CINXE.COM
Abdominal obesity and metabolic syndrome | Nature
<!DOCTYPE html> <html lang="en" class="grade-c"> <head> <title>Abdominal obesity and metabolic syndrome | Nature</title> <link rel="alternate" type="application/rss+xml" href="https://www.nature.com/nature.rss"/> <script id="save-data-connection-testing"> function hasConnection() { return navigator.connection || navigator.mozConnection || navigator.webkitConnection || navigator.msConnection; } function createLink(src) { var preloadLink = document.createElement("link"); preloadLink.rel = "preload"; preloadLink.href = src; preloadLink.as = "font"; preloadLink.type = "font/woff2"; preloadLink.crossOrigin = ""; document.head.insertBefore(preloadLink, document.head.firstChild); } var connectionDetail = { saveDataEnabled: false, slowConnection: false }; var connection = hasConnection(); if (connection) { connectionDetail.saveDataEnabled = connection.saveData; if (/\slow-2g|2g/.test(connection.effectiveType)) { connectionDetail.slowConnection = true; } } if (!(connectionDetail.saveDataEnabled || connectionDetail.slowConnection)) { createLink("/static/fonts/HardingText-Regular-Web-cecd90984f.woff2"); } else { document.documentElement.classList.add('save-data'); } </script> <link rel="preconnect" href="https://cmp.nature.com" crossorigin> <meta http-equiv="X-UA-Compatible" content="IE=edge"> <meta name="applicable-device" content="pc,mobile"> <meta name="viewport" content="width=device-width,initial-scale=1.0,maximum-scale=5,user-scalable=yes"> <meta name="360-site-verification" content="5a2dc4ab3fcb9b0393241ffbbb490480" /> <script data-test="dataLayer"> window.dataLayer = [{"content":{"category":{"contentType":"review article","legacy":{"webtrendsPrimaryArticleType":"reviews","webtrendsSubjectTerms":null,"webtrendsContentCategory":null,"webtrendsContentCollection":null,"webtrendsContentGroup":"Nature","webtrendsContentGroupType":null,"webtrendsContentSubGroup":"Review Article","status":null}},"article":{"doi":"10.1038/nature05488"},"attributes":{"cms":null,"deliveryPlatform":"oscar","copyright":{"open":false,"legacy":{"webtrendsLicenceType":null}}},"contentInfo":{"authors":["Jean-Pierre Després","Isabelle Lemieux"],"publishedAt":1165968000,"publishedAtString":"2006-12-13","title":"Abdominal obesity and metabolic syndrome","legacy":null,"publishedAtTime":null,"documentType":"aplusplus","subjects":""},"journal":{"pcode":"nature","title":"nature","volume":"444","issue":"7121","id":41586,"publishingModel":"Hybrid Access"},"authorization":{"status":false},"features":[{"name":"furtherReadingSection","present":true}],"collection":null},"page":{"category":{"pageType":"article"},"attributes":{"template":"mosaic","featureFlags":[{"name":"nature-onwards-journey","active":false}],"testGroup":null},"search":null},"privacy":{},"version":"1.0.0","product":null,"session":null,"user":null,"backHalfContent":true,"country":"SG","hasBody":true,"uneditedManuscript":false,"twitterId":["o3xnx","o43y9","o3ef7"],"baiduId":"d38bce82bcb44717ccc29a90c4b781ea","japan":false}]; window.dataLayer.push({ ga4MeasurementId: 'G-ERRNTNZ807', ga360TrackingId: 'UA-71668177-1', twitterId: ['3xnx', 'o43y9', 'o3ef7'], baiduId: 'd38bce82bcb44717ccc29a90c4b781ea', ga4ServerUrl: 'https://collect.nature.com', imprint: 'nature' }); </script> <script> (function(w, d) { w.config = w.config || {}; w.config.mustardcut = false; if (w.matchMedia && w.matchMedia('only print, only all and (prefers-color-scheme: no-preference), only all and (prefers-color-scheme: light), only all and (prefers-color-scheme: dark)').matches) { w.config.mustardcut = true; d.classList.add('js'); d.classList.remove('grade-c'); d.classList.remove('no-js'); } })(window, document.documentElement); </script> <style>@media only print, only all and (prefers-color-scheme: no-preference), only all and (prefers-color-scheme: light), only all and (prefers-color-scheme: dark) { .c-article-editorial-summary__container .c-article-editorial-summary__article-title,.c-card--major .c-card__title,.c-card__title,.u-h2,.u-h3,h2,h3{-webkit-font-smoothing:antialiased;font-family:Harding,Palatino,serif;font-weight:700;letter-spacing:-.0117156rem}.c-article-editorial-summary__container .c-article-editorial-summary__article-title,.c-card__title,.u-h3,h3{font-size:1.25rem;line-height:1.4rem}.c-reading-companion__figure-title,.u-h4,h4{-webkit-font-smoothing:antialiased;font-weight:700;line-height:1.4rem}html{text-size-adjust:100%;box-sizing:border-box;font-size:100%;height:100%;line-height:1.15;overflow-y:scroll}body{background:#eee;color:#222;font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;font-size:1.125rem;line-height:1.76;margin:0;min-height:100%}details,main{display:block}h1{font-size:2em;margin:.67em 0}a,sup{vertical-align:baseline}a{background-color:transparent;color:#069;overflow-wrap:break-word;text-decoration:underline;text-decoration-skip-ink:auto;word-break:break-word}b{font-weight:bolder}sup{font-size:75%;line-height:0;position:relative;top:-.5em}img{border:0;height:auto;max-width:100%;vertical-align:middle}button,input,select{font-family:inherit;font-size:100%;line-height:1.15;margin:0}button,input{overflow:visible}button,select{text-transform:none}[type=submit],button{-webkit-appearance:button}[type=checkbox]{box-sizing:border-box;padding:0}summary{display:list-item}[hidden]{display:none}button{border-radius:0;cursor:pointer;font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif}h1{-webkit-font-smoothing:antialiased;font-family:Harding,Palatino,serif;font-size:2rem;font-weight:700;letter-spacing:-.0390625rem;line-height:2.25rem}.c-card--major .c-card__title,.u-h2,.u-h3,h2{font-family:Harding,Palatino,serif;letter-spacing:-.0117156rem}.c-card--major .c-card__title,.u-h2,h2{-webkit-font-smoothing:antialiased;font-size:1.5rem;font-weight:700;line-height:1.6rem}.u-h3{font-size:1.25rem}.c-card__title,.c-reading-companion__figure-title,.u-h3,.u-h4,h4,h5,h6{-webkit-font-smoothing:antialiased;font-weight:700;line-height:1.4rem}.c-article-editorial-summary__container .c-article-editorial-summary__article-title,.c-card__title,h3{font-family:Harding,Palatino,serif;font-size:1.25rem}.c-article-editorial-summary__container .c-article-editorial-summary__article-title,h3{-webkit-font-smoothing:antialiased;font-weight:700;letter-spacing:-.0117156rem;line-height:1.4rem}.c-reading-companion__figure-title,.u-h4,h4{font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;font-size:1.125rem;letter-spacing:-.0117156rem}button:focus{outline:3px solid #fece3e;will-change:transform}input+label{padding-left:.5em}nav ol,nav ul{list-style:none none}p:empty{display:none}.sans-serif{font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif}.article-page{background:#fff}.c-article-header{font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;margin-bottom:40px}.c-article-identifiers{color:#6f6f6f;display:flex;flex-wrap:wrap;font-size:1rem;line-height:1.3;list-style:none;margin:0 0 8px;padding:0}.c-article-identifiers__item{border-right:1px solid #6f6f6f;list-style:none;margin-right:8px;padding-right:8px}.c-article-identifiers__item:last-child{border-right:0;margin-right:0;padding-right:0}.c-article-title{font-size:1.5rem;line-height:1.25;margin:0 0 16px}@media only screen and (min-width:768px){.c-article-title{font-size:1.875rem;line-height:1.2}}.c-article-author-list{display:inline;font-size:1rem;list-style:none;margin:0 8px 0 0;padding:0;width:100%}.c-article-author-list__item{display:inline;padding-right:0}.c-article-author-list svg{margin-left:4px}.c-article-author-list__show-more{display:none;margin-right:4px}.c-article-author-list__button,.js .c-article-author-list__item--hide,.js .c-article-author-list__show-more{display:none}.js .c-article-author-list--long .c-article-author-list__show-more,.js .c-article-author-list--long+.c-article-author-list__button{display:inline}@media only screen and (max-width:539px){.js .c-article-author-list__item--hide-small-screen{display:none}.js .c-article-author-list--short .c-article-author-list__show-more,.js .c-article-author-list--short+.c-article-author-list__button{display:inline}}#uptodate-client,.js .c-article-author-list--expanded .c-article-author-list__show-more{display:none!important}.js .c-article-author-list--expanded .c-article-author-list__item--hide-small-screen{display:inline!important}.c-article-author-list__button,.c-button-author-list{background:#ebf1f5;border:4px solid #ebf1f5;border-radius:20px;color:#666;font-size:.875rem;line-height:1.4;padding:2px 11px 2px 8px;text-decoration:none}.c-article-author-list__button svg,.c-button-author-list svg{margin:1px 4px 0 0}.c-article-author-list__button:hover,.c-button-author-list:hover{background:#069;border-color:transparent;color:#fff}.c-article-info-details{font-size:1rem;margin-bottom:8px;margin-top:16px}.c-article-info-details__cite-as{border-left:1px solid #6f6f6f;margin-left:8px;padding-left:8px}.c-article-metrics-bar{display:flex;flex-wrap:wrap;font-size:1rem;line-height:1.3}.c-article-metrics-bar__wrapper{margin:16px 0}.c-article-metrics-bar__item{align-items:baseline;border-right:1px solid #6f6f6f;margin-right:8px}.c-article-metrics-bar__item:last-child{border-right:0}.c-article-metrics-bar__count{font-weight:700;margin:0}.c-article-metrics-bar__label{color:#626262;font-style:normal;font-weight:400;margin:0 10px 0 5px}.c-article-metrics-bar__details{margin:0}.c-article-main-column{font-family:Harding,Palatino,serif;margin-right:8.6%;width:60.2%}@media only screen and (max-width:1023px){.c-article-main-column{margin-right:0;width:100%}}.c-article-extras{float:left;font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;width:31.2%}@media only screen and (max-width:1023px){.c-article-extras{display:none}}.c-article-associated-content__container .c-article-associated-content__title,.c-article-section__title{border-bottom:2px solid #d5d5d5;font-size:1.25rem;margin:0;padding-bottom:8px}@media only screen and (min-width:768px){.c-article-associated-content__container .c-article-associated-content__title,.c-article-section__title{font-size:1.5rem;line-height:1.24}}.c-article-associated-content__container .c-article-associated-content__title{margin-bottom:8px}.c-article-body p{margin-bottom:24px;margin-top:0}.c-article-section{clear:both}.c-article-section__content{margin-bottom:40px;padding-top:8px}@media only screen and (max-width:1023px){.c-article-section__content{padding-left:0}}.c-article-authors-search{margin-bottom:24px;margin-top:0}.c-article-authors-search__item,.c-article-authors-search__title{font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif}.c-article-authors-search__title{color:#626262;font-size:1.05rem;font-weight:700;margin:0;padding:0}.c-article-authors-search__item{font-size:1rem}.c-article-authors-search__text{margin:0}.c-article-license__badge,c-card__section{margin-top:8px}.c-code-block{border:1px solid #eee;font-family:monospace;margin:0 0 24px;padding:20px}.c-code-block__heading{font-weight:400;margin-bottom:16px}.c-code-block__line{display:block;overflow-wrap:break-word;white-space:pre-wrap}.c-article-share-box__no-sharelink-info{font-size:.813rem;font-weight:700;margin-bottom:24px;padding-top:4px}.c-article-share-box__only-read-input{border:1px solid #d5d5d5;box-sizing:content-box;display:inline-block;font-size:.875rem;font-weight:700;height:24px;margin-bottom:8px;padding:8px 10px}.c-article-share-box__button--link-like{background-color:transparent;border:0;color:#069;cursor:pointer;font-size:.875rem;margin-bottom:8px;margin-left:10px}.c-article-editorial-summary__container{font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;font-size:1rem}.c-article-editorial-summary__container .c-article-editorial-summary__content p:last-child{margin-bottom:0}.c-article-editorial-summary__container .c-article-editorial-summary__content--less{max-height:9.5rem;overflow:hidden}.c-article-editorial-summary__container .c-article-editorial-summary__button{background-color:#fff;border:0;color:#069;font-size:.875rem;margin-bottom:16px}.c-article-editorial-summary__container .c-article-editorial-summary__button.active,.c-article-editorial-summary__container .c-article-editorial-summary__button.hover,.c-article-editorial-summary__container .c-article-editorial-summary__button:active,.c-article-editorial-summary__container .c-article-editorial-summary__button:hover{text-decoration:underline;text-decoration-skip-ink:auto}.c-article-associated-content__container .c-article-associated-content__collection-label{font-size:.875rem;line-height:1.4}.c-article-associated-content__container .c-article-associated-content__collection-title{line-height:1.3}.c-context-bar{box-shadow:0 0 10px 0 rgba(51,51,51,.2);position:relative;width:100%}.c-context-bar__title{display:none}.c-reading-companion{clear:both;min-height:389px}.c-reading-companion__sticky{max-width:389px}.c-reading-companion__scroll-pane{margin:0;min-height:200px;overflow:hidden auto}.c-reading-companion__tabs{display:flex;flex-flow:row nowrap;font-size:1rem;list-style:none;margin:0 0 8px;padding:0}.c-reading-companion__tabs>li{flex-grow:1}.c-reading-companion__tab{background-color:#eee;border:1px solid #d5d5d5;border-image:initial;border-left-width:0;color:#069;font-size:1rem;padding:8px 8px 8px 15px;text-align:left;width:100%}.c-reading-companion__tabs li:first-child .c-reading-companion__tab{border-left-width:1px}.c-reading-companion__tab--active{background-color:#fff;border-bottom:1px solid #fff;color:#222;font-weight:700}.c-reading-companion__sections-list{list-style:none;padding:0}.c-reading-companion__figures-list,.c-reading-companion__references-list{list-style:none;min-height:389px;padding:0}.c-reading-companion__references-list--numeric{list-style:decimal inside}.c-reading-companion__sections-list{margin:0 0 8px;min-height:50px}.c-reading-companion__section-item{font-size:1rem;padding:0}.c-reading-companion__section-item a{display:block;line-height:1.5;overflow:hidden;padding:8px 0 8px 16px;text-overflow:ellipsis;white-space:nowrap}.c-reading-companion__figure-item{border-top:1px solid #d5d5d5;font-size:1rem;padding:16px 8px 16px 0}.c-reading-companion__figure-item:first-child{border-top:none;padding-top:8px}.c-reading-companion__reference-item{border-top:1px solid #d5d5d5;font-size:1rem;padding:8px 8px 8px 16px}.c-reading-companion__reference-item:first-child{border-top:none}.c-reading-companion__reference-item a{word-break:break-word}.c-reading-companion__reference-citation{display:inline}.c-reading-companion__reference-links{font-size:.813rem;font-weight:700;list-style:none;margin:8px 0 0;padding:0;text-align:right}.c-reading-companion__reference-links>a{display:inline-block;padding-left:8px}.c-reading-companion__reference-links>a:first-child{display:inline-block;padding-left:0}.c-reading-companion__figure-title{display:block;margin:0 0 8px}.c-reading-companion__figure-links{display:flex;justify-content:space-between;margin:8px 0 0}.c-reading-companion__figure-links>a{align-items:center;display:flex}.c-reading-companion__figure-full-link svg{height:.8em;margin-left:2px}.c-reading-companion__panel{border-top:none;display:none;margin-top:0;padding-top:0}.c-cod,.c-reading-companion__panel--active{display:block}.c-cod{font-size:1rem;width:100%}.c-cod__form{background:#ebf0f3}.c-cod__prompt{font-size:1.125rem;line-height:1.3;margin:0 0 24px}.c-cod__label{display:block;margin:0 0 4px}.c-cod__row{display:flex;margin:0 0 16px}.c-cod__row:last-child{margin:0}.c-cod__input{border:1px solid #d5d5d5;border-radius:2px;flex-basis:75%;flex-shrink:0;margin:0;padding:13px}.c-cod__input--submit{background-color:#069;border:1px solid #069;color:#fff;flex-shrink:1;margin-left:8px;transition:background-color .2s ease-out 0s,color .2s ease-out 0s}.c-cod__input--submit-single{flex-basis:100%;flex-shrink:0;margin:0}.c-cod__input--submit:focus,.c-cod__input--submit:hover{background-color:#fff;color:#069}.c-pdf-download__link .u-icon{padding-top:2px}.c-pdf-download{display:flex;margin-bottom:16px;max-height:48px}@media only screen and (min-width:540px){.c-pdf-download{max-height:none}}@media only screen and (min-width:1024px){.c-pdf-download{max-height:48px}}.c-pdf-download__link{display:flex;flex:1 1 0%}.c-pdf-download__link:hover{text-decoration:none}.c-pdf-download__text{padding-right:4px}@media only screen and (max-width:539px){.c-pdf-download__text{text-transform:capitalize}}@media only screen and (min-width:540px){.c-pdf-download__text{padding-right:8px}}.c-context-bar--sticky .c-pdf-download{display:block;margin-bottom:0;white-space:nowrap}@media only screen and (max-width:539px){.c-pdf-download .u-sticky-visually-hidden{clip:rect(0,0,0,0);border:0;height:1px;margin:-100%;overflow:hidden;padding:0;position:absolute!important;width:1px}}.c-pdf-container{display:flex;justify-content:flex-end}@media only screen and (max-width:539px){.c-pdf-container .c-pdf-download{display:flex;flex-basis:100%}}.c-pdf-container .c-pdf-download+.c-pdf-download{margin-left:16px}.c-article-extras .c-pdf-container .c-pdf-download{width:100%}.c-article-extras .c-pdf-container .c-pdf-download+.c-pdf-download{margin-left:0}@media only screen and (min-width:540px){.c-context-bar--sticky .c-pdf-download__link{align-items:center;flex:1 1 183px}}@media only screen and (max-width:320px){.c-context-bar--sticky .c-pdf-download__link{padding:16px}}.article-page--commercial .c-article-main-column .c-pdf-button__container .c-pdf-download{display:none}@media only screen and (max-width:1023px){.article-page--commercial .c-article-main-column .c-pdf-button__container .c-pdf-download{display:block}}.c-status-message--success{border-bottom:2px solid #00b8b0;justify-content:center;margin-bottom:16px;padding-bottom:8px}.c-recommendations-list__item .c-card{flex-basis:100%}.c-recommendations-list__item .c-card__image{align-items:baseline;flex:1 1 40%;margin:0 0 0 16px;max-width:150px}.c-recommendations-list__item .c-card__image img{border:1px solid #cedbe0;height:auto;min-height:0;position:static}@media only screen and (max-width:1023px){.c-recommendations-list__item .c-card__image{display:none}}.c-card__layout{display:flex;flex:1 1 auto;justify-content:space-between}.c-card__title-recommendation{-webkit-box-orient:vertical;-webkit-line-clamp:4;display:-webkit-box;font-size:1rem;font-weight:700;line-height:1.4;margin:0 0 8px;max-height:5.6em;overflow:hidden!important;text-overflow:ellipsis}.c-card__title-recommendation .c-card__link{color:inherit}.c-card__title-recommendation .c-card__link:hover{text-decoration:underline}.c-card__title-recommendation .MathJax_Display{display:inline!important}.c-card__link:not(.c-card__link--no-block-link):before{z-index:1}.c-article-metrics__heading a,.c-article-metrics__posts .c-card__title a,.c-article-recommendations-card__link{color:inherit}.c-recommendations-column-switch .c-meta{margin-top:auto}.c-article-recommendations-card__meta-type,.c-meta .c-meta__item:first-child{font-weight:700}.c-article-body .c-article-recommendations-card__authors{display:none;font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;font-size:.875rem;line-height:1.5;margin:0 0 8px}@media only screen and (max-width:539px){.c-article-body .c-article-recommendations-card__authors{display:block;margin:0}}.c-article-metrics__posts .c-card__title{font-size:1.05rem}.c-article-metrics__posts .c-card__title+span{color:#6f6f6f;font-size:1rem}p{overflow-wrap:break-word;word-break:break-word}.c-ad{text-align:center}@media only screen and (min-width:320px){.c-ad{padding:8px}}.c-ad--728x90{background-color:#ccc;display:none}.c-ad--728x90 .c-ad__inner{min-height:calc(1.5em + 94px)}@media only screen and (min-width:768px){.js .c-ad--728x90{display:none}}.c-ad__label{color:#333;font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;font-size:.875rem;font-weight:400;line-height:1.5;margin-bottom:4px}.c-author-list{color:#6f6f6f;font-family:inherit;font-size:1rem;line-height:inherit;list-style:none;margin:0;padding:0}.c-author-list>li,.c-breadcrumbs>li,.c-footer__links>li,.js .c-author-list,.u-list-comma-separated>li,.u-list-inline>li{display:inline}.c-author-list>li:not(:first-child):not(:last-child):before{content:", "}.c-author-list>li:not(:only-child):last-child:before{content:" & "}.c-author-list--compact{font-size:.875rem;line-height:1.4}.c-author-list--truncated>li:not(:only-child):last-child:before{content:" ... "}.js .c-author-list__hide{display:none;visibility:hidden}.js .c-author-list__hide:first-child+*{margin-block-start:0}.c-meta{color:inherit;font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;font-size:.875rem;line-height:1.4;list-style:none;margin:0;padding:0}.c-meta--large{font-size:1rem}.c-meta--large .c-meta__item{margin-bottom:8px}.c-meta__item{display:inline-block;margin-bottom:4px}.c-meta__item:not(:last-child){border-right:1px solid #d5d5d5;margin-right:4px;padding-right:4px}@media only screen and (max-width:539px){.c-meta__item--block-sm-max{display:block}.c-meta__item--block-sm-max:not(:last-child){border-right:none;margin-right:0;padding-right:0}}@media only screen and (min-width:1024px){.c-meta__item--block-at-lg{display:block}.c-meta__item--block-at-lg:not(:last-child){border-right:none;margin-right:0;padding-right:0}}.c-meta__type{font-weight:700;text-transform:none}.c-skip-link{background:#069;bottom:auto;color:#fff;font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;font-size:.875rem;padding:8px;position:absolute;text-align:center;transform:translateY(-100%);z-index:9999}@media (prefers-reduced-motion:reduce){.c-skip-link{transition:top .3s ease-in-out 0s}}@media print{.c-skip-link{display:none}}.c-skip-link:link{color:#fff}.c-status-message{align-items:center;box-sizing:border-box;display:flex;font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;font-size:1rem;position:relative;width:100%}.c-card__summary>p:last-child,.c-status-message :last-child{margin-bottom:0}.c-status-message--boxed{background-color:#fff;border:1px solid #eee;border-radius:2px;line-height:1.4;padding:16px}.c-status-message__heading{font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;font-size:1rem;font-weight:700}.c-status-message__icon{fill:currentcolor;display:inline-block;flex:0 0 auto;height:1.5em;margin-right:8px;transform:translate(0);vertical-align:text-top;width:1.5em}.c-status-message__icon--top{align-self:flex-start}.c-status-message--info .c-status-message__icon{color:#003f8d}.c-status-message--boxed.c-status-message--info{border-bottom:4px solid #003f8d}.c-status-message--error .c-status-message__icon{color:#c40606}.c-status-message--boxed.c-status-message--error{border-bottom:4px solid #c40606}.c-status-message--success .c-status-message__icon{color:#00b8b0}.c-status-message--boxed.c-status-message--success{border-bottom:4px solid #00b8b0}.c-status-message--warning .c-status-message__icon{color:#edbc53}.c-status-message--boxed.c-status-message--warning{border-bottom:4px solid #edbc53}.c-breadcrumbs{color:#000;font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;font-size:1rem;list-style:none;margin:0;padding:0}.c-breadcrumbs__link{color:#666}svg.c-breadcrumbs__chevron{fill:#888;height:10px;margin:4px 4px 0;width:10px}@media only screen and (max-width:539px){.c-breadcrumbs .c-breadcrumbs__item{display:none}.c-breadcrumbs .c-breadcrumbs__item:last-child,.c-breadcrumbs .c-breadcrumbs__item:nth-last-child(2){display:inline}}.c-card{background-color:transparent;border:0;box-shadow:none;display:flex;flex-direction:column;font-size:14px;min-width:0;overflow:hidden;padding:0;position:relative}.c-card--no-shape{background:0 0;border:0;box-shadow:none}.c-card__image{display:flex;justify-content:center;overflow:hidden;padding-bottom:56.25%;position:relative}@supports (aspect-ratio:1/1){.c-card__image{padding-bottom:0}}.c-card__image img{left:0;min-height:100%;min-width:100%;position:absolute}@supports ((-o-object-fit:cover) or (object-fit:cover)){.c-card__image img{height:100%;object-fit:cover;width:100%}}.c-card__body{flex:1 1 auto;padding:16px}.c-card--no-shape .c-card__body{padding:0}.c-card--no-shape .c-card__body:not(:first-child){padding-top:16px}.c-card__title{letter-spacing:-.01875rem;margin-bottom:8px;margin-top:0}[lang=de] .c-card__title{hyphens:auto}.c-card__summary{line-height:1.4}.c-card__summary>p{margin-bottom:5px}.c-card__summary a{text-decoration:underline}.c-card__link:not(.c-card__link--no-block-link):before{bottom:0;content:"";left:0;position:absolute;right:0;top:0}.c-card--flush .c-card__body{padding:0}.c-card--major{font-size:1rem}.c-card--dark{background-color:#29303c;border-width:0;color:#e3e4e5}.c-card--dark .c-card__title{color:#fff}.c-card--dark .c-card__link,.c-card--dark .c-card__summary a{color:inherit}.c-header{background-color:#fff;border-bottom:5px solid #000;font-size:1rem;line-height:1.4;margin-bottom:16px}.c-header__row{padding:0;position:relative}.c-header__row:not(:last-child){border-bottom:1px solid #eee}.c-header__split{align-items:center;display:flex;justify-content:space-between}.c-header__logo-container{flex:1 1 0px;line-height:0;margin:8px 24px 8px 0}.c-header__logo{transform:translateZ(0)}.c-header__logo img{max-height:32px}.c-header__container{margin:0 auto;max-width:1280px}.c-header__menu{align-items:center;display:flex;flex:0 1 auto;flex-wrap:wrap;font-weight:700;gap:8px 8px;line-height:1.4;list-style:none;margin:0 -8px;padding:0}@media print{.c-header__menu{display:none}}@media only screen and (max-width:1023px){.c-header__menu--hide-lg-max{display:none;visibility:hidden}}.c-header__menu--global{font-weight:400;justify-content:flex-end}.c-header__menu--global svg{display:none;visibility:hidden}.c-header__menu--global svg:first-child+*{margin-block-start:0}@media only screen and (min-width:540px){.c-header__menu--global svg{display:block;visibility:visible}}.c-header__menu--journal{font-size:.875rem;margin:8px 0 8px -8px}@media only screen and (min-width:540px){.c-header__menu--journal{flex-wrap:nowrap;font-size:1rem}}.c-header__item{padding-bottom:0;padding-top:0;position:static}.c-header__item--pipe{border-left:2px solid #eee;padding-left:8px}.c-header__item--padding{padding-bottom:8px;padding-top:8px}@media only screen and (min-width:540px){.c-header__item--dropdown-menu{position:relative}}@media only screen and (min-width:1024px){.c-header__item--hide-lg{display:none;visibility:hidden}}@media only screen and (max-width:767px){.c-header__item--hide-md-max{display:none;visibility:hidden}.c-header__item--hide-md-max:first-child+*{margin-block-start:0}}.c-header__link{align-items:center;color:inherit;display:inline-flex;gap:4px 4px;padding:8px;white-space:nowrap}.c-header__link svg{transition-duration:.2s}.c-header__show-text{display:none;visibility:hidden}.has-tethered .c-header__heading--js-hide:first-child+*{margin-block-start:0}@media only screen and (min-width:540px){.c-header__show-text{display:inline;visibility:visible}}.c-header__dropdown{background-color:#000;border-bottom:1px solid #2f2f2f;color:#eee;font-size:.875rem;line-height:1.2;padding:16px 0}@media print{.c-header__dropdown{display:none}}.c-header__heading{display:inline-block;font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;font-size:1.25rem;font-weight:400;line-height:1.4;margin-bottom:8px}.c-header__heading--keyline{border-top:1px solid;border-color:#2f2f2f;margin-top:16px;padding-top:16px;width:100%}.c-header__list{display:flex;flex-wrap:wrap;gap:0 16px;list-style:none;margin:0 -8px}.c-header__flush{margin:0 -8px}.c-header__visually-hidden{clip:rect(0,0,0,0);border:0;height:1px;margin:-100%;overflow:hidden;padding:0;position:absolute!important;width:1px}.c-header__search-form{margin-bottom:8px}.c-header__search-layout{display:flex;flex-wrap:wrap;gap:16px 16px}.c-header__search-layout>:first-child{flex:999 1 auto}.c-header__search-layout>*{flex:1 1 auto}.c-header__search-layout--max-width{max-width:720px}.c-header__search-button{align-items:center;background-color:transparent;background-image:none;border:1px solid #fff;border-radius:2px;color:#fff;cursor:pointer;display:flex;font-family:sans-serif;font-size:1rem;justify-content:center;line-height:1.15;margin:0;padding:8px 16px;position:relative;text-decoration:none;transition:all .25s ease 0s,color .25s ease 0s,border-color .25s ease 0s;width:100%}.u-button svg,.u-button--primary svg{fill:currentcolor}.c-header__input,.c-header__select{border:1px solid;border-radius:3px;box-sizing:border-box;font-size:1rem;padding:8px 16px;width:100%}.c-header__select{-webkit-appearance:none;background-image:url("data:image/svg+xml,%3Csvg height='16' viewBox='0 0 16 16' width='16' xmlns='http://www.w3.org/2000/svg'%3E%3Cpath d='m5.58578644 3-3.29289322-3.29289322c-.39052429-.39052429-.39052429-1.02368927 0-1.41421356s1.02368927-.39052429 1.41421356 0l4 4c.39052429.39052429.39052429 1.02368927 0 1.41421356l-4 4c-.39052429.39052429-1.02368927.39052429-1.41421356 0s-.39052429-1.02368927 0-1.41421356z' fill='%23333' fill-rule='evenodd' transform='matrix(0 1 -1 0 11 3)'/%3E%3C/svg%3E");background-position:right .7em top 50%;background-repeat:no-repeat;background-size:1em;box-shadow:0 1px 0 1px rgba(0,0,0,.04);display:block;margin:0;max-width:100%;min-width:150px}@media only screen and (min-width:540px){.c-header__menu--journal .c-header__item--dropdown-menu:last-child .c-header__dropdown.has-tethered{left:auto;right:0}}@media only screen and (min-width:768px){.c-header__menu--journal .c-header__item--dropdown-menu:last-child .c-header__dropdown.has-tethered{left:0;right:auto}}.c-header__dropdown.has-tethered{border-bottom:0;border-radius:0 0 2px 2px;left:0;position:absolute;top:100%;transform:translateY(5px);width:100%;z-index:1}@media only screen and (min-width:540px){.c-header__dropdown.has-tethered{transform:translateY(8px);width:auto}}@media only screen and (min-width:768px){.c-header__dropdown.has-tethered{min-width:225px}}.c-header__dropdown--full-width.has-tethered{padding:32px 0 24px;transform:none;width:100%}.has-tethered .c-header__heading--js-hide{display:none;visibility:hidden}.has-tethered .c-header__list--js-stack{flex-direction:column}.has-tethered .c-header__item--keyline,.has-tethered .c-header__list~.c-header__list .c-header__item:first-child{border-top:1px solid #d5d5d5;margin-top:8px;padding-top:8px}.c-header__item--snid-account-widget{display:flex}.c-header__container{padding:0 4px}.c-header__list{padding:0 12px}.c-header__menu .c-header__link{font-size:14px}.c-header__item--snid-account-widget .c-header__link{padding:8px}.c-header__menu--journal{margin-left:0}@media only screen and (min-width:540px){.c-header__container{padding:0 16px}.c-header__menu--journal{margin-left:-8px}.c-header__menu .c-header__link{font-size:16px}.c-header__link--search{gap:13px 13px}}.u-button{align-items:center;background-color:transparent;background-image:none;border:1px solid #069;border-radius:2px;color:#069;cursor:pointer;display:inline-flex;font-family:sans-serif;font-size:1rem;justify-content:center;line-height:1.3;margin:0;padding:8px;position:relative;text-decoration:none;transition:all .25s ease 0s,color .25s ease 0s,border-color .25s ease 0s;width:auto}.u-button--primary{background-color:#069;background-image:none;border:1px solid #069;color:#fff}.u-button--full-width{display:flex;width:100%}.u-display-none{display:none}.js .u-js-hide,.u-hide{display:none;visibility:hidden}.u-hide:first-child+*{margin-block-start:0}.u-visually-hidden{clip:rect(0,0,0,0);border:0;height:1px;margin:-100%;overflow:hidden;padding:0;position:absolute!important;width:1px}@media print{.u-hide-print{display:none}}@media only screen and (min-width:1024px){.u-hide-at-lg{display:none;visibility:hidden}.u-hide-at-lg:first-child+*{margin-block-start:0}}.u-clearfix:after,.u-clearfix:before{content:"";display:table}.u-clearfix:after{clear:both}.u-color-open-access{color:#b74616}.u-float-left{float:left}.u-icon{fill:currentcolor;display:inline-block;height:1em;transform:translate(0);vertical-align:text-top;width:1em}.u-full-height{height:100%}.u-list-reset{list-style:none;margin:0;padding:0}.u-sans-serif{font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif}.u-container{margin:0 auto;max-width:1280px;padding:0 16px}.u-justify-content-space-between{justify-content:space-between}.u-mt-32{margin-top:32px}.u-mb-8{margin-bottom:8px}.u-mb-16{margin-bottom:16px}.u-mb-24{margin-bottom:24px}.u-mb-32{margin-bottom:32px}.c-nature-box svg+.c-article__button-text,.u-ml-8{margin-left:8px}.u-pa-16{padding:16px}html *,html :after,html :before{box-sizing:inherit}.c-article-section__title,.c-article-title{font-weight:700}.c-card__title{line-height:1.4em}.c-article__button{background-color:#069;border:1px solid #069;border-radius:2px;color:#fff;display:flex;font-family:-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Oxygen-Sans,Ubuntu,Cantarell,Helvetica Neue,sans-serif;font-size:.875rem;line-height:1.4;margin-bottom:16px;padding:13px;transition:background-color .2s ease-out 0s,color .2s ease-out 0s}.c-article__button,.c-article__button:hover{text-decoration:none}.c-article__button--inverted,.c-article__button:hover{background-color:#fff;color:#069}.c-article__button--inverted:hover{background-color:#069;color:#fff}.c-header__link{text-decoration:inherit}.grade-c-hide{display:block}.u-lazy-ad-wrapper{background-color:#ccc;display:none;min-height:137px}@media only screen and (min-width:768px){.u-lazy-ad-wrapper{display:block}}.c-nature-box{background-color:#fff;border:1px solid #d5d5d5;border-radius:2px;box-shadow:0 0 5px 0 rgba(51,51,51,.1);line-height:1.3;margin-bottom:24px;padding:16px 16px 3px}.c-nature-box__text{font-size:1rem;margin-bottom:16px}.c-nature-box .c-pdf-download{margin-bottom:16px!important}.c-nature-box--version{background-color:#eee}.c-nature-box__wrapper{transform:translateZ(0)}.c-nature-box__wrapper--placeholder{min-height:165px}.c-pdf-download__link{padding:13px 24px} } </style> <link data-test="critical-css-handler" data-inline-css-source="critical-css" rel="stylesheet" href="/static/css/enhanced-article-nature-branded-d54f9178e8.css" media="print" onload="this.media='only print, only all and (prefers-color-scheme: no-preference), only all and (prefers-color-scheme: light), only all and (prefers-color-scheme: dark)';this.onload=null"> <noscript> <link rel="stylesheet" type="text/css" href="/static/css/enhanced-article-nature-branded-d54f9178e8.css" media="only print, only all and (prefers-color-scheme: no-preference), only all and (prefers-color-scheme: light), only all and (prefers-color-scheme: dark)"> </noscript> <link rel="stylesheet" type="text/css" href="/static/css/article-print-122346e276.css" media="print"> <link rel="apple-touch-icon" sizes="180x180" href=/static/images/favicons/nature/apple-touch-icon-f39cb19454.png> <link rel="icon" type="image/png" sizes="48x48" href=/static/images/favicons/nature/favicon-48x48-b52890008c.png> <link rel="icon" type="image/png" sizes="32x32" href=/static/images/favicons/nature/favicon-32x32-3fe59ece92.png> <link rel="icon" type="image/png" sizes="16x16" href=/static/images/favicons/nature/favicon-16x16-951651ab72.png> <link rel="manifest" href=/static/manifest.json crossorigin="use-credentials"> <link rel="mask-icon" href=/static/images/favicons/nature/safari-pinned-tab-69bff48fe6.svg color="#000000"> <link rel="shortcut icon" href=/static/images/favicons/nature/favicon.ico> <meta name="msapplication-TileColor" content="#000000"> <meta name="msapplication-config" content=/static/browserconfig.xml> <meta name="theme-color" content="#000000"> <meta name="application-name" content="Nature"> <script> (function () { if ( typeof window.CustomEvent === "function" ) return false; function CustomEvent ( event, params ) { params = params || { bubbles: false, cancelable: false, detail: null }; var evt = document.createEvent( 'CustomEvent' ); evt.initCustomEvent( event, params.bubbles, params.cancelable, params.detail ); return evt; } CustomEvent.prototype = window.Event.prototype; window.CustomEvent = CustomEvent; })(); </script> <!-- Google Tag Manager --> <script data-test="gtm-head"> window.initGTM = function() { if (window.config.mustardcut) { (function (w, d, s, l, i) { w[l] = w[l] || []; w[l].push({'gtm.start': new Date().getTime(), event: 'gtm.js'}); var f = d.getElementsByTagName(s)[0], j = d.createElement(s), dl = l != 'dataLayer' ? '&l=' + l : ''; j.async = true; j.src = 'https://www.googletagmanager.com/gtm.js?id=' + i + dl; f.parentNode.insertBefore(j, f); })(window, document, 'script', 'dataLayer', 'GTM-MRVXSHQ'); } } </script> <!-- End Google Tag Manager --> <script> (function(w,d,t) { function cc() { var h = w.location.hostname; if (h.indexOf('preview-www.nature.com') > -1) return; var e = d.createElement(t), s = d.getElementsByTagName(t)[0]; if (h.indexOf('nature.com') > -1) { if (h.indexOf('test-www.nature.com') > -1) { e.src = 'https://cmp.nature.com/production_live/en/consent-bundle-8-74.js'; e.setAttribute('onload', "initGTM(window,document,'script','dataLayer','GTM-MRVXSHQ')"); } else { e.src = 'https://cmp.nature.com/production_live/en/consent-bundle-8-74.js'; e.setAttribute('onload', "initGTM(window,document,'script','dataLayer','GTM-MRVXSHQ')"); } } else { e.src = '/static/js/cookie-consent-es5-bundle-cb57c2c98a.js'; e.setAttribute('data-consent', h); } s.insertAdjacentElement('afterend', e); } cc(); })(window,document,'script'); </script> <script id="js-position0"> (function(w, d) { w.idpVerifyPrefix = 'https://verify.nature.com'; w.ra21Host = 'https://wayf.springernature.com'; var moduleSupport = (function() { return 'noModule' in d.createElement('script'); })(); if (w.config.mustardcut === true) { w.loader = { index: 0, registered: [], scripts: [ {src: '/static/js/global-article-es6-bundle-c8a573ca90.js', test: 'global-article-js', module: true}, {src: '/static/js/global-article-es5-bundle-d17603b9e9.js', test: 'global-article-js', nomodule: true}, {src: '/static/js/shared-es6-bundle-606cb67187.js', test: 'shared-js', module: true}, {src: '/static/js/shared-es5-bundle-e919764a53.js', test: 'shared-js', nomodule: true}, {src: '/static/js/header-150-es6-bundle-5bb959eaa1.js', test: 'header-150-js', module: true}, {src: '/static/js/header-150-es5-bundle-994fde5b1d.js', test: 'header-150-js', nomodule: true} ].filter(function (s) { if (s.src === null) return false; if (moduleSupport && s.nomodule) return false; return !(!moduleSupport && s.module); }), register: function (value) { this.registered.push(value); }, ready: function () { if (this.registered.length === this.scripts.length) { this.registered.forEach(function (fn) { if (typeof fn === 'function') { setTimeout(fn, 0); } }); this.ready = function () {}; } }, insert: function (s) { var t = d.getElementById('js-position' + this.index); if (t && t.insertAdjacentElement) { t.insertAdjacentElement('afterend', s); } else { d.head.appendChild(s); } ++this.index; }, createScript: function (script, beforeLoad) { var s = d.createElement('script'); s.id = 'js-position' + (this.index + 1); s.setAttribute('data-test', script.test); if (beforeLoad) { s.defer = 'defer'; s.onload = function () { if (script.noinit) { loader.register(true); } if (d.readyState === 'interactive' || d.readyState === 'complete') { loader.ready(); } }; } else { s.async = 'async'; } s.src = script.src; return s; }, init: function () { this.scripts.forEach(function (s) { loader.insert(loader.createScript(s, true)); }); d.addEventListener('DOMContentLoaded', function () { loader.ready(); var conditionalScripts; conditionalScripts = [ {match: 'div[data-pan-container]', src: '/static/js/pan-zoom-es6-bundle-464a2af269.js', test: 'pan-zoom-js', module: true }, {match: 'div[data-pan-container]', src: '/static/js/pan-zoom-es5-bundle-98fb9b653b.js', test: 'pan-zoom-js', nomodule: true }, {match: 'math,span.mathjax-tex', src: '/static/js/math-es6-bundle-23597ae350.js', test: 'math-js', module: true}, {match: 'math,span.mathjax-tex', src: '/static/js/math-es5-bundle-6532c6f78b.js', test: 'math-js', nomodule: true} ]; if (conditionalScripts) { conditionalScripts.filter(function (script) { return !!document.querySelector(script.match) && !