Association between γ-Glutamyl Transferase and Metabolic Syndrome: A Cross-Sectional Study of an Adult Population in Beijing
Abstract
:1. Introduction
2. Methods
2.1.Study Population
2.2. Measurements
2.3. Definition of MetS
- Obesity: BMI ≥ 28 kg/m²;
- Elevated TG (drug treatment for elevated TG is an alternate indicator) ≥ 150 mg/dL (1.7 mmol/L);
- Reduced HDL-C (drug treatment for reduced HDL-C is an alternate indicator) < 40 mg/dL (1.0 mmol/L) in males, <50 mg/dL (1.3 mmol/L) in females;
- Elevated BP (anti-hypertensive drug treatment in a patient with a history of hypertension is an alternate indicator) systolic ≥ 130 mm Hg and/or diastolic ≥ 85 mm Hg; and,
- Elevated FPG (drug treatment of elevated glucose is an alternate indicator) ≥ 100 mg/dL.
2.4. Data Analysis
3. Results
3.1. Prevalence of MetS and its Components
3.2. Basic Characteristics and Hematological Parameters
Sex | Total | MetS | Elevated BP | Elevated TG | Reduced HDL-C | Elevated BMI | Elevated FPG | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | n | % | n | % | ||
Men | 4,764 | 941 | 19.75 | 1,702 | 35.73 | 1,666 | 34.97 | 1,214 | 25.48 | 794 | 16.67 | 1,371 | 28.78 |
Women | 5,789 | 476 | 8.22 | 849 | 14.67 | 769 | 13.28 | 1,488 | 25.70 | 342 | 5.91 | 1,059 | 18.29 |
Total | 10,553 | 1,417 | 13.43 | 2,551 | 24.17 | 2,435 | 23.07 | 2,702 | 25.60 | 1,136 | 10.76 | 2,430 | 23.03 |
Variables | Men | p Value | Women | p Value | ||
---|---|---|---|---|---|---|
MetS | non-MetS | MetS | non-MetS | |||
N | 941 | 3,823 | - | 476 | 5,313 | - |
Age (year) | 44 (35–53) | 38 (31–49) | <0.0001 a | 50 (43–57) | 40 (30–49) | <0.0001 a |
SBP (mmHg) | 130 ± 15 | 118 ± 14 | <0.0001 b | 128 ± 17 | 111 ± 13 | <0.0001 b |
DBP (mmHg) | 84 ± 10 | 75 ± 10 | <0.0001 b | 81 ± 10 | 70 ± 9 | <0.0001 b |
HDL-C (mmol/L) | 0.97 ± 0.22 | 1.26 ± 0.29 | <0.0001 b | 1.13 ± 0.21 | 1.58 ± 0.34 | <0.0001 b |
TG (mmol/L) | 2.97 ± 2.21 | 1.46 ± 1.18 | <0.0001 b | 2.34 ± 1.26 | 0.96 ± 0.60 | <0.0001 b |
FPG (mmol/L) | 6.34 ± 1.79 | 5.36 ± 1.04 | <0.0001 b | 6.40 ± 1.81 | 5.17 ± 0.74 | <0.0001 b |
BMI (kg/m2) | 28.21 ± 3.25 | 24.39 ± 4.02 | <0.0001 b | 27.41 ± 3.71 | 22.05 ± 2.93 | <0.0001 b |
GGT (U/L) | 52.09 ± 31.74 | 34.01 ± 22.97 | <0.0001 b | 33.53 ± 23.17 | 19.92 ± 13.51 | <0.0001 b |
ALT (U/L) | 45.58 ± 32.17 | 30.95 ± 30.22 | <0.0001 b | 31.84 ± 19.28 | 20.38 ± 19.59 | <0.0001 b |
AST (U/L) | 37.50 ± 14.52 | 31.05 ± 19.26 | <0.0001 b | 34.64 ± 13.25 | 27.54 ± 11.98 | <0.0001 b |
