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Wang L, Liu X, Du Z, Tian J, Zhang L, Yang L. Cardiometabolic Index and chronic obstructive pulmonary disease: A population-based cross-sectional study. Heart Lung 2024; 68:342-349. [PMID: 39244841 DOI: 10.1016/j.hrtlng.2024.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 08/27/2024] [Accepted: 09/02/2024] [Indexed: 09/10/2024]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide and constitutes a global health problem. The cardiometabolic index (CMI) is a new metric that combines abdominal obesity and lipid levels. Studies have shown that the prevalence of lipid metabolism disorders is greater among COPD patients and that the CMI can help reveal the potential role of lipid metabolism in disease progression by assessing the body's metabolic status; however, the association between the CMI and COPD is not known. OBJECTIVE To explore the association between the CMI and the prevalence of COPD. METHODS A cross-sectional study was conducted with 14,340 participants aged ≥ 20 years from the 2007-2018 NHANES databases. To assess the relationship between the CMI and the odds of COPD prevalence, we performed multivariate logistic regression analyses, subgroup analysis interaction tests, smoothed curve fitting, and threshold effect analyses. RESULTS The study included a total of 14,340 participants, 48.49 % male and 51.51 % female, and the average age was 49.75 ± 17.49 years. According to the regression model adjusted for all confounding variables, participants in the highest quartile of the CMI had 22 % greater odds of having COPD than did those in the lowest quartile (OR = 1.22, 95 % CI: 1.03, 1.21, p = 0.010). A nonlinear association was found between the CMI and COPD, with an inflection point of 0.26. The OR (95 % CI) before the inflection point was 1.27 (1.12, 1.44), p = 0.0002. The interaction was statistically significant only in the sex analysis. CONCLUSIONS The level of the CMI and the odds of COPD prevalence were positively correlated in our study. These findings suggest that managing abdominal obesity and lipid levels may help prevent or mitigate COPD, emphasizing the potential value of the CMI as an indicator for early intervention and precision therapy.
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Affiliation(s)
- Lina Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan 250000, China
| | - Xiaojun Liu
- School of Nursing and Rehabilitation, Shandong University, Jinan 250000, China
| | - Zhongyan Du
- School of Nursing and Rehabilitation, Shandong University, Jinan 250000, China
| | - Jiaqi Tian
- School of Nursing and Rehabilitation, Shandong University, Jinan 250000, China
| | - Ling Zhang
- School of Nursing and Rehabilitation, Shandong University, Jinan 250000, China
| | - Lijuan Yang
- Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, China.
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Yan L, Hu X, Wu S, Cui C, Zhao S. Association between the cardiometabolic index and NAFLD and fibrosis. Sci Rep 2024; 14:13194. [PMID: 38851771 PMCID: PMC11162484 DOI: 10.1038/s41598-024-64034-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 06/04/2024] [Indexed: 06/10/2024] Open
Abstract
Composed of obesity and lipid parameters, the cardiometabolic index (CMI) has emerged as a novel diagnostic tool. Originally developed for diabetes diagnosis, its application has expanded to identifying patients with cardiovascular diseases, such as atherosclerosis and hypertension. However, the relationship between CMI and non-alcoholic fatty liver disease (NAFLD) and liver fibrosis in the US population remains unclear. This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 2017-2020, involving 2996 participants aged 20 years or older. Vibration controlled transient elastography using a FibroScan® system (model 502, V2 Touch) with controlled attenuation parameter measurements identified NAFLD at a threshold of ≥ 274 dB/m, while liver stiffness measurement (LSM) results (median, ≥ 8.2 kPa) indicated fibrosis. A multifactorial logistic regression model explored the relationship between CMI and NAFLD and fibrosis. The effectiveness of CMI in detecting NAFLD and liver fibrosis was assessed through receiver operating characteristic curve analysis. Controlling for potential confounders, CMI showed a significant positive association with NAFLD (adjusted OR = 1.44, 95% CI 1.44-1.45) and liver fibrosis (adjusted OR = 1.84, 95% CI 1.84-1.85). The Areas Under the Curve for predicting NAFLD and fibrosis were 0.762 (95% CI 0.745 ~ 0.779) and 0.664(95% CI 0.633 ~ 0.696), respectively, with optimal cut-off values of 0.462 and 0.527. There is a positive correlation between CMI and NAFLD and fibrosis, which is a suitable and simple predictor of NAFLD and fibrosis.
