Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
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Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




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On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Best regards,
C.S. Ramesh Babu,
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Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
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An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2010 | Month : December | Volume : 4 | Issue : 6 | Page : 3421 - 3424

A Study Of Body Mass Index In Healthy Individuals And Its Relationship With Fasting Blood Sugar

VITTAL B G*, PRAVEEN G**, DEEPAK P***

*MD Biochemistry, **MD Community medicine, ***MD Pharmacology

Correspondence Address :
Dr. Vittal BG,
Assistant Professor,
Department of Biochemistry,
Government Medical College,
Hassan-573 201,
Karnataka
Mobile No: 09141400766
Email: vittal.bg@gmail.com

Abstract

Background and objectives: Obesity is a global epidemic and is on the rise. It is defined as a body mass index (BMI) which is equal to or more than 30. It is one of the modifiable risk factors of type 2 diabetes. This study was undertaken to assess the association between BMI and fasting blood sugar (FBS) and also to verify whether BMI increases with age.

Subjects and Methods: This prospective study included 400 healthy adult individuals who met the inclusion criteria. Fasting blood samples were collected to measure FBS by the glucose oxidase method. Thirty individuals were excluded from the study, as their blood glucose levels were in the diabetic range.

Results: Among 370 individuals, a positive correlation was observed (Pearson’s correlation coefficient r = + 0.26) between BMI and FBS. There was a stepwise increase in the magnitude of BMI with an increase in age in decades. Although the increase in mean FBS was observed with age, a statistically significant (p = 0.00093) increase in mean FBS was observed only in the 4th decade of life.

Interpretation and conclusions: The observed positive correlation between BMI and FBS reiterates the diabetogenic effect of adipose tissue and emphasizes the importance of the maintenance of normal BMI to prevent the early onset of diabetes.

Keywords

Obesity, Body mass index, Fasting blood sugar.

Introduction
Body mass index (BMI) is a good measure of general adiposity. It is defined as the weight in kilograms, divided by the square of the height in meters (kg/m2).(1) A person can be categorized as underweight if his/her BMI is ≤18.5, as normal weight if his/her BMI is in the range of 18.5–24.9, as overweight if his/her BMI is between 25 to 29.9 and as obese if his/her BMI is ≥30.(2) A raised BMI value is an established risk factor for ischaemic heart disease, stroke and carcinomas.(3)

Obesity is one of the most important modifiable risk factors in the pathogenesis of type 2 diabetes. The mechanism by which obesity induces insulin resistance is poorly understood. Adipocytes secrete a number of biological products (leptin, TNF-alfa, free fatty acids, resistin, and adiponectin) that modulate insulin secretion, insulin action and body weight and may contribute to insulin resistance.(4) A positive correlation is assumed to exist between BMI and fasting blood sugar (FBS) levels.

Global epidemic obesity - "globesity" - is rapidly becoming a major public health problem in the world and is on the rise. In many populations, the average BMI has been rising by a few percent per decade, thus fuelling the concern about the effects of increased adiposity on health.(5)

This study was undertaken to determine the correlation between FBS and BMI in an adult healthy Indian population and also to check whether BMI increases with age.

Material and Methods

This prospective study was conducted at Sri Chamarajendra Hospital, a teaching hospital which is affiliated to the Hassan Institute of Medical Sciences, during May – August 2010.

After obtaining permission from the Institutional Ethical Committee, normal healthy individuals attending the hospital for routine health check-up were included in the study. Paediatric, pregnant, psychiatric and diabetic subjects were excluded from the study. The study group included 400 persons of the age group of 21-60 years. After obtaining the informed consent, the age, sex, height and weight of the subjects were recorded. Weight was recorded to nearest 0.5 kg and height was recorded to nearest 0.5 cm. Fasting (8-12 hours of overnight fasting) venous blood samples were collected by venipuncture of the median cubital vein in a vacutainer and were centrifuged to separate the plasma. Fasting plasma glucose levels were estimated by the Glucose oxidase method by using an ERBA-Transasia fully automated analyser.

The BMI for each subject was calculated by using the standard formula i.e., weight in kilograms divided by height in square meters.1 All the variables including age, sex, height, weight, BMI and FBS from study group were tabulated and analysed statistically. Pearson’s correlation coefficient was used to find the correlation between FBS and BMI. Student’s t-test was used to check the statistical significance of the changes in BMI and FBS with respect to age.

Results

Four hundred apparently healthy subjects who met the inclusion and the exclusion criteria were included in the study. Thirty members were excluded from the study population as their fasting blood glucose levels were in the diabetic range. Of the 370 members, 289 (78.1%) were men and 81 (21.9%) were women. The study included subjects who were in the age group of 21 to 60 years. The mean age of the male subjects was 37.98 ± 10.51 years and the mean age of the female subjects was 36.4 ± 10.11 years.

(Table/Fig 1): Age and sex distribution of study population
The mean FBS of the study population was 90.70 ± 10.71 mg/dl and the mean BMI was 25.1 ± 3.38. The Pearson’s correlation coefficient between FBS and BMI of the study population was positive (r = + 0.26).

(Table/Fig 2): Mean BMI and mean FBS of different age groups
There was a stepwise increase in the magnitude of BMI, with an increase in age in decades. Although an increase in the mean FBS was observed over decades, a statistically significant increase in mean FBS was observed (p = 0.00093) only in the 4th decade of life i.e., as the age group increased from the 3rd to the 4th decade of life.

