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Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

The relationship of high sensitivity C-reactive protein to percent body fat mass, body mass index, waist-to-hip ratio, and waist circumference in a Taiwanese population

Authors: Cheng-Chieh Lin, Sharon LR Kardia, Chia-Ing Li, Chiu-Shong Liu, Ming-May Lai, Wen-Yuan Lin, Pei-Chia Chang, Yih-Dar Lee, Ching-Chu Chen, Chih-Hsueh Lin, Chuan-Wei Yang, Chih-Yi Hsiao, Walter Chen, Tsai-Chung Li

Published in: BMC Public Health | Issue 1/2010

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Abstract

Background

High-sensitivity C-reactive protein (hs-CRP) is an easily measured inflammatory biomarker. This study compared the association of percent body fat mass (%FM), body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with hs-CRP in a Taiwanese population.

Methods

A total of 1669 subjects aged 40-88 years were recruited in 2004 in a metropolitan city in Taiwan. The relationships between obesity indicators and a high level of hs-CRP were examined using multivariate logistic regression analysis. The upper quartile of the hs-CRP distributions was defined as the high category group. The areas under the curve (AUCs) of the receiver operating characteristic curves were calculated for all obesity indicators to compare their relative ability to correctly classify subjects with a high level of hs-CRP.

Results

After multivariate adjustment, the odds ratio for %FM was the only significant indicator that was associated with a high level of hs-CRP in men (1.55, 95% CI: 1.07-2.25). All indicators were associated with a high level of hs-CRP in women. In men, the AUCs for %FM were significantly higher than those for BMI, WHR, and WC, when demographic and lifestyle behaviors were considered (p < 0.001 for all comparisons), but they were not significantly different in females.