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Affiliation(s)
- Laisha Yan
- Department of Cardio Surgery Intensive Care Unit, Ningbo Medical Centre Li Huili Hospital, Ningbo, China
| | - Xiaoyan Hu
- Department of Cardio Surgery Intensive Care Unit, Ningbo Medical Centre Li Huili Hospital, Ningbo, China
| | - Shanshan Wu
- Department of Cardio Surgery Intensive Care Unit, Ningbo Medical Centre Li Huili Hospital, Ningbo, China
| | - Can Cui
- Department of Cardio Surgery Intensive Care Unit, Ningbo Medical Centre Li Huili Hospital, Ningbo, China
| | - Shunying Zhao
- Department of Cardio Surgery Intensive Care Unit, Ningbo Medical Centre Li Huili Hospital, Ningbo, China.
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Dong T, Lin W, Zhou Q, Yang Y, Liu X, Chen J, Liu H, Zhang C. Association of adiposity indicators with cardiometabolic multimorbidity risk in hypertensive patients: a large cross-sectional study. Front Endocrinol (Lausanne) 2024; 15:1302296. [PMID: 38577567 PMCID: PMC10991765 DOI: 10.3389/fendo.2024.1302296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/08/2024] [Indexed: 04/06/2024] Open
Abstract
Background Cardiometabolic multimorbidity (CMM) has emerged as a prominent public health concern. Hypertensive patients are prone to develop comorbidities. Moreover, the accumulation of visceral adipose tissue is the main cause for the development of cardiometabolic diseases. The cardiometabolic index (CMI), lipid accumulation product (LAP), visceral adiposity index (VAI), and Chinese visceral adiposity index (CVAI) not only assess adipose tissue mass but also reflect adipose tissue dysfunction. So far, no study has been reported to evaluate the association of CMI, LAP, VAI, and CVAI with CMM risk in hypertensive patients. Therefore, this study aimed to assess the association between these adiposity indicators and the risk of CMM among Chinese hypertensive patients. Methods In this cross-sectional study, a total of 229,287 hypertensive patients aged 35 years and older were included from the National Basic Public Health Service Project. All participants underwent a face-to-face questionnaire survey, physical examination, and the collection of fasting venous blood samples. Multivariable logistic regression models were performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Receiver operating characteristic curve was utilized to evaluate the identification ability for CMM. Results After adjusting for confounders, each 1-standard deviation increase in CMI, LAP, VAI, and CVAI was associated with a 14%, 8%, 12%, and 54% increased risk of CMM, respectively. When comparing the highest quartile of these indicators with the lowest quartile, individuals in the highest quartile of CMM, LAP, VAI, and CVAI had a 1.39-fold (95% CI 1.30, 1.48), 1.28-fold (95% CI 1.19, 1.37), 1.37-fold (95% CI 1.29, 1.46), and 2.56-fold (95% CI 2.34, 2.79) increased risk of CMM after adjusting for potential confounders. Notably, a nonlinear association was observed for CMI, LAP, and VAI with the risk of CMM (all P nonlinearity < 0.001). CVAI exhibited the highest area under the receiver operating characteristic curve (AUC) among all the included adiposity indices in this analysis. Conclusion This study indicated the significant positive association of CMI, LAP, VAI, and CVAI with the risk of CMM in hypertensive patients. Among these indicators, CVAI demonstrated the most robust performance in predicting CMM risk and may serve as a valuable tool for identifying CMM risk in Chinese hypertensive patients.
