Although in nonexposed populations autoimmune thyroid diseases or elevated thyroid antibody levels have been associated with higher risk of progression to overt hypothyroidism (Col et al. 2004; Kaplowitz 2010; Vanderpump 2011), the Ukrainian study also found a stronger dose–response relationship between hypothyroidism and 131I thyroid dose among ATPO-negative compared with ATPO-positive individuals (p for homogeneity < 0.001) (Ostroumova et al. 2009). This evidence concerns the gene ATP5PO and autoimmune thyroid disease.