Conclusions

Our study demonstrates that %FM is the only obesity indicator that is strongly associated with a high level of hs-CRP after adjusting for sociodemographic factors, lifestyle behaviors and components of metabolic syndrome in both genders in a Taiwanese population aged forty years and over. In men, %FM had the greatest ability to classify subjects with a high level of hs-CRP when only demographic and lifestyle behaviors were considered. Our study finding has important implications for the screening of obesity in community settings.
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Literature
1.
go back to reference Kannel WB, D'Agostino RB, Cobb JL: Effect of weight on cardiovascular disease. Am J Clin Nutr. 1996, 63 (Suppl 4): 19-22. Kannel WB, D'Agostino RB, Cobb JL: Effect of weight on cardiovascular disease. Am J Clin Nutr. 1996, 63 (Suppl 4): 19-22.
2.
go back to reference Carroll KK: Obesity as a risk factor for certain types of cancer. Lipids. 1998, 33: 1055-1059. 10.1007/s11745-998-0305-8.CrossRefPubMed Carroll KK: Obesity as a risk factor for certain types of cancer. Lipids. 1998, 33: 1055-1059. 10.1007/s11745-998-0305-8.CrossRefPubMed
3.
go back to reference Alberti KG, Zimmet PZ: Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998, 15: 539-553. 10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S.CrossRefPubMed Alberti KG, Zimmet PZ: Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998, 15: 539-553. 10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S.CrossRefPubMed
4.
go back to reference WHO: Obesity: Preventing and managing the global epidemic. 1998, Geneva: WHO WHO: Obesity: Preventing and managing the global epidemic. 1998, Geneva: WHO
5.
go back to reference Kuczmarki RJ, Flegal KM, Campbell SM, Johnson CL: Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA. 1998, 22: 39-47. Kuczmarki RJ, Flegal KM, Campbell SM, Johnson CL: Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA. 1998, 22: 39-47.
6.
go back to reference Seidell JC, Verschu Ren WM, Van Leer EM, Kromhout D: Overweight, underweight, and mortality: a prospective study of 48,287 men and women. Arch Intern Med. 1996, 14: 1132-1143. Seidell JC, Verschu Ren WM, Van Leer EM, Kromhout D: Overweight, underweight, and mortality: a prospective study of 48,287 men and women. Arch Intern Med. 1996, 14: 1132-1143.
7.
go back to reference Chu NF: Prevalence of obesity in Taiwan. Obesity Reviews. 2005, 6: 271-274. 10.1111/j.1467-789X.2005.00175.x.CrossRefPubMed Chu NF: Prevalence of obesity in Taiwan. Obesity Reviews. 2005, 6: 271-274. 10.1111/j.1467-789X.2005.00175.x.CrossRefPubMed
8.
go back to reference Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH: The disease burden associated with overweight and obesity. JAMA. 1999, 282: 1523-1529. 10.1001/jama.282.16.1523.CrossRefPubMed Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH: The disease burden associated with overweight and obesity. JAMA. 1999, 282: 1523-1529. 10.1001/jama.282.16.1523.CrossRefPubMed
9.
go back to reference Kopelman PG: Obesity as a medical problem. Nature. 2000, 404: 635-643.PubMed Kopelman PG: Obesity as a medical problem. Nature. 2000, 404: 635-643.PubMed
10.
go back to reference Frohlich M, Imhof A, Berg G, Hutchinson WL, Pepys MB, Boeing H, Muche R, Brenner H, Koenig W: Association between C-reactive protein and features of the metabolic syndrome: a population-based study. Diabetes Care. 2000, 23: 1835-1839. 10.2337/diacare.23.12.1835.CrossRefPubMed Frohlich M, Imhof A, Berg G, Hutchinson WL, Pepys MB, Boeing H, Muche R, Brenner H, Koenig W: Association between C-reactive protein and features of the metabolic syndrome: a population-based study. Diabetes Care. 2000, 23: 1835-1839. 10.2337/diacare.23.12.1835.CrossRefPubMed
11.
go back to reference Hak AE, Stehouwer CD, Bots ML, Polderman KH, Schalkwijk CG, Westendorp IC, Hofman A, Witteman JC: Associations of C-reactive protein with measures of obesity, insulin resistance, and subclinical atherosclerosis in healthy, middle-aged women. Arterioscler Thromb Vasc Biol. 1999, 19: 1986-1991.CrossRefPubMed Hak AE, Stehouwer CD, Bots ML, Polderman KH, Schalkwijk CG, Westendorp IC, Hofman A, Witteman JC: Associations of C-reactive protein with measures of obesity, insulin resistance, and subclinical atherosclerosis in healthy, middle-aged women. Arterioscler Thromb Vasc Biol. 1999, 19: 1986-1991.CrossRefPubMed
12.
