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Published in: Cardiovascular Diabetology 1/2012

Open Access 01-12-2012 | Original investigation

Prognostic significance of the Complex "Visceral Adiposity Index" vs. simple anthropometric measures: Tehran lipid and glucose study

Authors: Bozorgmanesh Mohammadreza, Hadaegh Farzad, Khalili Davoud, Azizi Fereidoun Prof

Published in: Cardiovascular Diabetology | Issue 1/2012

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Abstract

Background

Visceral adiposity index (VAI) has recently been suggested to be used as a surrogate of visceral adiposity. We examined if VAI could improve predictive performances for CVD of the Framingham's general CVD algorithm (a multivariate model incorporating established CVD risk factors). We compared the predictive abilities of the VAI with those of simple anthropometric measures i.e. BMI, waist-to-height ratio (WHtR) or waist-to-hip ratio (WHpR).

Design and methods

In a nine-year population-based follow-up, 6 407 (2 778 men) participants, free of CVD at baseline, aged ≥ 30 years were eligible for the current analysis. The risk of CVD was estimated by incorporating VAI, BMI, WHpR, and WHtR, one at a time, into multivariate accelerated failure time models.

Results

We documented 534 CVD events with the annual incidence rate (95%CIs) being 7.3 (6.4-8.3) among women and 13.0 (11.7-14.6) among men. Risk of future CVD increased with increasing levels of VAI among both men and women. VAI was associated with multivariate-adjusted increased risk of incident CVD among women. However, the magnitude of risk conferred by VAI was not significantly higher than those conferred by BMI, WHpR, or WHtR. Among men, after adjustment for established CVD risk factors, VAI was no longer associated with increased risk of CVD. VAI failed to add to the predictive ability of the Framingham general CVD algorithm.