((moduleSupport && script.nomodule) || (!moduleSupport && script.module)); }).forEach(function (script) { loader.insert(loader.createScript(script)); }); } }, false); } }; loader.init(); } })(window, document); </script> <meta name="robots" content="noarchive"> <meta name="access" content="No"> <link rel="search" href="https://www.nature.com/search"> <link rel="search" href="https://www.nature.com/opensearch/opensearch.xml" type="application/opensearchdescription+xml" title="nature.com"> <link rel="search" href="https://www.nature.com/opensearch/request" type="application/sru+xml" title="nature.com"> <script type="application/ld+json">{"mainEntity":{"headline":"Abdominal obesity and metabolic syndrome","description":"Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance or full-blown diabetes, and increased risk of developing cardiovascular disease. Proposed criteria for identifying patients with metabolic syndrome have contributed greatly to preventive medicine, but the value of metabolic syndrome as a scientific concept remains controversial. The presence of metabolic syndrome alone cannot predict global cardiovascular disease risk. But abdominal obesity — the most prevalent manifestation of metabolic syndrome — is a marker of 'dysfunctional adipose tissue', and is of central importance in clinical diagnosis. Better risk assessment algorithms are needed to quantify diabetes and cardiovascular disease risk on a global scale.","datePublished":"2006-12-13T00:00:00Z","dateModified":"2006-12-13T00:00:00Z","pageStart":"881","pageEnd":"887","sameAs":"https://doi.org/10.1038/nature05488","keywords":["Science","Humanities and Social Sciences","multidisciplinary"],"image":["https://media.springernature.com/lw1200/springer-static/image/art%3A10.1038%2Fnature05488/MediaObjects/41586_2006_Article_BFnature05488_Fig1_HTML.jpg","https://media.springernature.com/lw1200/springer-static/image/art%3A10.1038%2Fnature05488/MediaObjects/41586_2006_Article_BFnature05488_Fig2_HTML.jpg","https://media.springernature.com/lw1200/springer-static/image/art%3A10.1038%2Fnature05488/MediaObjects/41586_2006_Article_BFnature05488_Figa_HTML.jpg"],"isPartOf":{"name":"Nature","issn":["1476-4687","0028-0836"],"volumeNumber":"444","@type":["Periodical","PublicationVolume"]},"publisher":{"name":"Nature Publishing Group UK","logo":{"url":"https://www.springernature.com/app-sn/public/images/logo-springernature.png","@type":"ImageObject"},"@type":"Organization"},"author":[{"name":"Jean-Pierre Després","affiliation":[{"name":"Québec Heart Institute, Hôpital Laval Research Centre, 2725 chemin Sainte-Foy, Pavilion Marguerite-D'Youville, 4th Floor","address":{"name":"Québec Heart Institute, Hôpital Laval Research Centre, 2725 chemin Sainte-Foy, Pavilion Marguerite-D'Youville, 4th Floor, Quebec City, Canada","@type":"PostalAddress"},"@type":"Organization"},{"name":"Université Laval","address":{"name":"Division of Kinesiology, Department of Social and Preventive Medicine, Université Laval, Quebec City, Canada","@type":"PostalAddress"},"@type":"Organization"}],"@type":"Person"},{"name":"Isabelle Lemieux","affiliation":[{"name":"Québec Heart Institute, Hôpital Laval Research Centre, 2725 chemin Sainte-Foy, Pavilion Marguerite-D'Youville, 4th Floor","address":{"name":"Québec Heart Institute, Hôpital Laval Research Centre, 2725 chemin Sainte-Foy, Pavilion Marguerite-D'Youville, 4th Floor, Quebec City, Canada","@type":"PostalAddress"},"@type":"Organization"}],"@type":"Person"}],"isAccessibleForFree":false,"hasPart":{"isAccessibleForFree":false,"cssSelector":".main-content","@type":"WebPageElement"},"@type":"ScholarlyArticle"},"@context":"https://schema.org","@type":"WebPage"}</script> <link rel="canonical" href="https://www.nature.com/articles/nature05488"> <meta name="journal_id" content="41586"/> <meta name="dc.title" content="Abdominal obesity and metabolic syndrome"/> <meta name="dc.source" content="Nature 2006 444:7121"/> <meta name="dc.format" content="text/html"/> <meta name="dc.publisher" content="Nature Publishing Group"/> <meta name="dc.date" content="2006-12-13"/> <meta name="dc.type" content="ReviewPaper"/> <meta name="dc.language" content="En"/> <meta name="dc.copyright" content="2006 Springer Nature Limited"/> <meta name="dc.rights" content="2006 Springer Nature Limited"/> <meta name="dc.rightsAgent" content="journalpermissions@springernature.com"/> <meta name="dc.description" content="Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance or full-blown diabetes, and increased risk of developing cardiovascular disease. Proposed criteria for identifying patients with metabolic syndrome have contributed greatly to preventive medicine, but the value of metabolic syndrome as a scientific concept remains controversial. The presence of metabolic syndrome alone cannot predict global cardiovascular disease risk. But abdominal obesity — the most prevalent manifestation of metabolic syndrome — is a marker of 'dysfunctional adipose tissue', and is of central importance in clinical diagnosis. Better risk assessment algorithms are needed to quantify diabetes and cardiovascular disease risk on a global scale."/> <meta name="prism.issn" content="1476-4687"/> <meta name="prism.publicationName" content="Nature"/> <meta name="prism.publicationDate" content="2006-12-13"/> <meta name="prism.volume" content="444"/> <meta name="prism.number" content="7121"/> <meta name="prism.section" content="ReviewPaper"/> <meta name="prism.startingPage" content="881"/> <meta name="prism.endingPage" content="887"/> <meta name="prism.copyright" content="2006 Springer Nature Limited"/> <meta name="prism.rightsAgent" content="journalpermissions@springernature.com"/> <meta name="prism.url" content="https://www.nature.com/articles/nature05488"/> <meta name="prism.doi" content="doi:10.1038/nature05488"/> <meta name="citation_pdf_url" content="https://www.nature.com/articles/nature05488.pdf"/> <meta name="citation_fulltext_html_url" content="https://www.nature.com/articles/nature05488"/> <meta name="citation_journal_title" content="Nature"/> <meta name="citation_journal_abbrev" content="Nature"/> <meta name="citation_publisher" content="Nature Publishing Group"/> <meta name="citation_issn" content="1476-4687"/> <meta name="citation_title" content="Abdominal obesity and metabolic syndrome"/> <meta name="citation_volume" content="444"/> <meta name="citation_issue" content="7121"/> <meta name="citation_publication_date" content="2006/12"/> <meta name="citation_online_date" content="2006/12/13"/> <meta name="citation_firstpage" content="881"/> <meta name="citation_lastpage" content="887"/> <meta name="citation_article_type" content="Article"/> <meta name="citation_language" content="en"/> <meta name="dc.identifier" content="doi:10.1038/nature05488"/> <meta name="DOI" content="10.1038/nature05488"/> <meta name="size" content="197050"/> <meta name="citation_doi" content="10.1038/nature05488"/> <meta name="citation_springer_api_url" content="http://api.springer.com/xmldata/jats?q=doi:10.1038/nature05488&api_key="/> <meta name="description" content="Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance or full-blown diabetes, and increased risk of developing cardiovascular disease. Proposed criteria for identifying patients with metabolic syndrome have contributed greatly to preventive medicine, but the value of metabolic syndrome as a scientific concept remains controversial. The presence of metabolic syndrome alone cannot predict global cardiovascular disease risk. But abdominal obesity — the most prevalent manifestation of metabolic syndrome — is a marker of 'dysfunctional adipose tissue', and is of central importance in clinical diagnosis. Better risk assessment algorithms are needed to quantify diabetes and cardiovascular disease risk on a global scale."/> <meta name="dc.creator" content="Després, Jean-Pierre"/> <meta name="dc.creator" content="Lemieux, Isabelle"/> <meta name="dc.subject" content="Science, Humanities and Social Sciences, multidisciplinary"/> <meta name="dc.subject" content="Science, multidisciplinary"/> <meta name="citation_reference" content="citation_journal_title=J. Am. Coll. Cardiol.; citation_title=Metabolic syndrome: connecting and reconciling cardiovascular and diabetes worlds; citation_author=SM Grundy; citation_volume=47; citation_publication_date=2006; citation_pages=1093-1100; citation_doi=10.1016/j.jacc.2005.11.046; citation_id=CR1"/> <meta name="citation_reference" content="citation_journal_title=Am. J. Clin. Nutr.; citation_title=Does a diagnosis of metabolic syndrome have value in clinical practice?; citation_author=SM Grundy; citation_volume=83; citation_publication_date=2006; citation_pages=1248-1251; citation_doi=10.1093/ajcn/83.6.1248; citation_id=CR2"/> <meta name="citation_reference" content="citation_journal_title=Nature Rev. Drug Discov.; citation_title=Drug therapy of the metabolic syndrome: minimizing the emerging crisis of polypharmacy; citation_author=SM Grundy; citation_volume=5; citation_publication_date=2006; citation_pages=295-309; citation_doi=10.1038/nrd2005; citation_id=CR3"/> <meta name="citation_reference" content="citation_journal_title=Annu. Rev. Med.; citation_title=Metabolic syndrome: a clinical and molecular perspective; citation_author=DE Moller, KD Kaufman; citation_volume=56; citation_publication_date=2005; citation_pages=45-62; citation_doi=10.1146/annurev.med.56.082103.104751; citation_id=CR4"/> <meta name="citation_reference" content="citation_journal_title=Curr. Opin. Lipidol.; citation_title=The metabolic syndrome: should current criteria influence clinical practice?; citation_author=N Sattar; citation_volume=17; citation_publication_date=2006; citation_pages=404-411; citation_doi=10.1097/01.mol.0000236366.48593.07; citation_id=CR5"/> <meta name="citation_reference" content="citation_journal_title=Lancet; citation_title=The metabolic syndrome; citation_author=RH Eckel, SM Grundy, PZ Zimmet; citation_volume=365; citation_publication_date=2005; citation_pages=1415-1428; citation_doi=10.1016/S0140-6736(05)66378-7; citation_id=CR6"/> <meta name="citation_reference" content="citation_journal_title=Am. J. Clin. Nutr.; citation_title=The metabolic syndrome: is this diagnosis necessary?; citation_author=GM Reaven; citation_volume=83; citation_publication_date=2006; citation_pages=1237-1247; citation_doi=10.1093/ajcn/83.6.1237; citation_id=CR7"/> <meta name="citation_reference" content="citation_journal_title=Ann. Med.; citation_title=Is insulin resistance the cause of the metabolic syndrome?; citation_author=E Ferrannini; citation_volume=38; citation_publication_date=2006; citation_pages=43-51; citation_doi=10.1080/07853890500415358; citation_id=CR8"/> <meta name="citation_reference" content="citation_journal_title=Diabetologia; citation_title=The myth of the metabolic syndrome; citation_author=EA Gale; citation_volume=48; citation_publication_date=2005; citation_pages=1679-1683; citation_doi=10.1007/s00125-005-1873-5; citation_id=CR9"/> <meta name="citation_reference" content="citation_journal_title=Diabetes Care; citation_title=The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes; citation_author=R Kahn, J Buse, E Ferrannini, M Stern; citation_volume=28; citation_publication_date=2005; citation_pages=2289-2304; citation_doi=10.2337/diacare.28.9.2289; citation_id=CR10"/> <meta name="citation_reference" content="citation_journal_title=Clin. Chem.; citation_title=The metabolic syndrome: requiescat in pace; citation_author=GM Reaven; citation_volume=51; citation_publication_date=2005; citation_pages=931-938; citation_doi=10.1373/clinchem.2005.048611; citation_id=CR11"/> <meta name="citation_reference" content="citation_journal_title=Diabet. Med.; citation_title=Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation; citation_author=KG Alberti, PZ Zimmet; citation_volume=15; citation_publication_date=1998; citation_pages=539-553; citation_doi=10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S; citation_id=CR12"/> <meta name="citation_reference" content="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). J. Am. Med. Assoc. 285, 2486–2497 (2001)."/> <meta name="citation_reference" content="citation_journal_title=Lancet; citation_title=The metabolic syndrome — a new worldwide definition; citation_author=KG Alberti, P Zimmet, J Shaw; citation_volume=366; citation_publication_date=2005; citation_pages=1059-1062; citation_doi=10.1016/S0140-6736(05)67402-8; citation_id=CR14"/> <meta name="citation_reference" content="citation_journal_title=Am. J. Med.; citation_title=Metabolic syndrome and risk of cardiovascular disease: a meta-analysis; citation_author=A Galassi, K Reynolds, J He; citation_volume=119; citation_publication_date=2006; citation_pages=812-819; citation_doi=10.1016/j.amjmed.2006.02.031; citation_id=CR15"/> <meta name="citation_reference" content="citation_journal_title=J. Am. Med. Assoc.; citation_title=Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001; citation_author=AH Mokdad; citation_volume=289; citation_publication_date=2003; citation_pages=76-79; citation_doi=10.1001/jama.289.1.76; citation_id=CR16"/> <meta name="citation_reference" content="citation_journal_title=Nature; citation_title=Global and societal implications of the diabetes epidemic; citation_author=P Zimmet, KGMM Alberti, J Shaw; citation_volume=414; citation_publication_date=2001; citation_pages=782-787; citation_doi=10.1038/414782a; citation_id=CR17"/> <meta name="citation_reference" content="citation_journal_title=Obesity Rev.; citation_title=Redefining type 2 diabetes:'diabesity' or 'obesity dependent diabetes mellitus'?; citation_author=A Astrup, N Finer; citation_volume=1; citation_publication_date=2000; citation_pages=57-59; citation_doi=10.1046/j.1467-789x.2000.00013.x; citation_id=CR18"/> <meta name="citation_reference" content="citation_journal_title=Diabetes Metab.; citation_title=Development and consequences of insulin resistance: lessons from animals with hyperinsulinaemia; citation_author=E Shafrir; citation_volume=22; citation_publication_date=1996; citation_pages=122-131; citation_id=CR19"/> <meta name="citation_reference" content="citation_journal_title=Lancet; citation_title=Paul Zimmet: fighting the 'diabesity' pandemic; citation_author=S Pincock; citation_volume=368; citation_publication_date=2006; citation_pages=1643; citation_doi=10.1016/S0140-6736(06)69682-7; citation_id=CR20"/> <meta name="citation_reference" content="citation_journal_title=Arterioscler. Thromb. Vasc. Biol.; citation_title=Race, visceral adipose tissue, plasma lipids, and lipoprotein lipase activity in men and women: the Health, Risk Factors, Exercise Training, and Genetics (HERITAGE) family study; citation_author=JP Després; citation_volume=20; citation_publication_date=2000; citation_pages=1932-1938; citation_doi=10.1161/01.ATV.20.8.1932; citation_id=CR21"/> <meta name="citation_reference" content="citation_journal_title=Diabetes; citation_title=Visceral fat and race-dependent health risks in obese nondiabetic premenopausal women; citation_author=JB Albu, L Murphy, DH Frager, JA Johnson, FX Pi-Sunyer; citation_volume=46; citation_publication_date=1997; citation_pages=456-462; citation_doi=10.2337/diab.46.3.456; citation_id=CR22"/> <meta name="citation_reference" content="WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363, 157–163 (2004)."/> <meta name="citation_reference" content="citation_journal_title=Int. J. Obes. (Lond.); citation_title=Japanese men have larger areas of visceral adipose tissue than Caucasian men in the same levels of waist circumference in a population-based study; citation_author=T Kadowaki; citation_volume=30; citation_publication_date=2006; citation_pages=1163-1165; citation_doi=10.1038/sj.ijo.0803248; citation_id=CR24"/> <meta name="citation_reference" content="citation_journal_title=Metabolism; citation_title=Abdominal fat distribution and metabolic risk factors: effects of race; citation_author=JC Lovejoy, JA de la Bretonne, M Klemperer, R Tulley; citation_volume=45; citation_publication_date=1996; citation_pages=1119-1124; citation_doi=10.1016/S0026-0495(96)90011-6; citation_id=CR25"/> <meta name="citation_reference" content="citation_journal_title=Am. J. Clin. Nutr.; citation_title=Intrabdominal adipose tissue and anthropometric surrogates in African American women with upper- and lower-body obesity; citation_author=JM Conway, FF Chanetsa, P Wang; citation_volume=66; citation_publication_date=1997; citation_pages=1345-1351; citation_doi=10.1093/ajcn/66.6.1345; citation_id=CR26"/> <meta name="citation_reference" content="citation_journal_title=J. Am. Coll. Cardiol.; citation_title=Relationship between obesity, insulin resistance, and coronary heart disease risk; citation_author=F Abbasi, BW Brown, C Lamendola, T McLaughlin, GM Reaven; citation_volume=40; citation_publication_date=2002; citation_pages=937-943; citation_doi=10.1016/S0735-1097(02)02051-X; citation_id=CR27"/> <meta name="citation_reference" content="citation_journal_title=Arteriosclerosis; citation_title=Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease; citation_author=JP Després; citation_volume=10; citation_publication_date=1990; citation_pages=497-511; citation_doi=10.1161/01.ATV.10.4.497; citation_id=CR28"/> <meta name="citation_reference" content="citation_journal_title=Ann. Med.; citation_title=Is visceral obesity the cause of the metabolic syndrome?; citation_author=JP Després; citation_volume=38; citation_publication_date=2006; citation_pages=52-63; citation_doi=10.1080/07853890500383895; citation_id=CR29"/> <meta name="citation_reference" content="citation_journal_title=Diabetes Care; citation_title=Metabolic implications of body fat distribution; citation_author=P Björntorp; citation_volume=14; citation_publication_date=1991; citation_pages=1132-1143; citation_doi=10.2337/diacare.14.12.1132; citation_id=CR30"/> <meta name="citation_reference" content="citation_journal_title=Physiol. Rev.; citation_title=Regional adiposity and morbidity; citation_author=AH Kissebah, GR Krakower; citation_volume=74; citation_publication_date=1994; citation_pages=761-811; citation_doi=10.1152/physrev.1994.74.4.761; citation_id=CR31"/> <meta name="citation_reference" content="citation_journal_title=Diabetes Care; citation_title=Point: visceral adiposity is causally related to insulin resistance; citation_author=HE Lebovitz, MA Banerji; citation_volume=28; citation_publication_date=2005; citation_pages=2322-2325; citation_doi=10.2337/diacare.28.9.2322; citation_id=CR32"/> <meta name="citation_reference" content="citation_journal_title=Diabetes; citation_title=Extreme insulin resistance of the central adipose depot in vivo; citation_author=SD Mittelman, GW Van Citters, EL Kirkman, RN Bergman; citation_volume=51; citation_publication_date=2002; citation_pages=755-761; citation_doi=10.2337/diabetes.51.3.755; citation_id=CR33"/> <meta name="citation_reference" content="citation_journal_title=J. Lipid. Res.; citation_title=Regional variation in adipose tissue metabolism of severely obese premenopausal women; citation_author=P Mauriège; citation_volume=36; citation_publication_date=1995; citation_pages=672-684; citation_doi=10.1016/S0022-2275(20)40053-7; citation_id=CR34"/> <meta name="citation_reference" content="citation_journal_title=Obesity (Silver Spring); citation_title=Why visceral fat is bad: mechanisms of the metabolic syndrome; citation_author=RN Bergman; citation_volume=14; citation_issue=Suppl. 1; citation_publication_date=2006; citation_pages=16S-19S; citation_doi=10.1038/oby.2006.277; citation_id=CR35"/> <meta name="citation_reference" content="citation_journal_title=Obesity (Silver Spring); citation_title=Is visceral fat involved in the pathogenesis of the metabolic syndrome? Human model; citation_author=MD Jensen; citation_volume=14; citation_issue=Suppl. 1; citation_publication_date=2006; citation_pages=20S-24S; citation_doi=10.1038/oby.2006.278; citation_id=CR36"/> <meta name="citation_reference" content="citation_journal_title=J. Clin. Invest.; citation_title=Obesity is associated with macrophage accumulation in adipose tissue; citation_author=SP Weisberg; citation_volume=112; citation_publication_date=2003; citation_pages=1796-1808; citation_doi=10.1172/JCI200319246; citation_id=CR37"/> <meta name="citation_reference" content="citation_journal_title=Arterioscler. Thromb. Vasc. Biol.; citation_title=C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue?; citation_author=JS Yudkin, CD Stehouwer, JJ Emeis, SW Coppack; citation_volume=19; citation_publication_date=1999; citation_pages=972-978; citation_doi=10.1161/01.ATV.19.4.972; citation_id=CR38"/> <meta name="citation_reference" content="citation_journal_title=J. Am. Coll. Cardiol.; citation_title=C-reactive protein and other emerging blood biomarkers to optimize risk stratification of vulnerable patients; citation_author=S Tsimikas, JT Willerson, PM Ridker; citation_volume=47; citation_publication_date=2006; citation_pages=C19-C31; citation_doi=10.1016/j.jacc.2005.10.066; citation_id=CR39"/> <meta name="citation_reference" content="citation_journal_title=Arterioscler. Thromb. Vasc. Biol.; citation_title=Elevated C-reactive protein: another component of the atherothrombotic profile of abdominal obesity; citation_author=I Lemieux; citation_volume=21; citation_publication_date=2001; citation_pages=961-967; citation_doi=10.1161/01.ATV.21.6.961; citation_id=CR40"/> <meta name="citation_reference" content="citation_journal_title=Biochem. Biophys. Res. Commun.; citation_title=cDNA cloning and expression of a novel adipose specific collagen-like factor, apM1 (adipose most abundant gene transcript 1); citation_author=K Maeda; citation_volume=221; citation_publication_date=1996; citation_pages=286-289; citation_doi=10.1006/bbrc.1996.0587; citation_id=CR41"/> <meta name="citation_reference" content="citation_journal_title=J. Biol. Chem.; citation_title=A novel serum protein similar to C1q, produced exclusively in adipocytes; citation_author=PE Scherer, S Williams, M Fogliano, G Baldini, HF Lodish; citation_volume=270; citation_publication_date=1995; citation_pages=26746-26749; citation_doi=10.1074/jbc.270.45.26746; citation_id=CR42"/> <meta name="citation_reference" content="citation_journal_title=J. Clin. Endocrinol. Metab.; citation_title=Adiponectinemia in visceral obesity: impact on glucose tolerance and plasma lipoprotein and lipid levels in men; citation_author=M Côté; citation_volume=90; citation_publication_date=2005; citation_pages=1434-1439; citation_doi=10.1210/jc.2004-1711; citation_id=CR43"/> <meta name="citation_reference" content="citation_journal_title=Circ. Res.; citation_title=Adipose tissue, inflammation, and cardiovascular disease; citation_author=AH Berg, PE Scherer; citation_volume=96; citation_publication_date=2005; citation_pages=939-949; citation_doi=10.1161/01.RES.0000163635.62927.34; citation_id=CR44"/> <meta name="citation_reference" content="citation_journal_title=Nature Clin. Pract. Cardiovasc. Med.; citation_title=Therapy Insight: adipocytokines in metabolic syndrome and related cardiovascular disease; citation_author=Y Matsuzawa; citation_volume=3; citation_publication_date=2006; citation_pages=35-42; citation_doi=10.1038/ncpcardio0380; citation_id=CR45"/> <meta name="citation_reference" content="citation_journal_title=Obes. Res.; citation_title=Contribution of interleukin-6 and tumor necrosis factor-alpha to the elevated C-reactive protein levels found in abdominally obese men; citation_author=I Lemieux; citation_volume=9; citation_publication_date=2001; citation_pages=66S; citation_id=CR46"/> <meta name="citation_reference" content="citation_journal_title=Int. J. Obes. Relat. Metab. Disord.; citation_title=Molecular mechanisms of insulin resistance and the role of the adipocyte; citation_author=GS Hotamisligil; citation_volume=24; citation_issue=Suppl. 4; citation_publication_date=2000; citation_pages=S23-S27; citation_doi=10.1038/sj.ijo.0801497; citation_id=CR47"/> <meta name="citation_reference" content="citation_journal_title=Curr. Opin. Lipidol.; citation_title=Control of energy homeostasis and insulin action by adipocyte hormones: leptin, acylation stimulating protein, and adiponectin; citation_author=PJ Havel; citation_volume=13; citation_publication_date=2002; citation_pages=51-59; citation_doi=10.1097/00041433-200202000-00008; citation_id=CR48"/> <meta name="citation_reference" content="citation_journal_title=Arterioscler. Thromb. Vasc. Biol.; citation_title=Energy partitioning in gluteal-femoral fat: does the metabolic fate of triglycerides affect coronary heart disease risk?; citation_author=I Lemieux; citation_volume=24; citation_publication_date=2004; citation_pages=795-797; citation_doi=10.1161/01.ATV.0000126485.80373.33; citation_id=CR49"/> <meta name="citation_reference" content="citation_journal_title=Am. Heart J.; citation_title=Metabolic syndrome: definition, pathophysiology, and mechanisms; citation_author=PJ Miranda, RA DeFronzo, RM Califf, JR Guyton; citation_volume=149; citation_publication_date=2005; citation_pages=33-45; citation_doi=10.1016/j.ahj.2004.07.013; citation_id=CR50"/> <meta name="citation_reference" content="citation_journal_title=J. Clin. Invest.; citation_title=Surgical implantation of adipose tissue reverses diabetes in lipoatrophic mice; citation_author=O Gavrilova; citation_volume=105; citation_publication_date=2000; citation_pages=271-278; citation_doi=10.1172/JCI7901; citation_id=CR51"/> <meta name="citation_reference" content="citation_journal_title=J. Biol. Chem.; citation_title=Mechanism of insulin resistance in A-ZIP/F-1 fatless mice; citation_author=JK Kim, O Gavrilova, Y Chen, ML Reitman, GI Shulman; citation_volume=275; citation_publication_date=2000; citation_pages=8456-8460; citation_doi=10.1074/jbc.275.12.8456; citation_id=CR52"/> <meta name="citation_reference" content="citation_journal_title=Endocrinol. Metab. Clin. North Am.; citation_title=Lipodystrophies: rare disorders causing metabolic syndrome; citation_author=A Garg, A Misra; citation_volume=33; citation_publication_date=2004; citation_pages=305-331; citation_doi=10.1016/j.ecl.2004.03.003; citation_id=CR53"/> <meta name="citation_reference" content="citation_journal_title=Nature Genet.; citation_title=Failure of adipocyte differentiation causes type II diabetes mellitus?; citation_author=E Danforth; citation_volume=26; citation_publication_date=2000; citation_pages=13; citation_doi=10.1038/79111; citation_id=CR54"/> <meta name="citation_reference" content="citation_journal_title=J. Clin. Endocrinol. Metab.; citation_title=Effect of pioglitazone on abdominal fat distribution and insulin sensitivity in type 2 diabetic patients; citation_author=Y Miyazaki; citation_volume=87; citation_publication_date=2002; citation_pages=2784-2791; citation_doi=10.1210/jcem.87.6.8567; citation_id=CR55"/> <meta name="citation_reference" content="citation_journal_title=Circulation; citation_title=Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus; citation_author=PW Wilson, RB D'Agostino, H Parise, L Sullivan, JB Meigs; citation_volume=112; citation_publication_date=2005; citation_pages=3066-3072; citation_doi=10.1161/CIRCULATIONAHA.105.539528; citation_id=CR56"/> <meta name="citation_reference" content="citation_journal_title=Am. J. Epidemiol.; citation_title=Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study; citation_author=DE Laaksonen; citation_volume=156; citation_publication_date=2002; citation_pages=1070-1077; citation_doi=10.1093/aje/kwf145; citation_id=CR57"/> <meta name="citation_reference" content="citation_journal_title=Ann. Intern. Med.; citation_title=Identification of persons at high risk for type 2 diabetes mellitus: do we need the oral glucose tolerance test?; citation_author=MP Stern, K Williams, SM Haffner; citation_volume=136; citation_publication_date=2002; citation_pages=575-581; citation_doi=10.7326/0003-4819-136-8-200204160-00006; citation_id=CR58"/> <meta name="citation_reference" content="citation_journal_title=Diabetes Care; citation_title=Components of the metabolic syndrome and risk of cardiovascular disease and diabetes in beaver dam; citation_author=BE Klein, R Klein, KE Lee; citation_volume=25; citation_publication_date=2002; citation_pages=1790-1794; citation_doi=10.2337/diacare.25.10.1790; citation_id=CR59"/> <meta name="citation_reference" content="citation_journal_title=Am. Heart J.; citation_title=A clinically practicable diagnostic score for metabolic syndrome improves its predictivity of diabetes mellitus: the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico (GISSI)-Prevenzione scoring; citation_author=A Macchia; citation_volume=151; citation_publication_date=2006; citation_pages=754.e7-754.e17; citation_doi=10.1016/j.ahj.2005.10.023; citation_id=CR60"/> <meta name="citation_reference" content="UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 352, 854–865 (1998)."/> <meta name="citation_reference" content="citation_journal_title=Circulation; citation_title=Diabetic macrovascular disease: the glucose paradox?; citation_author=P Libby, J Plutzky; citation_volume=106; citation_publication_date=2002; citation_pages=2760-2763; citation_doi=10.1161/01.CIR.0000037282.92395.AE; citation_id=CR62"/> <meta name="citation_reference" content="citation_journal_title=Diabetes; citation_title=Hyperglycemia and cardiovascular disease in type 2 diabetes; citation_author=M Laakso; citation_volume=48; citation_publication_date=1999; citation_pages=937-942; citation_doi=10.2337/diabetes.48.5.937; citation_id=CR63"/> <meta name="citation_reference" content="citation_journal_title=Circulation; citation_title=Definition of metabolic syndrome. Report of the National Heart, Lung and Blood Institute/American Heart Association conference on scientific issues related to definition; citation_author=SM Grundy; citation_volume=109; citation_publication_date=2004; citation_pages=433-438; citation_doi=10.1161/01.CIR.0000111245.75752.C6; citation_id=CR64"/> <meta name="citation_reference" content="citation_journal_title=Diabetes; citation_title=Risk factor groupings related to insulin resistance and their synergistic effects on subclinical atherosclerosis: the atherosclerosis risk in communities study; citation_author=SH Golden; citation_volume=51; citation_publication_date=2002; citation_pages=3069-3076; citation_doi=10.2337/diabetes.51.10.3069; citation_id=CR65"/> <meta name="citation_reference" content="citation_journal_title=Circulation; citation_title=Prediction of coronary heart disease using risk factor categories; citation_author=PW Wilson; citation_volume=97; citation_publication_date=1998; citation_pages=1837-1847; citation_doi=10.1161/01.CIR.97.18.1837; citation_id=CR66"/> <meta name="citation_reference" content="citation_journal_title=Arch. Intern. Med.; citation_title=Metabolic syndrome vs Framingham Risk Score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus; citation_author=SG Wannamethee, AG Shaper, L Lennon, RW Morris; citation_volume=165; citation_publication_date=2005; citation_pages=2644-2650; citation_doi=10.1001/archinte.165.22.2644; citation_id=CR67"/> <meta name="citation_reference" content="citation_journal_title=Diabetes Care; citation_title=Does the metabolic syndrome improve identification of individuals at risk of type 2 diabetes and/or cardiovascular disease?; citation_author=MP Stern, K Williams, C Gonzalez-Villalpando, KJ Hunt, SM Haffner; citation_volume=27; citation_publication_date=2004; citation_pages=2676-2681; citation_doi=10.2337/diacare.27.11.2676; citation_id=CR68"/> <meta name="citation_reference" content="citation_journal_title=Circulation; citation_title=Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Munster (PROCAM) study; citation_author=G Assmann, P Cullen, H Schulte; citation_volume=105; citation_publication_date=2002; citation_pages=310-315; citation_doi=10.1161/hc0302.102575; citation_id=CR69"/> <meta name="citation_reference" content="citation_journal_title=Am. J. Cardiol.; citation_title=The metabolic syndrome and risk of major coronary events in the Scandinavian Simvastatin Survival Study (4S) and the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS); citation_author=CJ Girman; citation_volume=93; citation_publication_date=2004; citation_pages=136-141; citation_doi=10.1016/j.amjcard.2003.09.028; citation_id=CR70"/> <meta name="citation_reference" content="citation_journal_title=J. Am. Med. Assoc.; citation_title=Fasting insulin and apolipoprotein B levels and low-density lipoprotein particle size as risk factors for ischemic heart disease; citation_author=B Lamarche; citation_volume=279; citation_publication_date=1998; citation_pages=1955-1961; citation_doi=10.1001/jama.279.24.1955; citation_id=CR71"/> <meta name="citation_reference" content="citation_journal_title=Curr. Atheroscler. Rep.; citation_title=Insulin resistance in human partial lipodystrophy; citation_author=RA Hegele; citation_volume=2; citation_publication_date=2000; citation_pages=397-404; citation_doi=10.1007/s11883-000-0078-0; citation_id=CR72"/> <meta name="citation_reference" content="citation_journal_title=Ann. Intern. Med.; citation_title=Cigarette smoking and increased central adiposity; citation_author=E Barrett-Connor, KT Khaw; citation_volume=111; citation_publication_date=1989; citation_pages=783-787; citation_doi=10.7326/0003-4819-111-10-783; citation_id=CR73"/> <meta name="citation_reference" content="citation_journal_title=J. Am. Med. Assoc.; citation_title=Studies in the distribution of body fat. III. Effects of cigarette smoking; citation_author=H Shimokata, DC Muller, R Andres; citation_volume=261; citation_publication_date=1989; citation_pages=1169-1173; citation_doi=10.1001/jama.1989.03420080089037; citation_id=CR74"/> <meta name="citation_reference" content="citation_journal_title=J. Am. Coll. Cardiol.; citation_title=Insulin resistance and compensatory hyperinsulinemia: the key player between cigarette smoking and cardiovascular disease?; citation_author=G Reaven, PS Tsao; citation_volume=41; citation_publication_date=2003; citation_pages=1044-1047; citation_doi=10.1016/S0735-1097(02)02982-0; citation_id=CR75"/> <meta name="citation_reference" content="citation_journal_title=Diabetes; citation_title=Visceral obesity in men. Associations with glucose tolerance, plasma insulin, and lipoprotein levels; citation_author=MC Pouliot; citation_volume=41; citation_publication_date=1992; citation_pages=826-834; citation_doi=10.2337/diab.41.7.826; citation_id=CR76"/> <meta name="citation_reference" content="citation_journal_title=Brit. Med. J.; citation_title=Treatment of obesity: need to focus on high risk abdominally obese patients; citation_author=JP Després, I Lemieux, D Prud'homme; citation_volume=322; citation_publication_date=2001; citation_pages=716-720; citation_doi=10.1136/bmj.322.7288.716; citation_id=CR77"/> <meta name="citation_reference" content="citation_journal_title=Int. J. Obes. Relat. Metab. Disord.; citation_title=Obesity and central fat pattern among Greenland Inuit and a general population of Denmark (Inter99): relationship to metabolic risk factors; citation_author=ME Jorgensen; citation_volume=27; citation_publication_date=2003; citation_pages=1507-1515; citation_doi=10.1038/sj.ijo.0802434; citation_id=CR78"/> <meta name="citation_reference" content="citation_journal_title=Ann. Intern. Med.; citation_title=Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial; citation_author=R Ross; citation_volume=133; citation_publication_date=2000; citation_pages=92-103; citation_doi=10.7326/0003-4819-133-2-200007180-00008; citation_id=CR79"/> <meta name="citation_reference" content="citation_journal_title=Ann. Intern. Med.; citation_title=The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial; citation_author=TJ Orchard; citation_volume=142; citation_publication_date=2005; citation_pages=611-619; citation_doi=10.7326/0003-4819-142-8-200504190-00009; citation_id=CR80"/> <meta name="citation_reference" content="citation_journal_title=Med. Sci. Sports Exerc.; citation_title=Targeting the metabolic syndrome with exercise: evidence from the HERITAGE Family Study; citation_author=PT Katzmarzyk; citation_volume=35; citation_publication_date=2003; citation_pages=1703-1709; citation_doi=10.1249/01.MSS.0000089337.73244.9B; citation_id=CR81"/> <meta name="citation_reference" content="citation_journal_title=Int. J. Obes. Relat. Metab. Disord.; citation_title=Effect of a six month gemfibrozil treatment and dietary recommendations on the metabolic risk profile of visceral obese men; citation_author=M Dumont, P Mauriège, J Bergeron, JP Després, D Prud'homme; citation_volume=25; citation_publication_date=2001; citation_pages=1136-1143; citation_doi=10.1038/sj.ijo.0801665; citation_id=CR82"/> <meta name="citation_reference" content="citation_journal_title=Med. Sci. Sports Exerc.; citation_title=Response of blood lipids to exercise training alone or combined with dietary intervention; citation_author=AS Leon, OA Sanchez; citation_volume=33; citation_publication_date=2001; citation_pages=S502-S515; citation_doi=10.1097/00005768-200106001-00021; citation_id=CR83"/> <meta name="citation_reference" content="citation_journal_title=Diabetes Care; citation_title=Waist girth does not predict metabolic complications in severely obese men; citation_author=I Lemieux; citation_volume=29; citation_publication_date=2006; citation_pages=1417-1419; citation_doi=10.2337/dc06-0441; citation_id=CR84"/> <meta name="citation_reference" content="citation_journal_title=Circulation; citation_title=Hypertriglyceridemic waist. A marker of the atherogenic metabolic triad (hyperinsulinemia, hyperapolipoprotein B, small, dense LDL) in men?; citation_author=I Lemieux; citation_volume=102; citation_publication_date=2000; citation_pages=179-184; citation_doi=10.1161/01.CIR.102.2.179; citation_id=CR85"/> <meta name="citation_reference" content="citation_journal_title=Curr. Opin. Lipidol.; citation_title=Cardiovascular risk, the metabolic syndrome and the hypertriglyceridaemic waist; citation_author=PM Underwood; citation_volume=15; citation_publication_date=2004; citation_pages=495-497; citation_doi=10.1097/01.mol.0000137237.97341.fd; citation_id=CR86"/> <meta name="citation_reference" content="citation_journal_title=Am. J. Clin. Nutr.; citation_title=Metabolic risks identified by the combination of enlarged waist and elevated triacylglycerol concentration; citation_author=HS Kahn, R Valdez; citation_volume=78; citation_publication_date=2003; citation_pages=928-934; citation_doi=10.1093/ajcn/78.5.928; citation_id=CR87"/> <meta name="citation_reference" content="citation_journal_title=Br. Med. J.; citation_title=Waist circumference as a measure for indicating need for weight management; citation_author=ME Lean, TS Han, CE Morrison; citation_volume=311; citation_publication_date=1995; citation_pages=158-161; citation_doi=10.1136/bmj.311.6998.158; citation_id=CR88"/> <meta name="citation_reference" content="citation_journal_title=Am. J. Clin. Nutr.; citation_title=Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds; citation_author=S Zhu; citation_volume=76; citation_publication_date=2002; citation_pages=743-749; citation_doi=10.1093/ajcn/76.4.743; citation_id=CR89"/> <meta name="citation_reference" content="citation_journal_title=DOC News; citation_title=New ADA initiative moves beyond 'metabolic syndrome'. 'Cardiometabolic risk' proposed as umbrella term for diabetes risk factors; citation_author=ET Beckley; citation_volume=3; citation_publication_date=2006; citation_pages=1-3; citation_id=CR90"/> <meta name="citation_reference" content="citation_journal_title=Circulation; citation_title=Preventing cardiovascular disease and diabetes: a call to action from the American Diabetes Association and the American Heart Association; citation_author=RH Eckel, R Kahn, RM Robertson, RA Rizza; citation_volume=113; citation_publication_date=2006; citation_pages=2943-2946; citation_doi=10.1161/CIRCULATIONAHA.106.176583; citation_id=CR91"/> <meta name="citation_reference" content="Després, J. P. From CVD risk to cardiometabolic risk. Presented at the Symposium of the International Chair on Cardiometabolic Risk. XIV International Symposium on Atherosclerosis (Rome, 18–22 June 2006)."/> <meta name="citation_reference" content="Després, J. P. Visceral adiposity. Presented at the 66th Scientific Sessions, American Diabetes Association (Washington, DC, 9–13 June 2006)."/> <meta name="citation_reference" content="citation_journal_title=N. Engl. J. Med.; citation_title=The response to long-term overfeeding in identical twins; citation_author=C Bouchard; citation_volume=322; citation_publication_date=1990; citation_pages=1477-1482; citation_doi=10.1056/NEJM199005243222101; citation_id=CR94"/> <meta name="citation_author" content="Després, Jean-Pierre"/> <meta name="citation_author_institution" content="Québec Heart Institute, Hôpital Laval Research Centre, 2725 chemin Sainte-Foy, Pavilion Marguerite-D'Youville, 4th Floor, Quebec City, Canada"/> <meta name="citation_author_institution" content="Division of Kinesiology, Department of Social and Preventive Medicine, Université Laval, Quebec City, Canada"/> <meta name="citation_author" content="Lemieux, Isabelle"/> <meta name="citation_author_institution" content="Québec Heart Institute, Hôpital Laval Research Centre, 2725 chemin Sainte-Foy, Pavilion Marguerite-D'Youville, 4th Floor, Quebec City, Canada"/> <meta name="access_endpoint" content="https://www.nature.com/platform/readcube-access"/> <meta name="twitter:site" content="@nature"/> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:image:alt" content="Content cover image"/> <meta name="twitter:title" content="Abdominal obesity and metabolic syndrome"/> <meta name="twitter:description" content="Nature - Abdominal obesity and metabolic syndrome"/> <meta name="twitter:image" content="https://media.springernature.com/full/springer-static/image/art%3A10.1038%2Fnature05488/MediaObjects/41586_2006_Article_BFnature05488_Fig1_HTML.jpg"/> <meta property="og:url" content="https://www.nature.com/articles/nature05488"/> <meta property="og:type" content="article"/> <meta property="og:site_name" content="Nature"/> <meta property="og:title" content="Abdominal obesity and metabolic syndrome - Nature"/> <meta property="og:image" content="https://media.springernature.com/m685/springer-static/image/art%3A10.1038%2Fnature05488/MediaObjects/41586_2006_Article_BFnature05488_Fig1_HTML.jpg"/> <script> window.eligibleForRa21 = 'true'; </script> </head> <body class="article-page"> <noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-MRVXSHQ" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript> <div class="position-relative cleared z-index-50 background-white" data-test="top-containers"> <a class="c-skip-link" href="#content">Skip to main content</a> <div class="c-grade-c-banner u-hide"> <div class="c-grade-c-banner__container"> <p>Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.