go back to reference Chambers JC, Eda S, Bassett P, Karim Y, Thompson SG, Gallimore JR, Pepys MB, Kooner JS: C-reactive protein, insulin resistance, central obesity, and coronary heart disease risk in Indian Asians from the United Kingdom compared with European whites. Circulation. 2001, 104: 145-150.CrossRefPubMed Chambers JC, Eda S, Bassett P, Karim Y, Thompson SG, Gallimore JR, Pepys MB, Kooner JS: C-reactive protein, insulin resistance, central obesity, and coronary heart disease risk in Indian Asians from the United Kingdom compared with European whites. Circulation. 2001, 104: 145-150.CrossRefPubMed
13.
go back to reference Mendall MA, Patel P, Ballam L, Strachan D, Northfield TC: C reactive protein and its relation to cardiovascular risk factors: a population based cross sectional study. BMJ. 1996, 312: 1061-1065.CrossRefPubMedPubMedCentral Mendall MA, Patel P, Ballam L, Strachan D, Northfield TC: C reactive protein and its relation to cardiovascular risk factors: a population based cross sectional study. BMJ. 1996, 312: 1061-1065.CrossRefPubMedPubMedCentral
14.
go back to reference Greenfield JR, Samaras K, Jenkins AB, Kelly PJ, Spector TD, Gallimore JR, Pepys MB, Campbell LV: Obesity is an important determinant of baseline serum C-reactive protein concentration in monozygotic twins, independent of genetic influences. Circulation. 2004, 109: 3022-3028. 10.1161/01.CIR.0000130640.77501.79.CrossRefPubMed Greenfield JR, Samaras K, Jenkins AB, Kelly PJ, Spector TD, Gallimore JR, Pepys MB, Campbell LV: Obesity is an important determinant of baseline serum C-reactive protein concentration in monozygotic twins, independent of genetic influences. Circulation. 2004, 109: 3022-3028. 10.1161/01.CIR.0000130640.77501.79.CrossRefPubMed
15.
go back to reference Thorand B, Baumert J, Doring A, Herder C, Kolb H, Rathmann W, Giani G, Koenig W: Sex differences in the relation of body composition to markers of inflammation. Atherosclerosis. 2006, 184: 216-224. 10.1016/j.atherosclerosis.2005.04.011.CrossRefPubMed Thorand B, Baumert J, Doring A, Herder C, Kolb H, Rathmann W, Giani G, Koenig W: Sex differences in the relation of body composition to markers of inflammation. Atherosclerosis. 2006, 184: 216-224. 10.1016/j.atherosclerosis.2005.04.011.CrossRefPubMed
16.
go back to reference Festa A, D'Agostino R, Williams K, Karter AJ, Mayer-Davis EJ, Tracy RP, Haffner SM: The relation of body fat mass and distribution to markers of chronic inflammation. International Journal of Obesity. 2001, 25: 1407-1415. 10.1038/sj.ijo.0801792.CrossRefPubMed Festa A, D'Agostino R, Williams K, Karter AJ, Mayer-Davis EJ, Tracy RP, Haffner SM: The relation of body fat mass and distribution to markers of chronic inflammation. International Journal of Obesity. 2001, 25: 1407-1415. 10.1038/sj.ijo.0801792.CrossRefPubMed
17.
go back to reference Deurenberg P, Van der Kooy K, Leenen R, Westrate JA, Seidell JC: Sex and age specific prediction formulas for estimating body composition from bioelectrical impedance: a cross validation study. Int J Obes. 1991, 15: 17-25.PubMed Deurenberg P, Van der Kooy K, Leenen R, Westrate JA, Seidell JC: Sex and age specific prediction formulas for estimating body composition from bioelectrical impedance: a cross validation study. Int J Obes. 1991, 15: 17-25.PubMed
18.
go back to reference Houtkooper BL, Lohman GT, Going BS, Howell HW: Why bioelectrical impedance analysis should be used for estimating adiposity. Am J Clin Nutr. 1996, 64 (suppl): 436S-448S.PubMed Houtkooper BL, Lohman GT, Going BS, Howell HW: Why bioelectrical impedance analysis should be used for estimating adiposity. Am J Clin Nutr. 1996, 64 (suppl): 436S-448S.PubMed
19.
go back to reference Roubenoff R: Applications of bioelectrical impedance analysis for body composition to epidemiologic studies. Am J Clin Nur. 1996, 64 (suppl): 459S-462S. Roubenoff R: Applications of bioelectrical impedance analysis for body composition to epidemiologic studies. Am J Clin Nur. 1996, 64 (suppl): 459S-462S.
20.
go back to reference Chang PC, Li TC, Wu MT, Liu CS, Li CI, Chen CC, Lin WY, Yang SY, Lin CC: Association between television viewing and the risk of metabolic syndrome in a community-based population. BMC Public Health. 2008, 8: 193-10.1186/1471-2458-8-193.CrossRefPubMedPubMedCentral Chang PC, Li TC, Wu MT, Liu CS, Li CI, Chen CC, Lin WY, Yang SY, Lin CC: Association between television viewing and the risk of metabolic syndrome in a community-based population. BMC Public Health. 2008, 8: 193-10.1186/1471-2458-8-193.CrossRefPubMedPubMedCentral
21.
go back to reference Lin WY, Liu CS, Li TC, Lin T, Chen W, Chen CC, Li CI, Lin CC: In addition to insulin resistance and obesity, hyperuricemia is strongly associated with metabolic syndrome using different definitions in Chinese populations: a population-based study (Taichung Community Health Study). Ann Rheum Dis. 2008, 67 (3): 432-433. 10.1136/ard.2007.073601.CrossRefPubMed Lin WY, Liu CS, Li TC, Lin T, Chen W, Chen CC, Li CI, Lin CC: In addition to insulin resistance and obesity, hyperuricemia is strongly associated with metabolic syndrome using different definitions in Chinese populations: a population-based study (Taichung Community Health Study). Ann Rheum Dis. 2008, 67 (3): 432-433. 10.1136/ard.2007.073601.CrossRefPubMed