Conclusions

Using VAI instead of simple anthropometric measures may lead to loss of much information needed for predicting incident CVD.
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Literature
1.
go back to reference Litwin SE: Which Measures of Obesity Best Predict Cardiovascular Risk?. J Am Coll Cardiol. 2008, 52: 616-619. 10.1016/j.jacc.2008.05.017.CrossRefPubMed Litwin SE: Which Measures of Obesity Best Predict Cardiovascular Risk?. J Am Coll Cardiol. 2008, 52: 616-619. 10.1016/j.jacc.2008.05.017.CrossRefPubMed
2.
go back to reference Flegal KM, Shepherd JA, Looker AC, Graubard BI, Borrud LG, Ogden CL, Harris TB, Everhart JE, Schenker N: Comparisons of percentage body fat, body mass index, waist circumference, and waist-stature ratio in adults. American Journal of Clinical Nutrition. 2009, 89: 500-10.3945/ajcn.2008.26847.PubMedCentralCrossRefPubMed Flegal KM, Shepherd JA, Looker AC, Graubard BI, Borrud LG, Ogden CL, Harris TB, Everhart JE, Schenker N: Comparisons of percentage body fat, body mass index, waist circumference, and waist-stature ratio in adults. American Journal of Clinical Nutrition. 2009, 89: 500-10.3945/ajcn.2008.26847.PubMedCentralCrossRefPubMed
3.
go back to reference Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M, Galluzzo A: Group ftAS: Visceral Adiposity Index. Diabetes Care. 2010, 33: 920-922. 10.2337/dc09-1825.PubMedCentralCrossRefPubMed Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M, Galluzzo A: Group ftAS: Visceral Adiposity Index. Diabetes Care. 2010, 33: 920-922. 10.2337/dc09-1825.PubMedCentralCrossRefPubMed
4.
go back to reference Bozorgmanesh M, Hadaegh F, Azizi F: Diabetes prediction, lipid accumulation product, and adiposity measures; 6-year follow-up: Tehran lipid and glucose study. Lipids Health Dis. 2010, 9: 45-10.1186/1476-511X-9-45.PubMedCentralCrossRefPubMed Bozorgmanesh M, Hadaegh F, Azizi F: Diabetes prediction, lipid accumulation product, and adiposity measures; 6-year follow-up: Tehran lipid and glucose study. Lipids Health Dis. 2010, 9: 45-10.1186/1476-511X-9-45.PubMedCentralCrossRefPubMed
5.
go back to reference Bozorgmanesh M, Hadaegh F, Azizi F: Predictive performances of lipid accumulation product vs. adiposity measures for cardiovascular diseases and all-cause mortality, 8.6-year follow-up: Tehran lipid and glucose study. Lipids Health Dis. 2010, 9: 100-10.1186/1476-511X-9-100.PubMedCentralCrossRefPubMed Bozorgmanesh M, Hadaegh F, Azizi F: Predictive performances of lipid accumulation product vs. adiposity measures for cardiovascular diseases and all-cause mortality, 8.6-year follow-up: Tehran lipid and glucose study. Lipids Health Dis. 2010, 9: 100-10.1186/1476-511X-9-100.PubMedCentralCrossRefPubMed
6.
go back to reference Azizi F, Ghanbarian A, Momenan AA, Hadaegh F, Mirmiran P, Hedayati M, Mehrabi Y, Zahedi-Asl S: Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase II. Trials. 2009, 10: 5.PubMedCentralCrossRefPubMed Azizi F, Ghanbarian A, Momenan AA, Hadaegh F, Mirmiran P, Hedayati M, Mehrabi Y, Zahedi-Asl S: Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase II. Trials. 2009, 10: 5.PubMedCentralCrossRefPubMed
7.
go back to reference Freedman DS, Kahn HS, Mei Z, Grummer-Strawn LM, Dietz WH, Srinivasan SR, Berenson GS: Relation of body mass index and waist-to-height ratio to cardiovascular disease risk factors in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr. 2007, 86: 33-40.PubMed Freedman DS, Kahn HS, Mei Z, Grummer-Strawn LM, Dietz WH, Srinivasan SR, Berenson GS: Relation of body mass index and waist-to-height ratio to cardiovascular disease risk factors in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr. 2007, 86: 33-40.PubMed
8.
go back to reference Hadaegh F, Harati H, Ghanbarian A, Azizi F: Association of total cholesterol versus other serum lipid parameters with the short-term prediction of cardiovascular outcomes: Tehran Lipid and Glucose Study. Eur J Cardiovasc Prev Rehabil. 2006, 13: 571-577. 10.1097/01.hjr.0000216552.81882.ca.CrossRefPubMed Hadaegh F, Harati H, Ghanbarian A, Azizi F: Association of total cholesterol versus other serum lipid parameters with the short-term prediction of cardiovascular outcomes: Tehran Lipid and Glucose Study. Eur J Cardiovasc Prev Rehabil. 2006, 13: 571-577. 10.1097/01.hjr.0000216552.81882.ca.CrossRefPubMed
9.