Discussion

In the present study, BMI showed a positive correlation with FBS (Pearson’s correlation coefficient r = + 0.26). A positive correlation between BMI and blood sugar was also reported by other studies.(6),(7) Ethnicity affects the association between obesity and diabetes and that probably explains the different levels of association between obesity and blood glucose levels which are observed in various studies.(8)

The mean BMI of different age groups showed an increasing trend over the decades and an increase in mean BMI was found to be more marked from the 3rd to the 4th decade. The prevalence of obesity, as measured by BMI, is high in many countries all over the world and is rising. It is mainly attributed to the changing lifestyles and dietary habits.(5),(9)

Mean FBS increased with increasing age and with increasing BMI. Significant increase in mean FBS was observed during the 4th decade of life.

The mechanism by which obesity induces insulin resistance is poorly understood, but a number of mechanisms have been suspected to be involved. Obesity causes peripheral resistance to insulin-mediated glucose uptake and may also decrease the sensitivity of the beta-cells to glucose.(10) These changes are largely reversed by weight loss, leading to a fall in blood glucose concentrations towards normal levels. Weight gain precedes the onset of diabetes; conversely, weight loss is associated with a decreased risk of type 2 diabetes. (11),(12)

The administration of resistin, an adipocyte derived hormone, decreases while the neutralization of resistin increases insulin-mediated glucose uptake by the adipocytes. Thus, resistin may be a hormone that links obesity to diabetes.(4) Leptin is produced by adipocytes and is secreted in proportion to the adipocyte mass. It signals the hypothalamus about the quantity of stored fat. Studies in humans and animals have shown that leptin is associated with obesity and insulin resistance.(13) The deficiency of adiponectin, an adipocyte-derived hormone, plays a role in the development of insulin resistance and subsequently, type 2 diabetes.(14)

Retinol-binding protein 4, free fatty acids, tumour necrosis factor-alpha, plasminogen activator inhibitor 1, interleukin-1 beta, uncoupling protein 2 and obestatin are also implicated in the adipose tissue induced pathogenesis of type 2 diabetes.(15)

BMI is a good measure of adiposity; however, the relationship between actual body fat and BMI differs between ethnic groups, and as a consequence, the cut off points for the overweight status and obesity based on BMI, will have to be ethnicity specific.(16)

Conclusion

The observed positive correlation between BMI and FBS reiterates the effect of adipose tissue in impairing blood glucose regulation and emphasizes the importance of the maintenance of normal BMI.

The effects of increasing obesity, as indicated by an increase in BMI over the decades in a population can be disastrous, as it can lead to enormous health costs. Hence, awareness needs to be created in children right from the school age, as well as amongst the parents of these children, in order to have an appreciable impact in preventing or delaying the onset of type-2 diabetes in later life.

Limitations of the study:
Our study did not take into account the other indices of obesity like waist hip ratio and abdominal circumference.

Recommendations:
We recommend that further studies must be carried out on a larger sample size with the measurement of waist hip ratio and abdominal circumference as comparative indicators.

References

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Hu F. Obesity epidemiology. Oxford: Oxford university press, 2008;87-97
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World Health Organization Obesity: Preventing and Managing the Global Epidemic. World Health Organization Geneva, Switzerland,1997;786-987
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Prospective Studies Collaboration, Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, Qizilbash N, Collins R, Peto R. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. The Lancet 2009; 373(9669): 1083–96.
4.
Steppan CM, Bailey ST, Bhat S, Brown EJ, Banerjee RR, Wright CM, Patel HR, Ahima RS, Lazar MA. The hormone resistin links obesity to diabetes. Nature 2001; 409(6818):307-12.
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WHO Global InfoBase team. Surveillance of chronic diseases and risk factors: Country level data and comparable estimates. Geneva: World Health Organisation, 2005.
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Adamu GB, Geoffrey CO, Bala GS, Ibrahim SA, Sani SH, Tambaya MA. Relationship between random blood sugar and body mass index in an African population. Int J Diabetes & Metabolism 2006; 14: 144-5.
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Jhanghorbani M, Hedley AJ, Jones RB, Gilmour WH. Is the association between glucose level and “all causes” and cardiovascular mortality risk dependent on body mass index? Med. J. Islamic Republic Iran 1992; 6:205-12.
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Diaz VA, Mainous AG, Baker R, Carnemolla M, Majeed A. How does ethnicity affect the association between obesity and diabetes? Diabet Med. 2007; 24(11): 1199-204.
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Pelletier DL, Rahn M. Trends in body mass index in developing countries. Food and Nutrition Bulletin 1998; 19( 3): 223-39.
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DeFronzo RA, Ferrannini E. Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care 1991; 14(3):173-94.
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Felber JP. From obesity to diabetes. Pathophysiological considerations. Int J Obes Relat Metab Disord 1992; 16(12):937-52.
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Knowler WC, Pettitt DJ, Saad MF, Charles MA, Nelson RG, Howard BV, Bogardus C, Bennett PH. Obesity in the Pima Indians: its magnitude and relationship with diabetes. Am J Clin Nutr. 1991; 53(6 Suppl):1543S-51S.
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Niswender KD, Magnuson MA. Obesity and the beta cell: lessons from leptin. J Clin Invest. 2007; 117(10): 2753–6.
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Kadowaki T, Yamauchi T, Kubota N, Hara K, Ueki K, Tobe K. Adiponectin and adiponectin receptors in insulin resistance, diabetes, and the metabolic syndrome. J Clin Invest. 2006; 116(7): 1784–92.
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Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature 2006; 444(7121):840-6.
16.
Deurenberg P, Yap M. The assessment of obesity: methods for measuring body fat and global prevalence of obesity. Best Pract Res Clin Endocrinol Metab. 1999; 13(1): 1-11.

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