</p> </div> </div> <div class="u-hide u-show-following-ad"></div> <aside class="c-ad c-ad--728x90"> <div class="c-ad__inner" data-container-type="banner-advert"> <p class="c-ad__label">Advertisement</p> <div id="div-gpt-ad-top-1" class="div-gpt-ad advert leaderboard js-ad text-center hide-print grade-c-hide" data-ad-type="top" data-test="top-ad" data-pa11y-ignore data-gpt data-gpt-unitpath="/285/nature.com/article" data-gpt-sizes="728x90" data-gpt-targeting="type=article;pos=top;artid=nature05488;doi=10.1038/nature05488;kwrd=Science%2C+Humanities+and+Social+Sciences%2C+multidisciplinary,Science%2C+multidisciplinary"> <noscript> <a href="//pubads.g.doubleclick.net/gampad/jump?iu=/285/nature.com/article&sz=728x90&c=1914105593&t=pos%3Dtop%26type%3Darticle%26artid%3Dnature05488%26doi%3D10.1038/nature05488%26kwrd%3DScience%2C+Humanities+and+Social+Sciences%2C+multidisciplinary,Science%2C+multidisciplinary"> <img data-test="gpt-advert-fallback-img" src="//pubads.g.doubleclick.net/gampad/ad?iu=/285/nature.com/article&sz=728x90&c=1914105593&t=pos%3Dtop%26type%3Darticle%26artid%3Dnature05488%26doi%3D10.1038/nature05488%26kwrd%3DScience%2C+Humanities+and+Social+Sciences%2C+multidisciplinary,Science%2C+multidisciplinary" alt="Advertisement" width="728" height="90"></a> </noscript> </div> </div> </aside> <header class="c-header" id="header" data-header data-track-component="nature-150-split-header" style="border-color:#000"> <div class="c-header__row"> <div class="c-header__container"> <div class="c-header__split"> <div class="c-header__logo-container"> <a href="/" data-track="click" data-track-action="home" data-track-label="image"> <picture class="c-header__logo"> <source srcset="https://media.springernature.com/full/nature-cms/uploads/product/nature/header-86f1267ea01eccd46b530284be10585e.svg" media="(min-width: 875px)"> <img src="https://media.springernature.com/full/nature-cms/uploads/product/nature/header-86f1267ea01eccd46b530284be10585e.svg" height="32" alt="Nature"> </picture> </a> </div> <ul class="c-header__menu c-header__menu--global"> <li class="c-header__item c-header__item--padding c-header__item--hide-md-max"> <a class="c-header__link" href="https://www.nature.com/siteindex" data-test="siteindex-link" data-track="click" data-track-action="open nature research index" data-track-label="link"> <span>View all journals</span> </a> </li> <li class="c-header__item c-header__item--padding c-header__item--pipe"> <a class="c-header__link c-header__link--search" href="#search-menu" data-header-expander data-test="search-link" data-track="click" data-track-action="open search tray" data-track-label="button"> <svg role="img" aria-hidden="true" focusable="false" height="22" width="22" viewBox="0 0 18 18" xmlns="http://www.w3.org/2000/svg"><path d="M16.48 15.455c.283.282.29.749.007 1.032a.738.738 0 01-1.032-.007l-3.045-3.044a7 7 0 111.026-1.026zM8 14A6 6 0 108 2a6 6 0 000 12z"/></svg><span>Search</span> </a> </li> <li class="c-header__item c-header__item--padding c-header__item--snid-account-widget c-header__item--pipe"> <a class="c-header__link eds-c-header__link" id="identity-account-widget" data-track="click_login" data-track-context="header" href='https://idp.nature.com/auth/personal/springernature?redirect_uri=https://www.nature.com/articles/nature05488?error=cookies_not_supported&code=ca3745ca-f249-4384-8592-e8e746787b46'><span class="eds-c-header__widget-fragment-title">Log in</span></a> </li> </ul> </div> </div> </div> <div class="c-header__row"> <div class="c-header__container" data-test="navigation-row"> <div class="c-header__split"> <ul class="c-header__menu c-header__menu--journal"> <li class="c-header__item c-header__item--dropdown-menu" data-test="explore-content-button"> <a href="#explore" class="c-header__link" data-header-expander data-test="menu-button--explore" data-track="click" data-track-action="open explore expander" data-track-label="button"> <span><span class="c-header__show-text">Explore</span> content</span><svg role="img" aria-hidden="true" focusable="false" height="16" viewBox="0 0 16 16" width="16" xmlns="http://www.w3.org/2000/svg"><path d="m5.58578644 3-3.29289322-3.29289322c-.39052429-.39052429-.39052429-1.02368927 0-1.41421356s1.02368927-.39052429 1.41421356 0l4 4c.39052429.39052429.39052429 1.02368927 0 1.41421356l-4 4c-.39052429.39052429-1.02368927.39052429-1.41421356 0s-.39052429-1.02368927 0-1.41421356z" transform="matrix(0 1 -1 0 11 3)"/></svg> </a> </li> <li class="c-header__item c-header__item--dropdown-menu"> <a href="#about-the-journal" class="c-header__link" data-header-expander data-test="menu-button--about-the-journal" data-track="click" data-track-action="open about the journal expander" data-track-label="button"> <span>About <span class="c-header__show-text">the journal</span></span><svg role="img" aria-hidden="true" focusable="false" height="16" viewBox="0 0 16 16" width="16" xmlns="http://www.w3.org/2000/svg"><path d="m5.58578644 3-3.29289322-3.29289322c-.39052429-.39052429-.39052429-1.02368927 0-1.41421356s1.02368927-.39052429 1.41421356 0l4 4c.39052429.39052429.39052429 1.02368927 0 1.41421356l-4 4c-.39052429.39052429-1.02368927.39052429-1.41421356 0s-.39052429-1.02368927 0-1.41421356z" transform="matrix(0 1 -1 0 11 3)"/></svg> </a> </li> <li class="c-header__item c-header__item--dropdown-menu" data-test="publish-with-us-button"> <a href="#publish-with-us" class="c-header__link c-header__link--dropdown-menu" data-header-expander data-test="menu-button--publish" data-track="click" data-track-action="open publish with us expander" data-track-label="button"> <span>Publish <span class="c-header__show-text">with us</span></span><svg role="img" aria-hidden="true" focusable="false" height="16" viewBox="0 0 16 16" width="16" xmlns="http://www.w3.org/2000/svg"><path d="m5.58578644 3-3.29289322-3.29289322c-.39052429-.39052429-.39052429-1.02368927 0-1.41421356s1.02368927-.39052429 1.41421356 0l4 4c.39052429.39052429.39052429 1.02368927 0 1.41421356l-4 4c-.39052429.39052429-1.02368927.39052429-1.41421356 0s-.39052429-1.02368927 0-1.41421356z" transform="matrix(0 1 -1 0 11 3)"/></svg> </a> </li> <li class="c-header__item c-header__item--pipe c-header__item--hide-lg-max"> <a class="c-header__link" href="/nature/subscribe" data-track="click" data-track-action="subscribe" data-track-label="link" data-test="menu-button-subscribe"> <span>Subscribe</span> </a> </li> </ul> <ul class="c-header__menu c-header__menu--hide-lg-max"> <li class="c-header__item"> <a class="c-header__link" href="https://idp.nature.com/auth/personal/springernature?redirect_uri=https%3A%2F%2Fwww.nature.com%2Fmy-account%2Falerts%2Fsubscribe-journal%3Flist-id%3D1%26journal-link%3Dhttps%253A%252F%252Fwww.nature.com%252Fnature%252F" rel="nofollow" data-track="click" data-track-action="Sign up for alerts" data-track-label="link (desktop site header)" data-track-external> <span>Sign up for alerts</span><svg role="img" aria-hidden="true" focusable="false" height="18" viewBox="0 0 18 18" width="18" xmlns="http://www.w3.org/2000/svg"><path d="m4 10h2.5c.27614237 0 .5.2238576.5.5s-.22385763.5-.5.5h-3.08578644l-1.12132034 1.1213203c-.18753638.1875364-.29289322.4418903-.29289322.7071068v.1715729h14v-.1715729c0-.2652165-.1053568-.5195704-.2928932-.7071068l-1.7071068-1.7071067v-3.4142136c0-2.76142375-2.2385763-5-5-5-2.76142375 0-5 2.23857625-5 5zm3 4c0 1.1045695.8954305 2 2 2s2-.8954305 2-2zm-5 0c-.55228475 0-1-.4477153-1-1v-.1715729c0-.530433.21071368-1.0391408.58578644-1.4142135l1.41421356-1.4142136v-3c0-3.3137085 2.6862915-6 6-6s6 2.6862915 6 6v3l1.4142136 1.4142136c.3750727.3750727.5857864.8837805.5857864 1.4142135v.1715729c0 .5522847-.4477153 1-1 1h-4c0 1.6568542-1.3431458 3-3 3-1.65685425 0-3-1.3431458-3-3z" fill="#222"/></svg> </a> </li> <li class="c-header__item c-header__item--pipe"> <a class="c-header__link" href="https://www.nature.com/nature.rss" data-track="click" data-track-action="rss feed" data-track-label="link"> <span>RSS feed</span> </a> </li> </ul> </div> </div> </div> </header> <nav class="u-mb-16" aria-label="breadcrumbs"> <div class="u-container"> <ol class="c-breadcrumbs" itemscope itemtype="https://schema.org/BreadcrumbList"> <li class="c-breadcrumbs__item" id="breadcrumb0" itemprop="itemListElement" itemscope itemtype="https://schema.org/ListItem"><a class="c-breadcrumbs__link" href="/" itemprop="item" data-track="click" data-track-action="breadcrumb" data-track-category="header" data-track-label="link:nature"><span itemprop="name">nature</span></a><meta itemprop="position" content="1"> <svg class="c-breadcrumbs__chevron" role="img" aria-hidden="true" focusable="false" height="10" viewBox="0 0 10 10" width="10" xmlns="http://www.w3.org/2000/svg"> <path d="m5.96738168 4.70639573 2.39518594-2.41447274c.37913917-.38219212.98637524-.38972225 1.35419292-.01894278.37750606.38054586.37784436.99719163-.00013556 1.37821513l-4.03074001 4.06319683c-.37758093.38062133-.98937525.38100976-1.367372-.00003075l-4.03091981-4.06337806c-.37759778-.38063832-.38381821-.99150444-.01600053-1.3622839.37750607-.38054587.98772445-.38240057 1.37006824.00302197l2.39538588 2.4146743.96295325.98624457z" fill="#666" fill-rule="evenodd" transform="matrix(0 -1 1 0 0 10)"/> </svg> </li><li class="c-breadcrumbs__item" id="breadcrumb1" itemprop="itemListElement" itemscope itemtype="https://schema.org/ListItem"><a class="c-breadcrumbs__link" href="/nature/articles?type=review-article" itemprop="item" data-track="click" data-track-action="breadcrumb" data-track-category="header" data-track-label="link:review articles"><span itemprop="name">review articles</span></a><meta itemprop="position" content="2"> <svg class="c-breadcrumbs__chevron" role="img" aria-hidden="true" focusable="false" height="10" viewBox="0 0 10 10" width="10" xmlns="http://www.w3.org/2000/svg"> <path d="m5.96738168 4.70639573 2.39518594-2.41447274c.37913917-.38219212.98637524-.38972225 1.35419292-.01894278.37750606.38054586.37784436.99719163-.00013556 1.37821513l-4.03074001 4.06319683c-.37758093.38062133-.98937525.38100976-1.367372-.00003075l-4.03091981-4.06337806c-.37759778-.38063832-.38381821-.99150444-.01600053-1.3622839.37750607-.38054587.98772445-.38240057 1.37006824.00302197l2.39538588 2.4146743.96295325.98624457z" fill="#666" fill-rule="evenodd" transform="matrix(0 -1 1 0 0 10)"/> </svg> </li><li class="c-breadcrumbs__item" id="breadcrumb2" itemprop="itemListElement" itemscope itemtype="https://schema.org/ListItem"> <span itemprop="name">article</span><meta itemprop="position" content="3"></li> </ol> </div> </nav> </div> <div class="u-container u-mt-32 u-mb-32 u-clearfix" id="content" data-component="article-container" data-container-type="article"> <main class="c-article-main-column u-float-left js-main-column" data-track-component="article body"> <article lang="en"> <div class="c-article-header"> <header> <ul class="c-article-identifiers" data-test="article-identifier"> <li class="c-article-identifiers__item" data-test="article-category">Review Article</li> <li class="c-article-identifiers__item">Published: <time datetime="2006-12-13">13 December 2006</time></li> </ul> <h1 class="c-article-title" data-test="article-title" data-article-title="">Abdominal obesity and metabolic syndrome</h1> <ul class="c-article-author-list c-article-author-list--short" data-test="authors-list" data-component-authors-activator="authors-list"><li class="c-article-author-list__item"><a data-test="author-name" data-track="click" data-track-action="open author" data-track-label="link" href="#auth-Jean_Pierre-Despr_s-Aff1-Aff2" data-author-popup="auth-Jean_Pierre-Despr_s-Aff1-Aff2" data-author-search="Després, Jean-Pierre">Jean-Pierre Després</a><sup class="u-js-hide"><a href="#Aff1">1</a>,<a href="#Aff2">2</a></sup> & </li><li class="c-article-author-list__item"><a data-test="author-name" data-track="click" data-track-action="open author" data-track-label="link" href="#auth-Isabelle-Lemieux-Aff1" data-author-popup="auth-Isabelle-Lemieux-Aff1" data-author-search="Lemieux, Isabelle">Isabelle Lemieux</a><sup class="u-js-hide"><a href="#Aff1">1</a></sup> </li></ul> <p class="c-article-info-details" data-container-section="info"> <a data-test="journal-link" href="/" data-track="click" data-track-action="journal homepage" data-track-category="article body" data-track-label="link"><i data-test="journal-title">Nature</i></a> <b data-test="journal-volume"><span class="u-visually-hidden">volume</span> 444</b>, <span class="u-visually-hidden">pages </span>881–887 (<span data-test="article-publication-year">2006</span>)<a href="#citeas" class="c-article-info-details__cite-as u-hide-print" data-track="click" data-track-action="cite this article" data-track-label="link">Cite this article</a> </p> <div class="c-article-metrics-bar__wrapper u-clear-both"> <ul class="c-article-metrics-bar u-list-reset"> <li class=" c-article-metrics-bar__item" data-test="access-count"> <p class="c-article-metrics-bar__count">34k <span class="c-article-metrics-bar__label">Accesses</span></p> </li> <li class="c-article-metrics-bar__item" data-test="citation-count"> <p class="c-article-metrics-bar__count">3290 <span class="c-article-metrics-bar__label">Citations</span></p> </li> <li class="c-article-metrics-bar__item" data-test="altmetric-score"> <p class="c-article-metrics-bar__count">84 <span class="c-article-metrics-bar__label">Altmetric</span></p> </li> <li class="c-article-metrics-bar__item"> <p class="c-article-metrics-bar__details"><a href="/articles/nature05488/metrics" data-track="click" data-track-action="view metrics" data-track-label="link" rel="nofollow">Metrics <span class="u-visually-hidden">details</span></a></p> </li> </ul> </div> </header> </div> <div class="c-article-body"> <section aria-labelledby="Abs1" data-title="Abstract" lang="en"><div class="c-article-section" id="Abs1-section"><h2 class="c-article-section__title js-section-title js-c-reading-companion-sections-item" id="Abs1">Abstract</h2><div class="c-article-section__content" id="Abs1-content"><p>Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance or full-blown diabetes, and increased risk of developing cardiovascular disease. Proposed criteria for identifying patients with metabolic syndrome have contributed greatly to preventive medicine, but the value of metabolic syndrome as a scientific concept remains controversial. The presence of metabolic syndrome alone cannot predict global cardiovascular disease risk. But abdominal obesity — the most prevalent manifestation of metabolic syndrome — is a marker of 'dysfunctional adipose tissue', and is of central importance in clinical diagnosis. Better risk assessment algorithms are needed to quantify diabetes and cardiovascular disease risk on a global scale.</p></div></div></section> <noscript> <div class="c-nature-box c-nature-box--side " data-component="entitlement-box"> <div class="js-access-button"> <a href="https://wayf.springernature.com?redirect_uri=https%3A%2F%2Fwww.nature.com%2Farticles%2Fnature05488" class="c-article__button" data-test="ra21"> <svg class="u-icon" width="18" height="18" aria-hidden="true" focusable="false"><use href="#icon-institution"></use></svg> <span class="c-article__button-text">Access through your institution</span> </a> </div> <div class="js-buy-button"> <a href="#access-options" class="c-article__button c-article__button--inverted" data-test="ra21"> <span>Buy or subscribe</span> </a> </div> </div> </noscript> <div class="js-context-bar-sticky-point-mobile" data-track-context="article body"> </div> <div class="c-article-access-provider u-mb-32 u-mt-0"> <p class="c-article-access-provider__text u-sans-serif">This is a preview of subscription content, <a href="https://wayf.springernature.com?redirect_uri=https%3A%2F%2Fwww.nature.com%2Farticles%2Fnature05488" data-track="click_institution_login" data-track-context="article body link" data-track-action="institution access preview subscription" data-track-label="link">access via your institution</a></p> </div> <h2 class="c-article-section__title u-h2 u-mb-24" id="access-options">Access options</h2> <noscript> <div class="c-nature-box c-nature-box--side " data-component="entitlement-box"> <div class="js-access-button"> <a href="https://wayf.springernature.com?redirect_uri=https%3A%2F%2Fwww.nature.com%2Farticles%2Fnature05488" class="c-article__button" data-test="ra21"> <svg class="u-icon" width="18" height="18" aria-hidden="true" focusable="false"><use href="#icon-institution"></use></svg> <span class="c-article__button-text">Access through your institution</span> </a> </div> </div> </noscript> <div class="c-nature-box c-nature-box--side u-display-none u-hide-print" aria-hidden="true" data-component="entitlement-box" id=entitlement-box-main-column-unentitled data-force-hide-buy-button="true" data-unsubscribe-media-query-change="true" > <p class="c-nature-box__text js-text u-display-none" aria-hidden="true"></p> <div class="js-access-button u-display-none"> <a href="https://wayf.springernature.com?redirect_uri=https%3A%2F%2Fwww.nature.com%2Farticles%2Fnature05488" class="c-article__button" aria-hidden="true" data-test="ra21" data-track="click_institution_login" data-track-context="article body button" data-track-action="institution access above buybox" data-track-label="button"> <svg class="u-icon" width="18" height="18" aria-hidden="true" focusable="false"><use xlink:href="#icon-institution"></use></svg> <span class="c-article__button-text">Access through your institution</span> </a> </div> <div class="js-change-institution-button u-display-none"> <a href="https://wayf.springernature.com?redirect_uri=https%3A%2F%2Fwww.nature.com%2Farticles%2Fnature05488" class="c-article__button c-article__button--inverted" aria-hidden="true" data-test="ra21" data-track="click" data-track-action="change institution above buybox" data-track-label="button"> <span class="c-article__button-text">Change institution</span> </a> </div> <div class="js-buy-button u-display-none"> <a href="#access-options" class="c-article__button c-article__button--inverted" aria-hidden="true" data-test="ra21" data-track="click" data-track-action="buy or subscribe" data-track-label="button"> <span>Buy or subscribe</span> </a> </div> </div> <div class="LiveAreaSection"><style type="text/css">/* style specs start */ /* style specs end */</style><section class="BuyBoxSection"><div class="subscribe-buybox"> <div class="box-inner"> <p class="title-buybox">Subscribe to this journal</p> <p class="access-buybox"> Receive 51 print issues and online access </p> <div> <p class="price-buybox" id="subscription-price">185,98 € per year</p> <p class="issue-buybox">only 3,65 € per issue</p> </div> <div class="button-container"> <a href="/nature/subscribe" class="Button-1078489254" data-track="click" data-track-action="subscribe" data-track-label="link" data-track-category="article body" ><span class="ButtonLabel-3296148077">Learn more</span></a > </div> </div> </div><div class="readcube-buybox"> <div class="box-inner"> <p class="title-readcube">Buy this article</p> <ul> <li class="link-usp"><span>Purchase on SpringerLink</span></li> <li class="link-usp"> <span>Instant access to full article PDF</span> </li> </ul> <div class="button-container"> <a href="//link.springer.com/article/10.1038/nature05488?utm_source=nature&utm_medium=referral&utm_campaign=buyArticle" class="btn-secondary Button-2737859108" data-track="click" data-track-action="Go to SL article page" data-track-label="link" data-track-category="article body" rel="noreferrer" ><span class="btn-secondary-label ButtonLabel-1636778223" >Buy now</span ></a > </div> </div> </div><p class="tax-buybox">Prices may be subject to local taxes which are calculated during checkout</p></section><style type="text/css"> /* style specs start */ style { display: none !important; } .LiveAreaSection * { align-content: stretch; align-items: stretch; align-self: auto; animation-delay: 0s; animation-direction: normal; animation-duration: 0s; animation-fill-mode: none; animation-iteration-count: 1; animation-name: none; animation-play-state: running; animation-timing-function: ease; azimuth: center; backface-visibility: visible; background-attachment: scroll; background-blend-mode: normal; background-clip: borderBox; background-color: transparent; background-image: none; background-origin: paddingBox; background-position: 0 0; background-repeat: repeat; background-size: auto auto; block-size: auto; border-block-end-color: currentcolor; border-block-end-style: none; border-block-end-width: medium; border-block-start-color: currentcolor; border-block-start-style: none; border-block-start-width: medium; border-bottom-color: currentcolor; border-bottom-left-radius: 0; border-bottom-right-radius: 0; border-bottom-style: none; border-bottom-width: medium; border-collapse: separate; border-image-outset: 0s; border-image-repeat: stretch; border-image-slice: 100%; border-image-source: none; border-image-width: 1; border-inline-end-color: currentcolor; border-inline-end-style: none; border-inline-end-width: medium; border-inline-start-color: currentcolor; border-inline-start-style: none; border-inline-start-width: medium; border-left-color: currentcolor; border-left-style: none; border-left-width: medium; border-right-color: currentcolor; border-right-style: none; border-right-width: medium; border-spacing: 0; border-top-color: currentcolor; border-top-left-radius: 0; border-top-right-radius: 0; border-top-style: none; border-top-width: medium; bottom: auto; box-decoration-break: slice; box-shadow: none; box-sizing: border-box; break-after: auto; break-before: auto; break-inside: auto; caption-side: top; caret-color: auto; clear: none; clip: auto; clip-path: none; color: initial; column-count: auto; column-fill: balance; column-gap: normal; column-rule-color: currentcolor; column-rule-style: none; column-rule-width: medium; column-span: none; column-width: auto; content: normal; counter-increment: none; counter-reset: none; cursor: auto; display: inline; empty-cells: show; filter: none; flex-basis: auto; flex-direction: row; flex-grow: 0; flex-shrink: 1; flex-wrap: nowrap; float: none; font-family: initial; font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-size: medium; font-size-adjust: none; font-stretch: normal; font-style: normal; font-synthesis: weight style; font-variant: normal; font-variant-alternates: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-numeric: normal; font-variant-position: normal; font-weight: 400; grid-auto-columns: auto; grid-auto-flow: row; grid-auto-rows: auto; grid-column-end: auto; grid-column-gap: 0; grid-column-start: auto; grid-row-end: auto; grid-row-gap: 0; grid-row-start: auto; grid-template-areas: none; grid-template-columns: none; grid-template-rows: none; height: auto; hyphens: manual; image-orientation: 0deg; image-rendering: auto; image-resolution: 1dppx; ime-mode: auto; inline-size: auto; isolation: auto; justify-content: flexStart; left: auto; letter-spacing: normal; line-break: auto; line-height: normal; list-style-image: none; list-style-position: outside; list-style-type: disc; margin-block-end: 0; margin-block-start: 0; margin-bottom: 0; margin-inline-end: 0; margin-inline-start: 0; margin-left: 0; margin-right: 0; margin-top: 0; mask-clip: borderBox; mask-composite: add; mask-image: none; mask-mode: matchSource; mask-origin: borderBox; mask-position: 0 0; mask-repeat: repeat; mask-size: auto; mask-type: luminance; max-height: none; max-width: none; min-block-size: 0; min-height: 0; min-inline-size: 0; min-width: 0; mix-blend-mode: normal; object-fit: fill; object-position: 50% 50%; offset-block-end: auto; offset-block-start: auto; offset-inline-end: auto; offset-inline-start: auto; opacity: 1; order: 0; orphans: 2; outline-color: initial; outline-offset: 0; outline-style: none; outline-width: medium; overflow: visible; overflow-wrap: normal; overflow-x: visible; overflow-y: visible; padding-block-end: 0; padding-block-start: 0; padding-bottom: 0; padding-inline-end: 0; padding-inline-start: 0; padding-left: 0; padding-right: 0; padding-top: 0; page-break-after: auto; page-break-before: auto; page-break-inside: auto; perspective: none; perspective-origin: 50% 50%; pointer-events: auto; position: static; quotes: initial; resize: none; right: auto; ruby-align: spaceAround; ruby-merge: separate; ruby-position: over; scroll-behavior: auto; scroll-snap-coordinate: none; scroll-snap-destination: 0 0; scroll-snap-points-x: none; scroll-snap-points-y: none; scroll-snap-type: none; shape-image-threshold: 0; shape-margin: 0; shape-outside: none; tab-size: 8; table-layout: auto; text-align: initial; text-align-last: auto; text-combine-upright: none; text-decoration-color: currentcolor; text-decoration-line: none; text-decoration-style: solid; text-emphasis-color: currentcolor; text-emphasis-position: over right; text-emphasis-style: none; text-indent: 0; text-justify: auto; text-orientation: mixed; text-overflow: clip; text-rendering: auto; text-shadow: none; text-transform: none; text-underline-position: auto; top: auto; touch-action: auto; transform: none; transform-box: borderBox; transform-origin: 50% 50%0; transform-style: flat; transition-delay: 0s; transition-duration: 0s; transition-property: all; transition-timing-function: ease; vertical-align: baseline; visibility: visible; white-space: normal; widows: 2; width: auto; will-change: auto; word-break: normal; word-spacing: normal; word-wrap: normal; writing-mode: horizontalTb; z-index: auto; -webkit-appearance: none; -moz-appearance: none; -ms-appearance: none; appearance: none; margin: 0; } .LiveAreaSection { width: 100%; } .LiveAreaSection .login-option-buybox { display: block; width: 100%; font-size: 17px; line-height: 30px; color: #222; padding-top: 30px; font-family: Harding, Palatino, serif; } .LiveAreaSection .additional-access-options { display: block; font-weight: 700; font-size: 17px; line-height: 30px; color: #222; font-family: Harding, Palatino, serif; } .LiveAreaSection .additional-login > li:not(:first-child)::before { transform: translateY(-50%); content: ""; height: 1rem; position: absolute; top: 50%; left: 0; border-left: 2px solid #999; } .LiveAreaSection .additional-login > li:not(:first-child) { padding-left: 10px; } .LiveAreaSection .additional-login > li { display: inline-block; position: relative; vertical-align: middle; padding-right: 10px; } .BuyBoxSection { display: flex; flex-wrap: wrap; flex: 1; flex-direction: row-reverse; margin: -30px -15px 0; } .BuyBoxSection .box-inner { width: 100%; height: 100%; padding: 30px 5px; display: flex; flex-direction: column; justify-content: space-between; } .BuyBoxSection p { margin: 0; } .BuyBoxSection .readcube-buybox { background-color: #f3f3f3; flex-shrink: 1; flex-grow: 1; flex-basis: 255px; background-clip: content-box; padding: 0 15px; margin-top: 30px; } .BuyBoxSection .subscribe-buybox { background-color: #f3f3f3; flex-shrink: 1; flex-grow: 4; flex-basis: 300px; background-clip: content-box; padding: 0 15px; margin-top: 30px; } .BuyBoxSection .subscribe-buybox-nature-plus { background-color: #f3f3f3; flex-shrink: 1; flex-grow: 4; flex-basis: 100%; background-clip: content-box; padding: 0 15px; margin-top: 30px; } .BuyBoxSection .title-readcube, .BuyBoxSection .title-buybox { display: block; margin: 0; margin-right: 10%; margin-left: 10%; font-size: 24px; line-height: 32px; color: #222; text-align: center; font-family: Harding, Palatino, serif; } .BuyBoxSection .title-asia-buybox { display: block; margin: 0; margin-right: 5%; margin-left: 5%; font-size: 24px; line-height: 32px; color: #222; text-align: center; font-family: Harding, Palatino, serif; } .BuyBoxSection .asia-link, .Link-328123652, .Link-2926870917, .Link-2291679238, .Link-595459207 { color: #069; cursor: pointer; text-decoration: none; font-size: 1.05em; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; line-height: 1.05em6; } .BuyBoxSection .access-readcube { display: block; margin: 0; margin-right: 10%; margin-left: 10%; font-size: 14px; color: #222; padding-top: 10px; text-align: center; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; line-height: 20px; } .BuyBoxSection ul { margin: 0; } .BuyBoxSection .link-usp { display: list-item; margin: 0; margin-left: 20px; padding-top: 6px; list-style-position: inside; } .BuyBoxSection .link-usp span { font-size: 14px; color: #222; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; line-height: 20px; } .BuyBoxSection .access-asia-buybox { display: block; margin: 0; margin-right: 5%; margin-left: 5%; font-size: 14px; color: #222; padding-top: 10px; text-align: center; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; line-height: 20px; } .BuyBoxSection .access-buybox { display: block; margin: 0; margin-right: 10%; margin-left: 10%; font-size: 14px; color: #222; opacity: 0.8px; padding-top: 10px; text-align: center; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; line-height: 20px; } .BuyBoxSection .price-buybox { display: block; font-size: 30px; color: #222; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; padding-top: 30px; text-align: center; } .BuyBoxSection .price-buybox-to { display: block; font-size: 30px; color: #222; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; text-align: center; } .BuyBoxSection .price-info-text { font-size: 16px; padding-right: 10px; color: #222; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; } .BuyBoxSection .price-value { font-size: 30px; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; } .BuyBoxSection .price-per-period { font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; } .BuyBoxSection .price-from { font-size: 14px; padding-right: 10px; color: #222; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; line-height: 20px; } .BuyBoxSection .issue-buybox { display: block; font-size: 13px; text-align: center; color: #222; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; line-height: 19px; } .BuyBoxSection .no-price-buybox { display: block; font-size: 13px; line-height: 18px; text-align: center; padding-right: 10%; padding-left: 10%; padding-bottom: 20px; padding-top: 30px; color: #222; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; } .BuyBoxSection .vat-buybox { display: block; margin-top: 5px; margin-right: 20%; margin-left: 20%; font-size: 11px; color: #222; padding-top: 10px; padding-bottom: 15px; text-align: center; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; line-height: 17px; } .BuyBoxSection .tax-buybox { display: block; width: 100%; color: #222; padding: 20px 16px; text-align: center; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; line-height: NaNpx; } .BuyBoxSection .button-container { display: flex; padding-right: 20px; padding-left: 20px; justify-content: center; } .BuyBoxSection .button-container > * { flex: 1px; } .BuyBoxSection .button-container > a:hover, .Button-505204839:hover, .Button-1078489254:hover, .Button-2737859108:hover { text-decoration: none; } .BuyBoxSection .btn-secondary { background: #fff; } .BuyBoxSection .button-asia { background: #069; border: 1px solid #069; border-radius: 0; cursor: pointer; display: block; padding: 9px; outline: 0; text-align: center; text-decoration: none; min-width: 80px; margin-top: 75px; } .BuyBoxSection .button-label-asia, .ButtonLabel-3869432492, .ButtonLabel-3296148077, .ButtonLabel-1636778223 { display: block; color: #fff; font-size: 17px; line-height: 20px; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; text-align: center; text-decoration: none; cursor: pointer; } .Button-505204839, .Button-1078489254, .Button-2737859108 { background: #069; border: 1px solid #069; border-radius: 0; cursor: pointer; display: block; padding: 9px; outline: 0; text-align: center; text-decoration: none; min-width: 80px; max-width: 320px; margin-top: 20px; } .Button-505204839 .btn-secondary-label, .Button-1078489254 .btn-secondary-label, .Button-2737859108 .btn-secondary-label { color: #069; } .uList-2102244549 { list-style: none; padding: 0; margin: 0; } /* style specs end */</style><div></div></div> <nav class="c-access-options"> <h3 class="c-access-options__heading">Additional access options:</h3> <ul class="c-access-options__list"> <li> <a href="https://idp.nature.com/authorize/natureuser?client_id=grover&redirect_uri=https%3A%2F%2Fwww.nature.com%2Farticles%2Fnature05488" data-track="click" data-track-action="login" data-track-category="article body" data-track-label="link">Log in</a> </li> <li> <a href="https://www.springernature.com/gp/librarians/licensing/license-options" data-track="click" data-track-action="learn-subscription" data-track-category="article body" data-track-label="link">Learn about institutional subscriptions</a> </li> <li> <a href="https://support.nature.com/en/support/home" data-track="click" data-track-action="read our faqs" data-track-category="article body" data-track-label="link">Read our FAQs</a> </li> <li> <a href="https://www.springernature.com/gp/contact" data-track="click" data-track-action="contact customer support" data-track-category="article body" data-track-label="link">Contact customer support</a> </li> </ul> </nav> <div class="u-display-none"> <div class="c-article-section__figure js-c-reading-companion-figures-item" data-test="figure" data-container-section="figure" id="figure-1"><figure><figcaption><b id="Fig1" class="c-article-section__figure-caption" data-test="figure-caption-text">Figure 1: The lipid overflow–ectopic fat model.</b></figcaption><div class="c-article-section__figure-content"><div class="c-article-section__figure-item"><picture><source type="image/webp" srcset="//media.springernature.com/m312/springer-static/image/art%3A10.1038%2Fnature05488/MediaObjects/41586_2006_Article_BFnature05488_Fig1_HTML.jpg?as=webp"><img src="//media.springernature.com/m312/springer-static/image/art%3A10.1038%2Fnature05488/MediaObjects/41586_2006_Article_BFnature05488_Fig1_HTML.jpg" alt="" loading="lazy" width="118" height="312"></picture></div></div></figure></div><div class="c-article-section__figure js-c-reading-companion-figures-item" data-test="figure" data-container-section="figure" id="figure-2"><figure><figcaption><b id="Fig2" class="c-article-section__figure-caption" data-test="figure-caption-text">Figure 2: Factors contributing to global cardiometabolic risk.</b></figcaption><div class="c-article-section__figure-content"><div class="c-article-section__figure-item"><picture><source type="image/webp" srcset="//media.springernature.com/m312/springer-static/image/art%3A10.1038%2Fnature05488/MediaObjects/41586_2006_Article_BFnature05488_Fig2_HTML.jpg?as=webp"><img src="//media.springernature.com/m312/springer-static/image/art%3A10.1038%2Fnature05488/MediaObjects/41586_2006_Article_BFnature05488_Fig2_HTML.jpg" alt="" loading="lazy" width="312" height="190"></picture></div></div></figure></div> </div> <section aria-labelledby="inline-recommendations" data-title="Inline Recommendations" class="c-article-recommendations" data-track-component="inline-recommendations"> <h3 class="c-article-recommendations-title" id="inline-recommendations">Similar content being viewed by others</h3> <div class="c-article-recommendations-list"> <div class="c-article-recommendations-list__item"> <article class="c-article-recommendations-card" itemscope itemtype="http://schema.org/ScholarlyArticle"> <div class="c-article-recommendations-card__img"><img src="https://media.springernature.com/w215h120/springer-static/image/art%3A10.1038%2Fs41572-024-00563-5/MediaObjects/41572_2024_563_Fig1_HTML.png" loading="lazy" alt=""></div> <div class="c-article-recommendations-card__main"> <h3 class="c-article-recommendations-card__heading" itemprop="name headline"> <a class="c-article-recommendations-card__link" itemprop="url" href="https://www.nature.com/articles/s41572-024-00563-5?fromPaywallRec=true" data-track="select_recommendations_1" data-track-context="inline recommendations" data-track-action="click recommendations inline - 1" data-track-label="10.1038/s41572-024-00563-5">Metabolic syndrome </a> </h3> <div class="c-article-meta-recommendations" data-test="recommendation-info"> <span class="c-article-meta-recommendations__item-type">Article</span> <span class="c-article-meta-recommendations__date">17 October 2024</span> </div> </div> </article> </div> <div class="c-article-recommendations-list__item"> <article class="c-article-recommendations-card" itemscope itemtype="http://schema.org/ScholarlyArticle"> <div class="c-article-recommendations-card__img"><img src="https://media.springernature.com/w215h120/springer-static/image/art%3A10.1038%2Fs41569-023-00847-5/MediaObjects/41569_2023_847_Fig1_HTML.png" loading="lazy" alt=""></div> <div class="c-article-recommendations-card__main"> <h3 class="c-article-recommendations-card__heading" itemprop="name headline"> <a class="c-article-recommendations-card__link" itemprop="url" href="https://www.nature.com/articles/s41569-023-00847-5?fromPaywallRec=true" data-track="select_recommendations_2" data-track-context="inline recommendations" data-track-action="click recommendations inline - 2" data-track-label="10.1038/s41569-023-00847-5">Obesity and the risk of cardiometabolic diseases </a> </h3> <div class="c-article-meta-recommendations" data-test="recommendation-info"> <span class="c-article-meta-recommendations__item-type">Article</span> <span class="c-article-meta-recommendations__date">16 March 2023</span> </div> </div> </article> </div> <div class="c-article-recommendations-list__item"> <article class="c-article-recommendations-card" itemscope itemtype="http://schema.org/ScholarlyArticle"> <div class="c-article-recommendations-card__img"><img src="https://media.springernature.com/w215h120/springer-static/image/art%3A10.1038%2Fs41574-024-01008-5/MediaObjects/41574_2024_1008_Fig1_HTML.png" loading="lazy" alt=""></div> <div class="c-article-recommendations-card__main"> <h3 class="c-article-recommendations-card__heading" itemprop="name headline"> <a class="c-article-recommendations-card__link" itemprop="url" href="https://www.nature.com/articles/s41574-024-01008-5?fromPaywallRec=true" data-track="select_recommendations_3" data-track-context="inline recommendations" data-track-action="click recommendations inline - 3" data-track-label="10.1038/s41574-024-01008-5">Metabolically healthy obesity: from epidemiology and mechanisms to clinical implications </a> </h3> <div class="c-article-meta-recommendations" data-test="recommendation-info"> <span class="c-article-meta-recommendations__item-type">Article</span> <span class="c-article-meta-recommendations__date">27 June 2024</span> </div> </div> </article> </div> </div> </section> <script> window.dataLayer = window.dataLayer || []; window.dataLayer.push({ recommendations: { recommender: 'semantic', model: 'specter', policy_id: 'NA', timestamp: 1740489881, embedded_user: 'null' } }); </script> <div class="u-mt-32"> <div id="MagazineFulltextArticleBodySuffix"><section aria-labelledby="Bib1" data-title="References"><div class="c-article-section" id="Bib1-section"><h2 class="c-article-section__title js-section-title js-c-reading-companion-sections-item" id="Bib1">References</h2><div class="c-article-section__content" id="Bib1-content"><div data-container-section="references"><ol class="c-article-references" data-track-component="outbound reference" data-track-context="references section"><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="1"><p class="c-article-references__text" id="ref-CR1">Grundy, S. M. Metabolic syndrome: connecting and reconciling cardiovascular and diabetes worlds. <i>J. Am. Coll. Cardiol.</i> <b>47</b>, 1093–1100 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/j.jacc.2005.11.046" data-track-item_id="10.1016/j.jacc.2005.11.046" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2Fj.jacc.2005.11.046" aria-label="Article reference 1" data-doi="10.1016/j.jacc.2005.11.046">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD28XisF2itrY%3D" aria-label="CAS reference 1">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16545636" aria-label="PubMed reference 1">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 1" href="http://scholar.google.com/scholar_lookup?&title=Metabolic%20syndrome%3A%20connecting%20and%20reconciling%20cardiovascular%20and%20diabetes%20worlds&journal=J.%20Am.%20Coll.%20Cardiol.&doi=10.1016%2Fj.jacc.2005.11.046&volume=47&pages=1093-1100&publication_year=2006&author=Grundy%2CSM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="2"><p class="c-article-references__text" id="ref-CR2">Grundy, S. M. Does a diagnosis of metabolic syndrome have value in clinical practice? <i>Am. J. Clin. Nutr.</i> <b>83</b>, 1248–1251 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1093/ajcn/83.6.1248" data-track-item_id="10.1093/ajcn/83.6.1248" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1093%2Fajcn%2F83.6.1248" aria-label="Article reference 2" data-doi="10.1093/ajcn/83.6.1248">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD28XlvFCmtL8%3D" aria-label="CAS reference 2">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16762931" aria-label="PubMed reference 2">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 2" href="http://scholar.google.com/scholar_lookup?&title=Does%20a%20diagnosis%20of%20metabolic%20syndrome%20have%20value%20in%20clinical%20practice%3F&journal=Am.%20J.%20Clin.%20Nutr.&doi=10.1093%2Fajcn%2F83.6.1248&volume=83&pages=1248-1251&publication_year=2006&author=Grundy%2CSM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="3"><p class="c-article-references__text" id="ref-CR3">Grundy, S. M. Drug therapy of the metabolic syndrome: minimizing the emerging crisis of polypharmacy. <i>Nature Rev. Drug Discov.