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Affiliation(s)
- Ting Dong
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weiquan Lin
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Qin Zhou
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Yunou Yang
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Xiangyi Liu
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jiamin Chen
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Hui Liu
- Department of Basic Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Caixia Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Song J, Li Y, Zhu J, Liang J, Xue S, Zhu Z. Non-linear associations of cardiometabolic index with insulin resistance, impaired fasting glucose, and type 2 diabetes among US adults: a cross-sectional study. Front Endocrinol (Lausanne) 2024; 15:1341828. [PMID: 38410697 PMCID: PMC10894973 DOI: 10.3389/fendo.2024.1341828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/25/2024] [Indexed: 02/28/2024] Open
Abstract
Background Cardiometabolic index (CMI) is a novel indicator for predicting the risk of obesity-related diseases. We aimed to determine the relationships of CMI with insulin resistance (IR), impaired fasting glucose (IFG), and type 2 diabetes mellitus (T2DM) using NHANES data from 1999 to 2020. Methods After CMI values were estimated, weighted univariate and multivariate logistic regression analyses were used to ascertain whether CMI was an independent risk indicator for IR, IFG, and T2DM. Furthermore, stratified analyses and interaction analyses were carried out to investigate the heterogeneity of correlations across various subgroups. Subsequently, restricted cubic splines (RCS) were used to examine nonlinear relationships. Results 21,304 US adults were enrolled in our study, of whom 5,326 (22.38%) had IR, 4,706 (20.17%) had IFG, and 3,724 (13.02%) had T2DM. In the studied population, a higher CMI index value was significantly associated with an elevated likelihood of IR, IFG, and T2DM. In the RCS regression model, the relationship between CMI and IR, IFG, and T2DM was identified as nonlinear. A nonlinear inverted U-shaped relationship was found between CMI and IFG, and an inverse L-shaped association was observed between CMI and IR, CMI and T2DM. The cut-off values of CMI were 1.35, 1.48, and 1.30 for IR, IFG, and T2DM, respectively. Conclusion Our results indicate that CMI was positively correlated with an increase in IR, IFG, and T2DM in the studied population. CMI may be a simple and effective surrogate indicator of IR, IFG, and T2DM.
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Affiliation(s)
- Jimei Song
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yimei Li
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junxia Zhu
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jian Liang
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shan Xue
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhangzhi Zhu
- Department of Endocrinology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Yang Y, Li Q, Long Y, Yuan J, Zha Y. Associations of metabolic syndrome, its severity with cognitive impairment among hemodialysis patients. Diabetol Metab Syndr 2023; 15:108. [PMID: 37221557 DOI: 10.1186/s13098-023-01080-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/08/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND In the general population, metabolic syndrome (MetS) is associated with increased risk of cognitive impairment, including global and specific cognitive domains. These associations are not well studied in patients undergoing hemodialysis and were the focus of the current investigation. METHODS In this multicenter cross-sectional study, 5492 adult hemodialysis patients (3351 men; mean age: 54.4 ± 15.2 years) treated in twenty-two dialysis centers of Guizhou, China were included. The Mini-Mental State Examination (MMSE) was utilized to assess mild cognitive impairment (MCI). MetS was diagnosed with abdominal obesity, hypertension, hyperglycemia, and dyslipidemia. Multivariate logistic and linear regression models were used to examine the associations of MetS, its components, and metabolic scores with the risk of MCI. Restricted cubic spline analyses were performed to explore the dose-response associations. RESULTS Hemodialysis patients had a high prevalence of MetS (62.3%) and MCI (34.3%). MetS was positively associated with MCI risk with adjusted ORs of 1.22 [95% confidence interval (CI) 1.08-1.37, P = 0.001]. Compared to no MetS, adjusted ORs for MCI were 2.03 (95% CI 1.04-3.98) for 22.51 (95% CI 1.28-4.90) for 3, 2.35 (95% CI 1.20-4.62) for 4, and 2.94 (95% CI 1.48-5.84) for 5 components. Metabolic syndrome score, cardiometabolic index, and metabolic syndrome severity score were associated with increased risk of MCI. Further analysis showed that MetS was negatively associated with MMSE score, orientation, registration, recall and language (P < 0.05). Significant interaction effect of sex (P for interaction = 0.012) on the MetS-MCI was observed. CONCLUSION Metabolic syndrome was associated with MCI in hemodialysis patients in a positive dose-response effect.