go back to reference Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS, Ferguson TB, Fihn SD, Fraker TD, Gardin JM, et al: ACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina-Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina). Circulation. 2003, 107: 149-158. 10.1161/01.CIR.0000047041.66447.29.CrossRefPubMed Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS, Ferguson TB, Fihn SD, Fraker TD, Gardin JM, et al: ACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina-Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina). Circulation. 2003, 107: 149-158. 10.1161/01.CIR.0000047041.66447.29.CrossRefPubMed
10.
go back to reference Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, Jones RH, Kereiakes D, Kupersmith J, Levin TN, et al: ACC/AHA Guideline Update for the Management of Patients With Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction-2002: Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina). Circulation. 2002, 106: 1893-1900. 10.1161/01.CIR.0000037106.76139.53.CrossRefPubMed Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, Jones RH, Kereiakes D, Kupersmith J, Levin TN, et al: ACC/AHA Guideline Update for the Management of Patients With Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction-2002: Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina). Circulation. 2002, 106: 1893-1900. 10.1161/01.CIR.0000037106.76139.53.CrossRefPubMed
11.
go back to reference Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R, Kahn R, Kitzmiller J, Knowler WC, Lebovitz H, Lernmark A, et al: Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care. 2003, 26: 3160-3167.CrossRefPubMed Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R, Kahn R, Kitzmiller J, Knowler WC, Lebovitz H, Lernmark A, et al: Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care. 2003, 26: 3160-3167.CrossRefPubMed
12.
go back to reference D'Agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB: General Cardiovascular Risk Profile for Use in Primary Care: The Framingham Heart Study. Circulation. 2008, 117: 743-753. 10.1161/CIRCULATIONAHA.107.699579.CrossRefPubMed D'Agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB: General Cardiovascular Risk Profile for Use in Primary Care: The Framingham Heart Study. Circulation. 2008, 117: 743-753. 10.1161/CIRCULATIONAHA.107.699579.CrossRefPubMed
13.
go back to reference Bozorgmanesh M, Hadaegh F, Azizi F: Predictive accuracy of the 'Framingham's general CVD algorithm' in a Middle Eastern population: Tehran Lipid and Glucose Study. International Journal of Clinical Practice. 2011, 65: 264-273. 10.1111/j.1742-1241.2010.02529.x.CrossRefPubMed Bozorgmanesh M, Hadaegh F, Azizi F: Predictive accuracy of the 'Framingham's general CVD algorithm' in a Middle Eastern population: Tehran Lipid and Glucose Study. International Journal of Clinical Practice. 2011, 65: 264-273. 10.1111/j.1742-1241.2010.02529.x.CrossRefPubMed
14.
go back to reference Abbate LM, Stevens J, Schwartz TA, Renner JB, Helmick CG, Jordan JM: Anthropometric measures, body composition, body fat distribution, and knee osteoarthritis in women. Obesity (Silver Spring). 2006, 14: 1274-1281. 10.1038/oby.2006.145.CrossRef Abbate LM, Stevens J, Schwartz TA, Renner JB, Helmick CG, Jordan JM: Anthropometric measures, body composition, body fat distribution, and knee osteoarthritis in women. Obesity (Silver Spring). 2006, 14: 1274-1281. 10.1038/oby.2006.145.CrossRef
15.
go back to reference D'Agostino RB, Nam BH: Evaluation of the performance of survival analysis models: Discrimination and Calibration measures. Handbook of Statistics, Survival Methods. Edited by: Balakrishnan N, Rao CR. 2004, Amsterdam, The Netherlands: Elsevier B.V., 23: 1-25. D'Agostino RB, Nam BH: Evaluation of the performance of survival analysis models: Discrimination and Calibration measures. Handbook of Statistics, Survival Methods. Edited by: Balakrishnan N, Rao CR. 2004, Amsterdam, The Netherlands: Elsevier B.V., 23: 1-25.
16.
go back to reference Hosmer DW, Lemeshow S: Applied logistic regression. 2000, Wiley-InterscienceCrossRef Hosmer DW, Lemeshow S: Applied logistic regression. 2000, Wiley-InterscienceCrossRef
17.
go back to reference Hosmer DW, Lemeshow S, May S: Applied survival analysis: regression modeling of time-to-event data. 2008, Hoboken, N.J.: Wiley-Interscience, 2CrossRef Hosmer DW, Lemeshow S, May S: Applied survival analysis: regression modeling of time-to-event data. 2008, Hoboken, N.J.: Wiley-Interscience, 2CrossRef
18.
go back to reference Hanley JA, McNeil BJ: The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982, 143: 29-36.CrossRefPubMed Hanley JA, McNeil BJ: The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982, 143: 29-36.CrossRefPubMed