</i> <b>5</b>, 295–309 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1038/nrd2005" data-track-item_id="10.1038/nrd2005" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1038%2Fnrd2005" aria-label="Article reference 3" data-doi="10.1038/nrd2005">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD28XjtVaksr4%3D" aria-label="CAS reference 3">CAS</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 3" href="http://scholar.google.com/scholar_lookup?&title=Drug%20therapy%20of%20the%20metabolic%20syndrome%3A%20minimizing%20the%20emerging%20crisis%20of%20polypharmacy&journal=Nature%20Rev.%20Drug%20Discov.&doi=10.1038%2Fnrd2005&volume=5&pages=295-309&publication_year=2006&author=Grundy%2CSM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="4"><p class="c-article-references__text" id="ref-CR4">Moller, D. E. & Kaufman, K. D. Metabolic syndrome: a clinical and molecular perspective. <i>Annu. Rev. Med.</i> <b>56</b>, 45–62 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1146/annurev.med.56.082103.104751" data-track-item_id="10.1146/annurev.med.56.082103.104751" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1146%2Fannurev.med.56.082103.104751" aria-label="Article reference 4" data-doi="10.1146/annurev.med.56.082103.104751">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD2MXisVSrsLg%3D" aria-label="CAS reference 4">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15660501" aria-label="PubMed reference 4">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 4" href="http://scholar.google.com/scholar_lookup?&title=Metabolic%20syndrome%3A%20a%20clinical%20and%20molecular%20perspective&journal=Annu.%20Rev.%20Med.&doi=10.1146%2Fannurev.med.56.082103.104751&volume=56&pages=45-62&publication_year=2005&author=Moller%2CDE&author=Kaufman%2CKD"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="5"><p class="c-article-references__text" id="ref-CR5">Sattar, N. The metabolic syndrome: should current criteria influence clinical practice? <i>Curr. Opin. Lipidol.</i> <b>17</b>, 404–411 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1097/01.mol.0000236366.48593.07" data-track-item_id="10.1097/01.mol.0000236366.48593.07" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1097%2F01.mol.0000236366.48593.07" aria-label="Article reference 5" data-doi="10.1097/01.mol.0000236366.48593.07">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD28Xms1yrtbg%3D" aria-label="CAS reference 5">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16832164" aria-label="PubMed reference 5">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 5" href="http://scholar.google.com/scholar_lookup?&title=The%20metabolic%20syndrome%3A%20should%20current%20criteria%20influence%20clinical%20practice%3F&journal=Curr.%20Opin.%20Lipidol.&doi=10.1097%2F01.mol.0000236366.48593.07&volume=17&pages=404-411&publication_year=2006&author=Sattar%2CN"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="6"><p class="c-article-references__text" id="ref-CR6">Eckel, R. H., Grundy, S. M. & Zimmet, P. Z. The metabolic syndrome. <i>Lancet</i> <b>365</b>, 1415–1428 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/S0140-6736(05)66378-7" data-track-item_id="10.1016/S0140-6736(05)66378-7" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2FS0140-6736%2805%2966378-7" aria-label="Article reference 6" data-doi="10.1016/S0140-6736(05)66378-7">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD2MXjsVegtbg%3D" aria-label="CAS reference 6">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15836891" aria-label="PubMed reference 6">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 6" href="http://scholar.google.com/scholar_lookup?&title=The%20metabolic%20syndrome&journal=Lancet&doi=10.1016%2FS0140-6736%2805%2966378-7&volume=365&pages=1415-1428&publication_year=2005&author=Eckel%2CRH&author=Grundy%2CSM&author=Zimmet%2CPZ"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="7"><p class="c-article-references__text" id="ref-CR7">Reaven, G. M. The metabolic syndrome: is this diagnosis necessary? <i>Am. J. Clin. Nutr.</i> <b>83</b>, 1237–1247 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1093/ajcn/83.6.1237" data-track-item_id="10.1093/ajcn/83.6.1237" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1093%2Fajcn%2F83.6.1237" aria-label="Article reference 7" data-doi="10.1093/ajcn/83.6.1237">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD28XlvFCmtL4%3D" aria-label="CAS reference 7">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16762930" aria-label="PubMed reference 7">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 7" href="http://scholar.google.com/scholar_lookup?&title=The%20metabolic%20syndrome%3A%20is%20this%20diagnosis%20necessary%3F&journal=Am.%20J.%20Clin.%20Nutr.&doi=10.1093%2Fajcn%2F83.6.1237&volume=83&pages=1237-1247&publication_year=2006&author=Reaven%2CGM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="8"><p class="c-article-references__text" id="ref-CR8">Ferrannini, E. Is insulin resistance the cause of the metabolic syndrome? <i>Ann. Med.</i> <b>38</b>, 43–51 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1080/07853890500415358" data-track-item_id="10.1080/07853890500415358" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1080%2F07853890500415358" aria-label="Article reference 8" data-doi="10.1080/07853890500415358">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD28XhtVGnsbY%3D" aria-label="CAS reference 8">CAS</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 8" href="http://scholar.google.com/scholar_lookup?&title=Is%20insulin%20resistance%20the%20cause%20of%20the%20metabolic%20syndrome%3F&journal=Ann.%20Med.&doi=10.1080%2F07853890500415358&volume=38&pages=43-51&publication_year=2006&author=Ferrannini%2CE"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="9"><p class="c-article-references__text" id="ref-CR9">Gale, E. A. The myth of the metabolic syndrome. <i>Diabetologia</i> <b>48</b>, 1679–1683 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="noopener" data-track-label="10.1007/s00125-005-1873-5" data-track-item_id="10.1007/s00125-005-1873-5" data-track-value="article reference" data-track-action="article reference" href="https://link.springer.com/doi/10.1007/s00125-005-1873-5" aria-label="Article reference 9" data-doi="10.1007/s00125-005-1873-5">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16025251" aria-label="PubMed reference 9">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 9" href="http://scholar.google.com/scholar_lookup?&title=The%20myth%20of%20the%20metabolic%20syndrome&journal=Diabetologia&doi=10.1007%2Fs00125-005-1873-5&volume=48&pages=1679-1683&publication_year=2005&author=Gale%2CEA"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="10"><p class="c-article-references__text" id="ref-CR10">Kahn, R., Buse, J., Ferrannini, E. & Stern, M. The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. <i>Diabetes Care</i> <b>28</b>, 2289–2304 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.2337/diacare.28.9.2289" data-track-item_id="10.2337/diacare.28.9.2289" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.2337%2Fdiacare.28.9.2289" aria-label="Article reference 10" data-doi="10.2337/diacare.28.9.2289">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16123508" aria-label="PubMed reference 10">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 10" href="http://scholar.google.com/scholar_lookup?&title=The%20metabolic%20syndrome%3A%20time%20for%20a%20critical%20appraisal%3A%20joint%20statement%20from%20the%20American%20Diabetes%20Association%20and%20the%20European%20Association%20for%20the%20Study%20of%20Diabetes&journal=Diabetes%20Care&doi=10.2337%2Fdiacare.28.9.2289&volume=28&pages=2289-2304&publication_year=2005&author=Kahn%2CR&author=Buse%2CJ&author=Ferrannini%2CE&author=Stern%2CM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="11"><p class="c-article-references__text" id="ref-CR11">Reaven, G. M. The metabolic syndrome: requiescat in pace. <i>Clin. Chem.</i> <b>51</b>, 931–938 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1373/clinchem.2005.048611" data-track-item_id="10.1373/clinchem.2005.048611" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1373%2Fclinchem.2005.048611" aria-label="Article reference 11" data-doi="10.1373/clinchem.2005.048611">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD2MXkvF2gu7c%3D" aria-label="CAS reference 11">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15746300" aria-label="PubMed reference 11">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 11" href="http://scholar.google.com/scholar_lookup?&title=The%20metabolic%20syndrome%3A%20requiescat%20in%20pace&journal=Clin.%20Chem.&doi=10.1373%2Fclinchem.2005.048611&volume=51&pages=931-938&publication_year=2005&author=Reaven%2CGM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="12"><p class="c-article-references__text" id="ref-CR12">Alberti, K. G. & Zimmet, P. Z. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. <i>Diabet. Med.</i> <b>15</b>, 539–553 (1998).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S" data-track-item_id="10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1002%2F%28SICI%291096-9136%28199807%2915%3A7%3C539%3A%3AAID-DIA668%3E3.0.CO%3B2-S" aria-label="Article reference 12" data-doi="10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DyaK1czkvFCrsA%3D%3D" aria-label="CAS reference 12">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=9686693" aria-label="PubMed reference 12">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 12" href="http://scholar.google.com/scholar_lookup?&title=Definition%2C%20diagnosis%20and%20classification%20of%20diabetes%20mellitus%20and%20its%20complications.%20Part%201%3A%20diagnosis%20and%20classification%20of%20diabetes%20mellitus%20provisional%20report%20of%20a%20WHO%20consultation&journal=Diabet.%20Med.&doi=10.1002%2F%28SICI%291096-9136%28199807%2915%3A7%3C539%3A%3AAID-DIA668%3E3.0.CO%3B2-S&volume=15&pages=539-553&publication_year=1998&author=Alberti%2CKG&author=Zimmet%2CPZ"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="13"><p class="c-article-references__text" id="ref-CR13">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). <i>J. Am. Med. Assoc.</i> <b>285</b>, 2486–2497 (2001).</p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="14"><p class="c-article-references__text" id="ref-CR14">Alberti, K. G., Zimmet, P. & Shaw, J. The metabolic syndrome — a new worldwide definition. <i>Lancet</i> <b>366</b>, 1059–1062 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/S0140-6736(05)67402-8" data-track-item_id="10.1016/S0140-6736(05)67402-8" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2FS0140-6736%2805%2967402-8" aria-label="Article reference 14" data-doi="10.1016/S0140-6736(05)67402-8">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16182882" aria-label="PubMed reference 14">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 14" href="http://scholar.google.com/scholar_lookup?&title=The%20metabolic%20syndrome%20%E2%80%94%20a%20new%20worldwide%20definition&journal=Lancet&doi=10.1016%2FS0140-6736%2805%2967402-8&volume=366&pages=1059-1062&publication_year=2005&author=Alberti%2CKG&author=Zimmet%2CP&author=Shaw%2CJ"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="15"><p class="c-article-references__text" id="ref-CR15">Galassi, A., Reynolds, K. & He, J. Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. <i>Am. J. Med.</i> <b>119</b>, 812–819 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/j.amjmed.2006.02.031" data-track-item_id="10.1016/j.amjmed.2006.02.031" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2Fj.amjmed.2006.02.031" aria-label="Article reference 15" data-doi="10.1016/j.amjmed.2006.02.031">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD28XpvFemtrk%3D" aria-label="CAS reference 15">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=17000207" aria-label="PubMed reference 15">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 15" href="http://scholar.google.com/scholar_lookup?&title=Metabolic%20syndrome%20and%20risk%20of%20cardiovascular%20disease%3A%20a%20meta-analysis&journal=Am.%20J.%20Med.&doi=10.1016%2Fj.amjmed.2006.02.031&volume=119&pages=812-819&publication_year=2006&author=Galassi%2CA&author=Reynolds%2CK&author=He%2CJ"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="16"><p class="c-article-references__text" id="ref-CR16">Mokdad, A. H. et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. <i>J. Am. Med. Assoc.</i> <b>289</b>, 76–79 (2003).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1001/jama.289.1.76" data-track-item_id="10.1001/jama.289.1.76" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1001%2Fjama.289.1.76" aria-label="Article reference 16" data-doi="10.1001/jama.289.1.76">Article</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 16" href="http://scholar.google.com/scholar_lookup?&title=Prevalence%20of%20obesity%2C%20diabetes%2C%20and%20obesity-related%20health%20risk%20factors%2C%202001&journal=J.%20Am.%20Med.%20Assoc.&doi=10.1001%2Fjama.289.1.76&volume=289&pages=76-79&publication_year=2003&author=Mokdad%2CAH"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="17"><p class="c-article-references__text" id="ref-CR17">Zimmet, P., Alberti, K. G. M. M. & Shaw, J. Global and societal implications of the diabetes epidemic. <i>Nature</i> <b>414</b>, 782–787 (2001).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1038/414782a" data-track-item_id="10.1038/414782a" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1038%2F414782a" aria-label="Article reference 17" data-doi="10.1038/414782a">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="ads reference" data-track-action="ads reference" href="http://adsabs.harvard.edu/cgi-bin/nph-data_query?link_type=ABSTRACT&bibcode=2001Natur.414..782Z" aria-label="ADS reference 17">ADS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD38Xhtlymtg%3D%3D" aria-label="CAS reference 17">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11742409" aria-label="PubMed reference 17">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 17" href="http://scholar.google.com/scholar_lookup?&title=Global%20and%20societal%20implications%20of%20the%20diabetes%20epidemic&journal=Nature&doi=10.1038%2F414782a&volume=414&pages=782-787&publication_year=2001&author=Zimmet%2CP&author=Alberti%2CKGMM&author=Shaw%2CJ"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="18"><p class="c-article-references__text" id="ref-CR18">Astrup, A. & Finer, N. Redefining type 2 diabetes:'diabesity' or 'obesity dependent diabetes mellitus'? <i>Obesity Rev.</i> <b>1</b>, 57–59 (2000).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1046/j.1467-789x.2000.00013.x" data-track-item_id="10.1046/j.1467-789x.2000.00013.x" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1046%2Fj.1467-789x.2000.00013.x" aria-label="Article reference 18" data-doi="10.1046/j.1467-789x.2000.00013.x">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DC%2BD38znsVCkuw%3D%3D" aria-label="CAS reference 18">CAS</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 18" href="http://scholar.google.com/scholar_lookup?&title=Redefining%20type%202%20diabetes%3A%27diabesity%27%20or%20%27obesity%20dependent%20diabetes%20mellitus%27%3F&journal=Obesity%20Rev.&doi=10.1046%2Fj.1467-789x.2000.00013.x&volume=1&pages=57-59&publication_year=2000&author=Astrup%2CA&author=Finer%2CN"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="19"><p class="c-article-references__text" id="ref-CR19">Shafrir, E. Development and consequences of insulin resistance: lessons from animals with hyperinsulinaemia. <i>Diabetes Metab.</i> <b>22</b>, 122–131 (1996).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DyaK28XisFylu7g%3D" aria-label="CAS reference 19">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=8792092" aria-label="PubMed reference 19">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 19" href="http://scholar.google.com/scholar_lookup?&title=Development%20and%20consequences%20of%20insulin%20resistance%3A%20lessons%20from%20animals%20with%20hyperinsulinaemia&journal=Diabetes%20Metab.&volume=22&pages=122-131&publication_year=1996&author=Shafrir%2CE"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="20"><p class="c-article-references__text" id="ref-CR20">Pincock, S. Paul Zimmet: fighting the 'diabesity' pandemic. <i>Lancet</i> <b>368</b>, 1643 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/S0140-6736(06)69682-7" data-track-item_id="10.1016/S0140-6736(06)69682-7" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2FS0140-6736%2806%2969682-7" aria-label="Article reference 20" data-doi="10.1016/S0140-6736(06)69682-7">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=17098069" aria-label="PubMed reference 20">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 20" href="http://scholar.google.com/scholar_lookup?&title=Paul%20Zimmet%3A%20fighting%20the%20%27diabesity%27%20pandemic&journal=Lancet&doi=10.1016%2FS0140-6736%2806%2969682-7&volume=368&publication_year=2006&author=Pincock%2CS"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="21"><p class="c-article-references__text" id="ref-CR21">Després, J. P. et al. Race, visceral adipose tissue, plasma lipids, and lipoprotein lipase activity in men and women: the Health, Risk Factors, Exercise Training, and Genetics (HERITAGE) family study. <i>Arterioscler. Thromb. Vasc. Biol.</i> <b>20</b>, 1932–1938 (2000).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/01.ATV.20.8.1932" data-track-item_id="10.1161/01.ATV.20.8.1932" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2F01.ATV.20.8.1932" aria-label="Article reference 21" data-doi="10.1161/01.ATV.20.8.1932">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=10938014" aria-label="PubMed reference 21">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 21" href="http://scholar.google.com/scholar_lookup?&title=Race%2C%20visceral%20adipose%20tissue%2C%20plasma%20lipids%2C%20and%20lipoprotein%20lipase%20activity%20in%20men%20and%20women%3A%20the%20Health%2C%20Risk%20Factors%2C%20Exercise%20Training%2C%20and%20Genetics%20%28HERITAGE%29%20family%20study&journal=Arterioscler.%20Thromb.%20Vasc.%20Biol.&doi=10.1161%2F01.ATV.20.8.1932&volume=20&pages=1932-1938&publication_year=2000&author=Despr%C3%A9s%2CJP"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="22"><p class="c-article-references__text" id="ref-CR22">Albu, J. B., Murphy, L., Frager, D. H., Johnson, J. A. & Pi-Sunyer, F. X. Visceral fat and race-dependent health risks in obese nondiabetic premenopausal women. <i>Diabetes</i> <b>46</b>, 456–462 (1997).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.2337/diab.46.3.456" data-track-item_id="10.2337/diab.46.3.456" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.2337%2Fdiab.46.3.456" aria-label="Article reference 22" data-doi="10.2337/diab.46.3.456">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DyaK2sXhsVGqtb0%3D" aria-label="CAS reference 22">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=9032103" aria-label="PubMed reference 22">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 22" href="http://scholar.google.com/scholar_lookup?&title=Visceral%20fat%20and%20race-dependent%20health%20risks%20in%20obese%20nondiabetic%20premenopausal%20women&journal=Diabetes&doi=10.2337%2Fdiab.46.3.456&volume=46&pages=456-462&publication_year=1997&author=Albu%2CJB&author=Murphy%2CL&author=Frager%2CDH&author=Johnson%2CJA&author=Pi-Sunyer%2CFX"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="23"><p class="c-article-references__text" id="ref-CR23">WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. <i>Lancet</i> <b>363</b>, 157–163 (2004).</p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="24"><p class="c-article-references__text" id="ref-CR24">Kadowaki, T. et al. Japanese men have larger areas of visceral adipose tissue than Caucasian men in the same levels of waist circumference in a population-based study. <i>Int. J. Obes. (Lond.)</i> <b>30</b>, 1163–1165 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1038/sj.ijo.0803248" data-track-item_id="10.1038/sj.ijo.0803248" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1038%2Fsj.ijo.0803248" aria-label="Article reference 24" data-doi="10.1038/sj.ijo.0803248">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DC%2BD28zosFSntw%3D%3D" aria-label="CAS reference 24">CAS</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 24" href="http://scholar.google.com/scholar_lookup?&title=Japanese%20men%20have%20larger%20areas%20of%20visceral%20adipose%20tissue%20than%20Caucasian%20men%20in%20the%20same%20levels%20of%20waist%20circumference%20in%20a%20population-based%20study&journal=Int.%20J.%20Obes.%20%28Lond.%29&doi=10.1038%2Fsj.ijo.0803248&volume=30&pages=1163-1165&publication_year=2006&author=Kadowaki%2CT"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="25"><p class="c-article-references__text" id="ref-CR25">Lovejoy, J. C., de la Bretonne, J. A., Klemperer, M. & Tulley, R. Abdominal fat distribution and metabolic risk factors: effects of race. <i>Metabolism</i> <b>45</b>, 1119–1124 (1996).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/S0026-0495(96)90011-6" data-track-item_id="10.1016/S0026-0495(96)90011-6" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2FS0026-0495%2896%2990011-6" aria-label="Article reference 25" data-doi="10.1016/S0026-0495(96)90011-6">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DyaK28Xls1Wmu7o%3D" aria-label="CAS reference 25">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=8781299" aria-label="PubMed reference 25">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 25" href="http://scholar.google.com/scholar_lookup?&title=Abdominal%20fat%20distribution%20and%20metabolic%20risk%20factors%3A%20effects%20of%20race&journal=Metabolism&doi=10.1016%2FS0026-0495%2896%2990011-6&volume=45&pages=1119-1124&publication_year=1996&author=Lovejoy%2CJC&author=de%20la%20Bretonne%2CJA&author=Klemperer%2CM&author=Tulley%2CR"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="26"><p class="c-article-references__text" id="ref-CR26">Conway, J. M., Chanetsa, F. F. & Wang, P. Intrabdominal adipose tissue and anthropometric surrogates in African American women with upper- and lower-body obesity. <i>Am. J. Clin. Nutr.</i> <b>66</b>, 1345–1351 (1997).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1093/ajcn/66.6.1345" data-track-item_id="10.1093/ajcn/66.6.1345" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1093%2Fajcn%2F66.6.1345" aria-label="Article reference 26" data-doi="10.1093/ajcn/66.6.1345">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DyaK2sXnslOjsLk%3D" aria-label="CAS reference 26">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=9394685" aria-label="PubMed reference 26">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 26" href="http://scholar.google.com/scholar_lookup?&title=Intrabdominal%20adipose%20tissue%20and%20anthropometric%20surrogates%20in%20African%20American%20women%20with%20upper-%20and%20lower-body%20obesity&journal=Am.%20J.%20Clin.%20Nutr.&doi=10.1093%2Fajcn%2F66.6.1345&volume=66&pages=1345-1351&publication_year=1997&author=Conway%2CJM&author=Chanetsa%2CFF&author=Wang%2CP"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="27"><p class="c-article-references__text" id="ref-CR27">Abbasi, F., Brown, B. W., Lamendola, C., McLaughlin, T. & Reaven, G. M. Relationship between obesity, insulin resistance, and coronary heart disease risk. <i>J. Am. Coll. Cardiol.</i> <b>40</b>, 937–943 (2002).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/S0735-1097(02)02051-X" data-track-item_id="10.1016/S0735-1097(02)02051-X" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2FS0735-1097%2802%2902051-X" aria-label="Article reference 27" data-doi="10.1016/S0735-1097(02)02051-X">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD38Xns1OmsLg%3D" aria-label="CAS reference 27">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12225719" aria-label="PubMed reference 27">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 27" href="http://scholar.google.com/scholar_lookup?&title=Relationship%20between%20obesity%2C%20insulin%20resistance%2C%20and%20coronary%20heart%20disease%20risk&journal=J.%20Am.%20Coll.%20Cardiol.&doi=10.1016%2FS0735-1097%2802%2902051-X&volume=40&pages=937-943&publication_year=2002&author=Abbasi%2CF&author=Brown%2CBW&author=Lamendola%2CC&author=McLaughlin%2CT&author=Reaven%2CGM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="28"><p class="c-article-references__text" id="ref-CR28">Després, J. P. et al. Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease. <i>Arteriosclerosis</i> <b>10</b>, 497–511 (1990).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/01.ATV.10.4.497" data-track-item_id="10.1161/01.ATV.10.4.497" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2F01.ATV.10.4.497" aria-label="Article reference 28" data-doi="10.1161/01.ATV.10.4.497">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=2196040" aria-label="PubMed reference 28">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 28" href="http://scholar.google.com/scholar_lookup?&title=Regional%20distribution%20of%20body%20fat%2C%20plasma%20lipoproteins%2C%20and%20cardiovascular%20disease&journal=Arteriosclerosis&doi=10.1161%2F01.ATV.10.4.497&volume=10&pages=497-511&publication_year=1990&author=Despr%C3%A9s%2CJP"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="29"><p class="c-article-references__text" id="ref-CR29">Després, J. P. Is visceral obesity the cause of the metabolic syndrome? <i>Ann. Med.</i> <b>38</b>, 52–63 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1080/07853890500383895" data-track-item_id="10.1080/07853890500383895" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1080%2F07853890500383895" aria-label="Article reference 29" data-doi="10.1080/07853890500383895">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16448989" aria-label="PubMed reference 29">PubMed</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD28XhtVGntr8%3D" aria-label="CAS reference 29">CAS</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 29" href="http://scholar.google.com/scholar_lookup?&title=Is%20visceral%20obesity%20the%20cause%20of%20the%20metabolic%20syndrome%3F&journal=Ann.%20Med.&doi=10.1080%2F07853890500383895&volume=38&pages=52-63&publication_year=2006&author=Despr%C3%A9s%2CJP"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="30"><p class="c-article-references__text" id="ref-CR30">Björntorp, P. Metabolic implications of body fat distribution. <i>Diabetes Care</i> <b>14</b>, 1132–1143 (1991).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.2337/diacare.14.12.1132" data-track-item_id="10.2337/diacare.14.12.1132" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.2337%2Fdiacare.14.12.1132" aria-label="Article reference 30" data-doi="10.2337/diacare.14.12.1132">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=1773700" aria-label="PubMed reference 30">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 30" href="http://scholar.google.com/scholar_lookup?&title=Metabolic%20implications%20of%20body%20fat%20distribution&journal=Diabetes%20Care&doi=10.2337%2Fdiacare.14.12.1132&volume=14&pages=1132-1143&publication_year=1991&author=Bj%C3%B6rntorp%2CP"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="31"><p class="c-article-references__text" id="ref-CR31">Kissebah, A. H. & Krakower, G. R. Regional adiposity and morbidity. <i>Physiol. Rev.</i> <b>74</b>, 761–811 (1994).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1152/physrev.1994.74.4.761" data-track-item_id="10.1152/physrev.1994.74.4.761" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1152%2Fphysrev.1994.74.4.761" aria-label="Article reference 31" data-doi="10.1152/physrev.1994.74.4.761">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DyaK2M%2FisVCjsw%3D%3D" aria-label="CAS reference 31">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=7938225" aria-label="PubMed reference 31">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 31" href="http://scholar.google.com/scholar_lookup?&title=Regional%20adiposity%20and%20morbidity&journal=Physiol.%20Rev.&doi=10.1152%2Fphysrev.1994.74.4.761&volume=74&pages=761-811&publication_year=1994&author=Kissebah%2CAH&author=Krakower%2CGR"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="32"><p class="c-article-references__text" id="ref-CR32">Lebovitz, H. E. & Banerji, M. A. Point: visceral adiposity is causally related to insulin resistance. <i>Diabetes Care</i> <b>28</b>, 2322–2325 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.2337/diacare.28.9.2322" data-track-item_id="10.2337/diacare.28.9.2322" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.2337%2Fdiacare.28.9.2322" aria-label="Article reference 32" data-doi="10.2337/diacare.28.9.2322">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16123512" aria-label="PubMed reference 32">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 32" href="http://scholar.google.com/scholar_lookup?&title=Point%3A%20visceral%20adiposity%20is%20causally%20related%20to%20insulin%20resistance&journal=Diabetes%20Care&doi=10.2337%2Fdiacare.28.9.2322&volume=28&pages=2322-2325&publication_year=2005&author=Lebovitz%2CHE&author=Banerji%2CMA"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="33"><p class="c-article-references__text" id="ref-CR33">Mittelman, S. D., Van Citters, G. W., Kirkman, E. L. & Bergman, R. N. Extreme insulin resistance of the central adipose depot <i>in vivo</i>. <i>Diabetes</i> <b>51</b>, 755–761 (2002).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.2337/diabetes.51.3.755" data-track-item_id="10.2337/diabetes.51.3.755" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.2337%2Fdiabetes.51.3.755" aria-label="Article reference 33" data-doi="10.2337/diabetes.51.3.755">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD38XitFSgsb8%3D" aria-label="CAS reference 33">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11872676" aria-label="PubMed reference 33">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 33" href="http://scholar.google.com/scholar_lookup?&title=Extreme%20insulin%20resistance%20of%20the%20central%20adipose%20depot%20in%20vivo&journal=Diabetes&doi=10.2337%2Fdiabetes.51.3.755&volume=51&pages=755-761&publication_year=2002&author=Mittelman%2CSD&author=Van%20Citters%2CGW&author=Kirkman%2CEL&author=Bergman%2CRN"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="34"><p class="c-article-references__text" id="ref-CR34">Mauriège, P. et al. Regional variation in adipose tissue metabolism of severely obese premenopausal women. <i>J. Lipid. Res.</i> <b>36</b>, 672–684 (1995).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/S0022-2275(20)40053-7" data-track-item_id="10.1016/S0022-2275(20)40053-7" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2FS0022-2275%2820%2940053-7" aria-label="Article reference 34" data-doi="10.1016/S0022-2275(20)40053-7">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=7616115" aria-label="PubMed reference 34">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 34" href="http://scholar.google.com/scholar_lookup?&title=Regional%20variation%20in%20adipose%20tissue%20metabolism%20of%20severely%20obese%20premenopausal%20women&journal=J.%20Lipid.%20Res.&doi=10.1016%2FS0022-2275%2820%2940053-7&volume=36&pages=672-684&publication_year=1995&author=Mauri%C3%A8ge%2CP"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="35"><p class="c-article-references__text" id="ref-CR35">Bergman, R. N. et al. Why visceral fat is bad: mechanisms of the metabolic syndrome. <i>Obesity (Silver Spring)</i> <b>14</b> (Suppl. 1), 16S–19S (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1038/oby.2006.277" data-track-item_id="10.1038/oby.2006.277" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1038%2Foby.2006.277" aria-label="Article reference 35" data-doi="10.1038/oby.2006.277">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD28XlsVeks7g%3D" aria-label="CAS reference 35">CAS</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 35" href="http://scholar.google.com/scholar_lookup?&title=Why%20visceral%20fat%20is%20bad%3A%20mechanisms%20of%20the%20metabolic%20syndrome&journal=Obesity%20%28Silver%20Spring%29&doi=10.1038%2Foby.2006.277&volume=14&issue=Suppl.%201&pages=16S-19S&publication_year=2006&author=Bergman%2CRN"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="36"><p class="c-article-references__text" id="ref-CR36">Jensen, M. D. Is visceral fat involved in the pathogenesis of the metabolic syndrome? Human model. <i>Obesity (Silver Spring)</i> <b>14</b> (Suppl. 1), 20S–24S (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1038/oby.2006.278" data-track-item_id="10.1038/oby.2006.278" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1038%2Foby.2006.278" aria-label="Article reference 36" data-doi="10.1038/oby.2006.278">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="mathscinet reference" data-track-action="mathscinet reference" href="http://www.ams.org/mathscinet-getitem?mr=2245860" aria-label="MathSciNet reference 36">MathSciNet</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD28XlsVeks7Y%3D" aria-label="CAS reference 36">CAS</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 36" href="http://scholar.google.com/scholar_lookup?&title=Is%20visceral%20fat%20involved%20in%20the%20pathogenesis%20of%20the%20metabolic%20syndrome%3F%20Human%20model&journal=Obesity%20%28Silver%20Spring%29&doi=10.1038%2Foby.2006.278&volume=14&issue=Suppl.%201&pages=20S-24S&publication_year=2006&author=Jensen%2CMD"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="37"><p class="c-article-references__text" id="ref-CR37">Weisberg, S. P. et al. Obesity is associated with macrophage accumulation in adipose tissue. <i>J. Clin. Invest.</i> <b>112</b>, 1796–1808 (2003).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1172/JCI200319246" data-track-item_id="10.1172/JCI200319246" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1172%2FJCI200319246" aria-label="Article reference 37" data-doi="10.1172/JCI200319246">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD3sXhtVSmtLvO" aria-label="CAS reference 37">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=14679176" aria-label="PubMed reference 37">PubMed</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed central reference" data-track-action="pubmed central reference" href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC296995" aria-label="PubMed Central reference 37">PubMed Central</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="mathscinet reference" data-track-action="mathscinet reference" href="http://www.ams.org/mathscinet-getitem?mr=2133098" aria-label="MathSciNet reference 37">MathSciNet</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 37" href="http://scholar.google.com/scholar_lookup?&title=Obesity%20is%20associated%20with%20macrophage%20accumulation%20in%20adipose%20tissue&journal=J.%20Clin.%20Invest.&doi=10.1172%2FJCI200319246&volume=112&pages=1796-1808&publication_year=2003&author=Weisberg%2CSP"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="38"><p class="c-article-references__text" id="ref-CR38">Yudkin, J. S., Stehouwer, C. D., Emeis, J. J. & Coppack, S. W. C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? <i>Arterioscler. Thromb. Vasc. Biol.</i> <b>19</b>, 972–978 (1999).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/01.ATV.19.4.972" data-track-item_id="10.1161/01.ATV.19.4.972" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2F01.ATV.19.4.972" aria-label="Article reference 38" data-doi="10.1161/01.ATV.19.4.972">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DyaK1MXislaru70%3D" aria-label="CAS reference 38">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=10195925" aria-label="PubMed reference 38">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 38" href="http://scholar.google.com/scholar_lookup?&title=C-reactive%20protein%20in%20healthy%20subjects%3A%20associations%20with%20obesity%2C%20insulin%20resistance%2C%20and%20endothelial%20dysfunction%3A%20a%20potential%20role%20for%20cytokines%20originating%20from%20adipose%20tissue%3F&journal=Arterioscler.%20Thromb.%20Vasc.%20Biol.&doi=10.1161%2F01.ATV.19.4.972&volume=19&pages=972-978&publication_year=1999&author=Yudkin%2CJS&author=Stehouwer%2CCD&author=Emeis%2CJJ&author=Coppack%2CSW"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="39"><p class="c-article-references__text" id="ref-CR39">Tsimikas, S., Willerson, J. T. & Ridker, P. M. C-reactive protein and other emerging blood biomarkers to optimize risk stratification of vulnerable patients. <i>J. Am. Coll. Cardiol.</i> <b>47</b>, C19–C31 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/j.jacc.2005.10.066" data-track-item_id="10.1016/j.jacc.2005.10.066" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2Fj.jacc.2005.10.066" aria-label="Article reference 39" data-doi="10.1016/j.jacc.2005.10.066">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD28XksVKmtrk%3D" aria-label="CAS reference 39">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16631506" aria-label="PubMed reference 39">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 39" href="http://scholar.google.com/scholar_lookup?&title=C-reactive%20protein%20and%20other%20emerging%20blood%20biomarkers%20to%20optimize%20risk%20stratification%20of%20vulnerable%20patients&journal=J.%20Am.%20Coll.%20Cardiol.&doi=10.1016%2Fj.jacc.2005.10.066&volume=47&pages=C19-C31&publication_year=2006&author=Tsimikas%2CS&author=Willerson%2CJT&author=Ridker%2CPM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="40"><p class="c-article-references__text" id="ref-CR40">Lemieux, I. et al. Elevated C-reactive protein: another component of the atherothrombotic profile of abdominal obesity. <i>Arterioscler. Thromb. Vasc. Biol.</i> <b>21</b>, 961–967 (2001).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/01.ATV.21.6.961" data-track-item_id="10.1161/01.ATV.21.6.961" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2F01.ATV.21.6.961" aria-label="Article reference 40" data-doi="10.1161/01.ATV.21.6.961">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD3MXksVart70%3D" aria-label="CAS reference 40">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11397704" aria-label="PubMed reference 40">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 40" href="http://scholar.google.com/scholar_lookup?&title=Elevated%20C-reactive%20protein%3A%20another%20component%20of%20the%20atherothrombotic%20profile%20of%20abdominal%20obesity&journal=Arterioscler.%20Thromb.%20Vasc.%20Biol.&doi=10.1161%2F01.ATV.21.6.961&volume=21&pages=961-967&publication_year=2001&author=Lemieux%2CI"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="41"><p class="c-article-references__text" id="ref-CR41">Maeda, K. et al. cDNA cloning and expression of a novel adipose specific collagen-like factor, apM1 (adipose most abundant gene transcript 1). <i>Biochem. Biophys. Res. Commun.</i> <b>221</b>, 286–289 (1996).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1006/bbrc.1996.0587" data-track-item_id="10.1006/bbrc.1996.0587" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1006%2Fbbrc.1996.0587" aria-label="Article reference 41" data-doi="10.1006/bbrc.1996.0587">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DyaK28XisVaht7s%3D" aria-label="CAS reference 41">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=8619847" aria-label="PubMed reference 41">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 41" href="http://scholar.google.com/scholar_lookup?&title=cDNA%20cloning%20and%20expression%20of%20a%20novel%20adipose%20specific%20collagen-like%20factor%2C%20apM1%20%28adipose%20most%20abundant%20gene%20transcript%201%29&journal=Biochem.%20Biophys.%20Res.%20Commun.&doi=10.1006%2Fbbrc.1996.0587&volume=221&pages=286-289&publication_year=1996&author=Maeda%2CK"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="42"><p class="c-article-references__text" id="ref-CR42">Scherer, P. E., Williams, S., Fogliano, M., Baldini, G. & Lodish, H. F. A novel serum protein similar to C1q, produced exclusively in adipocytes. <i>J. Biol. Chem.</i> <b>270</b>, 26746–26749 (1995).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1074/jbc.270.45.26746" data-track-item_id="10.1074/jbc.270.45.26746" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1074%2Fjbc.270.45.26746" aria-label="Article reference 42" data-doi="10.1074/jbc.270.45.26746">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DyaK2MXpsVGmurY%3D" aria-label="CAS reference 42">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=7592907" aria-label="PubMed reference 42">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 42" href="http://scholar.google.com/scholar_lookup?&title=A%20novel%20serum%20protein%20similar%20to%20C1q%2C%20produced%20exclusively%20in%20adipocytes&journal=J.%20Biol.%20Chem.&doi=10.1074%2Fjbc.270.45.26746&volume=270&pages=26746-26749&publication_year=1995&author=Scherer%2CPE&author=Williams%2CS&author=Fogliano%2CM&author=Baldini%2CG&author=Lodish%2CHF"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="43"><p class="c-article-references__text" id="ref-CR43">Côté, M. et al. Adiponectinemia in visceral obesity: impact on glucose tolerance and plasma lipoprotein and lipid levels in men. <i>J. Clin. Endocrinol. Metab.</i> <b>90</b>, 1434–1439 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1210/jc.2004-1711" data-track-item_id="10.1210/jc.2004-1711" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1210%2Fjc.2004-1711" aria-label="Article reference 43" data-doi="10.1210/jc.2004-1711">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15598678" aria-label="PubMed reference 43">PubMed</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD2MXisVOhsLs%3D" aria-label="CAS reference 43">CAS</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 43" href="http://scholar.google.com/scholar_lookup?