ALP (U/L) | 65.68 ± 15.87 | 62.35 ± 15.10 | <0.0001 b | 65.18 ± 18.31 | 53.43 ± 16.19 | <0.0001 b |
History of alcoholic fatty liver, n (%) | 27 (2.87) | 41 (1.07) | <0.0001 c | 8 (1.68) | 11 (0.21) | <0.0001 c |
Anti-hypertensive drugs, n (%) | 256 (27.21) | 346 (9.05) | <0.0001 c | 174 (36.55) | 337 (6.34) | <0.0001 c |
Anti-dyslipidemic drugs, n (%) | 205 (21.79) | 206 (5.39) | <0.0001 c | 90 (18.91) | 272 (5.12) | <0.0001 c |
Anti-diabetic drugs, n (%) | 80 (8.50) | 93 (2.56) | <0.0001 c | 49 (10.29) | 92 (1.73) | <0.0001 c |
3.3. Association between Liver Enzymes and MetS, as well as its Components
Q1 | Q2 | Q3 | Q4 | |
---|---|---|---|---|
Men | ||||
GGT (U/L) | ≤20 | 21–29 | 30–43 | ≥44 |
Cases/subjects at risk | 64/1,178 | 151/1,213 | 261/1,167 | 465/1,206 |
OR (95% CI: lower–upper) | 1.00 | 1.40 (1.09–1.96) | 2.09 (1.50–2.91) | 3.50 (2.50–4.91) |
ALT (U/L) | ≤19 | 20–27 | 28–38 | ≥39 |
Cases/subjects at risk | 98/1,191 | 176/1,201 | 242/1,188 | 425/1,184 |
OR (95% CI: lower–upper) | 1.00 | 1.23 (0.90–1.66) | 1.43 (1.05–1.95) | 1.81 (1.28–2.55) |
AST (U/L) | ≤24 | 25–30 | 31–36 | ≥37 |
Cases/subjects at risk | 129/1,214 | 188/1,294 | 222/1,145 | 402/1,111 |
OR (95% CI: lower–upper) | 1.00 | 1.09 (0.82–1.45) | 1.07 (0.80–1.43) | 1.62 (1.19–2.20) |
ALP (U/L) | ≤52 | 53–61 | 62–71 | ≥72 |
Cases/subjects at risk | 198/1,288 | 217/1,106 | 244/1,202 | 282/1,168 |
OR (95% CI: lower–upper) | 1.00 | 1.24 (0.96–1.61) | 1.29 (0.99–1.66) | 1.48 (1.16–1.90) |
Women | ||||
GGT (U/L) | ≤13 | 14–17 | 18–22 | ≥23 |
Cases/subjects at risk | 22/1,843 | 44/1,386 | 100/1,151 | 310/1,409 |
OR (95% CI: lower–upper) | 1.00 | 1.80 (1.04–3.10) | 3.49 (2.11–5.78) | 5.61 (3.41–9.23) |
ALT (U/L) | ≤13 | 14–18 | 19–23 | ≥24 |
Cases/subjects at risk | 27/1,480 | 64/1,624 | 98/1,248 | 287/1,437 |
OR (95% CI: lower–upper) | 1.00 | 1.30 (0.79–2.13) | 1.44 (0.88–2.35) | 1.95 (1.19–3.21) |
AST (U/L) | ≤22 | 23–26 | 27–31 | ≥32 |
Cases/subjects at risk | 36/1,451 | 80/1,494 | 110/1,434 | 250/1,410 |
OR (95% CI: lower–upper) | 1.00 | 1.62 (1.04–2.54) | 1.33 (0.85–2.07) | 2.01 (1.29–3.15) |
ALP (U/L) | ≤42 | 43–51 | 52–63 | ≥64 |
Cases/subjects at risk | 43/1,556 | 66/1,352 | 141/1,519 | 226/1,362 |
Q1 | Q2 | Q3 | Q4 | |
---|---|---|---|---|
Men | ||||
GGT (U/L) | ≤20 | 21–29 | 30–43 | ≥44 |
n (%) | 272/1,178 | 374/1,213 | 453/1,167 | 603/1,206 |
OR (95% CI: lower–upper) | 1.00 | 1.24 (1.02–1.51) | 1.48 (1.21–1.81) | 2.18 (1.76–2.70) |
ALT (U/L) | ≤19 | 20–27 | 28–38 | ≥39 |
n (%) | 304/1,191 | 410/1,201 | 464/1,188 | 524/1,184 |