19.
go back to reference Harrell FE, Lee KL, Mark DB: Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med. 1996, 15: 361-387. 10.1002/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4.CrossRefPubMed Harrell FE, Lee KL, Mark DB: Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med. 1996, 15: 361-387. 10.1002/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4.CrossRefPubMed
20.
go back to reference Hlatky MA, Greenland P, Arnett DK, Ballantyne CM, Criqui MH, Elkind MSV, Go AS, Harrell FE, Hong Y, Howard BV, et al: Criteria for Evaluation of Novel Markers of Cardiovascular Risk: A Scientific Statement From the American Heart Association. Circulation. 2009, 119: 2408-2416. 10.1161/CIRCULATIONAHA.109.192278.PubMedCentralCrossRefPubMed Hlatky MA, Greenland P, Arnett DK, Ballantyne CM, Criqui MH, Elkind MSV, Go AS, Harrell FE, Hong Y, Howard BV, et al: Criteria for Evaluation of Novel Markers of Cardiovascular Risk: A Scientific Statement From the American Heart Association. Circulation. 2009, 119: 2408-2416. 10.1161/CIRCULATIONAHA.109.192278.PubMedCentralCrossRefPubMed
21.
go back to reference Pencina MJ, D'Agostino RB, D'Agostino RB, Vasan RS: Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond. Stat Med. 2008, 27: 157-172. 10.1002/sim.2929. discussion 207-112CrossRefPubMed Pencina MJ, D'Agostino RB, D'Agostino RB, Vasan RS: Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond. Stat Med. 2008, 27: 157-172. 10.1002/sim.2929. discussion 207-112CrossRefPubMed
23.
go back to reference Rose G: The strategy of preventive medicine. Rose&# 39; Strategy of Preventive Medicine. 2008, 1: 33-35. Rose G: The strategy of preventive medicine. Rose&# 39; Strategy of Preventive Medicine. 2008, 1: 33-35.
24.
go back to reference Amato MC, Giordano C, Pitrone M, Galluzzo A: Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population. Lipids in Health and Disease. 2011, 10: 183-10.1186/1476-511X-10-183.PubMedCentralCrossRefPubMed Amato MC, Giordano C, Pitrone M, Galluzzo A: Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population. Lipids in Health and Disease. 2011, 10: 183-10.1186/1476-511X-10-183.PubMedCentralCrossRefPubMed
25.
go back to reference Gelber RP, Gaziano JM, Orav EJ, Manson JE, Buring JE, Kurth T: Measures of Obesity and Cardiovascular Risk Among Men and Women. J Am Coll Cardiol. 2008, 52: 605-615. 10.1016/j.jacc.2008.03.066.PubMedCentralCrossRefPubMed Gelber RP, Gaziano JM, Orav EJ, Manson JE, Buring JE, Kurth T: Measures of Obesity and Cardiovascular Risk Among Men and Women. J Am Coll Cardiol. 2008, 52: 605-615. 10.1016/j.jacc.2008.03.066.PubMedCentralCrossRefPubMed
26.
go back to reference Hermans MP, Sacks FM, Ahn SA, Rousseau MF: Non-HDL-cholesterol as valid surrogate to apolipoprotein B100 measurement in diabetes: Discriminant Ratio and unbiased equivalence. Cardiovasc Diabetol. 2011, 10: 20-10.1186/1475-2840-10-20.PubMedCentralCrossRefPubMed Hermans MP, Sacks FM, Ahn SA, Rousseau MF: Non-HDL-cholesterol as valid surrogate to apolipoprotein B100 measurement in diabetes: Discriminant Ratio and unbiased equivalence. Cardiovasc Diabetol. 2011, 10: 20-10.1186/1475-2840-10-20.PubMedCentralCrossRefPubMed
27.
go back to reference Knowles KM, Paiva LL, Sanchez SE, Revilla L, Lopez T, Yasuda MB, Yanez ND, Gelaye B, Williams MA: Waist circumference, body mass index, and other measures of adiposity in predicting cardiovascular disease risk factors among Peruvian adults. 2011, Journal of Hypertension: International, 2011. Knowles KM, Paiva LL, Sanchez SE, Revilla L, Lopez T, Yasuda MB, Yanez ND, Gelaye B, Williams MA: Waist circumference, body mass index, and other measures of adiposity in predicting cardiovascular disease risk factors among Peruvian adults. 2011, Journal of Hypertension: International, 2011.
28.
go back to reference Dong X, Liu Y, Yang J, Sun Y, Chen L: Efficiency of anthropometric indicators of obesity for identifying cardiovascular risk factors in a Chinese population. Postgraduate Medical Journal. Dong X, Liu Y, Yang J, Sun Y, Chen L: Efficiency of anthropometric indicators of obesity for identifying cardiovascular risk factors in a Chinese population. Postgraduate Medical Journal.
29.
