSERM U1149, Centre de Recherche sur l'Inflammation, Paris, France
| | - Olivia Hentic
- Department of Gastroenterology and Pancreatology, ENETS Centre of Excellence, Beaujon University Hospital (APHP), Clichy, France
| | - Salim Idri
- Établissement Français du Sang Ile de France, Beaujon University Hospital (APHP), Clichy, France
| | - Alain Sauvanet
- Université de Paris, France; INSERM U1149, Centre de Recherche sur l'Inflammation, Paris, France; Department of Hepato-Bilio-Pancreatic Surgery, ENETS Centre of Excellence, Beaujon University Hospital (APHP), Clichy, France
| | - Vinciane Rebours
- Department of Gastroenterology and Pancreatology, ENETS Centre of Excellence, Beaujon University Hospital (APHP), Clichy, France; Université de Paris, France; INSERM U1149, Centre de Recherche sur l'Inflammation, Paris, France
| | - Jérôme Cros
- Université de Paris, France; INSERM U1149, Centre de Recherche sur l'Inflammation, Paris, France; Department of Pathology, ENETS Centre of Excellence, Bichat/Beaujon University Hospital (APHP), Paris/Clichy, France
| | - Anne Couvelard
- Université de Paris, France; INSERM U1149, Centre de Recherche sur l'Inflammation, Paris, France; Department of Pathology, ENETS Centre of Excellence, Bichat/Beaujon University Hospital (APHP), Paris/Clichy, France
| | - Philippe Ruszniewski
- Department of Gastroenterology and Pancreatology, ENETS Centre of Excellence, Beaujon University Hospital (APHP), Clichy, France; Université de Paris, France; INSERM U1149, Centre de Recherche sur l'Inflammation, Paris, France
| | - Louis de Mestier
- Department of Gastroenterology and Pancreatology, ENETS Centre of Excellence, Beaujon University Hospital (APHP), Clichy, France; Université de Paris, France; INSERM U1149, Centre de Recherche sur l'Inflammation, Paris, France.
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Nell S, van Leeuwaarde RS, Pieterman CRC, de Laat JM, Hermus AR, Dekkers OM, de Herder WW, van der Horst-Schrivers AN, Drent ML, Bisschop PH, Havekes B, Borel Rinkes IHM, Vriens MR, Valk GD. No Association of Blood Type O With Neuroendocrine Tumors in Multiple Endocrine Neoplasia Type 1. J Clin Endocrinol Metab 2015; 100:3850-5. [PMID: 26247473 DOI: 10.1210/jc.2015-2615] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT An association between ABO blood type and the development of cancer, in particular, pancreatic cancer, has been reported in the literature. An association between blood type O and neuroendocrine tumors in multiple endocrine neoplasia type 1 (MEN1) patients was recently suggested. Therefore, blood type O was proposed as an additional factor to personalize screening criteria for neuroendocrine tumors in MEN1 patients. OBJECTIVE The aim of this study was to assess the association between blood type O and the occurrence of neuroendocrine tumors in the national Dutch MEN1 cohort. DESIGN This is a cohort study using the Dutch National MEN1 database, which includes more than 90% of the Dutch MEN1 population. Demographic and clinical data were analyzed by blood type. Chi-square tests and Fisher exact tests were used to determine the association between blood type O and occurrence of neuroendocrine tumors. A cumulative incidence analysis (Gray's test) was performed to assess the equality of cumulative incidence of neuroendocrine tumors in blood type groups, taking death into account as a competing risk. RESULTS The ABO blood type of 200 of 322 MEN1 patients was known. Demographic and clinical characteristics were similar among blood type O and non-O type cohorts. The occurrence of neuroendocrine tumors of the lung, thymus, pancreas, and gastrointestinal tract was equally distributed across the blood type O and non-O type cohorts (Grays's test for equality; P = 0.72). Furthermore, we found no association between blood type O and the occurrence of metastatic disease or survival. CONCLUSIONS An association between blood type O and the occurrence of neuroendocrine tumors in MEN1 patients was not confirmed. For this reason, the addition of the blood type to screening and surveillance practice seems not to be of additional value for identifying MEN1 patients at risk for the development of neuroendocrine tumors, metastatic disease, or a shortened survival.
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Affiliation(s)
- Sjoerd Nell
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Rachel S van Leeuwaarde
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Carolina R C Pieterman
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Joanne M de Laat
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Ad R Hermus
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Olaf M Dekkers
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Wouter W de Herder
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Anouk N van der Horst-Schrivers
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Madeleine L Drent
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Peter H Bisschop
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Bas Havekes
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Inne H M Borel Rinkes
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Menno R Vriens
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Gerlof D Valk
- Department of Endocrine Surgical Oncology (S.N., I.H.M.B.R., M.R.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrine Oncology (R.S.v.L., C.R.C.P., J.M.d.L., G.D.V.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; Department of Endocrinology (A.R.H.), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; Departments of Endocrinology and Metabolism and Clinical Epidemiology (O.M.D.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands, and Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus, Denmark; Department of Internal Medicine (W.W.d.H.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands; Department of Endocrinology (A.N.v.d.H.-S.), University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; Department of Internal Medicine (M.L.D.), Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands; Department of Endocrinology and Metabolism (P.H.B.), Academic Medical Center, 1100 DD Amsterdam, The Netherlands; and Department of Internal Medicine, Division of Endocrinology (B.H.), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
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