OR (95% CI: lower–upper) | 1.00 | 1.26 (1.05–1.53) | 1.41 (1.16–1.72) | 1.45 (1.16–1.80) |
AST (U/L) | ≤24 | 25–30 | 31–36 | ≥37 |
n (%) | 340/1,214 | 463/1,294 | 408/1,145 | 491/1,111 |
OR (95% CI: lower–upper) | 1.00 | 1.20 (0.99–1.44) | 0.97 (0.80–1.18) | 1.04 (0.83–1.30) |
ALP (U/L) | ≤52 | 53–61 | 62–71 | ≥72 |
n (%) | 437/1,288 | 381/1,106 | 402/1,202 | 482/1,168 |
OR (95% CI: lower–upper) | 1.00 | 0.94 (0.78–1.12) | 0.86 (0.72–1.03) | 1.16 (0.97–1.38) |
Women | ||||
GGT (U/L) | ≤13 | 14–17 | 18–22 | ≥23 |
Cases/subjects at risk | 142/1,843 | 155/1,386 | 210/1,151 | 342/1,409 |
OR (95% CI: lower–upper) | 1.00 | 1.15 (0.89–1.48) | 1.46 (1.13–1.88) | 1.28 (0.98–1.66) |
ALT (U/L) | ≤13 | 14–18 | 19–23 | ≥24 |
Cases/subjects at risk | 111/1,480 | 187/1,624 | 202/1,248 | 349/1,437 |
OR (95% CI: lower–upper) | 1.00 | 1.26 (0.97–1.63) | 1.40 (1.07–1.83) | 1.68 (1.27–2.21) |
AST (U/L) | ≤22 | 23–26 | 27–31 | ≥32 |
Cases/subjects at risk | 134/1,451 | 172/1,494 | 233/1,434 | 310/1,410 |
OR (95% CI: lower–upper) | 1.00 | 0.95 (0.73–1.23) | 1.12 (0.86–1.44) | 1.15 (0.87–1.52) |
ALP (U/L) | ≤42 | 43–51 | 52–63 | ≥64 |
Cases/subjects at risk | 109/1,556 | 136/1,352 | 254/1,519 | 350/1,362 |
OR (95% CI: lower–upper) | 1.00 | 1.26 (0.95–1.65) | 1.79 (1.39–2.31) | 1.87 (1.43–2.45) |
Q1 | Q2 | Q3 | Q4 | |
---|---|---|---|---|
Men | ||||
GGT (U/L) | ≤20 | 21–29 | 30–43 | ≥44 |
Cases/subjects at risk | 212/1,178 | 272/1,213 | 328/1,167 | 402/1,206 |
OR (95% CI: lower–upper) | 1.00 | 2.03 (1.63–2.55) | 3.10 (2.47–3.89) | 4.79 (3.78–6.08) |
ALT (U/L) | ≤19 | 20–27 | 28–38 | ≥39 |
Cases/subjects at risk | 160/1,191 | 283/1,201 | 297/1,188 | 444/1,184 |
OR (95% CI: lower–upper) | 1.00 | 1.38 (1.12–1.71) | 1.56 (1.26–1.94) | 1.74 (1.36–2.23) |
AST (U/L) | ≤24 | 25–30 | 31–36 | ≥37 |
Cases/subjects at risk | 272/1,214 | 264/1,294 | 298/1,145 | 380/1,111 |
OR (95% CI: lower–upper) | 1.00 | 1.21 (0.99–1.47) | 1.44 (1.17–1.77) | 1.75 (1.39–2.20) |
ALP (U/L) | ≤52 | 53–61 | 62–71 | ≥72 |
Cases/subjects at risk | 241/1,288 | 289/1,106 | 322/1,202 | 362/1,168 |
OR (95% CI: lower–upper) | 1.00 | 1.29 (1.06–1.56) | 1.31 (1.09–1.52) | 1.40 (1.16–1.69) |
Women | ||||
GGT (U/L) | ≤13 | 14–17 | 18–22 | ≥23 |
Cases/subjects at risk | 302/1,843 | 299/1,386 | 334/1,151 | 553/1,409 |
OR (95% CI: lower–upper) | 1.00 | 1.73 (1.22–2.47) | 3.68 (2.65–5.11) | 5.15 (3.70–7.16) |
ALT (U/L) | ≤13 | 14–18 | 19–23 | ≥24 |
Cases/subjects at risk | 280/1,480 | 358/1,624 | 334/1,248 | 516/1,437 |