&title=Adiponectinemia%20in%20visceral%20obesity%3A%20impact%20on%20glucose%20tolerance%20and%20plasma%20lipoprotein%20and%20lipid%20levels%20in%20men&journal=J.%20Clin.%20Endocrinol.%20Metab.&doi=10.1210%2Fjc.2004-1711&volume=90&pages=1434-1439&publication_year=2005&author=C%C3%B4t%C3%A9%2CM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="44"><p class="c-article-references__text" id="ref-CR44">Berg, A. H. & Scherer, P. E. Adipose tissue, inflammation, and cardiovascular disease. <i>Circ. Res.</i> <b>96</b>, 939–949 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/01.RES.0000163635.62927.34" data-track-item_id="10.1161/01.RES.0000163635.62927.34" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2F01.RES.0000163635.62927.34" aria-label="Article reference 44" data-doi="10.1161/01.RES.0000163635.62927.34">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD2MXjvFynsbg%3D" aria-label="CAS reference 44">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15890981" aria-label="PubMed reference 44">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 44" href="http://scholar.google.com/scholar_lookup?&title=Adipose%20tissue%2C%20inflammation%2C%20and%20cardiovascular%20disease&journal=Circ.%20Res.&doi=10.1161%2F01.RES.0000163635.62927.34&volume=96&pages=939-949&publication_year=2005&author=Berg%2CAH&author=Scherer%2CPE"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="45"><p class="c-article-references__text" id="ref-CR45">Matsuzawa, Y. Therapy Insight: adipocytokines in metabolic syndrome and related cardiovascular disease. <i>Nature Clin. Pract. Cardiovasc. Med.</i> <b>3</b>, 35–42 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1038/ncpcardio0380" data-track-item_id="10.1038/ncpcardio0380" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1038%2Fncpcardio0380" aria-label="Article reference 45" data-doi="10.1038/ncpcardio0380">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD28XntlWqsQ%3D%3D" aria-label="CAS reference 45">CAS</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 45" href="http://scholar.google.com/scholar_lookup?&title=Therapy%20Insight%3A%20adipocytokines%20in%20metabolic%20syndrome%20and%20related%20cardiovascular%20disease&journal=Nature%20Clin.%20Pract.%20Cardiovasc.%20Med.&doi=10.1038%2Fncpcardio0380&volume=3&pages=35-42&publication_year=2006&author=Matsuzawa%2CY"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="46"><p class="c-article-references__text" id="ref-CR46">Lemieux, I. et al. Contribution of interleukin-6 and tumor necrosis factor-alpha to the elevated C-reactive protein levels found in abdominally obese men. <i>Obes. Res.</i> <b>9</b>, 66S (2001).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 46" href="http://scholar.google.com/scholar_lookup?&title=Contribution%20of%20interleukin-6%20and%20tumor%20necrosis%20factor-alpha%20to%20the%20elevated%20C-reactive%20protein%20levels%20found%20in%20abdominally%20obese%20men&journal=Obes.%20Res.&volume=9&publication_year=2001&author=Lemieux%2CI"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="47"><p class="c-article-references__text" id="ref-CR47">Hotamisligil, G. S. Molecular mechanisms of insulin resistance and the role of the adipocyte. <i>Int. J. Obes. Relat. Metab. Disord.</i> <b>24</b> (Suppl. 4), S23–S27 (2000).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1038/sj.ijo.0801497" data-track-item_id="10.1038/sj.ijo.0801497" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1038%2Fsj.ijo.0801497" aria-label="Article reference 47" data-doi="10.1038/sj.ijo.0801497">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD3cXovFGgtbc%3D" aria-label="CAS reference 47">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11126235" aria-label="PubMed reference 47">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 47" href="http://scholar.google.com/scholar_lookup?&title=Molecular%20mechanisms%20of%20insulin%20resistance%20and%20the%20role%20of%20the%20adipocyte&journal=Int.%20J.%20Obes.%20Relat.%20Metab.%20Disord.&doi=10.1038%2Fsj.ijo.0801497&volume=24&issue=Suppl.%204&pages=S23-S27&publication_year=2000&author=Hotamisligil%2CGS"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="48"><p class="c-article-references__text" id="ref-CR48">Havel, P. J. Control of energy homeostasis and insulin action by adipocyte hormones: leptin, acylation stimulating protein, and adiponectin. <i>Curr. Opin. Lipidol.</i> <b>13</b>, 51–59 (2002).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1097/00041433-200202000-00008" data-track-item_id="10.1097/00041433-200202000-00008" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1097%2F00041433-200202000-00008" aria-label="Article reference 48" data-doi="10.1097/00041433-200202000-00008">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD38XitV2msL0%3D" aria-label="CAS reference 48">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11790963" aria-label="PubMed reference 48">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 48" href="http://scholar.google.com/scholar_lookup?&title=Control%20of%20energy%20homeostasis%20and%20insulin%20action%20by%20adipocyte%20hormones%3A%20leptin%2C%20acylation%20stimulating%20protein%2C%20and%20adiponectin&journal=Curr.%20Opin.%20Lipidol.&doi=10.1097%2F00041433-200202000-00008&volume=13&pages=51-59&publication_year=2002&author=Havel%2CPJ"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="49"><p class="c-article-references__text" id="ref-CR49">Lemieux, I. Energy partitioning in gluteal-femoral fat: does the metabolic fate of triglycerides affect coronary heart disease risk? <i>Arterioscler. Thromb. Vasc. Biol.</i> <b>24</b>, 795–797 (2004).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/01.ATV.0000126485.80373.33" data-track-item_id="10.1161/01.ATV.0000126485.80373.33" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2F01.ATV.0000126485.80373.33" aria-label="Article reference 49" data-doi="10.1161/01.ATV.0000126485.80373.33">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD2cXktVKntLY%3D" aria-label="CAS reference 49">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15132969" aria-label="PubMed reference 49">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 49" href="http://scholar.google.com/scholar_lookup?&title=Energy%20partitioning%20in%20gluteal-femoral%20fat%3A%20does%20the%20metabolic%20fate%20of%20triglycerides%20affect%20coronary%20heart%20disease%20risk%3F&journal=Arterioscler.%20Thromb.%20Vasc.%20Biol.&doi=10.1161%2F01.ATV.0000126485.80373.33&volume=24&pages=795-797&publication_year=2004&author=Lemieux%2CI"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="50"><p class="c-article-references__text" id="ref-CR50">Miranda, P. J., DeFronzo, R. A., Califf, R. M. & Guyton, J. R. Metabolic syndrome: definition, pathophysiology, and mechanisms. <i>Am. Heart J.</i> <b>149</b>, 33–45 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/j.ahj.2004.07.013" data-track-item_id="10.1016/j.ahj.2004.07.013" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2Fj.ahj.2004.07.013" aria-label="Article reference 50" data-doi="10.1016/j.ahj.2004.07.013">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD2MXht1yktrk%3D" aria-label="CAS reference 50">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15660032" aria-label="PubMed reference 50">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 50" href="http://scholar.google.com/scholar_lookup?&title=Metabolic%20syndrome%3A%20definition%2C%20pathophysiology%2C%20and%20mechanisms&journal=Am.%20Heart%20J.&doi=10.1016%2Fj.ahj.2004.07.013&volume=149&pages=33-45&publication_year=2005&author=Miranda%2CPJ&author=DeFronzo%2CRA&author=Califf%2CRM&author=Guyton%2CJR"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="51"><p class="c-article-references__text" id="ref-CR51">Gavrilova, O. et al. Surgical implantation of adipose tissue reverses diabetes in lipoatrophic mice. <i>J. Clin. Invest.</i> <b>105</b>, 271–278 (2000).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1172/JCI7901" data-track-item_id="10.1172/JCI7901" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1172%2FJCI7901" aria-label="Article reference 51" data-doi="10.1172/JCI7901">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD3cXhtVSlt7c%3D" aria-label="CAS reference 51">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=10675352" aria-label="PubMed reference 51">PubMed</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed central reference" data-track-action="pubmed central reference" href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC377444" aria-label="PubMed Central reference 51">PubMed Central</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 51" href="http://scholar.google.com/scholar_lookup?&title=Surgical%20implantation%20of%20adipose%20tissue%20reverses%20diabetes%20in%20lipoatrophic%20mice&journal=J.%20Clin.%20Invest.&doi=10.1172%2FJCI7901&volume=105&pages=271-278&publication_year=2000&author=Gavrilova%2CO"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="52"><p class="c-article-references__text" id="ref-CR52">Kim, J. K., Gavrilova, O., Chen, Y., Reitman, M. L. & Shulman, G. I. Mechanism of insulin resistance in A-ZIP/F-1 fatless mice. <i>J. Biol. Chem.</i> <b>275</b>, 8456–8460 (2000).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1074/jbc.275.12.8456" data-track-item_id="10.1074/jbc.275.12.8456" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1074%2Fjbc.275.12.8456" aria-label="Article reference 52" data-doi="10.1074/jbc.275.12.8456">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD3cXit1enur8%3D" aria-label="CAS reference 52">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=10722680" aria-label="PubMed reference 52">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 52" href="http://scholar.google.com/scholar_lookup?&title=Mechanism%20of%20insulin%20resistance%20in%20A-ZIP%2FF-1%20fatless%20mice&journal=J.%20Biol.%20Chem.&doi=10.1074%2Fjbc.275.12.8456&volume=275&pages=8456-8460&publication_year=2000&author=Kim%2CJK&author=Gavrilova%2CO&author=Chen%2CY&author=Reitman%2CML&author=Shulman%2CGI"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="53"><p class="c-article-references__text" id="ref-CR53">Garg, A. & Misra, A. Lipodystrophies: rare disorders causing metabolic syndrome. <i>Endocrinol. Metab. Clin. North Am.</i> <b>33</b>, 305–331 (2004).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/j.ecl.2004.03.003" data-track-item_id="10.1016/j.ecl.2004.03.003" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2Fj.ecl.2004.03.003" aria-label="Article reference 53" data-doi="10.1016/j.ecl.2004.03.003">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD2cXlsFCgsr0%3D" aria-label="CAS reference 53">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15158521" aria-label="PubMed reference 53">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 53" href="http://scholar.google.com/scholar_lookup?&title=Lipodystrophies%3A%20rare%20disorders%20causing%20metabolic%20syndrome&journal=Endocrinol.%20Metab.%20Clin.%20North%20Am.&doi=10.1016%2Fj.ecl.2004.03.003&volume=33&pages=305-331&publication_year=2004&author=Garg%2CA&author=Misra%2CA"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="54"><p class="c-article-references__text" id="ref-CR54">Danforth, E. Failure of adipocyte differentiation causes type II diabetes mellitus? <i>Nature Genet.</i> <b>26</b>, 13 (2000).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1038/79111" data-track-item_id="10.1038/79111" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1038%2F79111" aria-label="Article reference 54" data-doi="10.1038/79111">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD3cXmsVKkur4%3D" aria-label="CAS reference 54">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=10973236" aria-label="PubMed reference 54">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 54" href="http://scholar.google.com/scholar_lookup?&title=Failure%20of%20adipocyte%20differentiation%20causes%20type%20II%20diabetes%20mellitus%3F&journal=Nature%20Genet.&doi=10.1038%2F79111&volume=26&publication_year=2000&author=Danforth%2CE"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="55"><p class="c-article-references__text" id="ref-CR55">Miyazaki, Y. et al. Effect of pioglitazone on abdominal fat distribution and insulin sensitivity in type 2 diabetic patients. <i>J. Clin. Endocrinol. Metab.</i> <b>87</b>, 2784–2791 (2002).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1210/jcem.87.6.8567" data-track-item_id="10.1210/jcem.87.6.8567" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1210%2Fjcem.87.6.8567" aria-label="Article reference 55" data-doi="10.1210/jcem.87.6.8567">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD38XkvFaku74%3D" aria-label="CAS reference 55">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12050251" aria-label="PubMed reference 55">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 55" href="http://scholar.google.com/scholar_lookup?&title=Effect%20of%20pioglitazone%20on%20abdominal%20fat%20distribution%20and%20insulin%20sensitivity%20in%20type%202%20diabetic%20patients&journal=J.%20Clin.%20Endocrinol.%20Metab.&doi=10.1210%2Fjcem.87.6.8567&volume=87&pages=2784-2791&publication_year=2002&author=Miyazaki%2CY"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="56"><p class="c-article-references__text" id="ref-CR56">Wilson, P. W., D'Agostino, R. B., Parise, H., Sullivan, L. & Meigs, J. B. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. <i>Circulation</i> <b>112</b>, 3066–3072 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/CIRCULATIONAHA.105.539528" data-track-item_id="10.1161/CIRCULATIONAHA.105.539528" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2FCIRCULATIONAHA.105.539528" aria-label="Article reference 56" data-doi="10.1161/CIRCULATIONAHA.105.539528">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD2MXhtF2rtbfL" aria-label="CAS reference 56">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16275870" aria-label="PubMed reference 56">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 56" href="http://scholar.google.com/scholar_lookup?&title=Metabolic%20syndrome%20as%20a%20precursor%20of%20cardiovascular%20disease%20and%20type%202%20diabetes%20mellitus&journal=Circulation&doi=10.1161%2FCIRCULATIONAHA.105.539528&volume=112&pages=3066-3072&publication_year=2005&author=Wilson%2CPW&author=D%27Agostino%2CRB&author=Parise%2CH&author=Sullivan%2CL&author=Meigs%2CJB"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="57"><p class="c-article-references__text" id="ref-CR57">Laaksonen, D. E. et al. Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. <i>Am. J. Epidemiol.</i> <b>156</b>, 1070–1077 (2002).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1093/aje/kwf145" data-track-item_id="10.1093/aje/kwf145" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1093%2Faje%2Fkwf145" aria-label="Article reference 57" data-doi="10.1093/aje/kwf145">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12446265" aria-label="PubMed reference 57">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 57" href="http://scholar.google.com/scholar_lookup?&title=Metabolic%20syndrome%20and%20development%20of%20diabetes%20mellitus%3A%20application%20and%20validation%20of%20recently%20suggested%20definitions%20of%20the%20metabolic%20syndrome%20in%20a%20prospective%20cohort%20study&journal=Am.%20J.%20Epidemiol.&doi=10.1093%2Faje%2Fkwf145&volume=156&pages=1070-1077&publication_year=2002&author=Laaksonen%2CDE"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="58"><p class="c-article-references__text" id="ref-CR58">Stern, M. P., Williams, K. & Haffner, S. M. Identification of persons at high risk for type 2 diabetes mellitus: do we need the oral glucose tolerance test? <i>Ann. Intern. Med.</i> <b>136</b>, 575–581 (2002).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.7326/0003-4819-136-8-200204160-00006" data-track-item_id="10.7326/0003-4819-136-8-200204160-00006" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.7326%2F0003-4819-136-8-200204160-00006" aria-label="Article reference 58" data-doi="10.7326/0003-4819-136-8-200204160-00006">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11955025" aria-label="PubMed reference 58">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 58" href="http://scholar.google.com/scholar_lookup?&title=Identification%20of%20persons%20at%20high%20risk%20for%20type%202%20diabetes%20mellitus%3A%20do%20we%20need%20the%20oral%20glucose%20tolerance%20test%3F&journal=Ann.%20Intern.%20Med.&doi=10.7326%2F0003-4819-136-8-200204160-00006&volume=136&pages=575-581&publication_year=2002&author=Stern%2CMP&author=Williams%2CK&author=Haffner%2CSM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="59"><p class="c-article-references__text" id="ref-CR59">Klein, B. E., Klein, R. & Lee, K. E. Components of the metabolic syndrome and risk of cardiovascular disease and diabetes in beaver dam. <i>Diabetes Care</i> <b>25</b>, 1790–1794 (2002).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.2337/diacare.25.10.1790" data-track-item_id="10.2337/diacare.25.10.1790" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.2337%2Fdiacare.25.10.1790" aria-label="Article reference 59" data-doi="10.2337/diacare.25.10.1790">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12351479" aria-label="PubMed reference 59">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 59" href="http://scholar.google.com/scholar_lookup?&title=Components%20of%20the%20metabolic%20syndrome%20and%20risk%20of%20cardiovascular%20disease%20and%20diabetes%20in%20beaver%20dam&journal=Diabetes%20Care&doi=10.2337%2Fdiacare.25.10.1790&volume=25&pages=1790-1794&publication_year=2002&author=Klein%2CBE&author=Klein%2CR&author=Lee%2CKE"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="60"><p class="c-article-references__text" id="ref-CR60">Macchia, A. et al. A clinically practicable diagnostic score for metabolic syndrome improves its predictivity of diabetes mellitus: the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico (GISSI)-Prevenzione scoring. <i>Am. Heart J.</i> <b>151</b>, 754.e7–754.e17 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/j.ahj.2005.10.023" data-track-item_id="10.1016/j.ahj.2005.10.023" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2Fj.ahj.2005.10.023" aria-label="Article reference 60" data-doi="10.1016/j.ahj.2005.10.023">Article</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 60" href="http://scholar.google.com/scholar_lookup?&title=A%20clinically%20practicable%20diagnostic%20score%20for%20metabolic%20syndrome%20improves%20its%20predictivity%20of%20diabetes%20mellitus%3A%20the%20Gruppo%20Italiano%20per%20lo%20Studio%20della%20Sopravvivenza%20nell%27Infarto%20miocardico%20%28GISSI%29-Prevenzione%20scoring&journal=Am.%20Heart%20J.&doi=10.1016%2Fj.ahj.2005.10.023&volume=151&pages=754.e7-754.e17&publication_year=2006&author=Macchia%2CA"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="61"><p class="c-article-references__text" id="ref-CR61">UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). <i>Lancet</i> <b>352</b>, 854–865 (1998).</p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="62"><p class="c-article-references__text" id="ref-CR62">Libby, P. & Plutzky, J. Diabetic macrovascular disease: the glucose paradox? <i>Circulation</i> <b>106</b>, 2760–2763 (2002).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/01.CIR.0000037282.92395.AE" data-track-item_id="10.1161/01.CIR.0000037282.92395.AE" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2F01.CIR.0000037282.92395.AE" aria-label="Article reference 62" data-doi="10.1161/01.CIR.0000037282.92395.AE">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12450998" aria-label="PubMed reference 62">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 62" href="http://scholar.google.com/scholar_lookup?&title=Diabetic%20macrovascular%20disease%3A%20the%20glucose%20paradox%3F&journal=Circulation&doi=10.1161%2F01.CIR.0000037282.92395.AE&volume=106&pages=2760-2763&publication_year=2002&author=Libby%2CP&author=Plutzky%2CJ"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="63"><p class="c-article-references__text" id="ref-CR63">Laakso, M. Hyperglycemia and cardiovascular disease in type 2 diabetes. <i>Diabetes</i> <b>48</b>, 937–942 (1999).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.2337/diabetes.48.5.937" data-track-item_id="10.2337/diabetes.48.5.937" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.2337%2Fdiabetes.48.5.937" aria-label="Article reference 63" data-doi="10.2337/diabetes.48.5.937">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DyaK1MXjtFSgsLk%3D" aria-label="CAS reference 63">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=10331395" aria-label="PubMed reference 63">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 63" href="http://scholar.google.com/scholar_lookup?&title=Hyperglycemia%20and%20cardiovascular%20disease%20in%20type%202%20diabetes&journal=Diabetes&doi=10.2337%2Fdiabetes.48.5.937&volume=48&pages=937-942&publication_year=1999&author=Laakso%2CM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="64"><p class="c-article-references__text" id="ref-CR64">Grundy, S. M. et al. Definition of metabolic syndrome. Report of the National Heart, Lung and Blood Institute/American Heart Association conference on scientific issues related to definition. <i>Circulation</i> <b>109</b>, 433–438 (2004).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/01.CIR.0000111245.75752.C6" data-track-item_id="10.1161/01.CIR.0000111245.75752.C6" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2F01.CIR.0000111245.75752.C6" aria-label="Article reference 64" data-doi="10.1161/01.CIR.0000111245.75752.C6">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=14744958" aria-label="PubMed reference 64">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 64" href="http://scholar.google.com/scholar_lookup?&title=Definition%20of%20metabolic%20syndrome.%20Report%20of%20the%20National%20Heart%2C%20Lung%20and%20Blood%20Institute%2FAmerican%20Heart%20Association%20conference%20on%20scientific%20issues%20related%20to%20definition&journal=Circulation&doi=10.1161%2F01.CIR.0000111245.75752.C6&volume=109&pages=433-438&publication_year=2004&author=Grundy%2CSM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="65"><p class="c-article-references__text" id="ref-CR65">Golden, S. H. et al. Risk factor groupings related to insulin resistance and their synergistic effects on subclinical atherosclerosis: the atherosclerosis risk in communities study. <i>Diabetes</i> <b>51</b>, 3069–3076 (2002).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.2337/diabetes.51.10.3069" data-track-item_id="10.2337/diabetes.51.10.3069" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.2337%2Fdiabetes.51.10.3069" aria-label="Article reference 65" data-doi="10.2337/diabetes.51.10.3069">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD38XnslGhsLg%3D" aria-label="CAS reference 65">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12351449" aria-label="PubMed reference 65">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 65" href="http://scholar.google.com/scholar_lookup?&title=Risk%20factor%20groupings%20related%20to%20insulin%20resistance%20and%20their%20synergistic%20effects%20on%20subclinical%20atherosclerosis%3A%20the%20atherosclerosis%20risk%20in%20communities%20study&journal=Diabetes&doi=10.2337%2Fdiabetes.51.10.3069&volume=51&pages=3069-3076&publication_year=2002&author=Golden%2CSH"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="66"><p class="c-article-references__text" id="ref-CR66">Wilson, P. W. et al. Prediction of coronary heart disease using risk factor categories. <i>Circulation</i> <b>97</b>, 1837–1847 (1998).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/01.CIR.97.18.1837" data-track-item_id="10.1161/01.CIR.97.18.1837" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2F01.CIR.97.18.1837" aria-label="Article reference 66" data-doi="10.1161/01.CIR.97.18.1837">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DyaK1c3msVOjsA%3D%3D" aria-label="CAS reference 66">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=9603539" aria-label="PubMed reference 66">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 66" href="http://scholar.google.com/scholar_lookup?&title=Prediction%20of%20coronary%20heart%20disease%20using%20risk%20factor%20categories&journal=Circulation&doi=10.1161%2F01.CIR.97.18.1837&volume=97&pages=1837-1847&publication_year=1998&author=Wilson%2CPW"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="67"><p class="c-article-references__text" id="ref-CR67">Wannamethee, S. G., Shaper, A. G., Lennon, L. & Morris, R. W. Metabolic syndrome vs Framingham Risk Score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus. <i>Arch. Intern. Med.</i> <b>165</b>, 2644–2650 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1001/archinte.165.22.2644" data-track-item_id="10.1001/archinte.165.22.2644" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1001%2Farchinte.165.22.2644" aria-label="Article reference 67" data-doi="10.1001/archinte.165.22.2644">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16344423" aria-label="PubMed reference 67">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 67" href="http://scholar.google.com/scholar_lookup?&title=Metabolic%20syndrome%20vs%20Framingham%20Risk%20Score%20for%20prediction%20of%20coronary%20heart%20disease%2C%20stroke%2C%20and%20type%202%20diabetes%20mellitus&journal=Arch.%20Intern.%20Med.&doi=10.1001%2Farchinte.165.22.2644&volume=165&pages=2644-2650&publication_year=2005&author=Wannamethee%2CSG&author=Shaper%2CAG&author=Lennon%2CL&author=Morris%2CRW"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="68"><p class="c-article-references__text" id="ref-CR68">Stern, M. P., Williams, K., Gonzalez-Villalpando, C., Hunt, K. J. & Haffner, S. M. Does the metabolic syndrome improve identification of individuals at risk of type 2 diabetes and/or cardiovascular disease? <i>Diabetes Care</i> <b>27</b>, 2676–2681 (2004).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.2337/diacare.27.11.2676" data-track-item_id="10.2337/diacare.27.11.2676" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.2337%2Fdiacare.27.11.2676" aria-label="Article reference 68" data-doi="10.2337/diacare.27.11.2676">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15505004" aria-label="PubMed reference 68">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 68" href="http://scholar.google.com/scholar_lookup?&title=Does%20the%20metabolic%20syndrome%20improve%20identification%20of%20individuals%20at%20risk%20of%20type%202%20diabetes%20and%2For%20cardiovascular%20disease%3F&journal=Diabetes%20Care&doi=10.2337%2Fdiacare.27.11.2676&volume=27&pages=2676-2681&publication_year=2004&author=Stern%2CMP&author=Williams%2CK&author=Gonzalez-Villalpando%2CC&author=Hunt%2CKJ&author=Haffner%2CSM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="69"><p class="c-article-references__text" id="ref-CR69">Assmann, G., Cullen, P. & Schulte, H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Munster (PROCAM) study. <i>Circulation</i> <b>105</b>, 310–315 (2002).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/hc0302.102575" data-track-item_id="10.1161/hc0302.102575" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2Fhc0302.102575" aria-label="Article reference 69" data-doi="10.1161/hc0302.102575">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11804985" aria-label="PubMed reference 69">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 69" href="http://scholar.google.com/scholar_lookup?&title=Simple%20scoring%20scheme%20for%20calculating%20the%20risk%20of%20acute%20coronary%20events%20based%20on%20the%2010-year%20follow-up%20of%20the%20prospective%20cardiovascular%20Munster%20%28PROCAM%29%20study&journal=Circulation&doi=10.1161%2Fhc0302.102575&volume=105&pages=310-315&publication_year=2002&author=Assmann%2CG&author=Cullen%2CP&author=Schulte%2CH"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="70"><p class="c-article-references__text" id="ref-CR70">Girman, C. J. et al. The metabolic syndrome and risk of major coronary events in the Scandinavian Simvastatin Survival Study (4S) and the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS). <i>Am. J. Cardiol.</i> <b>93</b>, 136–141 (2004).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/j.amjcard.2003.09.028" data-track-item_id="10.1016/j.amjcard.2003.09.028" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2Fj.amjcard.2003.09.028" aria-label="Article reference 70" data-doi="10.1016/j.amjcard.2003.09.028">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD2cXjsFSqug%3D%3D" aria-label="CAS reference 70">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=14715336" aria-label="PubMed reference 70">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 70" href="http://scholar.google.com/scholar_lookup?&title=The%20metabolic%20syndrome%20and%20risk%20of%20major%20coronary%20events%20in%20the%20Scandinavian%20Simvastatin%20Survival%20Study%20%284S%29%20and%20the%20Air%20Force%2FTexas%20Coronary%20Atherosclerosis%20Prevention%20Study%20%28AFCAPS%2FTexCAPS%29&journal=Am.%20J.%20Cardiol.&doi=10.1016%2Fj.amjcard.2003.09.028&volume=93&pages=136-141&publication_year=2004&author=Girman%2CCJ"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="71"><p class="c-article-references__text" id="ref-CR71">Lamarche, B. et al. Fasting insulin and apolipoprotein B levels and low-density lipoprotein particle size as risk factors for ischemic heart disease. <i>J. Am. Med. Assoc.</i> <b>279</b>, 1955–1961 (1998).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1001/jama.279.24.1955" data-track-item_id="10.1001/jama.279.24.1955" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1001%2Fjama.279.24.1955" aria-label="Article reference 71" data-doi="10.1001/jama.279.24.1955">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DyaK1cXksFelsLo%3D" aria-label="CAS reference 71">CAS</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 71" href="http://scholar.google.com/scholar_lookup?&title=Fasting%20insulin%20and%20apolipoprotein%20B%20levels%20and%20low-density%20lipoprotein%20particle%20size%20as%20risk%20factors%20for%20ischemic%20heart%20disease&journal=J.%20Am.%20Med.%20Assoc.&doi=10.1001%2Fjama.279.24.1955&volume=279&pages=1955-1961&publication_year=1998&author=Lamarche%2CB"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="72"><p class="c-article-references__text" id="ref-CR72">Hegele, R. A. Insulin resistance in human partial lipodystrophy. <i>Curr. Atheroscler. Rep.</i> <b>2</b>, 397–404 (2000).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="noopener" data-track-label="10.1007/s11883-000-0078-0" data-track-item_id="10.1007/s11883-000-0078-0" data-track-value="article reference" data-track-action="article reference" href="https://link.springer.com/doi/10.1007/s11883-000-0078-0" aria-label="Article reference 72" data-doi="10.1007/s11883-000-0078-0">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DC%2BD3Mzptlajug%3D%3D" aria-label="CAS reference 72">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11122771" aria-label="PubMed reference 72">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 72" href="http://scholar.google.com/scholar_lookup?&title=Insulin%20resistance%20in%20human%20partial%20lipodystrophy&journal=Curr.%20Atheroscler.%20Rep.&doi=10.1007%2Fs11883-000-0078-0&volume=2&pages=397-404&publication_year=2000&author=Hegele%2CRA"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="73"><p class="c-article-references__text" id="ref-CR73">Barrett-Connor, E. & Khaw, K. T. Cigarette smoking and increased central adiposity. <i>Ann. Intern. Med.</i> <b>111</b>, 783–787 (1989).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.7326/0003-4819-111-10-783" data-track-item_id="10.7326/0003-4819-111-10-783" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.7326%2F0003-4819-111-10-783" aria-label="Article reference 73" data-doi="10.7326/0003-4819-111-10-783">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DyaK3c%2FlsVKrtg%3D%3D" aria-label="CAS reference 73">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=2817625" aria-label="PubMed reference 73">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 73" href="http://scholar.google.com/scholar_lookup?&title=Cigarette%20smoking%20and%20increased%20central%20adiposity&journal=Ann.%20Intern.%20Med.&doi=10.7326%2F0003-4819-111-10-783&volume=111&pages=783-787&publication_year=1989&author=Barrett-Connor%2CE&author=Khaw%2CKT"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="74"><p class="c-article-references__text" id="ref-CR74">Shimokata, H., Muller, D. C. & Andres, R. Studies in the distribution of body fat. III. Effects of cigarette smoking. <i>J. Am. Med. Assoc.</i> <b>261</b>, 1169–1173 (1989).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1001/jama.1989.03420080089037" data-track-item_id="10.1001/jama.1989.03420080089037" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1001%2Fjama.1989.03420080089037" aria-label="Article reference 74" data-doi="10.1001/jama.1989.03420080089037">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DyaL1M7isFygsQ%3D%3D" aria-label="CAS reference 74">CAS</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 74" href="http://scholar.google.com/scholar_lookup?&title=Studies%20in%20the%20distribution%20of%20body%20fat.%20III.%20Effects%20of%20cigarette%20smoking&journal=J.%20Am.%20Med.%20Assoc.&doi=10.1001%2Fjama.1989.03420080089037&volume=261&pages=1169-1173&publication_year=1989&author=Shimokata%2CH&author=Muller%2CDC&author=Andres%2CR"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="75"><p class="c-article-references__text" id="ref-CR75">Reaven, G. & Tsao, P. S. Insulin resistance and compensatory hyperinsulinemia: the key player between cigarette smoking and cardiovascular disease? <i>J. Am. Coll. Cardiol.</i> <b>41</b>, 1044–1047 (2003).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1016/S0735-1097(02)02982-0" data-track-item_id="10.1016/S0735-1097(02)02982-0" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1016%2FS0735-1097%2802%2902982-0" aria-label="Article reference 75" data-doi="10.1016/S0735-1097(02)02982-0">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD3sXislejsb4%3D" aria-label="CAS reference 75">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12651055" aria-label="PubMed reference 75">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 75" href="http://scholar.google.com/scholar_lookup?&title=Insulin%20resistance%20and%20compensatory%20hyperinsulinemia%3A%20the%20key%20player%20between%20cigarette%20smoking%20and%20cardiovascular%20disease%3F&journal=J.%20Am.%20Coll.%20Cardiol.&doi=10.1016%2FS0735-1097%2802%2902982-0&volume=41&pages=1044-1047&publication_year=2003&author=Reaven%2CG&author=Tsao%2CPS"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="76"><p class="c-article-references__text" id="ref-CR76">Pouliot, M. C. et al. Visceral obesity in men. Associations with glucose tolerance, plasma insulin, and lipoprotein levels. <i>Diabetes</i> <b>41</b>, 826–834 (1992).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.2337/diab.41.7.826" data-track-item_id="10.2337/diab.41.7.826" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.2337%2Fdiab.41.7.826" aria-label="Article reference 76" data-doi="10.2337/diab.41.7.826">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DyaK38zgslWnsw%3D%3D" aria-label="CAS reference 76">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=1612197" aria-label="PubMed reference 76">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 76" href="http://scholar.google.com/scholar_lookup?&title=Visceral%20obesity%20in%20men.%20Associations%20with%20glucose%20tolerance%2C%20plasma%20insulin%2C%20and%20lipoprotein%20levels&journal=Diabetes&doi=10.2337%2Fdiab.41.7.826&volume=41&pages=826-834&publication_year=1992&author=Pouliot%2CMC"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="77"><p class="c-article-references__text" id="ref-CR77">Després, J. P., Lemieux, I. & Prud'homme, D. Treatment of obesity: need to focus on high risk abdominally obese patients. <i>Brit. Med. J.</i> <b>322</b>, 716–720 (2001).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1136/bmj.322.7288.716" data-track-item_id="10.1136/bmj.322.7288.716" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1136%2Fbmj.322.7288.716" aria-label="Article reference 77" data-doi="10.1136/bmj.322.7288.716">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11264213" aria-label="PubMed reference 77">PubMed</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed central reference" data-track-action="pubmed central reference" href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119905" aria-label="PubMed Central reference 77">PubMed Central</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 77" href="http://scholar.google.com/scholar_lookup?&title=Treatment%20of%20obesity%3A%20need%20to%20focus%20on%20high%20risk%20abdominally%20obese%20patients&journal=Brit.%20Med.%20J.&doi=10.1136%2Fbmj.322.7288.716&volume=322&pages=716-720&publication_year=2001&author=Despr%C3%A9s%2CJP&author=Lemieux%2CI&author=Prud%27homme%2CD"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="78"><p class="c-article-references__text" id="ref-CR78">Jorgensen, M. E. et al. Obesity and central fat pattern among Greenland Inuit and a general population of Denmark (Inter99): relationship to metabolic risk factors. <i>Int. J. Obes. Relat. Metab. Disord.</i> <b>27</b>, 1507–1515 (2003).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1038/sj.ijo.0802434" data-track-item_id="10.1038/sj.ijo.0802434" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1038%2Fsj.ijo.0802434" aria-label="Article reference 78" data-doi="10.1038/sj.ijo.0802434">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DC%2BD3srlsVajtA%3D%3D" aria-label="CAS reference 78">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=14634682" aria-label="PubMed reference 78">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 78" href="http://scholar.google.com/scholar_lookup?&title=Obesity%20and%20central%20fat%20pattern%20among%20Greenland%20Inuit%20and%20a%20general%20population%20of%20Denmark%20%28Inter99%29%3A%20relationship%20to%20metabolic%20risk%20factors&journal=Int.%20J.%20Obes.%20Relat.%20Metab.%20Disord.&doi=10.1038%2Fsj.ijo.0802434&volume=27&pages=1507-1515&publication_year=2003&author=Jorgensen%2CME"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="79"><p class="c-article-references__text" id="ref-CR79">Ross, R. et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. <i>Ann. Intern. Med.</i> <b>133</b>, 92–103 (2000).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.7326/0003-4819-133-2-200007180-00008" data-track-item_id="10.7326/0003-4819-133-2-200007180-00008" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.7326%2F0003-4819-133-2-200007180-00008" aria-label="Article reference 79" data-doi="10.7326/0003-4819-133-2-200007180-00008">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DC%2BD3czktVCjug%3D%3D" aria-label="CAS reference 79">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=10896648" aria-label="PubMed reference 79">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 79" href="http://scholar.google.com/scholar_lookup?&title=Reduction%20in%20obesity%20and%20related%20comorbid%20conditions%20after%20diet-induced%20weight%20loss%20or%20exercise-induced%20weight%20loss%20in%20men.%20A%20randomized%2C%20controlled%20trial&journal=Ann.%20Intern.%20Med.&doi=10.7326%2F0003-4819-133-2-200007180-00008&volume=133&pages=92-103&publication_year=2000&author=Ross%2CR"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="80"><p class="c-article-references__text" id="ref-CR80">Orchard, T. J. et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. <i>Ann. Intern. Med.</i> <b>142</b>, 611–619 (2005).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.7326/0003-4819-142-8-200504190-00009" data-track-item_id="10.7326/0003-4819-142-8-200504190-00009" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.7326%2F0003-4819-142-8-200504190-00009" aria-label="Article reference 80" data-doi="10.7326/0003-4819-142-8-200504190-00009">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD2MXktFahtrY%3D" aria-label="CAS reference 80">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15838067" aria-label="PubMed reference 80">PubMed</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed central reference" data-track-action="pubmed central reference" href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505046" aria-label="PubMed Central reference 80">PubMed Central</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 80" href="http://scholar.google.com/scholar_lookup?&title=The%20effect%20of%20metformin%20and%20intensive%20lifestyle%20intervention%20on%20the%20metabolic%20syndrome%3A%20the%20Diabetes%20Prevention%20Program%20randomized%20trial&journal=Ann.%20Intern.%20Med.&doi=10.7326%2F0003-4819-142-8-200504190-00009&volume=142&pages=611-619&publication_year=2005&author=Orchard%2CTJ"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="81"><p class="c-article-references__text" id="ref-CR81">Katzmarzyk, P. T. et al. Targeting the metabolic syndrome with exercise: evidence from the HERITAGE Family Study. <i>Med. Sci. Sports Exerc.</i> <b>35</b>, 1703–1709 (2003).