go back to reference Sacco RL, Khatri M, Rundek T, Xu Q, Gardener H, Boden-Albala B, Di Tullio MR, Homma S, Elkind MSV, Paik MC: Improving Global Vascular Risk Prediction With Behavioral and Anthropometric Factors: The Multiethnic NOMAS (Northern Manhattan Cohort Study). J Am Coll Cardiol. 2009, 54: 2303-2311. 10.1016/j.jacc.2009.07.047.PubMedCentralCrossRefPubMed Sacco RL, Khatri M, Rundek T, Xu Q, Gardener H, Boden-Albala B, Di Tullio MR, Homma S, Elkind MSV, Paik MC: Improving Global Vascular Risk Prediction With Behavioral and Anthropometric Factors: The Multiethnic NOMAS (Northern Manhattan Cohort Study). J Am Coll Cardiol. 2009, 54: 2303-2311. 10.1016/j.jacc.2009.07.047.PubMedCentralCrossRefPubMed
30.
go back to reference Schneider HJ, Friedrich N, Klotsche J, Pieper L, Nauck M, John U, Dorr M, Felix S, Lehnert H, Pittrow D, et al: The Predictive Value of Different Measures of Obesity for Incident Cardiovascular Events and Mortality. J Clin Endocrinol Metab. 2010, 95: 1777-1785. 10.1210/jc.2009-1584.CrossRefPubMed Schneider HJ, Friedrich N, Klotsche J, Pieper L, Nauck M, John U, Dorr M, Felix S, Lehnert H, Pittrow D, et al: The Predictive Value of Different Measures of Obesity for Incident Cardiovascular Events and Mortality. J Clin Endocrinol Metab. 2010, 95: 1777-1785. 10.1210/jc.2009-1584.CrossRefPubMed
31.
go back to reference Hadaegh F, Zabetian A, Sarbakhsh P, Khalili D, James WP, Azizi F: Appropriate cutoff values of anthropometric variables to predict cardiovascular outcomes: 7.6 years follow-up in an Iranian population. Int J Obes (Lond). 2009, 33: 1437-1445. 10.1038/ijo.2009.180.CrossRef Hadaegh F, Zabetian A, Sarbakhsh P, Khalili D, James WP, Azizi F: Appropriate cutoff values of anthropometric variables to predict cardiovascular outcomes: 7.6 years follow-up in an Iranian population. Int J Obes (Lond). 2009, 33: 1437-1445. 10.1038/ijo.2009.180.CrossRef
32.
go back to reference Despres JP: Is visceral obesity the cause of the metabolic syndrome?. Ann Med. 2006, 38: 52-63. 10.1080/07853890500383895.CrossRefPubMed Despres JP: Is visceral obesity the cause of the metabolic syndrome?. Ann Med. 2006, 38: 52-63. 10.1080/07853890500383895.CrossRefPubMed
33.
go back to reference Lebovitz HE, Banerji MA: Point: Visceral Adiposity Is Causally Related to Insulin Resistance. Diabetes Care. 2005, 28: 2322-2325. 10.2337/diacare.28.9.2322.CrossRefPubMed Lebovitz HE, Banerji MA: Point: Visceral Adiposity Is Causally Related to Insulin Resistance. Diabetes Care. 2005, 28: 2322-2325. 10.2337/diacare.28.9.2322.CrossRefPubMed
34.
go back to reference Kramer CK, von Muhlen D, Gross JL, Barrett-Connor E: A Prospective Study of Abdominal Obesity and Coronary Artery Calcium Progression in Older Adults. J Clin Endocrinol Metab. 2009, 94: 5039-5044. 10.1210/jc.2009-1497.PubMedCentralCrossRefPubMed Kramer CK, von Muhlen D, Gross JL, Barrett-Connor E: A Prospective Study of Abdominal Obesity and Coronary Artery Calcium Progression in Older Adults. J Clin Endocrinol Metab. 2009, 94: 5039-5044. 10.1210/jc.2009-1497.PubMedCentralCrossRefPubMed
35.
go back to reference Gutin B, Johnson MH, Humphries MC, Hatfield-Laube JL, Kapuku GK, Allison JD, Gower BA, Daniels SR, Barbeau P: Relationship of Visceral Adiposity to Cardiovascular Disease Risk Factors in Black and White Teens[ast]. Obesity. 2007, 15: 1029-1035. 10.1038/oby.2007.602.CrossRefPubMed Gutin B, Johnson MH, Humphries MC, Hatfield-Laube JL, Kapuku GK, Allison JD, Gower BA, Daniels SR, Barbeau P: Relationship of Visceral Adiposity to Cardiovascular Disease Risk Factors in Black and White Teens[ast]. Obesity. 2007, 15: 1029-1035. 10.1038/oby.2007.602.CrossRefPubMed
36.
go back to reference Moebus S, Balijepalli C, Lösch C, Göres L, von Stritzky B, Bramlage P, Wasem J, Jöckel KH: Age-and sex-specific prevalence and ten-year risk for cardiovascular disease of all 16 risk factor combinations of the metabolic syndrome-A cross-sectional study. Cardiovasc Diabetol. 2010, 9: 34-10.1186/1475-2840-9-34.PubMedCentralCrossRefPubMed Moebus S, Balijepalli C, Lösch C, Göres L, von Stritzky B, Bramlage P, Wasem J, Jöckel KH: Age-and sex-specific prevalence and ten-year risk for cardiovascular disease of all 16 risk factor combinations of the metabolic syndrome-A cross-sectional study. Cardiovasc Diabetol. 2010, 9: 34-10.1186/1475-2840-9-34.PubMedCentralCrossRefPubMed
Metadata
Title
Prognostic significance of the Complex "Visceral Adiposity Index" vs. simple anthropometric measures: Tehran lipid and glucose study
Authors
Bozorgmanesh Mohammadreza
Hadaegh Farzad
Khalili Davoud
Azizi Fereidoun Prof
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2012
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/1475-2840-11-20

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