OR (95% CI: lower–upper) | 1.00 | 1.39 (0.99–1.94) | 1.62 (1.15–2.27) | 1.81 (1.27–2.57) |
AST (U/L) | ≤22 | 23–26 | 27–31 | ≥32 |
Cases/subjects at risk | 307/1,451 | 350/1,494 | 361/1,434 | 470/1,410 |
OR (95% CI: lower–upper) | 1.00 | 1.24 (0.91–1.69) | 1.22 (0.90–1.65) | 1.68 (1.24–2.30) |
ALP (U/L) | ≤42 | 43–51 | 52–63 | ≥64 |
Cases/subjects at risk | 271/1,556 | 331/1,352 | 428/1,519 | 458/1,362 |
OR (95% CI: lower–upper) | 1.00 | 1.45 (1.06–1.99) | 1.72 (1.29–2.31) | 2.06 (1.53–2.78) |
Q1 | Q2 | Q3 | Q4 | |
---|---|---|---|---|
Men | ||||
GGT (U/L) | ≤20 | 21–29 | 30–43 | ≥44 |
Cases/subjects at risk | 212/1,178 | 272/1,213 | 328/1,167 | 402/1,206 |
OR (95% CI: lower–upper) | 1.00 | 1.04 (0.84–1.28) | 1.14 (0.92–1.43) | 1.20 (0.95–1.51) |
ALT (U/L) | ≤19 | 20–27 | 28–38 | ≥39 |
Cases/subjects at risk | 191/1,191 | 283/1,201 | 297/1,188 | 444/1,184 |
OR (95% CI: lower–upper) | 1.00 | 1.54 (1.25–1.91) | 1.61 (1.29–2.00) | 2.45 (1.92–3.11) |
AST (U/L) | ≤24 | 25–30 | 31–36 | ≥37 |
Cases/subjects at risk | 272/1,214 | 264/1,294 | 298/1,145 | 380/1,111 |
OR (95% CI: lower–upper) | 1.00 | 0.73 (0.60–0.89) | 0.81 (0.66–1.00) | 0.84 (0.66–1.06) |
ALP (U/L) | ≤52 | 53–61 | 62–71 | ≥72 |
Cases/subjects at risk | 241/1,288 | 289/1,106 | 322/1,202 | 362/1,168 |
OR (95% CI: lower–upper) | 1.00 | 1.50 (1.23–1.84) | 1.53 (1.26–1.86) | 1.78 (1.46–2.16) |
Women | ||||
GGT (U/L) | ≤13 | 14–17 | 18–22 | ≥23 |
Cases/subjects at risk | 302/1,843 | 299/1,386 | 334/1,151 | 553/1,409 |
OR (95% CI: lower–upper) | 1.00 | 1.30 (1.08–1.55) | 1.78 (1.48–2.14) | 2.38 (1.98–2.85) |
ALT (U/L) | ≤13 | 14–18 | 19–23 | ≥24 |
Cases/subjects at risk | 280/1,480 | 358/1,624 | 334/1,248 | 516/1,437 |
OR (95% CI: lower–upper) | 1.00 | 1.05 (0.87–1.26) | 1.13 (0.92–1.38) | 1.22 (0.98–1.53) |
AST (U/L) | ≤22 | 23–26 | 27–31 | ≥32 |
Cases/subjects at risk | 307/1,451 | 350/1,494 | 361/1,434 | 470/1,410 |
OR (95% CI: lower–upper) | 1.00 | 0.99 (0.83–1.20) | 0.90 (0.74–1.09) | 1.01 (0.82–1.24) |
ALP (U/L) | ≤42 | 43–51 | 52–63 | ≥64 |
Cases/subjects at risk | 271/1,556 | 331/1,352 | 428/1,519 | 458/1,362 |
OR (95% CI: lower–upper) | 1.00 | 1.39 (1.15–1.67) | 1.53 (1.28–1.83) | 1.68 (1.38–2.05) |
Q1 | Q2 | Q3 | Q4 | |
---|---|---|---|---|
Men | ||||
GGT (U/L) | ≤20 | 21–29 | 30–43 | ≥44 |
Cases/subjects at risk | 210/1,178 | 280/1,213 | 393/1,167 | 488/1,206 |
OR (95% CI: lower–upper) | 1.00 | 1.15 (0.92–1.44) | 1.75 (1.41–2.19) | 2.23 (1.77–2.80) |
ALT (U/L) | ≤19 | 20–27 | 28–38 | ≥39 |