22.
go back to reference Chen CC, Li TC, Chang PC, Liu CS, Lin WY, Wu MT, Li CI, Lai MM, Li CC: Association among cigarette smoking, metabolic syndrome and its individual components: the metabolic syndrome study in Taiwan. Metabolism. 2008, 57: 544-548. 10.1016/j.metabol.2007.11.018.CrossRefPubMed Chen CC, Li TC, Chang PC, Liu CS, Lin WY, Wu MT, Li CI, Lai MM, Li CC: Association among cigarette smoking, metabolic syndrome and its individual components: the metabolic syndrome study in Taiwan. Metabolism. 2008, 57: 544-548. 10.1016/j.metabol.2007.11.018.CrossRefPubMed
23.
go back to reference Chen CC, Li TC, Li CI, Liu CS, Lin WY, Wu MT, Lai MM, Lin CC: The relationship between visfatin levels and anthropometric and metabolic parameters: association with cholesterol levels in women. Metabolism. 2007, 56: 1216-1220. 10.1016/j.metabol.2007.04.018.CrossRefPubMed Chen CC, Li TC, Li CI, Liu CS, Lin WY, Wu MT, Lai MM, Lin CC: The relationship between visfatin levels and anthropometric and metabolic parameters: association with cholesterol levels in women. Metabolism. 2007, 56: 1216-1220. 10.1016/j.metabol.2007.04.018.CrossRefPubMed
24.
go back to reference Lin CC, Liu CS, Li TC, Chen CC, Li CI, Lin WY: Microalbuminuria and the metabolic syndrome and its components in the Chinese population. European Journal of Clinical Investigation. 2007, 37 (10): 783-790. 10.1111/j.1365-2362.2007.01865.x.CrossRefPubMed Lin CC, Liu CS, Li TC, Chen CC, Li CI, Lin WY: Microalbuminuria and the metabolic syndrome and its components in the Chinese population. European Journal of Clinical Investigation. 2007, 37 (10): 783-790. 10.1111/j.1365-2362.2007.01865.x.CrossRefPubMed
25.
go back to reference Lin CC, Liu CS, Lai MM, Li CI, Chen CC, Chang PC, Lin WY, Lee YD, Lin T, Li TC: Metabolic syndrome and its associated risk factors in a Taiwanese metropolitan adult population. BMC Public Health. 2007, 7 (1): 739-743. Lin CC, Liu CS, Lai MM, Li CI, Chen CC, Chang PC, Lin WY, Lee YD, Lin T, Li TC: Metabolic syndrome and its associated risk factors in a Taiwanese metropolitan adult population. BMC Public Health. 2007, 7 (1): 739-743.
26.
go back to reference Bell NA, McClure PD, Hill RJ, Davies PSW: Assessment of foot-to-foot bioelectrical impedance analysis for the prediction of total body water. Eur J Clin Nutr. 1998, 52: 856-859. 10.1038/sj.ejcn.1600661.CrossRefPubMed Bell NA, McClure PD, Hill RJ, Davies PSW: Assessment of foot-to-foot bioelectrical impedance analysis for the prediction of total body water. Eur J Clin Nutr. 1998, 52: 856-859. 10.1038/sj.ejcn.1600661.CrossRefPubMed
27.
go back to reference Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985, 28 (7): 412-419. 10.1007/BF00280883.CrossRefPubMed Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985, 28 (7): 412-419. 10.1007/BF00280883.CrossRefPubMed
28.
go back to reference Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F, American Heart Association; National Heart and Blood Institute: Diagnosis and management of the metabolic syndrome: an American heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005, 112 (17): 2735-2752. 10.1161/CIRCULATIONAHA.105.169404.CrossRefPubMed Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F, American Heart Association; National Heart and Blood Institute: Diagnosis and management of the metabolic syndrome: an American heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005, 112 (17): 2735-2752. 10.1161/CIRCULATIONAHA.105.169404.CrossRefPubMed
29.
go back to reference WHO: Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. 1999, Geneva: World Health Organization WHO: Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. 1999, Geneva: World Health Organization
30.
go back to reference Report of Department of Health: Department of Health definition and classification of obesity. Taiwan. 2001, --- Either first page or author must be supplied.. Report of Department of Health: Department of Health definition and classification of obesity. Taiwan. 2001, --- Either first page or author must be supplied..
31.
go back to reference DeLong ER, DeLong DM, Clarke-Pearson DL: Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988, 44: 837-845. 10.2307/2531595.CrossRefPubMed DeLong ER, DeLong DM, Clarke-Pearson DL: Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988, 44: 837-845. 10.2307/2531595.CrossRefPubMed
