TPO and hypothyroidism: Currently, there is a lack of effective tools and risk stratification criteria for identifying individuals at risk of its progression to either overt or subclinical hypothyroidism.<h4>Objective</h4>To investigate the independent risk factors for future onset of hypothyroidism and determine an optimal anti-thyroid peroxidase antibody (TPOAb) cutoff for identifying high-risk individuals.<h4>Methods</h4>A multicenter retrospective cohort study was conducted.