Cases/subjects at risk | 275/1,191 | 346/1,201 | 345/1,188 | 405/1,184 |
OR (95% CI: lower–upper) | 1.00 | 1.04 (0.84–1.29) | 0.95 (0.75–1.19) | 1.10 (0.84–1.44) |
AST (U/L) | ≤24 | 25–30 | 31–36 | ≥37 |
Cases/subjects at risk | 277/1,214 | 329/1,294 | 330/1,145 | 435/1,111 |
OR (95% CI: lower–upper) | 1.00 | 1.08 (0.88–1.33) | 1.13 (0.91–1.40) | 1.56 (1.25–1.95) |
ALP (U/L) | ≤52 | 53–61 | 62–71 | ≥72 |
Cases/subjects at risk | 356/1,288 | 314/1,106 | 332/1,202 | 369/1,168 |
OR (95% CI: lower–upper) | 1.00 | 0.95 (0.77–1.16) | 0.92 (0.75–1.12) | 0.95 (0.78–1.15) |
Women | ||||
GGT (U/L) | ≤13 | 14–17 | 18–22 | ≥23 |
Cases/subjects at risk | 160/1,843 | 193/1,386 | 243/1,151 | 463/1,409 |
OR (95% CI: lower–upper) | 1.00 | 1.46 (1.16–1.84) | 1.90 (1.51–2.39) | 2.38 (1.90–2.99) |
ALT (U/L) | ≤13 | 14–18 | 19–23 | ≥24 |
Cases/subjects at risk | 147/1,480 | 210/1,624 | 251/1,248 | 451/1,437 |
OR (95% CI: lower–upper) | 1.00 | 1.24 (0.95–1.62) | 1.35 (1.02–1.79) | 1.55 (1.15–2.09) |
AST (U/L) | ≤22 | 23–26 | 27–31 | ≥32 |
Cases/subjects at risk | 154/1,451 | 231/1,494 | 250/1,434 | 424/1,410 |
OR (95% CI: lower–upper) | 1.00 | 1.32 (1.05–1.68) | 1.17 (0.93–1.49) | 1.86 (1.48–2.35) |
ALP (U/L) | ≤42 | 43–51 | 52–63 | ≥64 |
Cases/subjects at risk | 159/1,556 | 181/1,352 | 316/1,519 | 403/1,362 |
OR (95% CI: lower–upper) | 1.00 | 1.25 (0.95–1.65) | 1.78 (1.38–2.30) | 1.85 (1.41–2.42) |
Q1 | Q2 | Q3 | Q4 | |
---|---|---|---|---|
Men | ||||
GGT (U/L) | ≤20 | 21–29 | 30–43 | ≥44 |
Cases/subjects at risk | 45/1,178 | 151/1,213 | 228/1,167 | 370/1,206 |
OR (95% CI: lower–upper) | 1.00 | 2.65 (1.86–3.78) | 3.28 (2.30–4.68) | 4.97 (3.47–7.11) |
ALT (U/L) | ≤19 | 20–27 | 28–38 | ≥39 |
Cases/subjects at risk | 72/1,191 | 141/1,201 | 191/1,188 | 390/1,184 |
OR (95% CI: lower–upper) | 1.00 | 1.49 (1.09–2.03) | 1.68 (1.23–2.29) | 3.17 (2.33–4.32) |
AST (U/L) | ≤24 | 25–30 | 31–36 | ≥37 |
Cases/subjects at risk | 116/1,214 | 157/1,294 | 203/1,145 | 318/1,111 |
OR (95% CI: lower–upper) | 1.00 | 0.86 (0.65–1.13) | 0.96 (0.73–1.28) | 1.00 (0.74–1.35) |
ALP (U/L) | ≤52 | 53–61 | 62–71 | ≥72 |
Cases/subjects at risk | 188/1,288 | 194/1,106 | 215/1,202 | 197/1,168 |
OR (95% CI: lower–upper) | 1.00 | 1.20 (0.94–1.52) | 1.11 (0.88–1.41) | 0.85 (0.67–1.09) |
Women | ||||
GGT (U/L) | ≤13 | 14–17 | 18–22 | ≥23 |
Cases/subjects at risk | 21/1,843 | 42/1,386 | 71/1,151 | 208/1,409 |
OR (95% CI: lower–upper) | 1.00 | 2.15 (1.26–3.67) | 3.32 (1.99–5.55) | 5.88 (3.56–9.70) |