32.
go back to reference Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW: C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue?. Arterioscler Thromb Vasc Biol. 1999, 19: 972-978.CrossRefPubMed Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW: C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue?. Arterioscler Thromb Vasc Biol. 1999, 19: 972-978.CrossRefPubMed
33.
go back to reference Manns PJ, Williams DP, Snow CM, Wander RC: Physical activity, body fat, and serum C-reactive protein in postmenopausal women with and without hormone replacement. Am J Hum Biol. 2003, 15: 91-100. 10.1002/ajhb.10117.CrossRefPubMed Manns PJ, Williams DP, Snow CM, Wander RC: Physical activity, body fat, and serum C-reactive protein in postmenopausal women with and without hormone replacement. Am J Hum Biol. 2003, 15: 91-100. 10.1002/ajhb.10117.CrossRefPubMed
34.
go back to reference Han TS, van Leer EM, Seidell JC, Lean MEJ: Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. Br Med J. 1995, 311: 1401-1405.CrossRef Han TS, van Leer EM, Seidell JC, Lean MEJ: Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. Br Med J. 1995, 311: 1401-1405.CrossRef
35.
go back to reference Lean MEJ, Han TS, Morrison CE: Waist circumference as a measure for indicating need for weight management. Br Med J. 1995, 311: 158-161.CrossRef Lean MEJ, Han TS, Morrison CE: Waist circumference as a measure for indicating need for weight management. Br Med J. 1995, 311: 158-161.CrossRef
36.
go back to reference Lemieux S, Prud'homme D, Bouchard C, Tremblay A, Despres J-P: A single threshold value of waist girth identifies normal-weight and overweight subjects with excess visceral adipose tissue. Am J Clin Nutr. 1996, 64: 685-693.PubMed Lemieux S, Prud'homme D, Bouchard C, Tremblay A, Despres J-P: A single threshold value of waist girth identifies normal-weight and overweight subjects with excess visceral adipose tissue. Am J Clin Nutr. 1996, 64: 685-693.PubMed
37.
go back to reference Taylor RW, Keil D, Gold EJ, Williams SM, Goulding A: Body mass index, waist girth, and waist-to-hip ratio as indexes of total and regional adiposity in women: evaluation using receiver operating characteristic curves. Am J Clin Nutr. 1998, 67 (1): 44-49.PubMed Taylor RW, Keil D, Gold EJ, Williams SM, Goulding A: Body mass index, waist girth, and waist-to-hip ratio as indexes of total and regional adiposity in women: evaluation using receiver operating characteristic curves. Am J Clin Nutr. 1998, 67 (1): 44-49.PubMed
38.
go back to reference Expert Panel on Detection and Treatment of High Blood Cholesterol in Adults: Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001, 285: 2486-2497. 10.1001/jama.285.19.2486.CrossRef Expert Panel on Detection and Treatment of High Blood Cholesterol in Adults: Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001, 285: 2486-2497. 10.1001/jama.285.19.2486.CrossRef
39.
go back to reference Alberti KG, Zimmet P, Shaw J: The metabolic syndrome--a new worldwide definition. Lancet. 2005, 366 (9491): 1059-1062. 10.1016/S0140-6736(05)67402-8.CrossRefPubMed Alberti KG, Zimmet P, Shaw J: The metabolic syndrome--a new worldwide definition. Lancet. 2005, 366 (9491): 1059-1062. 10.1016/S0140-6736(05)67402-8.CrossRefPubMed
40.
go back to reference Chen J, Muntner P, Hamm LL, Jones DW, Batuman V, Fonseca V, Whelton PK, He J: The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med. 2004, 140: 167-174.CrossRefPubMed Chen J, Muntner P, Hamm LL, Jones DW, Batuman V, Fonseca V, Whelton PK, He J: The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med. 2004, 140: 167-174.CrossRefPubMed
41.
go back to reference Craig P, Colagiuri S, Hussain Z, Palu T: Identifying cut-points in anthropometric indexes for predicting previously undiagnosed diabetes and cardiovascular risk factors in the Tongan population. Obesity Research &Clinical Practice. 2007, 1: 17-25.CrossRef Craig P, Colagiuri S, Hussain Z, Palu T: Identifying cut-points in anthropometric indexes for predicting previously undiagnosed diabetes and cardiovascular risk factors in the Tongan population. Obesity Research &Clinical Practice. 2007, 1: 17-25.CrossRef
Metadata
Title
The relationship of high sensitivity C-reactive protein to percent body fat mass, body mass index, waist-to-hip ratio, and waist circumference in a Taiwanese population
Authors
Cheng-Chieh Lin
Sharon LR Kardia
Chia-Ing Li
Chiu-Shong Liu
Ming-May Lai
Wen-Yuan Lin
Pei-Chia Chang
Yih-Dar Lee
Ching-Chu Chen
Chih-Hsueh Lin
Chuan-Wei Yang
Chih-Yi Hsiao
Walter Chen
Tsai-Chung Li
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-579

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