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1249/01.MSS.0000089337.73244.9B" data-track-item_id="10.1249/01.MSS.0000089337.73244.9B" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1249%2F01.MSS.0000089337.73244.9B" aria-label="Article reference 81" data-doi="10.1249/01.MSS.0000089337.73244.9B">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD3sXnslaku7Y%3D" aria-label="CAS reference 81">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=14523308" aria-label="PubMed reference 81">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 81" href="http://scholar.google.com/scholar_lookup?&title=Targeting%20the%20metabolic%20syndrome%20with%20exercise%3A%20evidence%20from%20the%20HERITAGE%20Family%20Study&journal=Med.%20Sci.%20Sports%20Exerc.&doi=10.1249%2F01.MSS.0000089337.73244.9B&volume=35&pages=1703-1709&publication_year=2003&author=Katzmarzyk%2CPT"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="82"><p class="c-article-references__text" id="ref-CR82">Dumont, M., Mauriège, P., Bergeron, J., Després, J. P. & Prud'homme, D. Effect of a six month gemfibrozil treatment and dietary recommendations on the metabolic risk profile of visceral obese men. <i>Int. J. Obes. Relat. Metab. Disord.</i> <b>25</b>, 1136–1143 (2001).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1038/sj.ijo.0801665" data-track-item_id="10.1038/sj.ijo.0801665" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1038%2Fsj.ijo.0801665" aria-label="Article reference 82" data-doi="10.1038/sj.ijo.0801665">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD3MXmtF2jtLc%3D" aria-label="CAS reference 82">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11477498" aria-label="PubMed reference 82">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 82" href="http://scholar.google.com/scholar_lookup?&title=Effect%20of%20a%20six%20month%20gemfibrozil%20treatment%20and%20dietary%20recommendations%20on%20the%20metabolic%20risk%20profile%20of%20visceral%20obese%20men&journal=Int.%20J.%20Obes.%20Relat.%20Metab.%20Disord.&doi=10.1038%2Fsj.ijo.0801665&volume=25&pages=1136-1143&publication_year=2001&author=Dumont%2CM&author=Mauri%C3%A8ge%2CP&author=Bergeron%2CJ&author=Despr%C3%A9s%2CJP&author=Prud%27homme%2CD"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="83"><p class="c-article-references__text" id="ref-CR83">Leon, A. S. & Sanchez, O. A. Response of blood lipids to exercise training alone or combined with dietary intervention. <i>Med. Sci. Sports Exerc.</i> <b>33</b>, S502–S515 (2001).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1097/00005768-200106001-00021" data-track-item_id="10.1097/00005768-200106001-00021" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1097%2F00005768-200106001-00021" aria-label="Article reference 83" data-doi="10.1097/00005768-200106001-00021">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD3MXkslOhtL8%3D" aria-label="CAS reference 83">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11427777" aria-label="PubMed reference 83">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 83" href="http://scholar.google.com/scholar_lookup?&title=Response%20of%20blood%20lipids%20to%20exercise%20training%20alone%20or%20combined%20with%20dietary%20intervention&journal=Med.%20Sci.%20Sports%20Exerc.&doi=10.1097%2F00005768-200106001-00021&volume=33&pages=S502-S515&publication_year=2001&author=Leon%2CAS&author=Sanchez%2COA"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="84"><p class="c-article-references__text" id="ref-CR84">Lemieux, I. et al. Waist girth does not predict metabolic complications in severely obese men. <i>Diabetes Care</i> <b>29</b>, 1417–1419 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.2337/dc06-0441" data-track-item_id="10.2337/dc06-0441" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.2337%2Fdc06-0441" aria-label="Article reference 84" data-doi="10.2337/dc06-0441">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16732038" aria-label="PubMed reference 84">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 84" href="http://scholar.google.com/scholar_lookup?&title=Waist%20girth%20does%20not%20predict%20metabolic%20complications%20in%20severely%20obese%20men&journal=Diabetes%20Care&doi=10.2337%2Fdc06-0441&volume=29&pages=1417-1419&publication_year=2006&author=Lemieux%2CI"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="85"><p class="c-article-references__text" id="ref-CR85">Lemieux, I. et al. Hypertriglyceridemic waist. A marker of the atherogenic metabolic triad (hyperinsulinemia, hyperapolipoprotein B, small, dense LDL) in men? <i>Circulation</i> <b>102</b>, 179–184 (2000).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/01.CIR.102.2.179" data-track-item_id="10.1161/01.CIR.102.2.179" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2F01.CIR.102.2.179" aria-label="Article reference 85" data-doi="10.1161/01.CIR.102.2.179">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DC%2BD3czkvFeqsQ%3D%3D" aria-label="CAS reference 85">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=10889128" aria-label="PubMed reference 85">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 85" href="http://scholar.google.com/scholar_lookup?&title=Hypertriglyceridemic%20waist.%20A%20marker%20of%20the%20atherogenic%20metabolic%20triad%20%28hyperinsulinemia%2C%20hyperapolipoprotein%20B%2C%20small%2C%20dense%20LDL%29%20in%20men%3F&journal=Circulation&doi=10.1161%2F01.CIR.102.2.179&volume=102&pages=179-184&publication_year=2000&author=Lemieux%2CI"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="86"><p class="c-article-references__text" id="ref-CR86">Underwood, P. M. Cardiovascular risk, the metabolic syndrome and the hypertriglyceridaemic waist. <i>Curr. Opin. Lipidol.</i> <b>15</b>, 495–497 (2004).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1097/01.mol.0000137237.97341.fd" data-track-item_id="10.1097/01.mol.0000137237.97341.fd" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1097%2F01.mol.0000137237.97341.fd" aria-label="Article reference 86" data-doi="10.1097/01.mol.0000137237.97341.fd">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD2cXlsV2hs7c%3D" aria-label="CAS reference 86">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15243227" aria-label="PubMed reference 86">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 86" href="http://scholar.google.com/scholar_lookup?&title=Cardiovascular%20risk%2C%20the%20metabolic%20syndrome%20and%20the%20hypertriglyceridaemic%20waist&journal=Curr.%20Opin.%20Lipidol.&doi=10.1097%2F01.mol.0000137237.97341.fd&volume=15&pages=495-497&publication_year=2004&author=Underwood%2CPM"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="87"><p class="c-article-references__text" id="ref-CR87">Kahn, H. S. & Valdez, R. Metabolic risks identified by the combination of enlarged waist and elevated triacylglycerol concentration. <i>Am. J. Clin. Nutr.</i> <b>78</b>, 928–934 (2003).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1093/ajcn/78.5.928" data-track-item_id="10.1093/ajcn/78.5.928" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1093%2Fajcn%2F78.5.928" aria-label="Article reference 87" data-doi="10.1093/ajcn/78.5.928">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD3sXoslCjsbg%3D" aria-label="CAS reference 87">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=14594778" aria-label="PubMed reference 87">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 87" href="http://scholar.google.com/scholar_lookup?&title=Metabolic%20risks%20identified%20by%20the%20combination%20of%20enlarged%20waist%20and%20elevated%20triacylglycerol%20concentration&journal=Am.%20J.%20Clin.%20Nutr.&doi=10.1093%2Fajcn%2F78.5.928&volume=78&pages=928-934&publication_year=2003&author=Kahn%2CHS&author=Valdez%2CR"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="88"><p class="c-article-references__text" id="ref-CR88">Lean, M. E., Han, T. S. & Morrison, C. E. Waist circumference as a measure for indicating need for weight management. <i>Br. Med. J.</i> <b>311</b>, 158–161 (1995).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1136/bmj.311.6998.158" data-track-item_id="10.1136/bmj.311.6998.158" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1136%2Fbmj.311.6998.158" aria-label="Article reference 88" data-doi="10.1136/bmj.311.6998.158">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DyaK2MzjvVSrsg%3D%3D" aria-label="CAS reference 88">CAS</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 88" href="http://scholar.google.com/scholar_lookup?&title=Waist%20circumference%20as%20a%20measure%20for%20indicating%20need%20for%20weight%20management&journal=Br.%20Med.%20J.&doi=10.1136%2Fbmj.311.6998.158&volume=311&pages=158-161&publication_year=1995&author=Lean%2CME&author=Han%2CTS&author=Morrison%2CCE"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="89"><p class="c-article-references__text" id="ref-CR89">Zhu, S. et al. Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds. <i>Am. J. Clin. Nutr.</i> <b>76</b>, 743–749 (2002).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1093/ajcn/76.4.743" data-track-item_id="10.1093/ajcn/76.4.743" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1093%2Fajcn%2F76.4.743" aria-label="Article reference 89" data-doi="10.1093/ajcn/76.4.743">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:CAS:528:DC%2BD38Xns1eqsL8%3D" aria-label="CAS reference 89">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12324286" aria-label="PubMed reference 89">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 89" href="http://scholar.google.com/scholar_lookup?&title=Waist%20circumference%20and%20obesity-associated%20risk%20factors%20among%20whites%20in%20the%20third%20National%20Health%20and%20Nutrition%20Examination%20Survey%3A%20clinical%20action%20thresholds&journal=Am.%20J.%20Clin.%20Nutr.&doi=10.1093%2Fajcn%2F76.4.743&volume=76&pages=743-749&publication_year=2002&author=Zhu%2CS"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="90"><p class="c-article-references__text" id="ref-CR90">Beckley, E. T. New ADA initiative moves beyond 'metabolic syndrome'. 'Cardiometabolic risk' proposed as umbrella term for diabetes risk factors. <i>DOC News</i> <b>3</b>, 1–3 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 90" href="http://scholar.google.com/scholar_lookup?&title=New%20ADA%20initiative%20moves%20beyond%20%27metabolic%20syndrome%27.%20%27Cardiometabolic%20risk%27%20proposed%20as%20umbrella%20term%20for%20diabetes%20risk%20factors&journal=DOC%20News&volume=3&pages=1-3&publication_year=2006&author=Beckley%2CET"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="91"><p class="c-article-references__text" id="ref-CR91">Eckel, R. H., Kahn, R., Robertson, R. M. & Rizza, R. A. Preventing cardiovascular disease and diabetes: a call to action from the American Diabetes Association and the American Heart Association. <i>Circulation</i> <b>113</b>, 2943–2946 (2006).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1161/CIRCULATIONAHA.106.176583" data-track-item_id="10.1161/CIRCULATIONAHA.106.176583" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1161%2FCIRCULATIONAHA.106.176583" aria-label="Article reference 91" data-doi="10.1161/CIRCULATIONAHA.106.176583">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16801475" aria-label="PubMed reference 91">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 91" href="http://scholar.google.com/scholar_lookup?&title=Preventing%20cardiovascular%20disease%20and%20diabetes%3A%20a%20call%20to%20action%20from%20the%20American%20Diabetes%20Association%20and%20the%20American%20Heart%20Association&journal=Circulation&doi=10.1161%2FCIRCULATIONAHA.106.176583&volume=113&pages=2943-2946&publication_year=2006&author=Eckel%2CRH&author=Kahn%2CR&author=Robertson%2CRM&author=Rizza%2CRA"> Google Scholar</a> </p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="92"><p class="c-article-references__text" id="ref-CR92">Després, J. P. From CVD risk to cardiometabolic risk. Presented at the Symposium of the International Chair on Cardiometabolic Risk. XIV International Symposium on Atherosclerosis (Rome, 18–22 June 2006).</p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="93"><p class="c-article-references__text" id="ref-CR93">Després, J. P. Visceral adiposity. Presented at the 66th Scientific Sessions, American Diabetes Association (Washington, DC, 9–13 June 2006).</p></li><li class="c-article-references__item js-c-reading-companion-references-item" data-counter="94"><p class="c-article-references__text" id="ref-CR94">Bouchard, C. et al. The response to long-term overfeeding in identical twins. <i>N. Engl. J. Med.</i> <b>322</b>, 1477–1482 (1990).</p><p class="c-article-references__links u-hide-print"><a data-track="click_references" rel="nofollow noopener" data-track-label="10.1056/NEJM199005243222101" data-track-item_id="10.1056/NEJM199005243222101" data-track-value="article reference" data-track-action="article reference" href="https://doi.org/10.1056%2FNEJM199005243222101" aria-label="Article reference 94" data-doi="10.1056/NEJM199005243222101">Article</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="cas reference" data-track-action="cas reference" href="/articles/cas-redirect/1:STN:280:DyaK3c3ksFSgtQ%3D%3D" aria-label="CAS reference 94">CAS</a> <a data-track="click_references" rel="nofollow noopener" data-track-label="link" data-track-item_id="link" data-track-value="pubmed reference" data-track-action="pubmed reference" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=2336074" aria-label="PubMed reference 94">PubMed</a> <a data-track="click_references" data-track-action="google scholar reference" data-track-value="google scholar reference" data-track-label="link" data-track-item_id="link" rel="nofollow noopener" aria-label="Google Scholar reference 94" href="http://scholar.google.com/scholar_lookup?&title=The%20response%20to%20long-term%20overfeeding%20in%20identical%20twins&journal=N.%20Engl.%20J.%20Med.&doi=10.1056%2FNEJM199005243222101&volume=322&pages=1477-1482&publication_year=1990&author=Bouchard%2CC"> Google Scholar</a> </p></li></ol><p class="c-article-references__download u-hide-print"><a data-track="click" data-track-action="download citation references" data-track-label="link" rel="nofollow" href="https://citation-needed.springer.com/v2/references/10.1038/nature05488?format=refman&flavour=references">Download references<svg width="16" height="16" focusable="false" role="img" aria-hidden="true" class="u-icon"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="#icon-eds-i-download-medium"></use></svg></a></p></div></div></div></section></div><section data-title="Acknowledgements"><div class="c-article-section" id="Ack1-section"><h2 class="c-article-section__title js-section-title js-c-reading-companion-sections-item" id="Ack1">Acknowledgements</h2><div class="c-article-section__content" id="Ack1-content"><p>The work of the authors has been supported by research grants from the Canadian Institutes of Health Research, the Canadian Diabetes Association, the Heart and Stroke Foundation and by the Foundation of the Québec Heart Institute. J.-P.D. is Scientific Director of the International Chair on Cardiometabolic Risk, which is supported by an unrestricted grant from Sanofi Aventis awarded to Université Laval.</p></div></div></section><section aria-labelledby="author-information" data-title="Author information"><div class="c-article-section" id="author-information-section"><h2 class="c-article-section__title js-section-title js-c-reading-companion-sections-item" id="author-information">Author information</h2><div class="c-article-section__content" id="author-information-content"><h3 class="c-article__sub-heading" id="affiliations">Authors and Affiliations</h3><ol class="c-article-author-affiliation__list"><li id="Aff1"><p class="c-article-author-affiliation__address">Québec Heart Institute, Hôpital Laval Research Centre, 2725 chemin Sainte-Foy, Pavilion Marguerite-D'Youville, 4th Floor, Quebec City, QC G1V 4G5, Canada</p><p class="c-article-author-affiliation__authors-list">Jean-Pierre Després & Isabelle Lemieux</p></li><li id="Aff2"><p class="c-article-author-affiliation__address">Division of Kinesiology, Department of Social and Preventive Medicine, Université Laval, Quebec City, QC G1K 7P4, Canada</p><p class="c-article-author-affiliation__authors-list">Jean-Pierre Després</p></li></ol><div class="u-js-hide u-hide-print" data-test="author-info"><span class="c-article__sub-heading">Authors</span><ol class="c-article-authors-search u-list-reset"><li id="auth-Jean_Pierre-Despr_s-Aff1-Aff2"><span class="c-article-authors-search__title u-h3 js-search-name">Jean-Pierre Després</span><div class="c-article-authors-search__list"><div class="c-article-authors-search__item c-article-authors-search__list-item--left"><a href="/search?author=Jean-Pierre%20Despr%C3%A9s" class="c-article-button" data-track="click" data-track-action="author link - publication" data-track-label="link" rel="nofollow">View author publications</a></div><div class="c-article-authors-search__item c-article-authors-search__list-item--right"><p class="search-in-title-js c-article-authors-search__text">You can also search for this author in <span class="c-article-identifiers"><a class="c-article-identifiers__item" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&term=Jean-Pierre%20Despr%C3%A9s" data-track="click" data-track-action="author link - pubmed" data-track-label="link" rel="nofollow">PubMed</a><span class="u-hide"> </span><a class="c-article-identifiers__item" href="http://scholar.google.co.uk/scholar?as_q=&num=10&btnG=Search+Scholar&as_epq=&as_oq=&as_eq=&as_occt=any&as_sauthors=%22Jean-Pierre%20Despr%C3%A9s%22&as_publication=&as_ylo=&as_yhi=&as_allsubj=all&hl=en" data-track="click" data-track-action="author link - scholar" data-track-label="link" rel="nofollow">Google Scholar</a></span></p></div></div></li><li id="auth-Isabelle-Lemieux-Aff1"><span class="c-article-authors-search__title u-h3 js-search-name">Isabelle Lemieux</span><div class="c-article-authors-search__list"><div class="c-article-authors-search__item c-article-authors-search__list-item--left"><a href="/search?author=Isabelle%20Lemieux" class="c-article-button" data-track="click" data-track-action="author link - publication" data-track-label="link" rel="nofollow">View author publications</a></div><div class="c-article-authors-search__item c-article-authors-search__list-item--right"><p class="search-in-title-js c-article-authors-search__text">You can also search for this author in <span class="c-article-identifiers"><a class="c-article-identifiers__item" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&term=Isabelle%20Lemieux" data-track="click" data-track-action="author link - pubmed" data-track-label="link" rel="nofollow">PubMed</a><span class="u-hide"> </span><a class="c-article-identifiers__item" href="http://scholar.google.co.uk/scholar?as_q=&num=10&btnG=Search+Scholar&as_epq=&as_oq=&as_eq=&as_occt=any&as_sauthors=%22Isabelle%20Lemieux%22&as_publication=&as_ylo=&as_yhi=&as_allsubj=all&hl=en" data-track="click" data-track-action="author link - scholar" data-track-label="link" rel="nofollow">Google Scholar</a></span></p></div></div></li></ol></div></div></div></section><section data-title="Ethics declarations"><div class="c-article-section" id="ethics-section"><h2 class="c-article-section__title js-section-title js-c-reading-companion-sections-item" id="ethics">Ethics declarations</h2><div class="c-article-section__content" id="ethics-content"> <h3 class="c-article__sub-heading">Competing interests</h3> <p>Jean-Pierre Després has received honoraria payments from the following pharmaceutical companies as a consultant or lecturer: Abbott Laboratories, AstraZeneca, Fournier Pharma/Solvay Pharma, GlaxoSmithKline, MSD, Pfizer Canada/Pharmacia, Sanofi-Aventis and Novartis. </p> </div></div></section><section data-title="Rights and permissions"><div class="c-article-section" id="rightslink-section"><h2 class="c-article-section__title js-section-title js-c-reading-companion-sections-item" id="rightslink">Rights and permissions</h2><div class="c-article-section__content" id="rightslink-content"><p class="c-article-rights"><a data-track="click" data-track-action="view rights and permissions" data-track-label="link" href="https://s100.copyright.com/AppDispatchServlet?title=Abdominal%20obesity%20and%20metabolic%20syndrome&author=Jean-Pierre%20Despr%C3%A9s%20et%20al&contentID=10.1038%2Fnature05488&copyright=Springer%20Nature%20Limited&publication=0028-0836&publicationDate=2006-12-13&publisherName=SpringerNature&orderBeanReset=true">Reprints and permissions</a></p></div></div></section><section aria-labelledby="article-info" data-title="About this article"><div class="c-article-section" id="article-info-section"><h2 class="c-article-section__title js-section-title js-c-reading-companion-sections-item" id="article-info">About this article</h2><div class="c-article-section__content" id="article-info-content"><div class="c-bibliographic-information"><div class="c-bibliographic-information__column"><h3 class="c-article__sub-heading" id="citeas">Cite this article</h3><p class="c-bibliographic-information__citation">Després, JP., Lemieux, I. Abdominal obesity and metabolic syndrome. <i>Nature</i> <b>444</b>, 881–887 (2006). https://doi.org/10.1038/nature05488</p><p class="c-bibliographic-information__download-citation u-hide-print"><a data-test="citation-link" data-track="click" data-track-action="download article citation" data-track-label="link" data-track-external="" rel="nofollow" href="https://citation-needed.springer.com/v2/references/10.1038/nature05488?format=refman&flavour=citation">Download citation<svg width="16" height="16" focusable="false" role="img" aria-hidden="true" class="u-icon"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="#icon-eds-i-download-medium"></use></svg></a></p><ul class="c-bibliographic-information__list" data-test="publication-history"><li class="c-bibliographic-information__list-item"><p>Published<span class="u-hide">: </span><span class="c-bibliographic-information__value"><time datetime="2006-12-13">13 December 2006</time></span></p></li><li class="c-bibliographic-information__list-item"><p>Issue Date<span class="u-hide">: </span><span class="c-bibliographic-information__value"><time datetime="2006-12-14">14 December 2006</time></span></p></li><li class="c-bibliographic-information__list-item c-bibliographic-information__list-item--full-width"><p><abbr title="Digital Object Identifier">DOI</abbr><span class="u-hide">: </span><span class="c-bibliographic-information__value">https://doi.org/10.1038/nature05488</span></p></li></ul><div data-component="share-box"><div class="c-article-share-box u-display-none" hidden=""><h3 class="c-article__sub-heading">Share this article</h3><p class="c-article-share-box__description">Anyone you share the following link with will be able to read this content:</p><button class="js-get-share-url c-article-share-box__button" type="button" id="get-share-url" data-track="click" data-track-label="button" data-track-external="" data-track-action="get shareable link">Get shareable link</button><div class="js-no-share-url-container u-display-none" hidden=""><p class="js-c-article-share-box__no-sharelink-info c-article-share-box__no-sharelink-info">Sorry, a shareable link is not currently available for this article.</p></div><div class="js-share-url-container u-display-none" hidden=""><p class="js-share-url c-article-share-box__only-read-input" id="share-url" data-track="click" data-track-label="button" data-track-action="select share url"></p><button class="js-copy-share-url c-article-share-box__button--link-like" type="button" id="copy-share-url" data-track="click" data-track-label="button" data-track-action="copy share url" data-track-external="">Copy to clipboard</button></div><p class="js-c-article-share-box__additional-info c-article-share-box__additional-info"> Provided by the Springer Nature SharedIt content-sharing initiative </p></div></div><div data-component="article-info-list"></div></div></div></div></div></section> </div> <section> <div class="c-article-section js-article-section" id="further-reading-section" data-test="further-reading-section"> <h2 class="c-article-section__title js-section-title js-c-reading-companion-sections-item" id="further-reading">This article is cited by</h2> <div class="c-article-section__content js-collapsible-section" id="further-reading-content"> <ul class="c-article-further-reading__list" id="further-reading-list"> <li class="c-article-further-reading__item js-ref-item"> <h3 class="c-article-further-reading__title" data-test="article-title"> <a class="print-link" data-track="click" data-track-action="view further reading article" data-track-label="link:Extracellular vesicle therapy for obesity-induced NAFLD: a comprehensive review of current evidence" href="https://doi.org/10.1186/s12964-023-01292-0"> Extracellular vesicle therapy for obesity-induced NAFLD: a comprehensive review of current evidence </a> </h3> <ul data-test="author-list" class="c-author-list c-author-list--compact c-author-list--truncated u-sans-serif u-mb-4 u-mt-auto"> <li>Jiali Zhang</li><li>Baochen Ma</li><li>Yulan Dong</li> </ul> <p class="c-article-further-reading__journal-title"><i>Cell Communication and Signaling</i> (2024)</p> </li> <li class="c-article-further-reading__item js-ref-item"> <h3 class="c-article-further-reading__title" data-test="article-title"> <a class="print-link" data-track="click" data-track-action="view further reading article" data-track-label="link:Impact of comorbidities in COPD clinical control criteria. The CLAVE study" href="https://doi.org/10.1186/s12890-023-02758-0"> Impact of comorbidities in COPD clinical control criteria. The CLAVE study </a> </h3> <ul data-test="author-list" class="c-author-list c-author-list--compact c-author-list--truncated u-sans-serif u-mb-4 u-mt-auto"> <li>Pere Almagro</li><li>Juan José Soler-Cataluña</li><li>Borja G. Cosío</li> </ul> <p class="c-article-further-reading__journal-title"><i>BMC Pulmonary Medicine</i> (2024)</p> </li> <li class="c-article-further-reading__item js-ref-item"> <h3 class="c-article-further-reading__title" data-test="article-title"> <a class="print-link" data-track="click" data-track-action="view further reading article" data-track-label="link:Dysregulation of mitochondrial dynamics mediated aortic perivascular adipose tissue-associated vascular reactivity impairment under excessive fructose intake" href="https://doi.org/10.1186/s12986-023-00776-7"> Dysregulation of mitochondrial dynamics mediated aortic perivascular adipose tissue-associated vascular reactivity impairment under excessive fructose intake </a> </h3> <ul data-test="author-list" class="c-author-list c-author-list--compact c-author-list--truncated u-sans-serif u-mb-4 u-mt-auto"> <li>Kay L. H. Wu</li><li>Chih-Wei Wu</li><li>Wen-Chung Liu</li> </ul> <p class="c-article-further-reading__journal-title"><i>Nutrition & Metabolism</i> (2024)</p> </li> <li class="c-article-further-reading__item js-ref-item"> <h3 class="c-article-further-reading__title" data-test="article-title"> <a class="print-link" data-track="click" data-track-action="view further reading article" data-track-label="link:Correlation analysis between occupational stress and metabolic syndrome in workers of a petrochemical enterprise: based on two assessment models of occupational stress" href="https://doi.org/10.1186/s12889-024-18305-3"> Correlation analysis between occupational stress and metabolic syndrome in workers of a petrochemical enterprise: based on two assessment models of occupational stress </a> </h3> <ul data-test="author-list" class="c-author-list c-author-list--compact c-author-list--truncated u-sans-serif u-mb-4 u-mt-auto"> <li>Min Zhang</li><li>Bin Liu</li><li>Huifeng Chen</li> </ul> <p class="c-article-further-reading__journal-title"><i>BMC Public Health</i> (2024)</p> </li> <li class="c-article-further-reading__item js-ref-item"> <h3 class="c-article-further-reading__title" data-test="article-title"> <a class="print-link" data-track="click" data-track-action="view further reading article" data-track-label="link:Triglyceride-glucose body mass index predicts prognosis in patients with ST-elevation myocardial infarction" href="https://doi.org/10.1038/s41598-023-51136-7"> Triglyceride-glucose body mass index predicts prognosis in patients with ST-elevation myocardial infarction </a> </h3> <ul data-test="author-list" class="c-author-list c-author-list--compact c-author-list--truncated u-sans-serif u-mb-4 u-mt-auto"> <li>Ming Liu</li><li>Jianyuan Pan</li><li>Xiaofan Yu</li> </ul> <p class="c-article-further-reading__journal-title"><i>Scientific Reports</i> (2024)</p> </li> </ul> </div> </div> </section> </div> </article> </main> <aside class="c-article-extras u-hide-print" aria-label="Article navigation" data-component-reading-companion data-container-type="reading-companion" data-track-component="reading companion"> <div class="js-context-bar-sticky-point-desktop" data-track-context="reading companion"> <noscript> <div class="c-nature-box c-nature-box--side " data-component="entitlement-box"> <div class="js-access-button"> <a href="https://wayf.springernature.com?redirect_uri=https%3A%2F%2Fwww.nature.com%2Farticles%2Fnature05488" class="c-article__button" data-test="ra21"> <svg class="u-icon" width="18" height="18" aria-hidden="true" focusable="false"><use href="#icon-institution"></use></svg> <span class="c-article__button-text">Access through your institution</span> </a> </div> <div class="js-buy-button"> <a href="#access-options" class="c-article__button c-article__button--inverted" data-test="ra21"> <span>Buy or subscribe</span> </a> </div> </div> </noscript> <div class="c-nature-box__wrapper c-nature-box__wrapper--placeholder"> <div class="c-nature-box c-nature-box--side u-display-none u-hide-print" aria-hidden="true" data-component="entitlement-box" id=entitlement-box-right-column > <p class="c-nature-box__text js-text u-display-none" aria-hidden="true"></p> <div class="js-access-button u-display-none"> <a href="https://wayf.springernature.com?redirect_uri=https%3A%2F%2Fwww.nature.com%2Farticles%2Fnature05488" class="c-article__button" aria-hidden="true" data-test="ra21" data-track="click_institution_login" data-track-context="reading companion" data-track-action="institution access" data-track-label="button"> <svg class="u-icon" width="18" height="18" aria-hidden="true" focusable="false"><use xlink:href="#icon-institution"></use></svg> <span class="c-article__button-text">Access through your institution</span> </a> </div> <div class="js-change-institution-button u-display-none"> <a href="https://wayf.springernature.com?redirect_uri=https%3A%2F%2Fwww.nature.com%2Farticles%2Fnature05488" class="c-article__button c-article__button--inverted" aria-hidden="true" data-test="ra21" data-track="click" data-track-action="change institution" data-track-label="button"> <span class="c-article__button-text">Change institution</span> </a> </div> <div class="js-buy-button u-display-none"> <a href="#access-options" class="c-article__button c-article__button--inverted" aria-hidden="true" data-test="ra21" data-track="click" data-track-action="buy or subscribe" data-track-label="button"> <span>Buy or subscribe</span> </a> </div> </div> </div> </div> <div class="c-reading-companion"> <div class="c-reading-companion__sticky" data-component="reading-companion-sticky" data-test="reading-companion-sticky"> <div class="c-reading-companion__panel c-reading-companion__sections c-reading-companion__panel--active" id="tabpanel-sections"> <div class="u-lazy-ad-wrapper u-mt-16 u-hide" data-component-mpu> <div class="c-ad c-ad--300x250"> <div class="c-ad__inner"> <p class="c-ad__label">Advertisement</p> <div id="div-gpt-ad-right-2" class="div-gpt-ad advert medium-rectangle js-ad text-center hide-print grade-c-hide" data-ad-type="right" data-test="right-ad" data-pa11y-ignore data-gpt data-gpt-unitpath="/285/nature.com/article" data-gpt-sizes="300x250" data-gpt-targeting="type=article;pos=right;artid=nature05488;doi=10.1038/nature05488;kwrd=Science%2C+Humanities+and+Social+Sciences%2C+multidisciplinary,Science%2C+multidisciplinary"> <noscript> <a href="//pubads.g.doubleclick.net/gampad/jump?iu=/285/nature.com/article&sz=300x250&c=-366161458&t=pos%3Dright%26type%3Darticle%26artid%3Dnature05488%26doi%3D10.1038/nature05488%26kwrd%3DScience%2C+Humanities+and+Social+Sciences%2C+multidisciplinary,Science%2C+multidisciplinary"> <img data-test="gpt-advert-fallback-img" src="//pubads.g.doubleclick.net/gampad/ad?iu=/285/nature.com/article&sz=300x250&c=-366161458&t=pos%3Dright%26type%3Darticle%26artid%3Dnature05488%26doi%3D10.1038/nature05488%26kwrd%3DScience%2C+Humanities+and+Social+Sciences%2C+multidisciplinary,Science%2C+multidisciplinary" alt="Advertisement" width="300" height="250"></a> </noscript> </div> </div> </div> </div> </div> <div class="c-reading-companion__panel c-reading-companion__figures c-reading-companion__panel--full-width" id="tabpanel-figures"></div> <div class="c-reading-companion__panel c-reading-companion__references c-reading-companion__panel--full-width" id="tabpanel-references"></div> </div> </div> </aside> </div> <nav class="c-header__dropdown" aria-labelledby="Explore-content" data-test="Explore-content" id="explore" data-track-component="nature-150-split-header"> <div class="c-header__container"> <h2 id="Explore-content" class="c-header__heading c-header__heading--js-hide">Explore content</h2> <ul class="c-header__list c-header__list--js-stack"> <li class="c-header__item"> <a class="c-header__link" href="/nature/research-articles" data-track="click" data-track-action="research articles" data-track-label="link" data-test="explore-nav-item"> Research articles </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/news" data-track="click" data-track-action="news" data-track-label="link" data-test="explore-nav-item"> News </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/opinion" data-track="click" data-track-action="opinion" data-track-label="link" data-test="explore-nav-item"> Opinion </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/research-analysis" data-track="click" data-track-action="research analysis" data-track-label="link" data-test="explore-nav-item"> Research Analysis </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/careers" data-track="click" data-track-action="careers" data-track-label="link" data-test="explore-nav-item"> Careers </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/books-culture" data-track="click" data-track-action="books & culture" data-track-label="link" data-test="explore-nav-item"> Books & Culture </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/podcasts" data-track="click" data-track-action="podcasts" data-track-label="link" data-test="explore-nav-item"> Podcasts </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/videos" data-track="click" data-track-action="videos" data-track-label="link" data-test="explore-nav-item"> Videos </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/current-issue" data-track="click" data-track-action="current issue" data-track-label="link" data-test="explore-nav-item"> Current issue </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/browse-issues" data-track="click" data-track-action="browse issues" data-track-label="link" data-test="explore-nav-item"> Browse issues </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/collections" data-track="click" data-track-action="collections" data-track-label="link" data-test="explore-nav-item"> Collections </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/browse-subjects" data-track="click" data-track-action="subjects" data-track-label="link" data-test="explore-nav-item"> Subjects </a> </li> </ul> <ul class="c-header__list c-header__list--js-stack"> <li class="c-header__item"> <a class="c-header__link" href="https://www.facebook.com/Nature" data-track="click" data-track-action="facebook" data-track-label="link">Follow us on Facebook </a> </li> <li class="c-header__item"> <a class="c-header__link" href="https://twitter.com/nature" data-track="click" data-track-action="twitter" data-track-label="link">Follow us on Twitter </a> </li> <li class="c-header__item c-header__item--hide-lg"> <a data-test="subscribe-button" class="c-header__link" href="https://www.nature.com/nature/subscribe" data-track="click" data-track-action="subscribe" data-track-label="link"> <span>Subscribe</span> </a> </li> <li class="c-header__item c-header__item--hide-lg"> <a class="c-header__link" href="https://www.nature.com/my-account/alerts/subscribe-journal?list-id=1" rel="nofollow" data-track="click" data-track-action="Sign up for alerts" data-track-external data-track-label="link (mobile dropdown)">Sign up for alerts<svg role="img" aria-hidden="true" focusable="false" height="18" viewBox="0 0 18 18" width="18" xmlns="http://www.w3.org/2000/svg"><path d="m4 10h2.5c.27614237 0 .5.2238576.5.5s-.22385763.5-.5.5h-3.08578644l-1.12132034 1.1213203c-.18753638.1875364-.29289322.4418903-.29289322.7071068v.1715729h14v-.1715729c0-.2652165-.1053568-.5195704-.2928932-.7071068l-1.7071068-1.7071067v-3.4142136c0-2.76142375-2.2385763-5-5-5-2.76142375 0-5 2.23857625-5 5zm3 4c0 1.1045695.8954305 2 2 2s2-.8954305 2-2zm-5 0c-.55228475 0-1-.4477153-1-1v-.1715729c0-.530433.21071368-1.0391408.58578644-1.4142135l1.41421356-1.4142136v-3c0-3.3137085 2.6862915-6 6-6s6 2.6862915 6 6v3l1.4142136 1.4142136c.3750727.3750727.5857864.8837805.5857864 1.4142135v.1715729c0 .5522847-.4477153 1-1 1h-4c0 1.6568542-1.3431458 3-3 3-1.65685425 0-3-1.3431458-3-3z" fill="#fff"/></svg> </a> </li> <li class="c-header__item c-header__item--hide-lg"> <a class="c-header__link" href="https://www.nature.com/nature.rss" data-track="click" data-track-action="rss feed" data-track-label="link"> <span>RSS feed</span> </a> </li> </ul> </div> </nav> <nav class="c-header__dropdown" aria-labelledby="About-the-journal" id="about-the-journal" data-test="about-the-journal" data-track-component="nature-150-split-header"> <div class="c-header__container"> <h2 id="About-the-journal" class="c-header__heading c-header__heading--js-hide">About the journal</h2> <ul class="c-header__list c-header__list--js-stack"> <li class="c-header__item"> <a class="c-header__link" href="/nature/journal-staff" data-track="click" data-track-action="journal staff" data-track-label="link"> Journal Staff </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/editors" data-track="click" data-track-action="about the editors" data-track-label="link"> About the Editors </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/journal-information" data-track="click" data-track-action="journal information" data-track-label="link"> Journal Information </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/our-publishing-models" data-track="click" data-track-action="our publishing models" data-track-label="link"> Our publishing models </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/editorial-values-statement" data-track="click" data-track-action="editorial values statement" data-track-label="link"> Editorial Values Statement </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/journal-impact" data-track="click" data-track-action="journal metrics" data-track-label="link"> Journal Metrics </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/awards" data-track="click" data-track-action="awards" data-track-label="link"> Awards </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/contact" data-track="click" data-track-action="contact" data-track-label="link"> Contact </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/editorial-policies" data-track="click" data-track-action="editorial policies" data-track-label="link"> Editorial policies </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/history-of-nature" data-track="click" data-track-action="history of nature" data-track-label="link"> History of Nature </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/send-a-news-tip" data-track="click" data-track-action="send a news tip" data-track-label="link"> Send a news tip </a> </li> </ul> </div> </nav> <nav class="c-header__dropdown" aria-labelledby="Publish-with-us-label" id="publish-with-us" data-test="publish-with-us" data-track-component="nature-150-split-header"> <div class="c-header__container"> <h2 id="Publish-with-us-label" class="c-header__heading c-header__heading--js-hide">Publish with us</h2> <ul class="c-header__list c-header__list--js-stack"> <li class="c-header__item"> <a class="c-header__link" href="/nature/for-authors" data-track="click" data-track-action="for authors" data-track-label="link"> For Authors </a> </li> <li class="c-header__item"> <a class="c-header__link" href="/nature/for-referees" data-track="click" data-track-action="for referees" data-track-label="link"> For Referees </a> </li> <li class="c-header__item"> <a class="c-header__link" data-test="nature-author-services" data-track="nav_language_services" data-track-context="header publish with us dropdown menu" data-track-action="manuscript author services" data-track-label="link manuscript author services" href="https://authorservices.springernature.com/go/sn/?utm_source=For+Authors&utm_medium=Website_Nature&utm_campaign=Platform+Experimentation+2022&utm_id=PE2022"> Language editing services </a> </li> <li class="c-header__item c-header__item--keyline"> <a class="c-header__link" href="https://mts-nature.nature.com/" data-track="click_submit_manuscript" data-track-context="submit link in Nature