ALT (U/L) | ≤13 | 14–18 | 19–23 | ≥24 |
Cases/subjects at risk | 22/1,480 | 50/1,624 | 80/1,248 | 190/1,437 |
OR (95% CI: lower–upper) | 1.00 | 1.54 (0.92–2.58) | 2.26 (1.36–3.75) | 2.87 (1.74–4.72) |
AST (U/L) | ≤22 | 23–26 | 27–31 | ≥32 |
Cases/subjects at risk | 36/1,451 | 52/1,494 | 97/1,434 | 157/1,410 |
OR (95% CI: lower–upper) | 1.00 | 0.94 (0.60–1.48) | 1.28 (0.83–1.96) | 1.26 (0.81–1.96) |
ALP (U/L) | ≤42 | 43–51 | 52–63 | ≥64 |
Cases/subjects at risk | 36/1,556 | 58/1,352 | 96/1,519 | 152/1,362 |
OR (95% CI: lower–upper) | 1.00 | 1.38 (0.89–2.15) | 1.56 (0.83–2.37) | 1.75 (0.95–2.68) |
3.4. ROC Analysis of Various Liver Enzymes for the Diagnosis of MetS
Variables | Area | 95% CI | ||
---|---|---|---|---|
Lower | Upper | |||
Men | ||||
GGT (U/L) | 0.73 | 0.71 | 0.75 | |
ALT (U/L) | 0.69 | 0.67 | 0.71 | |
AST (U/L) | 0.67 | 0.65 | 0.69 | |
ALP (U/L) | 0.56 | 0.54 | 0.58 | |
Women | ||||
GGT (U/L) | 0.80 | 0.78 | 0.82 | |
ALT (U/L) | 0.76 | 0.74 | 0.79 | |
AST (U/L) | 0.71 | 0.69 | 0.74 | |
ALP (U/L) | 0.70 | 0.68 | 0.73 |
GGT (U/L) | Sensitivity | Specificity | |
---|---|---|---|
Men | |||
29.50 | 0.77 | 0.57 | |
30.50 | 0.76 | 0.60 | |
31.50 | 0.74 | 0.62 | |
32.50 | 0.71 | 0.64 | |
Women | |||
17.50 | 0.86 | 0.60 | |
18.50 | 0.81 | 0.65 | |
19.50 | 0.76 | 0.70 | |
20.50 | 0.71 | 0.74 | |
21.50 | 0.68 | 0.77 |
4. Discussion
5. Conclusions
Acknowledgments
Conflicts of Interest
References
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Tao, L.; Li, X.; Zhu, H.; Gao, Y.; Luo, Y.; Wang, W.; Wang, Z.; Chen, D.; Wu, L.; Guo, X. Association between γ-Glutamyl Transferase and Metabolic Syndrome: A Cross-Sectional Study of an Adult Population in Beijing. Int. J. Environ. Res. Public Health 2013, 10, 5523-5540. https://doi.org/10.3390/ijerph10115523
Tao L, Li X, Zhu H, Gao Y, Luo Y, Wang W, Wang Z, Chen D, Wu L, Guo X. Association between γ-Glutamyl Transferase and Metabolic Syndrome: A Cross-Sectional Study of an Adult Population in Beijing. International Journal of Environmental Research and Public Health. 2013; 10(11):5523-5540. https://doi.org/10.3390/ijerph10115523
Chicago/Turabian StyleTao, Lixin, Xia Li, Huiping Zhu, Yue Gao, Yanxia Luo, Wei Wang, Zhaoping Wang, Dongning Chen, Lijuan Wu, and Xiuhua Guo. 2013. "Association between γ-Glutamyl Transferase and Metabolic Syndrome: A Cross-Sectional Study of an Adult Population in Beijing" International Journal of Environmental Research and Public Health 10, no. 11: 5523-5540. https://doi.org/10.3390/ijerph10115523