header dropdown menu" data-track-action="submit manuscript" data-track-label="link (publish with us dropdown menu)" data-track-external data-gtm-criteo="submit-manuscript">Submit manuscript<svg role="img" aria-hidden="true" focusable="false" height="18" viewBox="0 0 18 18" width="18" xmlns="http://www.w3.org/2000/svg"><path d="m15 0c1.1045695 0 2 .8954305 2 2v5.5c0 .27614237-.2238576.5-.5.5s-.5-.22385763-.5-.5v-5.5c0-.51283584-.3860402-.93550716-.8833789-.99327227l-.1166211-.00672773h-9v3c0 1.1045695-.8954305 2-2 2h-3v10c0 .5128358.38604019.9355072.88337887.9932723l.11662113.0067277h7.5c.27614237 0 .5.2238576.5.5s-.22385763.5-.5.5h-7.5c-1.1045695 0-2-.8954305-2-2v-10.17157288c0-.53043297.21071368-1.0391408.58578644-1.41421356l3.82842712-3.82842712c.37507276-.37507276.88378059-.58578644 1.41421356-.58578644zm-.5442863 8.18867991 3.3545404 3.35454039c.2508994.2508994.2538696.6596433.0035959.909917-.2429543.2429542-.6561449.2462671-.9065387-.0089489l-2.2609825-2.3045251.0010427 7.2231989c0 .3569916-.2898381.6371378-.6473715.6371378-.3470771 0-.6473715-.2852563-.6473715-.6371378l-.0010428-7.2231995-2.2611222 2.3046654c-.2531661.2580415-.6562868.2592444-.9065605.0089707-.24295423-.2429542-.24865597-.6576651.0036132-.9099343l3.3546673-3.35466731c.2509089-.25090888.6612706-.25227691.9135302-.00001728zm-.9557137-3.18867991c.2761424 0 .5.22385763.5.5s-.2238576.5-.5.5h-6c-.27614237 0-.5-.22385763-.5-.5s.22385763-.5.5-.5zm-8.5-3.587-3.587 3.587h2.587c.55228475 0 1-.44771525 1-1zm8.5 1.587c.2761424 0 .5.22385763.5.5s-.2238576.5-.5.5h-6c-.27614237 0-.5-.22385763-.5-.5s.22385763-.5.5-.5z" fill="#fff"/></svg> </a> </li> </ul> </div> </nav> <div id="search-menu" class="c-header__dropdown c-header__dropdown--full-width" data-track-component="nature-150-split-header"> <div class="c-header__container"> <h2 class="c-header__visually-hidden">Search</h2> <form class="c-header__search-form" action="/search" method="get" role="search" autocomplete="off" data-test="inline-search"> <label class="c-header__heading" for="keywords">Search articles by subject, keyword or author</label> <div class="c-header__search-layout c-header__search-layout--max-width"> <div> <input type="text" required="" class="c-header__input" id="keywords" name="q" value=""> </div> <div class="c-header__search-layout"> <div> <label for="results-from" class="c-header__visually-hidden">Show results from</label> <select id="results-from" name="journal" class="c-header__select"> <option value="" selected>All journals</option> <option value="nature">This journal</option> </select> </div> <div> <button type="submit" class="c-header__search-button">Search</button> </div> </div> </div> </form> <div class="c-header__flush"> <a class="c-header__link" href="/search/advanced" data-track="click" data-track-action="advanced search" data-track-label="link"> Advanced search </a> </div> <h3 class="c-header__heading c-header__heading--keyline">Quick links</h3> <ul class="c-header__list"> <li><a class="c-header__link" href="/subjects" data-track="click" data-track-action="explore articles by subject" data-track-label="link">Explore articles by subject</a></li> <li><a class="c-header__link" href="/naturecareers" data-track="click" data-track-action="find a job" data-track-label="link">Find a job</a></li> <li><a class="c-header__link" href="/authors/index.html" data-track="click" data-track-action="guide to authors" data-track-label="link">Guide to authors</a></li> <li><a class="c-header__link" href="/authors/editorial_policies/" data-track="click" data-track-action="editorial policies" data-track-label="link">Editorial policies</a></li> </ul> </div> </div> <footer class="composite-layer" itemscope itemtype="http://schema.org/Periodical"> <meta itemprop="publisher" content="Springer Nature"> <div class="u-mt-16 u-mb-16"> <div class="u-container"> <div class="u-display-flex u-flex-wrap u-justify-content-space-between"> <p class="c-meta u-ma-0 u-flex-shrink"> <span class="c-meta__item"> Nature (<i>Nature</i>) </span> <span class="c-meta__item"> <abbr title="International Standard Serial Number">ISSN</abbr> <span itemprop="onlineIssn">1476-4687</span> (online) </span> <span class="c-meta__item"> <abbr title="International Standard Serial Number">ISSN</abbr> <span itemprop="printIssn">0028-0836</span> (print) </span> </p> </div> </div> </div> <div class="c-footer"> <div class="u-hide-print" data-track-component="footer"> <h2 class="u-visually-hidden">nature.com sitemap</h2> <div class="c-footer__container"> <div class="c-footer__grid c-footer__group--separator"> <div class="c-footer__group"> <h3 class="c-footer__heading u-mt-0">About Nature Portfolio</h3> <ul class="c-footer__list"> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/npg_/company_info/index.html" data-track="click" data-track-action="about us" data-track-label="link">About us</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/npg_/press_room/press_releases.html" data-track="click" data-track-action="press releases" data-track-label="link">Press releases</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://press.nature.com/" data-track="click" data-track-action="press office" data-track-label="link">Press office</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://support.nature.com/support/home" data-track="click" data-track-action="contact us" data-track-label="link">Contact us</a></li> </ul> </div> <div class="c-footer__group"> <h3 class="c-footer__heading u-mt-0">Discover content</h3> <ul class="c-footer__list"> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/siteindex" data-track="click" data-track-action="journals a-z" data-track-label="link">Journals A-Z</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/subjects" data-track="click" data-track-action="article by subject" data-track-label="link">Articles by subject</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.protocols.io/" data-track="click" data-track-action="protocols.io" data-track-label="link">protocols.io</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.natureindex.com/" data-track="click" data-track-action="nature index" data-track-label="link">Nature Index</a></li> </ul> </div> <div class="c-footer__group"> <h3 class="c-footer__heading u-mt-0">Publishing policies</h3> <ul class="c-footer__list"> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/authors/editorial_policies" data-track="click" data-track-action="Nature portfolio policies" data-track-label="link">Nature portfolio policies</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/nature-research/open-access" data-track="click" data-track-action="open access" data-track-label="link">Open access</a></li> </ul> </div> <div class="c-footer__group"> <h3 class="c-footer__heading u-mt-0">Author & Researcher services</h3> <ul class="c-footer__list"> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/reprints" data-track="click" data-track-action="reprints and permissions" data-track-label="link">Reprints & permissions</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.springernature.com/gp/authors/research-data" data-track="click" data-track-action="data research service" data-track-label="link">Research data</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://authorservices.springernature.com/language-editing/" data-track="click" data-track-action="language editing" data-track-label="link">Language editing</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://authorservices.springernature.com/scientific-editing/" data-track="click" data-track-action="scientific editing" data-track-label="link">Scientific editing</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://masterclasses.nature.com/" data-track="click" data-track-action="nature masterclasses" data-track-label="link">Nature Masterclasses</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://solutions.springernature.com/" data-track="click" data-track-action="research solutions" data-track-label="link">Research Solutions</a></li> </ul> </div> <div class="c-footer__group"> <h3 class="c-footer__heading u-mt-0">Libraries & institutions</h3> <ul class="c-footer__list"> <li class="c-footer__item"><a class="c-footer__link" href="https://www.springernature.com/gp/librarians/tools-services" data-track="click" data-track-action="librarian service and tools" data-track-label="link">Librarian service & tools</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.springernature.com/gp/librarians/manage-your-account/librarianportal" data-track="click" data-track-action="librarian portal" data-track-label="link">Librarian portal</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/openresearch/about-open-access/information-for-institutions" data-track="click" data-track-action="open research" data-track-label="link">Open research</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.springernature.com/gp/librarians/recommend-to-your-library" data-track="click" data-track-action="Recommend to library" data-track-label="link">Recommend to library</a></li> </ul> </div> <div class="c-footer__group"> <h3 class="c-footer__heading u-mt-0">Advertising & partnerships</h3> <ul class="c-footer__list"> <li class="c-footer__item"><a class="c-footer__link" href="https://partnerships.nature.com/product/digital-advertising/" data-track="click" data-track-action="advertising" data-track-label="link">Advertising</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://partnerships.nature.com/" data-track="click" data-track-action="partnerships and services" data-track-label="link">Partnerships & Services</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://partnerships.nature.com/media-kits/" data-track="click" data-track-action="media kits" data-track-label="link">Media kits</a> </li> <li class="c-footer__item"><a class="c-footer__link" href="https://partnerships.nature.com/product/branded-content-native-advertising/" data-track-action="branded content" data-track-label="link">Branded content</a></li> </ul> </div> <div class="c-footer__group"> <h3 class="c-footer__heading u-mt-0">Professional development</h3> <ul class="c-footer__list"> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/naturecareers/" data-track="click" data-track-action="nature careers" data-track-label="link">Nature Careers</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://conferences.nature.com" data-track="click" data-track-action="nature conferences" data-track-label="link">Nature<span class="u-visually-hidden"> </span> Conferences</a></li> </ul> </div> <div class="c-footer__group"> <h3 class="c-footer__heading u-mt-0">Regional websites</h3> <ul class="c-footer__list"> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/natafrica" data-track="click" data-track-action="nature africa" data-track-label="link">Nature Africa</a></li> <li class="c-footer__item"><a class="c-footer__link" href="http://www.naturechina.com" data-track="click" data-track-action="nature china" data-track-label="link">Nature China</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/nindia" data-track="click" data-track-action="nature india" data-track-label="link">Nature India</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/natitaly" data-track="click" data-track-action="nature Italy" data-track-label="link">Nature Italy</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.natureasia.com/ja-jp" data-track="click" data-track-action="nature japan" data-track-label="link">Nature Japan</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/nmiddleeast" data-track="click" data-track-action="nature middle east" data-track-label="link">Nature Middle East</a></li> </ul> </div> </div> </div> <div class="c-footer__container"> <ul class="c-footer__links"> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/info/privacy" data-track="click" data-track-action="privacy policy" data-track-label="link">Privacy Policy</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/info/cookies" data-track="click" data-track-action="use of cookies" data-track-label="link">Use of cookies</a></li> <li class="c-footer__item"> <button class="optanon-toggle-display c-footer__link" onclick="javascript:;" data-cc-action="preferences" data-track="click" data-track-action="manage cookies" data-track-label="link">Your privacy choices/Manage cookies </button> </li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/info/legal-notice" data-track="click" data-track-action="legal notice" data-track-label="link">Legal notice</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/info/accessibility-statement" data-track="click" data-track-action="accessibility statement" data-track-label="link">Accessibility statement</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.nature.com/info/terms-and-conditions" data-track="click" data-track-action="terms and conditions" data-track-label="link">Terms & Conditions</a></li> <li class="c-footer__item"><a class="c-footer__link" href="https://www.springernature.com/ccpa" data-track="click" data-track-action="california privacy statement" data-track-label="link">Your US state privacy rights</a></li> </ul> </div> </div> <div class="c-footer__container"> <a href="https://www.springernature.com/" class="c-footer__link"> <img src="/static/images/logos/sn-logo-white-ea63208b81.svg" alt="Springer Nature" loading="lazy" width="200" height="20"/> </a> <p class="c-footer__legal" data-test="copyright">© 2025 Springer Nature Limited</p> </div> </div> <div class="u-visually-hidden" aria-hidden="true"> <?xml version="1.0" encoding="UTF-8"?><!DOCTYPE svg PUBLIC "-//W3C//DTD SVG 1.1//EN" "http://www.w3.org/Graphics/SVG/1.1/DTD/svg11.dtd"><svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><defs><path id="a" d="M0 .74h56.72v55.24H0z"/></defs><symbol id="icon-access" viewBox="0 0 18 18"><path d="m14 8c.5522847 0 1 .44771525 1 1v7h2.5c.2761424 0 .5.2238576.5.5v1.5h-18v-1.5c0-.2761424.22385763-.5.5-.5h2.5v-7c0-.55228475.44771525-1 1-1s1 .44771525 1 1v6.9996556h8v-6.9996556c0-.55228475.4477153-1 1-1zm-8 0 2 1v5l-2 1zm6 0v7l-2-1v-5zm-2.42653766-7.59857636 7.03554716 4.92488299c.4162533.29137735.5174853.86502537.226108 1.28127873-.1721584.24594054-.4534847.39241464-.7536934.39241464h-14.16284822c-.50810197 0-.92-.41189803-.92-.92 0-.30020869.1464741-.58153499.39241464-.75369337l7.03554714-4.92488299c.34432015-.2410241.80260453-.2410241 1.14692468 0zm-.57346234 2.03988748-3.65526982 2.55868888h7.31053962z" fill-rule="evenodd"/></symbol><symbol id="icon-account" viewBox="0 0 18 18"><path d="m10.2379028 16.9048051c1.3083556-.2032362 2.5118471-.7235183 3.5294683-1.4798399-.8731327-2.5141501-2.0638925-3.935978-3.7673711-4.3188248v-1.27684611c1.1651924-.41183641 2-1.52307546 2-2.82929429 0-1.65685425-1.3431458-3-3-3-1.65685425 0-3 1.34314575-3 3 0 1.30621883.83480763 2.41745788 2 2.82929429v1.27684611c-1.70347856.3828468-2.89423845 1.8046747-3.76737114 4.3188248 1.01762123.7563216 2.22111275 1.2766037 3.52946833 1.4798399.40563808.0629726.81921174.0951949 1.23790281.0951949s.83226473-.0322223 1.2379028-.0951949zm4.3421782-2.1721994c1.4927655-1.4532925 2.419919-3.484675 2.419919-5.7326057 0-4.418278-3.581722-8-8-8s-8 3.581722-8 8c0 2.2479307.92715352 4.2793132 2.41991895 5.7326057.75688473-2.0164459 1.83949951-3.6071894 3.48926591-4.3218837-1.14534283-.70360829-1.90918486-1.96796271-1.90918486-3.410722 0-2.209139 1.790861-4 4-4s4 1.790861 4 4c0 1.44275929-.763842 2.70711371-1.9091849 3.410722 1.6497664.7146943 2.7323812 2.3054378 3.4892659 4.3218837zm-5.580081 3.2673943c-4.97056275 0-9-4.0294373-9-9 0-4.97056275 4.02943725-9 9-9 4.9705627 0 9 4.02943725 9 9 0 4.9705627-4.0294373 9-9 9z" fill-rule="evenodd"/></symbol><symbol id="icon-alert" viewBox="0 0 18 18"><path d="m4 10h2.5c.27614237 0 .5.2238576.5.5s-.22385763.5-.5.5h-3.08578644l-1.12132034 1.1213203c-.18753638.1875364-.29289322.4418903-.29289322.7071068v.1715729h14v-.1715729c0-.2652165-.1053568-.5195704-.2928932-.7071068l-1.7071068-1.7071067v-3.4142136c0-2.76142375-2.2385763-5-5-5-2.76142375 0-5 2.23857625-5 5zm3 4c0 1.1045695.8954305 2 2 2s2-.8954305 2-2zm-5 0c-.55228475 0-1-.4477153-1-1v-.1715729c0-.530433.21071368-1.0391408.58578644-1.4142135l1.41421356-1.4142136v-3c0-3.3137085 2.6862915-6 6-6s6 2.6862915 6 6v3l1.4142136 1.4142136c.3750727.3750727.5857864.8837805.5857864 1.4142135v.1715729c0 .5522847-.4477153 1-1 1h-4c0 1.6568542-1.3431458 3-3 3-1.65685425 0-3-1.3431458-3-3z" fill-rule="evenodd"/></symbol><symbol id="icon-arrow-broad" viewBox="0 0 16 16"><path d="m6.10307866 2.97190702v7.69043288l2.44965196-2.44676915c.38776071-.38730439 1.0088052-.39493524 1.38498697-.01919617.38609051.38563612.38643641 1.01053024-.00013864 1.39665039l-4.12239817 4.11754683c-.38616704.3857126-1.01187344.3861062-1.39846576-.0000311l-4.12258206-4.11773056c-.38618426-.38572979-.39254614-1.00476697-.01636437-1.38050605.38609047-.38563611 1.01018509-.38751562 1.4012233.00306241l2.44985644 2.4469734v-8.67638639c0-.54139983.43698413-.98042709.98493125-.98159081l7.89910522-.0043627c.5451687 0 .9871152.44142642.9871152.98595351s-.4419465.98595351-.9871152.98595351z" fill-rule="evenodd" transform="matrix(-1 0 0 -1 14 15)"/></symbol><symbol id="icon-arrow-down" viewBox="0 0 16 16"><path d="m3.28337502 11.5302405 4.03074001 4.176208c.37758093.3912076.98937525.3916069 1.367372-.0000316l4.03091977-4.1763942c.3775978-.3912252.3838182-1.0190815.0160006-1.4001736-.3775061-.39113013-.9877245-.39303641-1.3700683.003106l-2.39538585 2.4818345v-11.6147896l-.00649339-.11662112c-.055753-.49733869-.46370161-.88337888-.95867408-.88337888-.49497246 0-.90292107.38604019-.95867408.88337888l-.00649338.11662112v11.6147896l-2.39518594-2.4816273c-.37913917-.39282218-.98637524-.40056175-1.35419292-.0194697-.37750607.3911302-.37784433 1.0249269.00013556 1.4165479z" fill-rule="evenodd"/></symbol><symbol id="icon-arrow-left" viewBox="0 0 16 16"><path d="m4.46975946 3.28337502-4.17620792 4.03074001c-.39120768.37758093-.39160691.98937525.0000316 1.367372l4.1763942 4.03091977c.39122514.3775978 1.01908149.3838182 1.40017357.0160006.39113012-.3775061.3930364-.9877245-.00310603-1.3700683l-2.48183446-2.39538585h11.61478958l.1166211-.00649339c.4973387-.055753.8833789-.46370161.8833789-.95867408 0-.49497246-.3860402-.90292107-.8833789-.95867408l-.1166211-.00649338h-11.61478958l2.4816273-2.39518594c.39282216-.37913917.40056173-.98637524.01946965-1.35419292-.39113012-.37750607-1.02492687-.37784433-1.41654791.00013556z" fill-rule="evenodd"/></symbol><symbol id="icon-arrow-right" viewBox="0 0 16 16"><path d="m11.5302405 12.716625 4.176208-4.03074003c.3912076-.37758093.3916069-.98937525-.0000316-1.367372l-4.1763942-4.03091981c-.3912252-.37759778-1.0190815-.38381821-1.4001736-.01600053-.39113013.37750607-.39303641.98772445.003106 1.37006824l2.4818345 2.39538588h-11.6147896l-.11662112.00649339c-.49733869.055753-.88337888.46370161-.88337888.95867408 0 .49497246.38604019.90292107.88337888.95867408l.11662112.00649338h11.6147896l-2.4816273 2.39518592c-.39282218.3791392-.40056175.9863753-.0194697 1.3541929.3911302.3775061 1.0249269.3778444 1.4165479-.0001355z" fill-rule="evenodd"/></symbol><symbol id="icon-arrow-sub" viewBox="0 0 16 16"><path d="m7.89692134 4.97190702v7.69043288l-2.44965196-2.4467692c-.38776071-.38730434-1.0088052-.39493519-1.38498697-.0191961-.38609047.3856361-.38643643 1.0105302.00013864 1.3966504l4.12239817 4.1175468c.38616704.3857126 1.01187344.3861062 1.39846576-.0000311l4.12258202-4.1177306c.3861843-.3857298.3925462-1.0047669.0163644-1.380506-.3860905-.38563612-1.0101851-.38751563-1.4012233.0030624l-2.44985643 2.4469734v-8.67638639c0-.54139983-.43698413-.98042709-.98493125-.98159081l-7.89910525-.0043627c-.54516866 0-.98711517.44142642-.98711517.98595351s.44194651.98595351.98711517.98595351z" fill-rule="evenodd"/></symbol><symbol id="icon-arrow-up" viewBox="0 0 16 16"><path d="m12.716625 4.46975946-4.03074003-4.17620792c-.37758093-.39120768-.98937525-.39160691-1.367372.0000316l-4.03091981 4.1763942c-.37759778.39122514-.38381821 1.01908149-.01600053 1.40017357.37750607.39113012.98772445.3930364 1.37006824-.00310603l2.39538588-2.48183446v11.61478958l.00649339.1166211c.055753.4973387.46370161.8833789.95867408.8833789.49497246 0 .90292107-.3860402.95867408-.8833789l.00649338-.1166211v-11.61478958l2.39518592 2.4816273c.3791392.39282216.9863753.40056173 1.3541929.01946965.3775061-.39113012.3778444-1.02492687-.0001355-1.41654791z" fill-rule="evenodd"/></symbol><symbol id="icon-article" viewBox="0 0 18 18"><path d="m13 15v-12.9906311c0-.0073595-.0019884-.0093689.0014977-.0093689l-11.00158888.00087166v13.00506804c0 .5482678.44615281.9940603.99415146.9940603h10.27350412c-.1701701-.2941734-.2675644-.6357129-.2675644-1zm-12 .0059397v-13.00506804c0-.5562408.44704472-1.00087166.99850233-1.00087166h11.00299537c.5510129 0 .9985023.45190985.9985023 1.0093689v2.9906311h3v9.9914698c0 1.1065798-.8927712 2.0085302-1.9940603 2.0085302h-12.01187942c-1.09954652 0-1.99406028-.8927712-1.99406028-1.9940603zm13-9.0059397v9c0 .5522847.4477153 1 1 1s1-.4477153 1-1v-9zm-10-2h7v4h-7zm1 1v2h5v-2zm-1 4h7v1h-7zm0 2h7v1h-7zm0 2h7v1h-7z" fill-rule="evenodd"/></symbol><symbol id="icon-audio" viewBox="0 0 18 18"><path d="m13.0957477 13.5588459c-.195279.1937043-.5119137.193729-.7072234.0000551-.1953098-.193674-.1953346-.5077061-.0000556-.7014104 1.0251004-1.0168342 1.6108711-2.3905226 1.6108711-3.85745208 0-1.46604976-.5850634-2.83898246-1.6090736-3.85566829-.1951894-.19379323-.1950192-.50782531.0003802-.70141028.1953993-.19358497.512034-.19341614.7072234.00037709 1.2094886 1.20083761 1.901635 2.8250555 1.901635 4.55670148 0 1.73268608-.6929822 3.35779608-1.9037571 4.55880738zm2.1233994 2.1025159c-.195234.193749-.5118687.1938462-.7072235.0002171-.1953548-.1936292-.1954528-.5076613-.0002189-.7014104 1.5832215-1.5711805 2.4881302-3.6939808 2.4881302-5.96012998 0-2.26581266-.9046382-4.3883241-2.487443-5.95944795-.1952117-.19377107-.1950777-.50780316.0002993-.70141031s.5120117-.19347426.7072234.00029682c1.7683321 1.75528196 2.7800854 4.12911258 2.7800854 6.66056144 0 2.53182498-1.0120556 4.90597838-2.7808529 6.66132328zm-14.21898205-3.6854911c-.5523759 0-1.00016505-.4441085-1.00016505-.991944v-3.96777631c0-.54783558.44778915-.99194407 1.00016505-.99194407h2.0003301l5.41965617-3.8393633c.44948677-.31842296 1.07413994-.21516983 1.39520191.23062232.12116339.16823446.18629727.36981184.18629727.57655577v12.01603479c0 .5478356-.44778914.9919441-1.00016505.9919441-.20845738 0-.41170538-.0645985-.58133413-.184766l-5.41965617-3.8393633zm0-.991944h2.32084805l5.68047235 4.0241292v-12.01603479l-5.68047235 4.02412928h-2.32084805z" fill-rule="evenodd"/></symbol><symbol id="icon-block" viewBox="0 0 24 24"><path d="m0 0h24v24h-24z" fill-rule="evenodd"/></symbol><symbol id="icon-book" viewBox="0 0 18 18"><path d="m4 13v-11h1v11h11v-11h-13c-.55228475 0-1 .44771525-1 1v10.2675644c.29417337-.1701701.63571286-.2675644 1-.2675644zm12 1h-13c-.55228475 0-1 .4477153-1 1s.44771525 1 1 1h13zm0 3h-13c-1.1045695 0-2-.8954305-2-2v-12c0-1.1045695.8954305-2 2-2h13c.5522847 0 1 .44771525 1 1v14c0 .5522847-.4477153 1-1 1zm-8.5-13h6c.2761424 0 .5.22385763.5.5s-.2238576.5-.5.5h-6c-.27614237 0-.5-.22385763-.5-.5s.22385763-.5.5-.5zm1 2h4c.2761424 0 .5.22385763.5.5s-.2238576.5-.5.5h-4c-.27614237 0-.5-.22385763-.5-.5s.22385763-.5.5-.5z" fill-rule="evenodd"/></symbol><symbol id="icon-broad" viewBox="0 0 24 24"><path d="m9.18274226 7.81v7.7999954l2.48162734-2.4816273c.3928221-.3928221 1.0219731-.4005617 1.4030652-.0194696.3911301.3911301.3914806 1.0249268-.0001404 1.4165479l-4.17620796 4.1762079c-.39120769.3912077-1.02508144.3916069-1.41671995-.0000316l-4.1763942-4.1763942c-.39122514-.3912251-.39767006-1.0190815-.01657798-1.4001736.39113012-.3911301 1.02337106-.3930364 1.41951349.0031061l2.48183446 2.4818344v-8.7999954c0-.54911294.4426881-.99439484.99778758-.99557515l8.00221246-.00442485c.5522847 0 1 .44771525 1 1s-.4477153 1-1 1z" fill-rule="evenodd" transform="matrix(-1 0 0 -1 20.182742 24.805206)"/></symbol><symbol id="icon-calendar" viewBox="0 0 18 18"><path d="m12.5 0c.2761424 0 .5.21505737.5.49047852v.50952148h2c1.1072288 0 2 .89451376 2 2v12c0 1.1072288-.8945138 2-2 2h-12c-1.1072288 0-2-.8945138-2-2v-12c0-1.1072288.89451376-2 2-2h1v1h-1c-.55393837 0-1 .44579254-1 1v3h14v-3c0-.55393837-.4457925-1-1-1h-2v1.50952148c0 .27088381-.2319336.49047852-.5.49047852-.2761424 0-.5-.21505737-.5-.49047852v-3.01904296c0-.27088381.2319336-.49047852.5-.49047852zm3.5 7h-14v8c0 .5539384.44579254 1 1 1h12c.5539384 0 1-.4457925 1-1zm-11 6v1h-1v-1zm3 0v1h-1v-1zm3 0v1h-1v-1zm-6-2v1h-1v-1zm3 0v1h-1v-1zm6 0v1h-1v-1zm-3 0v1h-1v-1zm-3-2v1h-1v-1zm6 0v1h-1v-1zm-3 0v1h-1v-1zm-5.5-9c.27614237 0 .5.21505737.5.49047852v.50952148h5v1h-5v1.50952148c0 .27088381-.23193359.49047852-.5.49047852-.27614237 0-.5-.21505737-.5-.49047852v-3.01904296c0-.27088381.23193359-.49047852.5-.49047852z" fill-rule="evenodd"/></symbol><symbol id="icon-cart" viewBox="0 0 18 18"><path d="m5 14c1.1045695 0 2 .8954305 2 2s-.8954305 2-2 2-2-.8954305-2-2 .8954305-2 2-2zm10 0c1.1045695 0 2 .8954305 2 2s-.8954305 2-2 2-2-.8954305-2-2 .8954305-2 2-2zm-10 1c-.55228475 0-1 .4477153-1 1s.44771525 1 1 1 1-.4477153 1-1-.44771525-1-1-1zm10 0c-.5522847 0-1 .4477153-1 1s.4477153 1 1 1 1-.4477153 1-1-.4477153-1-1-1zm-12.82032249-15c.47691417 0 .88746157.33678127.98070211.80449199l.23823144 1.19501025 13.36277974.00045554c.5522847.00001882.9999659.44774934.9999659 1.00004222 0 .07084994-.0075361.14150708-.022474.2107727l-1.2908094 5.98534344c-.1007861.46742419-.5432548.80388386-1.0571651.80388386h-10.24805106c-.59173366 0-1.07142857.4477153-1.07142857 1 0 .5128358.41361449.9355072.94647737.9932723l.1249512.0067277h10.35933776c.2749512 0 .4979349.2228539.4979349.4978051 0 .2749417-.2227336.4978951-.4976753.4980063l-10.35959736.0041886c-1.18346732 0-2.14285714-.8954305-2.14285714-2 0-.6625717.34520317-1.24989198.87690425-1.61383592l-1.63768102-8.19004794c-.01312273-.06561364-.01950005-.131011-.0196107-.19547395l-1.71961253-.00064219c-.27614237 0-.5-.22385762-.5-.5 0-.27614237.22385763-.5.5-.5zm14.53193359 2.99950224h-13.11300004l1.20580469 6.02530174c.11024034-.0163252.22327998-.02480398.33844139-.02480398h10.27064786z"/></symbol><symbol id="icon-chevron-less" viewBox="0 0 10 10"><path d="m5.58578644 4-3.29289322-3.29289322c-.39052429-.39052429-.39052429-1.02368927 0-1.41421356s1.02368927-.39052429 1.41421356 0l4 4c.39052429.39052429.39052429 1.02368927 0 1.41421356l-4 4c-.39052429.39052429-1.02368927.39052429-1.41421356 0s-.39052429-1.02368927 0-1.41421356z" fill-rule="evenodd" transform="matrix(0 -1 -1 0 9 9)"/></symbol><symbol id="icon-chevron-more" viewBox="0 0 10 10"><path d="m5.58578644 6-3.29289322-3.29289322c-.39052429-.39052429-.39052429-1.02368927 0-1.41421356s1.02368927-.39052429 1.41421356 0l4 4c.39052429.39052429.39052429 1.02368927 0 1.41421356l-4 4.00000002c-.39052429.3905243-1.02368927.3905243-1.41421356 0s-.39052429-1.02368929 0-1.41421358z" fill-rule="evenodd" transform="matrix(0 1 -1 0 11 1)"/></symbol><symbol id="icon-chevron-right" viewBox="0 0 10 10"><path d="m5.96738168 4.70639573 2.39518594-2.41447274c.37913917-.38219212.98637524-.38972225 1.35419292-.01894278.37750606.38054586.37784436.99719163-.00013556 1.37821513l-4.03074001 4.06319683c-.37758093.38062133-.98937525.38100976-1.367372-.00003075l-4.03091981-4.06337806c-.37759778-.38063832-.38381821-.99150444-.01600053-1.3622839.37750607-.38054587.98772445-.38240057 1.37006824.00302197l2.39538588 2.4146743.96295325.98624457z" fill-rule="evenodd" transform="matrix(0 -1 1 0 0 10)"/></symbol><symbol id="icon-circle-fill" viewBox="0 0 16 16"><path d="m8 14c-3.3137085 0-6-2.6862915-6-6s2.6862915-6 6-6 6 2.6862915 6 6-2.6862915 6-6 6z" fill-rule="evenodd"/></symbol><symbol id="icon-circle" viewBox="0 0 16 16"><path d="m8 12c2.209139 0 4-1.790861 4-4s-1.790861-4-4-4-4 1.790861-4 4 1.790861 4 4 4zm0 2c-3.3137085 0-6-2.6862915-6-6s2.6862915-6 6-6 6 2.6862915 6 6-2.6862915 6-6 6z" fill-rule="evenodd"/></symbol><symbol id="icon-citation" viewBox="0 0 18 18"><path d="m8.63593473 5.99995183c2.20913897 0 3.99999997 1.79084375 3.99999997 3.99996146 0 1.40730761-.7267788 2.64486871-1.8254829 3.35783281 1.6240224.6764218 2.8754442 2.0093871 3.4610603 3.6412466l-1.0763845.000006c-.5310008-1.2078237-1.5108121-2.1940153-2.7691712-2.7181346l-.79002167-.329052v-1.023992l.63016577-.4089232c.8482885-.5504661 1.3698342-1.4895187 1.3698342-2.51898361 0-1.65683828-1.3431457-2.99996146-2.99999997-2.99996146-1.65685425 0-3 1.34312318-3 2.99996146 0 1.02946491.52154569 1.96851751 1.36983419 2.51898361l.63016581.4089232v1.023992l-.79002171.329052c-1.25835905.5241193-2.23817037 1.5103109-2.76917113 2.7181346l-1.07638453-.000006c.58561612-1.6318595 1.8370379-2.9648248 3.46106024-3.6412466-1.09870405-.7129641-1.82548287-1.9505252-1.82548287-3.35783281 0-2.20911771 1.790861-3.99996146 4-3.99996146zm7.36897597-4.99995183c1.1018574 0 1.9950893.89353404 1.9950893 2.00274083v5.994422c0 1.10608317-.8926228 2.00274087-1.9950893 2.00274087l-3.0049107-.0009037v-1l3.0049107.00091329c.5490631 0 .9950893-.44783123.9950893-1.00275046v-5.994422c0-.55646537-.4450595-1.00275046-.9950893-1.00275046h-14.00982141c-.54906309 0-.99508929.44783123-.99508929 1.00275046v5.9971821c0 .66666024.33333333.99999036 1 .99999036l2-.00091329v1l-2 .0009037c-1 0-2-.99999041-2-1.99998077v-5.9971821c0-1.10608322.8926228-2.00274083 1.99508929-2.00274083zm-8.5049107 2.9999711c.27614237 0 .5.22385547.5.5 0 .2761349-.22385763.5-.5.5h-4c-.27614237 0-.5-.2238651-.5-.5 0-.27614453.22385763-.5.5-.5zm3 0c.2761424 0 .5.22385547.5.5 0 .2761349-.2238576.5-.5.5h-1c-.27614237 0-.5-.2238651-.5-.5 0-.27614453.22385763-.5.5-.5zm4 0c.2761424 0 .5.22385547.5.5 0 .2761349-.2238576.5-.5.5h-2c-.2761424 0-.5-.2238651-.5-.5 0-.27614453.2238576-.5.5-.5z" fill-rule="evenodd"/></symbol><symbol id="icon-close" viewBox="0 0 16 16"><path d="m2.29679575 12.2772478c-.39658757.3965876-.39438847 1.0328109-.00062148 1.4265779.39651227.3965123 1.03246768.3934888 1.42657791-.0006214l4.27724782-4.27724787 4.2772478 4.27724787c.3965876.3965875 1.0328109.3943884 1.4265779.0006214.3965123-.3965122.3934888-1.0324677-.0006214-1.4265779l-4.27724787-4.2772478 4.27724787-4.27724782c.3965875-.39658757.3943884-1.03281091.0006214-1.42657791-.3965122-.39651226-1.0324677-.39348875-1.4265779.00062148l-4.2772478 4.27724782-4.27724782-4.27724782c-.39658757-.39658757-1.03281091-.39438847-1.42657791-.00062148-.39651226.39651227-.39348875 1.03246768.00062148 1.42657791l4.27724782 4.27724782z" fill-rule="evenodd"/></symbol><symbol id="icon-collections" viewBox="0 0 18 18"><path d="m15 4c1.1045695 0 2 .8954305 2 2v9c0 1.1045695-.8954305 2-2 2h-8c-1.1045695 0-2-.8954305-2-2h1c0 .5128358.38604019.9355072.88337887.9932723l.11662113.0067277h8c.5128358 0 .9355072-.3860402.9932723-.8833789l.0067277-.1166211v-9c0-.51283584-.3860402-.93550716-.8833789-.99327227l-.1166211-.00672773h-1v-1zm-4-3c1.1045695 0 2 .8954305 2 2v9c0 1.1045695-.8954305 2-2 2h-8c-1.1045695 0-2-.8954305-2-2v-9c0-1.1045695.8954305-2 2-2zm0 1h-8c-.51283584 0-.93550716.38604019-.99327227.88337887l-.00672773.11662113v9c0 .5128358.38604019.9355072.88337887.9932723l.11662113.0067277h8c.5128358 0 .9355072-.3860402.9932723-.8833789l.0067277-.1166211v-9c0-.51283584-.3860402-.93550716-.8833789-.99327227zm-1.5 7c.27614237 0 .5.22385763.5.5s-.22385763.5-.5.5h-5c-.27614237 0-.5-.22385763-.5-.5s.22385763-.5.5-.5zm0-2c.27614237 0 .5.22385763.5.5s-.22385763.5-.5.5h-5c-.27614237 0-.5-.22385763-.5-.5s.22385763-.5.5-.5zm0-2c.27614237 0 .5.22385763.5.5s-.22385763.5-.5.5h-5c-.27614237 0-.5-.22385763-.5-.5s.22385763-.5.5-.5z" fill-rule="evenodd"/></symbol><symbol id="icon-compare" viewBox="0 0 18 18"><path d="m12 3c3.3137085 0 6 2.6862915 6 6s-2.6862915 6-6 6c-1.0928452 0-2.11744941-.2921742-2.99996061-.8026704-.88181407.5102749-1.90678042.8026704-3.00003939.8026704-3.3137085 0-6-2.6862915-6-6s2.6862915-6 6-6c1.09325897 0 2.11822532.29239547 3.00096303.80325037.88158756-.51107621 1.90619177-.80325037 2.99903697-.80325037zm-6 1c-2.76142375 0-5 2.23857625-5 5 0 2.7614237 2.23857625 5 5 5 .74397391 0 1.44999672-.162488 2.08451611-.4539116-1.27652344-1.1000812-2.08451611-2.7287264-2.08451611-4.5460884s.80799267-3.44600721 2.08434391-4.5463015c-.63434719-.29121054-1.34037-.4536985-2.08434391-.4536985zm6 0c-.7439739 0-1.4499967.16248796-2.08451611.45391156 1.27652341 1.10008123 2.08451611 2.72872644 2.08451611 4.54608844s-.8079927 3.4460072-2.08434391 4.5463015c.63434721.2912105 1.34037001.4536985 2.08434391.4536985 2.7614237 0 5-2.2385763 5-5 0-2.76142375-2.2385763-5-5-5zm-1.4162763 7.0005324h-3.16744736c.15614659.3572676.35283837.6927622.58425872 1.0006671h1.99892988c.23142036-.3079049.42811216-.6433995.58425876-1.0006671zm.4162763-2.0005324h-4c0 .34288501.0345146.67770871.10025909 1.0011864h3.79948181c.0657445-.32347769.1002591-.65830139.1002591-1.0011864zm-.4158423-1.99953894h-3.16831543c-.13859957.31730812-.24521946.651783-.31578599.99935097h3.79988742c-.0705665-.34756797-.1771864-.68204285-.315786-.99935097zm-1.58295822-1.999926-.08316107.06199199c-.34550042.27081213-.65446126.58611297-.91825862.93727862h2.00044041c-.28418626-.37830727-.6207872-.71499149-.99902072-.99927061z" fill-rule="evenodd"/></symbol><symbol id="icon-download-file" viewBox="0 0 18 18"><path d="m10.0046024 0c.5497429 0 1.3179837.32258606 1.707238.71184039l4.5763192 4.57631922c.3931386.39313859.7118404 1.16760135.7118404 1.71431368v8.98899651c0 1.1092806-.8945138 2.0085302-1.9940603 2.0085302h-12.01187942c-1.10128908 0-1.99406028-.8926228-1.99406028-1.9950893v-14.00982141c0-1.10185739.88743329-1.99508929 1.99961498-1.99508929zm0 1h-7.00498742c-.55709576 0-.99961498.44271433-.99961498.99508929v14.00982141c0 .5500396.44491393.9950893.99406028.9950893h12.01187942c.5463747 0 .9940603-.4506622.9940603-1.0085302v-8.98899651c0-.28393444-.2150684-.80332809-.4189472-1.0072069l-4.5763192-4.57631922c-.2038461-.20384606-.718603-.41894717-1.0001312-.41894717zm-1.5046024 4c.27614237 0 .5.21637201.5.49209595v6.14827645l1.7462789-1.77990922c.1933927-.1971171.5125222-.19455839.7001689-.0069117.1932998.19329992.1910058.50899492-.0027774.70277812l-2.59089271 2.5908927c-.19483374.1948337-.51177825.1937771-.70556873-.0000133l-2.59099079-2.5909908c-.19484111-.1948411-.19043735-.5151448-.00279066-.70279146.19329987-.19329987.50465175-.19237083.70018565.00692852l1.74638684 1.78001764v-6.14827695c0-.27177709.23193359-.49209595.5-.49209595z" fill-rule="evenodd"/></symbol><symbol id="icon-download" viewBox="0 0 16 16"><path d="m12.9975267 12.999368c.5467123 0 1.0024733.4478567 1.0024733 1.000316 0 .5563109-.4488226 1.000316-1.0024733 1.000316h-9.99505341c-.54671233 0-1.00247329-.4478567-1.00247329-1.000316 0-.5563109.44882258-1.000316 1.00247329-1.000316zm-4.9975267-11.999368c.55228475 0 1 .44497754 1 .99589209v6.80214418l2.4816273-2.48241149c.3928222-.39294628 1.0219732-.4006883 1.4030652-.01947579.3911302.39125371.3914806 1.02525073-.0001404 1.41699553l-4.17620792 4.17752758c-.39120769.3913313-1.02508144.3917306-1.41671995-.0000316l-4.17639421-4.17771394c-.39122513-.39134876-.39767006-1.01940351-.01657797-1.40061601.39113012-.39125372 1.02337105-.3931606 1.41951349.00310701l2.48183446 2.48261871v-6.80214418c0-.55001601.44386482-.99589209 1-.99589209z" fill-rule="evenodd"/></symbol><symbol id="icon-editors" viewBox="0 0 18 18"><path d="m8.72592184 2.54588137c-.48811714-.34391207-1.08343326-.54588137-1.72592184-.54588137-1.65685425 0-3 1.34314575-3 3 0 1.02947485.5215457 1.96853646 1.3698342 2.51900785l.6301658.40892721v1.02400182l-.79002171.32905522c-1.93395773.8055207-3.20997829 2.7024791-3.20997829 4.8180274v.9009805h-1v-.9009805c0-2.5479714 1.54557359-4.79153984 3.82548288-5.7411543-1.09870406-.71297106-1.82548288-1.95054399-1.82548288-3.3578652 0-2.209139 1.790861-4 4-4 1.09079823 0 2.07961816.43662103 2.80122451 1.1446278-.37707584.09278571-.7373238.22835063-1.07530267.40125357zm-2.72592184 14.45411863h-1v-.9009805c0-2.5479714 1.54557359-4.7915398 3.82548288-5.7411543-1.09870406-.71297106-1.82548288-1.95054399-1.82548288-3.3578652 0-2.209139 1.790861-4 4-4s4 1.790861 4 4c0 1.40732121-.7267788 2.64489414-1.8254829 3.3578652 2.2799093.9496145 3.8254829 3.1931829 3.8254829 5.7411543v.9009805h-1v-.9009805c0-2.1155483-1.2760206-4.0125067-3.2099783-4.8180274l-.7900217-.3290552v-1.02400184l.6301658-.40892721c.8482885-.55047139 1.3698342-1.489533 1.3698342-2.51900785 0-1.65685425-1.3431458-3-3-3-1.65685425 0-3 1.34314575-3 3 0 1.02947485.5215457 1.96853646 1.3698342 2.51900785l.6301658.40892721v1.02400184l-.79002171.3290552c-1.93395773.8055207-3.20997829 2.7024791-3.20997829 4.8180274z" fill-rule="evenodd"/></symbol><symbol id="icon-email" viewBox="0 0 18 18"><path d="m16.0049107 2c1.1018574 0 1.9950893.89706013 1.9950893 2.00585866v9.98828264c0 1.1078052-.8926228 2.0058587-1.9950893 2.0058587h-14.00982141c-1.10185739 0-1.99508929-.8970601-1.99508929-2.0058587v-9.98828264c0-1.10780515.8926228-2.00585866 1.99508929-2.00585866zm0 1h-14.00982141c-.54871518 0-.99508929.44887827-.99508929 1.00585866v9.98828264c0 .5572961.44630695 1.0058587.99508929 1.0058587h14.00982141c.5487152 0 .9950893-.4488783.9950893-1.0058587v-9.98828264c0-.55729607-.446307-1.00585866-.9950893-1.00585866zm-.0049107 2.55749512v1.44250488l-7 4-7-4v-1.44250488l7 4z" fill-rule="evenodd"/></symbol><symbol id="icon-error" viewBox="0 0 18 18"><path d="m9 0c4.9705627 0 9 4.02943725 9 9 0 4.9705627-4.0294373 9-9 9-4.97056275 0-9-4.0294373-9-9 0-4.97056275 4.02943725-9 9-9zm2.8630343 4.71100931-2.8630343 2.86303426-2.86303426-2.86303426c-.39658757-.39658757-1.03281091-.39438847-1.4265779-.00062147-.39651227.39651226-.39348876 1.03246767.00062147 1.4265779l2.86303426 2.86303426-2.86303426 2.8630343c-.39658757.3965875-.39438847 1.0328109-.00062147 1.4265779.39651226.3965122 1.03246767.3934887 1.4265779-.0006215l2.86303426-2.8630343 2.8630343 2.8630343c.3965875.3965876 1.0328109.3943885 1.4265779.0006215.3965122-.3965123.3934887-1.0324677-.0006215-1.4265779l-2.8630343-2.8630343 2.8630343-2.86303426c.3965876-.39658757.3943885-1.03281091.0006215-1.4265779-.3965123-.39651227-1.0324677-.39348876-1.4265779.00062147z" fill-rule="evenodd"/></symbol><symbol id="icon-ethics" viewBox="0 0 18 18"><path d="m6.76384967 1.41421356.83301651-.8330165c.77492941-.77492941 2.03133823-.77492941 2.80626762 0l.8330165.8330165c.3750728.37507276.8837806.58578644 1.4142136.58578644h1.3496361c1.1045695 0 2 .8954305 2 2v1.34963611c0 .53043298.2107137 1.03914081.5857864 1.41421356l.8330165.83301651c.7749295.77492941.7749295 2.03133823 0 2.80626762l-.8330165.8330165c-.3750727.3750728-.5857864.8837806-.5857864 1.4142136v1.3496361c0 1.1045695-.8954305 2-2 2h-1.3496361c-.530433 0-1.0391408.2107137-1.4142136.5857864l-.8330165.8330165c-.77492939.7749295-2.03133821.7749295-2.80626762 0l-.83301651-.8330165c-.37507275-.3750727-.88378058-.5857864-1.41421356-.5857864h-1.34963611c-1.1045695 0-2-.8954305-2-2v-1.3496361c0-.530433-.21071368-1.0391408-.58578644-1.4142136l-.8330165-.8330165c-.77492941-.77492939-.77492941-2.03133821 0-2.80626762l.8330165-.83301651c.37507276-.37507275.58578644-.88378058.58578644-1.41421356v-1.34963611c0-1.1045695.8954305-2 2-2h1.34963611c.53043298 0 1.03914081-.21071368 1.41421356-.58578644zm-1.41421356 1.58578644h-1.34963611c-.55228475 0-1 .44771525-1 1v1.34963611c0 .79564947-.31607052 1.55871121-.87867966 2.12132034l-.8330165.83301651c-.38440512.38440512-.38440512 1.00764896 0 1.39205408l.8330165.83301646c.56260914.5626092.87867966 1.3256709.87867966 2.1213204v1.3496361c0 .5522847.44771525 1 1 1h1.34963611c.79564947 0 1.55871121.3160705 2.12132034.8786797l.83301651.8330165c.38440512.3844051 1.00764896.3844051 1.39205408 0l.83301646-.8330165c.5626092-.5626092 1.3256709-.8786797 2.1213204-.8786797h1.3496361c.5522847 0 1-.4477153 1-1v-1.3496361c0-.7956495.3160705-1.5587112.8786797-2.1213204l.8330165-.83301646c.3844051-.38440512.3844051-1.00764896 0-1.39205408l-.8330165-.83301651c-.5626092-.56260913-.8786797-1.32567087-.8786797-2.12132034v-1.34963611c0-.55228475-.4477153-1-1-1h-1.3496361c-.7956495 0-1.5587112-.31607052-2.1213204-.87867966l-.83301646-.8330165c-.38440512-.38440512-1.00764896-.38440512-1.39205408 0l-.83301651.8330165c-.56260913.56260914-1.32567087.87867966-2.12132034.87867966zm3.58698944 11.4960218c-.02081224.002155-.04199226.0030286-.06345763.002542-.98766446-.0223875-1.93408568-.3063547-2.75885125-.8155622-.23496767-.1450683-.30784554-.4531483-.16277726-.688116.14506827-.2349677.45314827-.3078455.68811595-.1627773.67447084.4164161 1.44758575.6483839 2.25617384.6667123.01759529.0003988.03495764.0017019.05204365.0038639.01713363-.0017748.03452416-.0026845.05212715-.0026845 2.4852814 0 4.5-2.0147186 4.5-4.5 0-1.04888973-.3593547-2.04134635-1.0074477-2.83787157-.1742817-.21419731-.1419238-.5291218.0722736-.70340353.2141973-.17428173.5291218-.14192375.7034035.07227357.7919032.97327203 1.2317706 2.18808682 1.2317706 3.46900153 0 3.0375661-2.4624339 5.5-5.5 5.5-.02146768 0-.04261937-.0013529-.06337445-.0039782zm1.57975095-10.78419583c.2654788.07599731.419084.35281842.3430867.61829728-.0759973.26547885-.3528185.419084-.6182973.3430867-.37560116-.10752146-.76586237-.16587951-1.15568824-.17249193-2.5587807-.00064534-4.58547766 2.00216524-4.58547766 4.49928198 0 .62691557.12797645 1.23496.37274865 1.7964426.11035133.2531347-.0053975.5477984-.25853224.6581497-.25313473.1103514-.54779841-.0053975-.65814974-.2585322-.29947131-.6869568-.45606667-1.43097603-.45606667-2.1960601 0-3.05211432 2.47714695-5.50006595 5.59399617-5.49921198.48576182.00815502.96289603.0795037 1.42238033.21103795zm-1.9766658 6.41091303 2.69835-2.94655317c.1788432-.21040373.4943901-.23598862.7047939-.05714545.2104037.17884318.2359886.49439014.0571454.70479387l-3.01637681 3.34277395c-.18039088.1999106-.48669547.2210637-.69285412.0478478l-1.93095347-1.62240047c-.21213845-.17678204-.24080048-.49206439-.06401844-.70420284.17678204-.21213844.49206439-.24080048.70420284-.06401844z" fill-rule="evenodd"/></symbol><symbol id="icon-expand"><path d="M7.498 11.918a.997.997 0 0 0-.003-1.411.995.995 0 0 0-1.412-.003l-4.102 4.102v-3.51A1 1 0 0 0 .98 10.09.992.992 0 0 0 0 11.092V17c0 .554.448 1.002 1.002 1.002h5.907c.554 0 1.002-.45 1.002-1.003 0-.539-.45-.978-1.006-.978h-3.51zm3.005-5.835a.997.997 0 0 0 .003 1.412.995.995 0 0 0 1.411.003l4.103-4.103v3.51a1 1 0 0 0 1.001 1.006A.992.992 0 0 0 18 6.91V1.002A1 1 0 0 0 17 0h-5.907a1.003 1.003 0 0 0-1.002 1.003c0 .539.45.978 1.006.978h3.51z" fill-rule="evenodd"/></symbol><symbol id="icon-explore" viewBox="0 0 18 18"><path d="m9 17c4.418278 0 8-3.581722 8-8s-3.581722-8-8-8-8 3.581722-8 8 3.581722 8 8 8zm0 1c-4.97056275 0-9-4.0294373-9-9 0-4.97056275 4.02943725-9 9-9 4.9705627 0 9 4.02943725 9 9 0 4.9705627-4.0294373 9-9 9zm0-2.5c-.27614237 0-.5-.2238576-.5-.5s.22385763-.5.5-.5c2.969509 0 5.400504-2.3575119 5.497023-5.31714844.0090007-.27599565.2400359-.49243782.5160315-.48343711.2759957.0090007.4924378.2400359.4834371.51603155-.114093 3.4985237-2.9869632 6.284554-6.4964916 6.284554zm-.29090657-12.99359748c.27587424-.01216621.50937715.20161139.52154336.47748563.01216621.27587423-.20161139.50937715-.47748563.52154336-2.93195733.12930094-5.25315116 2.54886451-5.25315116 5.49456849 0 .27614237-.22385763.5-.5.5s-.5-.22385763-.5-.5c0-3.48142406 2.74307146-6.34074398 6.20909343-6.49359748zm1.13784138 8.04763908-1.2004882-1.20048821c-.19526215-.19526215-.19526215-.51184463 0-.70710678s.51184463-.19526215.70710678 0l1.20048821 1.2004882 1.6006509-4.00162734-4.50670359 1.80268144-1.80268144 4.50670359zm4.10281269-6.50378907-2.6692597 6.67314927c-.1016411.2541026-.3029834.4554449-.557086.557086l-6.67314927 2.6692597 2.66925969-6.67314926c.10164107-.25410266.30298336-.45544495.55708602-.55708602z" fill-rule="evenodd"/></symbol><symbol id="icon-filter" viewBox="0 0 16 16"><path d="m14.9738641 0c.5667192 0 1.0261359.4477136 1.0261359 1 0 .24221858-.0902161.47620768-.2538899.65849851l-5.6938314 6.34147206v5.49997973c0 .3147562-.1520673.6111434-.4104543.7999971l-2.05227171 1.4999945c-.45337535.3313696-1.09655869.2418269-1.4365902-.1999993-.13321514-.1730955-.20522717-.3836284-.20522717-.5999978v-6.99997423l-5.69383133-6.34147206c-.3731872-.41563511-.32996891-1.0473954.09653074-1.41107611.18705584-.15950448.42716133-.2474224.67571519-.2474224zm-5.9218641 8.5h-2.105v6.491l.01238459.0070843.02053271.0015705.01955278-.0070558 2.0532976-1.4990996zm-8.02585008-7.5-.01564945.00240169 5.83249953 6.49759831h2.313l5.836-6.499z"/></symbol><symbol id="icon-home" viewBox="0 0 18 18"><path d="m9 5-6 6v5h4v-4h4v4h4v-5zm7 6.5857864v4.4142136c0 .5522847-.4477153 1-1 1h-5v-4h-2v4h-5c-.55228475 0-1-.4477153-1-1v-4.4142136c-.25592232 0-.51184464-.097631-.70710678-.2928932l-.58578644-.5857864c-.39052429-.3905243-.39052429-1.02368929 0-1.41421358l8.29289322-8.29289322 8.2928932 8.29289322c.3905243.39052429.3905243 1.02368928 0 1.41421358l-.5857864.5857864c-.1952622.1952622-.4511845.2928932-.7071068.2928932zm-7-9.17157284-7.58578644 7.58578644.58578644.5857864 7-6.99999996 7 6.99999996.5857864-.5857864z" fill-rule="evenodd"/></symbol><symbol id="icon-image" viewBox="0 0 18 18"><path d="m10.0046024 0c.5497429 0 1.3179837.32258606 1.707238.71184039l4.5763192 4.57631922c.3931386.39313859.7118404 1.16760135.7118404 1.71431368v8.98899651c0 1.1092806-.8945138 2.0085302-1.9940603 2.0085302h-12.01187942c-1.10128908 0-1.99406028-.8926228-1.99406028-1.9950893v-14.00982141c0-1.10185739.88743329-1.99508929 1.99961498-1.99508929zm-3.49645283 10.1752453-3.89407257 6.7495552c.11705545.048464.24538859.0751995.37998328.0751995h10.60290092l-2.4329715-4.2154691-1.57494129 2.7288098zm8.49779013 6.8247547c.5463747 0 .9940603-.4506622.9940603-1.0085302v-8.98899651c0-.28393444-.2150684-.80332809-.4189472-1.0072069l-4.5763192-4.57631922c-.2038461-.20384606-.718603-.41894717-1.0001312-.41894717h-7.00498742c-.55709576 0-.99961498.44271433-.99961498.99508929v13.98991071l4.50814957-7.81026689 3.08089884 5.33809539 1.57494129-2.7288097 3.5875735 6.2159812zm-3.0059397-11c1.1045695 0 2 .8954305 2 2s-.8954305 2-2 2-2-.8954305-2-2 .8954305-2 2-2zm0 1c-.5522847 0-1 .44771525-1 1s.4477153 1 1 1 1-.44771525 1-1-.4477153-1-1-1z" fill-rule="evenodd"/></symbol><symbol id="icon-info" viewBox="0 0 18 18"><path d="m9 0c4.9705627 0 9 4.02943725 9 9 0 4.9705627-4.0294373 9-9 9-4.97056275 0-9-4.0294373-9-9 0-4.97056275 4.02943725-9 9-9zm0 7h-1.5l-.11662113.00672773c-.49733868.05776511-.88337887.48043643-.88337887.99327227 0 .47338693.32893365.86994729.77070917.97358929l.1126697.01968298.11662113.00672773h.5v3h-.5l-.11662113.0067277c-.42082504.0488782-.76196299.3590206-.85696816.7639815l-.01968298.1126697-.00672773.1166211.00672773.1166211c.04887817.4208251.35902055.761963.76398144.8569682l.1126697.019683.11662113.0067277h3l.1166211-.0067277c.4973387-.0577651.8833789-.4804365.8833789-.9932723 0-.4733869-.3289337-.8699473-.7707092-.9735893l-.1126697-.019683-.1166211-.0067277h-.5v-4l-.00672773-.11662113c-.04887817-.42082504-.35902055-.76196299-.76398144-.85696816l-.1126697-.01968298zm0-3.25c-.69035594 0-1.25.55964406-1.25 1.25s.55964406 1.25 1.25 1.25 1.25-.55964406 1.25-1.25-.55964406-1.25-1.25-1.25z" fill-rule="evenodd"/></symbol><symbol id="icon-institution" viewBox="0 0 18 18"><path d="m7 16.9998189v-2.0003623h4v2.0003623h2v-3.0005434h-8v3.0005434zm-3-10.00181122h-1.52632364c-.27614237 0-.5-.22389817-.5-.50009056 0-.13995446.05863589-.27350497.16166338-.36820841l1.23156713-1.13206327h-2.36690687v12.00217346h3v-2.0003623h-3v-1.0001811h3v-1.0001811h1v-4.00072448h-1zm10 0v2.00036224h-1v4.00072448h1v1.0001811h3v1.0001811h-3v2.0003623h3v-12.00217346h-2.3695309l1.2315671 1.13206327c.2033191.186892.2166633.50325042.0298051.70660631-.0946863.10304615-.2282126.16169266-.3681417.16169266zm3-3.00054336c.5522847 0 1 .44779634 1 1.00018112v13.00235456h-18v-13.00235456c0-.55238478.44771525-1.00018112 1-1.00018112h3.45499992l4.20535144-3.86558216c.19129876-.17584288.48537447-.17584288.67667324 0l4.2053514 3.86558216zm-4 3.00054336h-8v1.00018112h8zm-2 6.00108672h1v-4.00072448h-1zm-1 0v-4.00072448h-2v4.00072448zm-3 0v-4.00072448h-1v4.00072448zm8-4.00072448c.5522847 0 1 .44779634 1 1.00018112v2.00036226h-2v-2.00036226c0-.55238478.4477153-1.00018112 1-1.00018112zm-12 0c.55228475 0 1 .44779634 1 1.00018112v2.00036226h-2v-2.00036226c0-.55238478.44771525-1.00018112 1-1.00018112zm5.99868798-7.81907007-5.24205601 4.81852671h10.48411203zm.00131202 3.81834559c-.55228475 0-1-.44779634-1-1.00018112s.44771525-1.00018112 1-1.00018112 1 .44779634 1 1.00018112-.44771525 1.00018112-1 1.00018112zm-1 11.00199236v1.0001811h2v-1.0001811z" fill-rule="evenodd"/></symbol><symbol id="icon-location" viewBox="0 0 18 18"><path d="m9.39521328 16.2688008c.79596342-.7770119 1.59208152-1.6299956 2.33285652-2.5295081 1.4020032-1.7024324 2.4323601-3.3624519 2.9354918-4.871847.2228715-.66861448.3364384-1.29323246.3364384-1.8674457 0-3.3137085-2.6862915-6-6-6-3.36356866 0-6 2.60156856-6 6 0 .57421324.11356691 1.19883122.3364384 1.8674457.50313169 1.5093951 1.53348863 3.1694146 2.93549184 4.871847.74077492.8995125 1.53689309 1.7524962 2.33285648 2.5295081.13694479.1336842.26895677.2602648.39521328.3793207.12625651-.1190559.25826849-.2456365.39521328-.3793207zm-.39521328 1.7311992s-7-6-7-11c0-4 3.13400675-7 7-7 3.8659932 0 7 3.13400675 7 7 0 5-7 11-7 11zm0-8c-1.65685425 0-3-1.34314575-3-3s1.34314575-3 3-3c1.6568542 0 3 1.34314575 3 3s-1.3431458 3-3 3zm0-1c1.1045695 0 2-.8954305 2-2s-.8954305-2-2-2-2 .8954305-2 2 .8954305 2 2 2z" fill-rule="evenodd"/></symbol><symbol id="icon-minus" viewBox="0 0 16 16"><path d="m2.00087166 7h11.99825664c.5527662 0 1.0008717.44386482 1.0008717 1 0 .55228475-.4446309 1-1.0008717 1h-11.99825664c-.55276616 0-1.00087166-.44386482-1.00087166-1 0-.55228475.44463086-1 1.00087166-1z" fill-rule="evenodd"/></symbol><symbol id="icon-newsletter" viewBox="0 0 18 18"><path d="m9 11.8482489 2-1.1428571v-1.7053918h-4v1.7053918zm-3-1.7142857v-2.1339632h6v2.1339632l3-1.71428574v-6.41967746h-12v6.41967746zm10-5.3839632 1.5299989.95624934c.2923814.18273835.4700011.50320827.4700011.8479983v8.44575236c0 1.1045695-.8954305 2-2 2h-14c-1.1045695 0-2-.8954305-2-2v-8.44575236c0-.34479003.1776197-.66525995.47000106-.8479983l1.52999894-.95624934v-2.75c0-.55228475.44771525-1 1-1h12c.5522847 0 1 .44771525 1 1zm0 1.17924764v3.07075236l-7 4-7-4v-3.07075236l-1 .625v8.44575236c0 .5522847.44771525 1 1 1h14c.5522847 0 1-.4477153 1-1v-8.44575236zm-10-1.92924764h6v1h-6zm-1 2h8v1h-8z" fill-rule="evenodd"/></symbol><symbol id="icon-orcid" viewBox="0 0 18 18"><path d="m9 1c4.418278 0 8 3.581722 8 8s-3.581722 8-8 8-8-3.581722-8-8 3.581722-8 8-8zm-2.90107518 5.2732337h-1.41865256v7.1712107h1.41865256zm4.55867178.02508949h-2.99247027v7.14612121h2.91062487c.7673039 0 1.4476365-.1483432 2.0410182-.445034s1.0511995-.7152915 1.3734671-1.2558144c.3222677-.540523.4833991-1.1603247.4833991-1.85942385 0-.68545815-.1602789-1.30270225-.4808414-1.85175082-.3205625-.54904856-.7707074-.97532211-1.3504481-1.27883343-.5797408-.30351132-1.2413173-.45526471-1.9847495-.45526471zm-.1892674 1.07933542c.7877654 0 1.4143875.22336734 1.8798852.67010873.4654977.44674138.698243 1.05546001.698243 1.82617415 0 .74343221-.2310402 1.34447791-.6931277 1.80315511-.4620874.4586773-1.0750688.6880124-1.8389625.6880124h-1.46810075v-4.98745039zm-5.08652545-3.71099194c-.21825533 0-.410525.08444276-.57681478.25333081-.16628977.16888806-.24943341.36245684-.24943341.58071218 0 .22345188.08314364.41961891.24943341.58850696.16628978.16888806.35855945.25333082.57681478.25333082.233845 0 .43390938-.08314364.60019916-.24943342.16628978-.16628977.24943342-.36375592.24943342-.59240436 0-.233845-.08314364-.43131115-.24943342-.59240437s-.36635416-.24163862-.60019916-.24163862z" fill-rule="evenodd"/></symbol><symbol id="icon-plus" viewBox="0 0 16 16"><path d="m2.00087166 7h4.99912834v-4.99912834c0-.55276616.44386482-1.00087166 1-1.00087166.55228475 0 1 .44463086 1 1.00087166v4.99912834h4.9991283c.5527662 0 1.0008717.44386482 1.0008717 1 0 .55228475-.4446309 1-1.0008717 1h-4.9991283v4.9991283c0 .5527662-.44386482 1.0008717-1 1.0008717-.55228475 0-1-.4446309-1-1.0008717v-4.9991283h-4.99912834c-.55276616 0-1.00087166-.44386482-1.00087166-1 0-.55228475.44463086-1 1.00087166-1z" fill-rule="evenodd"/></symbol><symbol id="icon-print" viewBox="0 0 18 18"><path d="m16.0049107 5h-14.00982141c-.54941618 0-.99508929.4467783-.99508929.99961498v6.00077002c0 .5570958.44271433.999615.99508929.999615h1.00491071v-3h12v3h1.0049107c.5494162 0 .9950893-.4467783.9950893-.999615v-6.00077002c0-.55709576-.4427143-.99961498-.9950893-.99961498zm-2.0049107-1v-2.00208688c0-.54777062-.4519464-.99791312-1.0085302-.99791312h-7.9829396c-.55661731 0-1.0085302.44910695-1.0085302.99791312v2.00208688zm1 10v2.0018986c0 1.103521-.9019504 1.9981014-2.0085302 1.9981014h-7.9829396c-1.1092806 0-2.0085302-.8867064-2.0085302-1.9981014v-2.0018986h-1.00491071c-1.10185739 0-1.99508929-.8874333-1.99508929-1.999615v-6.00077002c0-1.10435686.8926228-1.99961498 1.99508929-1.99961498h1.00491071v-2.00208688c0-1.10341695.90195036-1.99791312 2.0085302-1.99791312h7.9829396c1.1092806 0 2.0085302.89826062 2.0085302 1.99791312v2.00208688h1.0049107c1.1018574 0 1.9950893.88743329 1.9950893 1.99961498v6.00077002c0 1.1043569-.8926228 1.999615-1.9950893 1.999615zm-1-3h-10v5.0018986c0 .5546075.44702548.9981014 1.0085302.9981014h7.9829396c.5565964 0 1.0085302-.4491701 1.0085302-.9981014zm-9 1h8v1h-8zm0 2h5v1h-5zm9-5c-.5522847 0-1-.44771525-1-1s.4477153-1 1-1 1 .44771525 1 1-.4477153 1-1 1z" fill-rule="evenodd"/></symbol><symbol id="icon-search" viewBox="0 0 22 22"><path d="M21.697 20.261a1.028 1.028 0 01.01 1.448 1.034 1.034 0 01-1.448-.01l-4.267-4.267A9.812 9.811 0 010 9.812a9.812 9.811 0 1117.43 6.182zM9.812 18.222A8.41 8.41 0 109.81 1.403a8.41 8.41 0 000 16.82z" fill-rule="evenodd"/></symbol><symbol id="icon-social-facebook" viewBox="0 0 24 24"><path d="m6.00368507 20c-1.10660471 0-2.00368507-.8945138-2.00368507-1.9940603v-12.01187942c0-1.10128908.89451376-1.99406028 1.99406028-1.99406028h12.01187942c1.1012891 0 1.9940603.89451376 1.9940603 1.99406028v12.01187942c0 1.1012891-.88679 1.9940603-2.0032184 1.9940603h-2.9570132v-6.1960818h2.0797387l.3114113-2.414723h-2.39115v-1.54164807c0-.69911803.1941355-1.1755439 1.1966615-1.1755439l1.2786739-.00055875v-2.15974763l-.2339477-.02492088c-.3441234-.03134957-.9500153-.07025255-1.6293054-.07025255-1.8435726 0-3.1057323 1.12531866-3.1057323 3.19187953v1.78079225h-2.0850778v2.414723h2.0850778v6.1960818z" fill-rule="evenodd"/></symbol><symbol id="icon-social-twitter" viewBox="0 0 24 24"><path d="m18.8767135 6.87445248c.7638174-.46908424 1.351611-1.21167363 1.6250764-2.09636345-.7135248.43394112-1.50406.74870123-2.3464594.91677702-.6695189-.73342162-1.6297913-1.19486605-2.6922204-1.19486605-2.0399895 0-3.6933555 1.69603749-3.6933555 3.78628909 0 .29642457.0314329.58673729.0942985.8617704-3.06469922-.15890802-5.78835241-1.66547825-7.60988389-3.9574208-.3174714.56076194-.49978171 1.21167363-.49978171 1.90536824 0 1.31404706.65223085 2.47224203 1.64236444 3.15218497-.60350999-.0198635-1.17401554-.1925232-1.67222562-.47366811v.04583885c0 1.83355406 1.27302891 3.36609966 2.96411421 3.71294696-.31118484.0886217-.63651445.1329326-.97441718.1329326-.2357461 0-.47149219-.0229194-.69466516-.0672303.47149219 1.5065703 1.83253297 2.6036468 3.44975116 2.632678-1.2651707 1.0160946-2.85724264 1.6196394-4.5891906 1.6196394-.29861172 0-.59093688-.0152796-.88011875-.0504227 1.63450624 1.0726291 3.57548241 1.6990934 5.66104951 1.6990934 6.79263079 0 10.50641749-5.7711113 10.50641749-10.7751859l-.0094298-.48894775c.7229547-.53478659 1.3516109-1.20250585 1.8419628-1.96190282-.6632323.30100846-1.3751855.50422736-2.1217148.59590507z" fill-rule="evenodd"/></symbol><symbol id="icon-social-youtube" viewBox="0 0 24 24"><path d="m10.1415 14.3973208-.0005625-5.19318431 4.863375 2.60554491zm9.963-7.92753362c-.6845625-.73643756-1.4518125-.73990314-1.803375-.7826454-2.518875-.18714178-6.2971875-.18714178-6.2971875-.18714178-.007875 0-3.7861875 0-6.3050625.18714178-.352125.04274226-1.1188125.04620784-1.8039375.7826454-.5394375.56084773-.7149375 1.8344515-.7149375 1.8344515s-.18 1.49597903-.18 2.99138042v1.4024082c0 1.495979.18 2.9913804.18 2.9913804s.1755 1.2736038.7149375 1.8344515c.685125.7364376 1.5845625.7133337 1.9850625.7901542 1.44.1420891 6.12.1859866 6.12.1859866s3.78225-.005776 6.301125-.1929178c.3515625-.0433198 1.1188125-.0467854 1.803375-.783223.5394375-.5608477.7155-1.8344515.7155-1.8344515s.18-1.4954014.18-2.9913804v-1.4024082c0-1.49540139-.18-2.99138042-.18-2.99138042s-.1760625-1.27360377-.7155-1.8344515z" fill-rule="evenodd"/></symbol><symbol id="icon-subject-medicine" viewBox="0 0 18 18"><path d="m12.5 8h-6.5c-1.65685425 0-3 1.34314575-3 3v1c0 1.6568542 1.34314575 3 3 3h1v-2h-.5c-.82842712 0-1.5-.6715729-1.5-1.5s.67157288-1.5 1.5-1.5h1.5 2 1 2c1.6568542 0 3-1.34314575 3-3v-1c0-1.65685425-1.3431458-3-3-3h-2v2h1.5c.8284271 0 1.5.67157288 1.5 1.5s-.6715729 1.5-1.5 1.5zm-5.5-1v-1h-3.5c-1.38071187 0-2.5-1.11928813-2.5-2.5s1.11928813-2.5 2.5-2.5h1.02786405c.46573528 0 .92507448.10843528 1.34164078.31671843l1.13382424.56691212c.06026365-1.05041141.93116291-1.88363055 1.99667093-1.88363055 1.1045695 0 2 .8954305 2 2h2c2.209139 0 4 1.790861 4 4v1c0 2.209139-1.790861 4-4 4h-2v1h2c1.1045695 0 2 .8954305 2 2s-.8954305 2-2 2h-2c0 1.1045695-.8954305 2-2 2s-2-.8954305-2-2h-1c-2.209139 0-4-1.790861-4-4v-1c0-2.209139 1.790861-4 4-4zm0-2v-2.05652691c-.14564246-.03538148-.28733393-.08714006-.42229124-.15461871l-1.15541752-.57770876c-.27771087-.13885544-.583937-.21114562-.89442719-.21114562h-1.02786405c-.82842712 0-1.5.67157288-1.5 1.5s.67157288 1.5 1.5 1.5zm4 1v1h1.5c.2761424 0 .5-.22385763.5-.5s-.2238576-.5-.5-.5zm-1 1v-5c0-.55228475-.44771525-1-1-1s-1 .44771525-1 1v5zm-2 4v5c0 .5522847.44771525 1 1 1s1-.4477153 1-1v-5zm3 2v2h2c.5522847 0 1-.4477153 1-1s-.4477153-1-1-1zm-4-1v-1h-.5c-.27614237 0-.5.2238576-.5.5s.22385763.5.5.5zm-3.5-9h1c.27614237 0 .5.22385763.5.5s-.22385763.5-.5.5h-1c-.27614237 0-.5-.22385763-.5-.5s.22385763-.5.5-.5z" fill-rule="evenodd"/></symbol><symbol id="icon-success" viewBox="0 0 18 18"><path d="m9 0c4.9705627 0 9 4.02943725 9 9 0 4.9705627-4.0294373 9-9 9-4.97056275 0-9-4.0294373-9-9 0-4.97056275 4.02943725-9 9-9zm3.4860198 4.98163161-4.71802968 5.50657859-2.62834168-2.02300024c-.42862421-.36730544-1.06564993-.30775346-1.42283677.13301307-.35718685.44076653-.29927542 1.0958383.12934879 1.46314377l3.40735508 2.7323063c.42215801.3385221 1.03700951.2798252 1.38749189-.1324571l5.38450527-6.33394549c.3613513-.43716226.3096573-1.09278382-.115462-1.46437175-.4251192-.37158792-1.0626796-.31842941-1.4240309.11873285z" fill-rule="evenodd"/></symbol><symbol id="icon-table" viewBox="0 0 18 18"><path d="m16.0049107 2c1.1018574 0 1.9950893.89706013 1.9950893 2.00585866v9.98828264c0 1.1078052-.8926228 2.0058587-1.9950893 2.0058587l-4.0059107-.001.001.001h-1l-.001-.001h-5l.001.001h-1l-.001-.001-3.00391071.001c-1.10185739 0-1.99508929-.8970601-1.99508929-2.0058587v-9.98828264c0-1.10780515.8926228-2.00585866 1.99508929-2.00585866zm-11.0059107 5h-3.999v6.9941413c0 .5572961.44630695 1.0058587.99508929 1.0058587h3.00391071zm6 0h-5v8h5zm5.0059107-4h-4.0059107v3h5.001v1h-5.001v7.999l4.0059107.001c.5487152 0 .9950893-.4488783.9950893-1.0058587v-9.98828264c0-.55729607-.446307-1.00585866-.9950893-1.00585866zm-12.5049107 9c.27614237 0 .5.2238576.5.5s-.22385763.5-.5.5h-1c-.27614237 0-.5-.2238576-.5-.5s.22385763-.5.5-.5zm12 0c.2761424 0 .5.2238576.5.5s-.2238576.5-.5.5h-2c-.2761424 0-.5-.2238576-.5-.5s.2238576-.5.5-.5zm-6 0c.27614237 0 .5.2238576.5.5s-.22385763.5-.5.5h-2c-.27614237 0-.5-.2238576-.5-.5s.22385763-.5.5-.5zm-6-2c.27614237 0 .5.2238576.5.5s-.22385763.5-.5.5h-1c-.27614237 0-.5-.2238576-.5-.5s.22385763-.5.5-.5zm12 0c.2761424 0 .5.2238576.5.5s-.2238576.5-.5.5h-2c-.2761424 0-.5-.2238576-.5-.5s.2238576-.5.5-.5zm-6 0c.27614237 0 .5.2238576.5.5s-.22385763.5-.5.5h-2c-.27614237 0-.5-.2238576-.5-.5s.22385763-.5.5-.5zm-6-2c.27614237 0 .5.22385763.5.5s-.22385763.5-.5.5h-1c-.27614237 0-.5-.22385763-.5-.5s.22385763-.5.5-.5zm12 0c.2761424 0 .5.22385763.5.5s-.2238576.5-.5.5h-2c-.2761424 0-.5-.22385763-.5-.5s.2238576-.5.5-.5zm-6 0c.27614237 0 .5.22385763.5.5s-.22385763.5-.5.5h-2c-.27614237 0-.5-.22385763-.5-.5s.22385763-.5.5-.5zm1.499-5h-5v3h5zm-6 0h-3.00391071c-.54871518 0-.99508929.44887827-.99508929 1.00585866v1.99414134h3.999z" fill-rule="evenodd"/></symbol><symbol id="icon-tick-circle" viewBox="0 0 24 24"><path d="m12 2c5.5228475 0 10 4.4771525 10 10s-4.4771525 10-10 10-10-4.4771525-10-10 4.4771525-10 10-10zm0 1c-4.97056275 0-9 4.02943725-9 9 0 4.9705627 4.02943725 9 9 9 4.9705627 0 9-4.0294373 9-9 0-4.97056275-4.0294373-9-9-9zm4.2199868 5.36606669c.3613514-.43716226.9989118-.49032077 1.424031-.11873285s.4768133 1.02720949.115462 1.46437175l-6.093335 6.94397871c-.3622945.4128716-.9897871.4562317-1.4054264.0971157l-3.89719065-3.3672071c-.42862421-.3673054-.48653564-1.0223772-.1293488-1.4631437s.99421256-.5003185 1.42283677-.1330131l3.11097438 2.6987741z" fill-rule="evenodd"/></symbol><symbol id="icon-tick" viewBox="0 0 16 16"><path d="m6.76799012 9.21106946-3.1109744-2.58349728c-.42862421-.35161617-1.06564993-.29460792-1.42283677.12733148s-.29927541 1.04903009.1293488 1.40064626l3.91576307 3.23873978c.41034319.3393961 1.01467563.2976897 1.37450571-.0948578l6.10568327-6.660841c.3613513-.41848908.3096572-1.04610608-.115462-1.4018218-.4251192-.35571573-1.0626796-.30482786-1.424031.11366122z" fill-rule="evenodd"/></symbol><symbol id="icon-update" viewBox="0 0 18 18"><path d="m1 13v1c0 .5522847.44771525 1 1 1h14c.5522847 0 1-.4477153 1-1v-1h-1v-10h-14v10zm16-1h1v2c0 1.1045695-.8954305 2-2 2h-14c-1.1045695 0-2-.8954305-2-2v-2h1v-9c0-.55228475.44771525-1 1-1h14c.5522847 0 1 .44771525 1 1zm-1 0v1h-4.5857864l-1 1h-2.82842716l-1-1h-4.58578644v-1h5l1 1h2l1-1zm-13-8h12v7h-12zm1 1v5h10v-5zm1 1h4v1h-4zm0 2h4v1h-4z" fill-rule="evenodd"/></symbol><symbol id="icon-upload" viewBox="0 0 18 18"><path d="m10.0046024 0c.5497429 0 1.3179837.32258606 1.707238.71184039l4.5763192 4.57631922c.3931386.39313859.7118404 1.16760135.7118404 1.71431368v8.98899651c0 1.1092806-.8945138 2.0085302-1.9940603 2.0085302h-12.01187942c-1.10128908 0-1.99406028-.8926228-1.99406028-1.9950893v-14.00982141c0-1.10185739.88743329-1.99508929 1.99961498-1.99508929zm0 1h-7.00498742c-.55709576 0-.99961498.44271433-.99961498.99508929v14.00982141c0 .5500396.44491393.9950893.99406028.9950893h12.01187942c.5463747 0 .9940603-.4506622.9940603-1.0085302v-8.98899651c0-.28393444-.2150684-.80332809-.4189472-1.0072069l-4.5763192-4.57631922c-.2038461-.20384606-.718603-.41894717-1.0001312-.41894717zm-1.85576936 4.14572769c.19483374-.19483375.51177826-.19377714.70556874.00001334l2.59099082 2.59099079c.1948411.19484112.1904373.51514474.0027906.70279143-.1932998.19329987-.5046517.19237083-.7001856-.00692852l-1.74638687-1.7800176v6.14827687c0 .2717771-.23193359.492096-.5.492096-.27614237 0-.5-.216372-.5-.492096v-6.14827641l-1.74627892 1.77990922c-.1933927.1971171-.51252214.19455839-.70016883.0069117-.19329987-.19329988-.19100584-.50899493.00277731-.70277808z" fill-rule="evenodd"/></symbol><symbol id="icon-video" viewBox="0 0 18 18"><path d="m16.0049107 2c1.1018574 0 1.9950893.89706013 1.9950893 2.00585866v9.98828264c0 1.1078052-.8926228 2.0058587-1.9950893 2.0058587h-14.00982141c-1.10185739 0-1.99508929-.8970601-1.99508929-2.0058587v-9.98828264c0-1.10780515.8926228-2.00585866 1.99508929-2.00585866zm0 1h-14.00982141c-.54871518 0-.99508929.44887827-.99508929 1.00585866v9.98828264c0 .5572961.44630695 1.0058587.99508929 1.0058587h14.00982141c.5487152 0 .9950893-.4488783.9950893-1.0058587v-9.98828264c0-.55729607-.446307-1.00585866-.9950893-1.00585866zm-8.30912922 2.24944486 4.60460462 2.73982242c.9365543.55726659.9290753 1.46522435 0 2.01804082l-4.60460462 2.7398224c-.93655425.5572666-1.69578148.1645632-1.69578148-.8937585v-5.71016863c0-1.05087579.76670616-1.446575 1.69578148-.89375851zm-.67492769.96085624v5.5750128c0 .2995102-.10753745.2442517.16578928.0847713l4.58452283-2.67497259c.3050619-.17799716.3051624-.21655446 0-.39461026l-4.58452283-2.67497264c-.26630747-.15538481-.16578928-.20699944-.16578928.08477139z" fill-rule="evenodd"/></symbol><symbol id="icon-warning" viewBox="0 0 18 18"><path d="m9 11.75c.69035594 0 1.25.5596441 1.25 1.25s-.55964406 1.25-1.25 1.25-1.25-.5596441-1.25-1.25.55964406-1.25 1.25-1.25zm.41320045-7.75c.55228475 0 1.00000005.44771525 1.00000005 1l-.0034543.08304548-.3333333 4c-.043191.51829212-.47645714.91695452-.99654578.91695452h-.15973424c-.52008864 0-.95335475-.3986624-.99654576-.91695452l-.33333333-4c-.04586475-.55037702.36312325-1.03372649.91350028-1.07959124l.04148683-.00259031zm-.41320045 14c-4.97056275 0-9-4.0294373-9-9 0-4.97056275 4.02943725-9 9-9 4.9705627 0 9 4.02943725 9 9 0 4.9705627-4.0294373 9-9 9z" fill-rule="evenodd"/></symbol><symbol id="icon-checklist-banner" viewBox="0 0 56.69 56.69"><path style="fill:none" d="M0 0h56.69v56.69H0z"/><clipPath id="b"><use xlink:href="#a" style="overflow:visible"/></clipPath><path d="M21.14 34.46c0-6.77 5.48-12.26 12.24-12.26s12.24 5.49 12.24 12.26-5.48 12.26-12.24 12.26c-6.76-.01-12.24-5.49-12.24-12.26zm19.33 10.66 10.23 9.22s1.21 1.09 2.3-.12l2.09-2.32s1.09-1.21-.12-2.3l-10.23-9.22m-19.29-5.92c0-4.38 3.55-7.94 7.93-7.94s7.93 3.55 7.93 7.94c0 4.38-3.55 7.94-7.93 7.94-4.38-.01-7.93-3.56-7.93-7.94zm17.58 12.99 4.14-4.81" style="clip-path:url(#b);fill:none;stroke:#01324b;stroke-width:2;stroke-linecap:round"/><path d="M8.26 9.75H28.6M8.26 15.98H28.6m-20.34 6.2h12.5m14.42-5.2V4.86s0-2.93-2.93-2.93H4.13s-2.93 0-2.93 2.93v37.57s0 2.93 2.93 2.93h15.01M8.26 9.75H28.6M8.26 15.98H28.6m-20.34 6.2h12.5" style="clip-path:url(#b);fill:none;stroke:#01324b;stroke-width:2;stroke-linecap:round;stroke-linejoin:round"/></symbol><symbol id="icon-chevron-down" viewBox="0 0 16 16"><path d="m5.58578644 3-3.29289322-3.29289322c-.39052429-.39052429-.39052429-1.02368927 0-1.41421356s1.02368927-.39052429 1.41421356 0l4 4c.39052429.39052429.39052429 1.02368927 0 1.41421356l-4 4c-.39052429.39052429-1.02368927.39052429-1.41421356 0s-.39052429-1.02368927 0-1.41421356z" fill-rule="evenodd" transform="matrix(0 1 -1 0 11 1)"/></symbol><symbol id="icon-eds-i-arrow-right-medium" viewBox="0 0 24 24"><path d="m12.728 3.293 7.98 7.99a.996.996 0 0 1 .281.561l.011.157c0 .32-.15.605-.384.788l-7.908 7.918a1 1 0 0 1-1.416-1.414L17.576 13H4a1 1 0 0 1 0-2h13.598l-6.285-6.293a1 1 0 0 1-.082-1.32l.083-.095a1 1 0 0 1 1.414.001Z"/></symbol><symbol id="icon-eds-i-chevron-down-medium" viewBox="0 0 16 16"><path d="m2.00087166 7h4.99912834v-4.99912834c0-.55276616.44386482-1.00087166 1-1.00087166.55228475 0 1 .44463086 1 1.00087166v4.99912834h4.9991283c.5527662 0 1.0008717.44386482 1.0008717 1 0 .55228475-.4446309 1-1.0008717 1h-4.9991283v4.9991283c0 .5527662-.44386482 1.0008717-1 1.0008717-.55228475 0-1-.4446309-1-1.0008717v-4.9991283h-4.99912834c-.55276616 0-1.00087166-.44386482-1.00087166-1 0-.55228475.44463086-1 1.00087166-1z" fill-rule="evenodd"/></symbol><symbol id="icon-eds-i-chevron-down-small" viewBox="0 0 16 16"><path d="M13.692 5.278a1 1 0 0 1 .03 1.414L9.103 11.51a1.491 1.491 0 0 1-2.188.019L2.278 6.692a1 1 0 0 1 1.444-1.384L8 9.771l4.278-4.463a1 1 0 0 1 1.318-.111l.096.081Z"/></symbol><symbol id="icon-eds-i-chevron-right-medium" viewBox="0 0 10 10"><path d="m5.96738168 4.70639573 2.39518594-2.41447274c.37913917-.38219212.98637524-.38972225 1.35419292-.01894278.37750606.38054586.37784436.99719163-.00013556 1.37821513l-4.03074001 4.06319683c-.37758093.38062133-.98937525.38100976-1.367372-.00003075l-4.03091981-4.06337806c-.37759778-.38063832-.38381821-.99150444-.01600053-1.3622839.37750607-.38054587.98772445-.38240057 1.37006824.00302197l2.39538588 2.4146743.96295325.98624457z" fill-rule="evenodd" transform="matrix(0 -1 1 0 0 10)"/></symbol><symbol id="icon-eds-i-chevron-right-small" viewBox="0 0 10 10"><path d="m5.96738168 4.70639573 2.39518594-2.41447274c.37913917-.38219212.98637524-.38972225 1.35419292-.01894278.37750606.38054586.37784436.99719163-.00013556 1.37821513l-4.03074001 4.06319683c-.37758093.38062133-.98937525.38100976-1.367372-.00003075l-4.03091981-4.06337806c-.37759778-.38063832-.38381821-.99150444-.01600053-1.3622839.37750607-.38054587.98772445-.38240057 1.37006824.00302197l2.39538588 2.4146743.96295325.98624457z" fill-rule="evenodd" transform="matrix(0 -1 1 0 0 10)"/></symbol><symbol id="icon-eds-i-chevron-up-medium" viewBox="0 0 16 16"><path d="m2.00087166 7h11.99825664c.5527662 0 1.0008717.44386482 1.0008717 1 0 .55228475-.4446309 1-1.0008717 1h-11.99825664c-.55276616 0-1.00087166-.44386482-1.00087166-1 0-.55228475.44463086-1 1.00087166-1z" fill-rule="evenodd"/></symbol><symbol id="icon-eds-i-close-medium" viewBox="0 0 16 16"><path d="m2.29679575 12.2772478c-.39658757.3965876-.39438847 1.0328109-.00062148 1.4265779.39651227.3965123 1.03246768.3934888 1.42657791-.0006214l4.27724782-4.27724787 4.2772478 4.27724787c.3965876.3965875 1.0328109.3943884 1.4265779.0006214.3965123-.3965122.3934888-1.0324677-.0006214-1.4265779l-4.27724787-4.2772478 4.27724787-4.27724782c.3965875-.39658757.3943884-1.03281091.0006214-1.42657791-.3965122-.39651226-1.0324677-.39348875-1.4265779.00062148l-4.2772478 4.27724782-4.27724782-4.27724782c-.39658757-.39658757-1.03281091-.39438847-1.42657791-.00062148-.39651226.39651227-.39348875 1.03246768.00062148 1.42657791l4.27724782 4.27724782z" fill-rule="evenodd"/></symbol><symbol id="icon-eds-i-download-medium" viewBox="0 0 16 16"><path d="m12.9975267 12.999368c.5467123 0 1.0024733.4478567 1.0024733 1.000316 0 .5563109-.4488226 1.000316-1.0024733 1.000316h-9.99505341c-.54671233 0-1.00247329-.4478567-1.00247329-1.000316 0-.5563109.44882258-1.000316 1.00247329-1.000316zm-4.9975267-11.999368c.55228475 0 1 .44497754 1 .99589209v6.80214418l2.4816273-2.48241149c.3928222-.39294628 1.0219732-.4006883 1.4030652-.01947579.3911302.39125371.3914806 1.02525073-.0001404 1.41699553l-4.17620792 4.17752758c-.39120769.3913313-1.02508144.3917306-1.41671995-.0000316l-4.17639421-4.17771394c-.39122513-.39134876-.39767006-1.01940351-.01657797-1.40061601.39113012-.39125372 1.02337105-.3931606 1.41951349.00310701l2.48183446 2.48261871v-6.80214418c0-.55001601.44386482-.99589209 1-.99589209z" fill-rule="evenodd"/></symbol><symbol id="icon-eds-i-info-filled-medium" viewBox="0 0 18 18"><path d="m9 0c4.9705627 0 9 4.02943725 9 9 0 4.9705627-4.0294373 9-9 9-4.97056275 0-9-4.0294373-9-9 0-4.97056275 4.02943725-9 9-9zm0 7h-1.5l-.11662113.00672773c-.49733868.05776511-.88337887.48043643-.88337887.99327227 0 .47338693.32893365.86994729.77070917.97358929l.1126697.01968298.11662113.00672773h.5v3h-.5l-.11662113.0067277c-.42082504.0488782-.76196299.3590206-.85696816.7639815l-.01968298.1126697-.00672773.1166211.00672773.1166211c.04887817.4208251.35902055.761963.76398144.8569682l.1126697.019683.11662113.0067277h3l.1166211-.0067277c.4973387-.0577651.8833789-.4804365.8833789-.9932723 0-.4733869-.3289337-.8699473-.7707092-.9735893l-.1126697-.019683-.1166211-.0067277h-.5v-4l-.00672773-.11662113c-.04887817-.42082504-.35902055-.76196299-.76398144-.85696816l-.1126697-.01968298zm0-3.25c-.69035594 0-1.25.55964406-1.25 1.25s.55964406 1.25 1.25 1.25 1.25-.55964406 1.25-1.25-.55964406-1.25-1.25-1.25z" fill-rule="evenodd"/></symbol><symbol id="icon-eds-i-mail-medium" viewBox="0 0 24 24"><path d="m19.462 0c1.413 0 2.538 1.184 2.538 2.619v12.762c0 1.435-1.125 2.619-2.538 2.619h-16.924c-1.413 0-2.538-1.184-2.538-2.619v-12.762c0-1.435 1.125-2.619 2.538-2.619zm.538 5.158-7.378 6.258a2.549 2.549 0 0 1 -3.253-.008l-7.369-6.248v10.222c0 .353.253.619.538.619h16.924c.285 0 .538-.266.538-.619zm-.538-3.158h-16.924c-.264 0-.5.228-.534.542l8.65 7.334c.2.165.492.165.684.007l8.656-7.342-.001-.025c-.044-.3-.274-.516-.531-.516z"/></symbol><symbol id="icon-eds-i-menu-medium" viewBox="0 0 24 24"><path d="M21 4a1 1 0 0 1 0 2H3a1 1 0 1 1 0-2h18Zm-4 7a1 1 0 0 1 0 2H3a1 1 0 0 1 0-2h14Zm4 7a1 1 0 0 1 0 2H3a1 1 0 0 1 0-2h18Z"/></symbol><symbol id="icon-eds-i-search-medium" viewBox="0 0 24 24"><path d="M11 1c5.523 0 10 4.477 10 10 0 2.4-.846 4.604-2.256 6.328l3.963 3.965a1 1 0 0 1-1.414 1.414l-3.965-3.963A9.959 9.959 0 0 1 11 21C5.477 21 1 16.523 1 11S5.477 1 11 1Zm0 2a8 8 0 1 0 0 16 8 8 0 0 0 0-16Z"/></symbol><symbol id="icon-eds-i-user-single-medium" viewBox="0 0 24 24"><path d="M12 1a5 5 0 1 1 0 10 5 5 0 0 1 0-10Zm0 2a3 3 0 1 0 0 6 3 3 0 0 0 0-6Zm-.406 9.008a8.965 8.965 0 0 1 6.596 2.494A9.161 9.161 0 0 1 21 21.025V22a1 1 0 0 1-1 1H4a1 1 0 0 1-1-1v-.985c.05-4.825 3.815-8.777 8.594-9.007Zm.39 1.992-.299.006c-3.63.175-6.518 3.127-6.678 6.775L5 21h13.998l-.009-.268a7.157 7.157 0 0 0-1.97-4.573l-.214-.213A6.967 6.967 0 0 0 11.984 14Z"/></symbol><symbol id="icon-eds-i-warning-filled-medium" viewBox="0 0 18 18"><path d="m9 11.75c.69035594 0 1.25.5596441 1.25 1.25s-.55964406 1.25-1.25 1.25-1.25-.5596441-1.25-1.25.55964406-1.25 1.25-1.25zm.41320045-7.75c.55228475 0 1.00000005.44771525 1.00000005 1l-.0034543.08304548-.3333333 4c-.043191.51829212-.47645714.91695452-.99654578.91695452h-.15973424c-.52008864 0-.95335475-.3986624-.99654576-.91695452l-.33333333-4c-.04586475-.55037702.36312325-1.03372649.91350028-1.07959124l.04148683-.00259031zm-.41320045 14c-4.97056275 0-9-4.0294373-9-9 0-4.97056275 4.02943725-9 9-9 4.9705627 0 9 4.02943725 9 9 0 4.9705627-4.0294373 9-9 9z" fill-rule="evenodd"/></symbol><symbol id="icon-expand-image" viewBox="0 0 18 18"><path d="m7.49754099 11.9178212c.38955542-.3895554.38761957-1.0207846-.00290473-1.4113089-.39324695-.3932469-1.02238878-.3918247-1.41130883-.0029047l-4.10273549 4.1027355.00055454-3.5103985c.00008852-.5603185-.44832171-1.006032-1.00155062-1.0059446-.53903074.0000852-.97857527.4487442-.97866268 1.0021075l-.00093318 5.9072465c-.00008751.553948.44841131 1.001882 1.00174994 1.0017946l5.906983-.0009331c.5539233-.0000875 1.00197907-.4486389 1.00206646-1.0018679.00008515-.5390307-.45026621-.9784332-1.00588841-.9783454l-3.51010549.0005545zm3.00571741-5.83449376c-.3895554.38955541-.3876196 1.02078454.0029047 1.41130883.393247.39324696 1.0223888.39182478 1.4113089.00290473l4.1027355-4.10273549-.0005546 3.5103985c-.0000885.56031852.4483217 1.006032 1.0015506 1.00594461.5390308-.00008516.9785753-.44874418.9786627-1.00210749l.0009332-5.9072465c.0000875-.553948-.4484113-1.00188204-1.0017499-1.00179463l-5.906983.00093313c-.5539233.00008751-1.0019791.44863892-1.0020665 1.00186784-.0000852.53903074.4502662.97843325 1.0058884.97834547l3.5101055-.00055449z" fill-rule="evenodd"/></symbol><symbol id="icon-github" viewBox="0 0 100 100"><path fill-rule="evenodd" clip-rule="evenodd" d="M48.854 0C21.839 0 0 22 0 49.217c0 21.756 13.993 40.172 33.405 46.69 2.427.49 3.316-1.059 3.316-2.362 0-1.141-.08-5.052-.08-9.127-13.59 2.934-16.42-5.867-16.42-5.867-2.184-5.704-5.42-7.17-5.42-7.17-4.448-3.015.324-3.015.324-3.015 4.934.326 7.523 5.052 7.523 5.052 4.367 7.496 11.404 5.378 14.235 4.074.404-3.178 1.699-5.378 3.074-6.6-10.839-1.141-22.243-5.378-22.243-24.283 0-5.378 1.94-9.778 5.014-13.2-.485-1.222-2.184-6.275.486-13.038 0 0 4.125-1.304 13.426 5.052a46.97 46.97 0 0 1 12.214-1.63c4.125 0 8.33.571 12.213 1.63 9.302-6.356 13.427-5.052 13.427-5.052 2.67 6.763.97 11.816.485 13.038 3.155 3.422 5.015 7.822 5.015 13.2 0 18.905-11.404 23.06-22.324 24.283 1.78 1.548 3.316 4.481 3.316 9.126 0 6.6-.08 11.897-.08 13.526 0 1.304.89 2.853 3.316 2.364 19.412-6.52 33.405-24.935 33.405-46.691C97.707 22 75.788 0 48.854 0z"/></symbol><symbol id="icon-springer-arrow-left"><path d="M15 7a1 1 0 000-2H3.385l2.482-2.482a.994.994 0 00.02-1.403 1.001 1.001 0 00-1.417 0L.294 5.292a1.001 1.001 0 000 1.416l4.176 4.177a.991.991 0 001.4.016 1 1 0 00-.003-1.42L3.385 7H15z"/></symbol><symbol id="icon-springer-arrow-right"><path d="M1 7a1 1 0 010-2h11.615l-2.482-2.482a.994.994 0 01-.02-1.403 1.001 1.001 0 011.417 0l4.176 4.177a1.001 1.001 0 010 1.416l-4.176 4.177a.991.991 0 01-1.4.016 1 1 0 01.003-1.42L12.615 7H1z"/></symbol><symbol id="icon-submit-open" viewBox="0 0 16 17"><path d="M12 0c1.10457 0 2 .895431 2 2v5c0 .276142-.223858.5-.5.5S13 7.276142 13 7V2c0-.512836-.38604-.935507-.883379-.993272L12 1H6v3c0 1.10457-.89543 2-2 2H1v8c0 .512836.38604.935507.883379.993272L2 15h6.5c.276142 0 .5.223858.5.5s-.223858.5-.5.5H2c-1.104569 0-2-.89543-2-2V5.828427c0-.530433.210714-1.039141.585786-1.414213L4.414214.585786C4.789286.210714 5.297994 0 5.828427 0H12Zm3.41 11.14c.250899.250899.250274.659726 0 .91-.242954.242954-.649606.245216-.9-.01l-1.863671-1.900337.001043 5.869492c0 .356992-.289839.637138-.647372.637138-.347077 0-.647371-.285256-.647371-.637138l-.001043-5.869492L9.5 12.04c-.253166.258042-.649726.260274-.9.01-.242954-.242954-.252269-.657731 0-.91l2.942184-2.951303c.250908-.250909.66127-.252277.91353-.000017L15.41 11.14ZM5 1.413 1.413 5H4c.552285 0 1-.447715 1-1V1.413ZM11 3c.276142 0 .5.223858.5.5s-.223858.5-.5.5H7.5c-.276142 0-.5-.223858-.5-.5s.223858-.5.5-.5H11Zm0 2c.276142 0 .5.223858.5.5s-.223858.5-.5.5H7.5c-.276142 0-.5-.223858-.5-.5s.223858-.5.5-.5H11Z" fill-rule="nonzero"/></symbol></svg> </div> </footer> <div class="c-site-messages message u-hide u-hide-print c-site-messages--nature-briefing c-site-messages--nature-briefing-email-variant c-site-messages--nature-briefing-redesign-2020 sans-serif " data-component-id="nature-briefing-banner" data-component-expirydays="30" data-component-trigger-scroll-percentage="15" data-track="in-view" data-track-action="in-view" data-track-category="nature briefing" data-track-label="Briefing banner visible: Flagship"> <div class="c-site-messages__banner-large"> <div class="c-site-messages__close-container"> <button class="c-site-messages__close" data-track="click" data-track-category="nature briefing" data-track-label="Briefing banner dismiss: Flagship"> <svg width="25px" height="25px" focusable="false" aria-hidden="true" viewBox="0 0 25 25" version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"> <title>Close banner</title> <defs></defs> <g stroke="none" stroke-width="1" fill="none" fill-rule="evenodd"> <rect opacity="0" x="0" y="0" width="25" height="25"></rect> <path d="M6.29679575,16.2772478 C5.90020818,16.6738354 5.90240728,17.3100587 6.29617427,17.7038257 C6.69268654,18.100338 7.32864195,18.0973145 7.72275218,17.7032043 L12,13.4259564 L16.2772478,17.7032043 C16.6738354,18.0997918 17.3100587,18.0975927 17.7038257,17.7038257 C18.100338,17.3073135 18.0973145,16.671358 17.7032043,16.2772478 L13.4259564,12 L17.7032043,7.72275218 C18.0997918,7.32616461 18.0975927,6.68994127 17.7038257,6.29617427 C17.3073135,5.89966201 16.671358,5.90268552 16.2772478,6.29679575 L12,10.5740436 L7.72275218,6.29679575 C7.32616461,5.90020818 6.68994127,5.90240728 6.29617427,6.29617427 C5.89966201,6.69268654 5.90268552,7.32864195 6.29679575,7.72275218 L10.5740436,12 L6.29679575,16.2772478 Z" fill="#ffffff"></path> </g> </svg> <span class="visually-hidden">Close</span> </button> </div> <div class="c-site-messages__form-container"> <div class="grid grid-12 last"> <div class="grid grid-4"> <img alt="Nature Briefing" src="/static/images/logos/nature-briefing-logo-n150-white-d81c9da3ec.svg" width="250" height="40"> <p class="c-site-messages--nature-briefing__strapline extra-tight-line-height">Sign up for the <em>Nature Briefing</em> newsletter — what matters in science, free to your inbox daily.</p> </div> <div class="grid grid-8 last"> <form action="https://www.nature.com/briefing/briefing" method="post" data-location="banner" data-track="signup_nature_briefing_banner" data-track-action="transmit-form" data-track-category="nature briefing" data-track-label="Briefing banner submit: Flagship"> <input id="briefing-banner-signup-form-input-track-originReferralPoint" type="hidden" name="track_originReferralPoint" value="MainBriefingBanner"> <input id="briefing-banner-signup-form-input-track-formType" type="hidden" name="track_formType" value="DirectEmailBanner"> <input type="hidden" value="false" name="gdpr_tick" id="gdpr_tick_banner"> <input type="hidden" value="false" name="marketing" id="marketing_input_banner"> <input type="hidden" value="false" name="marketing_tick" id="marketing_tick_banner"> <input type="hidden" value="MainBriefingBanner" name="brieferEntryPoint" id="brieferEntryPoint_banner"> <label class="nature-briefing-banner__email-label" for="emailAddress">Email address</label> <div class="nature-briefing-banner__email-wrapper"> <input class="nature-briefing-banner__email-input box-sizing text14" type="email" id="emailAddress" name="emailAddress" value="" placeholder="e.g. jo.smith@university.ac.uk" required data-test-element="briefing-emailbanner-email-input"> <input type="hidden" value="true" name="N:nature_briefing_daily" id="defaultNewsletter_banner"> <button type="submit" class="nature-briefing-banner__submit-button box-sizing text14" data-test-element="briefing-emailbanner-signup-button">Sign up</button> </div> <div class="nature-briefing-banner__checkbox-wrapper grid grid-12 last"> <input class="nature-briefing-banner__checkbox-checkbox" id="gdpr-briefing-banner-checkbox" type="checkbox" name="gdpr" value="true" data-test-element="briefing-emailbanner-gdpr-checkbox" required> <label class="nature-briefing-banner__checkbox-label box-sizing text13 sans-serif block tighten-line-height" for="gdpr-briefing-banner-checkbox">I agree my information will be processed in accordance with the <em>Nature</em> and Springer Nature Limited <a href="https://www.nature.com/info/privacy">Privacy Policy</a>.</label> </div> </form> </div> </div> </div> </div> <div class="c-site-messages__banner-small"> <div class="c-site-messages__close-container"> <button class="c-site-messages__close" data-track="click" data-track-category="nature briefing" data-track-label="Briefing banner dismiss: Flagship"> <svg width="25px" height="25px" focusable="false" aria-hidden="true" viewBox="0 0 25 25" version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"> <title>Close banner</title> <defs></defs> <g stroke="none" stroke-width="1" fill="none" fill-rule="evenodd"> <rect opacity="0" x="0" y="0" width="25" height="25"></rect> <path d="M6.29679575,16.2772478 C5.90020818,16.6738354 5.90240728,17.3100587 6.29617427,17.7038257 C6.69268654,18.100338 7.32864195,18.0973145 7.72275218,17.7032043 L12,13.4259564 L16.2772478,17.7032043 C16.6738354,18.0997918 17.3100587,18.0975927 17.7038257,17.7038257 C18.100338,17.3073135 18.0973145,16.671358 17.7032043,16.2772478 L13.4259564,12 L17.7032043,7.72275218 C18.0997918,7.32616461 18.0975927,6.68994127 17.7038257,6.29617427 C17.3073135,5.89966201 16.671358,5.90268552 16.2772478,6.29679575 L12,10.5740436 L7.72275218,6.29679575 C7.32616461,5.90020818 6.68994127,5.90240728 6.29617427,6.29617427 C5.89966201,6.69268654 5.90268552,7.32864195 6.29679575,7.72275218 L10.5740436,12 L6.29679575,16.2772478 Z" fill="#ffffff"></path> </g> </svg> <span class="visually-hidden">Close</span> </button> </div> <div class="c-site-messages__content text14"> <span class="c-site-messages--nature-briefing__strapline strong">Get the most important science stories of the day, free in your inbox.</span> <a class="nature-briefing__link text14 sans-serif" data-track="click" data-track-category="nature briefing" data-track-label="Small-screen banner CTA to site" data-test-element="briefing-banner-link" target="_blank" rel="noreferrer noopener" href="https://www.nature.com/briefing/signup/?brieferEntryPoint=MainBriefingBanner">Sign up for Nature Briefing </a> </div> </div> </div> <noscript> <img hidden src="https://verify.nature.com/verify/nature.png" width="0" height="0" style="display: none" alt=""> </noscript> <script src="//content.readcube.com/ping?doi=10.1038/nature05488&format=js&last_modified=2006-12-14" async></script> </body> </html>