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Affiliation(s)
- Yuqi Yang
- Deparment of Nephrology, Guizhou Provincial People's Hospital, Guiyang, 550002, China
- NHC Key Laboratory of Pulmonary Immune-Related Diseases, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Qian Li
- Deparment of Nephrology, Guizhou Provincial People's Hospital, Guiyang, 550002, China
- NHC Key Laboratory of Pulmonary Immune-Related Diseases, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Yanjun Long
- Deparment of Nephrology, Guizhou Provincial People's Hospital, Guiyang, 550002, China
- NHC Key Laboratory of Pulmonary Immune-Related Diseases, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Jing Yuan
- Deparment of Nephrology, Guizhou Provincial People's Hospital, Guiyang, 550002, China
- NHC Key Laboratory of Pulmonary Immune-Related Diseases, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Yan Zha
- Deparment of Nephrology, Guizhou Provincial People's Hospital, Guiyang, 550002, China.
- NHC Key Laboratory of Pulmonary Immune-Related Diseases, Guizhou Provincial People's Hospital, Guiyang, 550002, China.
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Zha F, Cao C, Hong M, Hou H, Zhang Q, Tang B, Hu H, Han Y, Zan Y, Wang Y, Xu J. The nonlinear correlation between the cardiometabolic index and the risk of diabetes: A retrospective Japanese cohort study. Front Endocrinol (Lausanne) 2023; 14:1120277. [PMID: 36875460 PMCID: PMC9980900 DOI: 10.3389/fendo.2023.1120277] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/03/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND The cardiometabolic index (CMI) has been proposed as a novel indicator of cardiometabolic status. However, evidence on the relationship between CMI and diabetes mellitus (DM) risk was limited. Our study aimed to explore the relationship between CMI and DM risk among a large cohort of Japanese adults. METHODS This retrospective cohort study recruited 15453 Japanese adults without diabetes at baseline who underwent physical examinations at the Murakami Memorial Hospital between 2004 and 2015. Cox proportional-hazards regression was applied to evaluate the independent relationship between CMI and diabetes. Our study performed a generalized smooth curve fitting (penalized spline technique) and an additive model (GAM) to determine the non-linear relationship between CMI and DM risk. In addition, a set of sensitivity analyses and subgroup analyses were employed to evaluate the relationship between CMI and incident DM. RESULTS After adjusting for confounding covariates, CMI was positively related to the DM risk in Japanese adults (HR: 1.65, 95%CI: 1.43-1.90, P<0.0001). A series of sensitivity analyses were also employed in this study to guarantee the reliability of the findings. In addition, our study discovered a non-linear association between CMI and diabetes risk. CMI's inflection point was 1.01. A strong positive association between CMI and diabetes incidence was also discovered to the left of the inflection point (HR: 2.96, 95%CI: 1.96-4.46, P<<0.0001). However, their association was not significant when CMI was higher than 1.01 (HR: 1.27, 95%CI: 0.98-1.64, P=0.0702). Interaction analysis showed that gender, BMI, habit of exercise, and smoking status interacted with CMI. CONCLUSION Increased CMI level at baseline is associated with incident DM. The association between CMI and incident DM is also non-linear. A high CMI level is associated with an increased risk for DM when CMI is below 1.01.
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Affiliation(s)
- Fubing Zha
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- Department of Rehabilitation, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Mengru Hong
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Huili Hou
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Qionghua Zhang
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Bin Tang
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
| | - Yibing Zan
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Yulong Wang
- Department of Rehabilitation, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
- *Correspondence: Yulong Wang, ; Jianwen Xu,
| | - Jianwen Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- *Correspondence: Yulong Wang, ; Jianwen Xu,
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Associations of the Cardiometabolic Index with the Risk of Cardiovascular Disease in Patients with Hypertension and Obstructive Sleep Apnea: Results of a Longitudinal Cohort Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:4914791. [PMID: 35783191 PMCID: PMC9246614 DOI: 10.1155/2022/4914791] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/08/2022] [Accepted: 05/25/2022] [Indexed: 11/22/2022]
Abstract
Purpose We aimed to explore the relationship between the cardiometabolic index (CMI) and cardiovascular disease (CVD) and its subtypes (coronary artery disease and stroke) in patients with hypertension and obstructive sleep apnea (OSA). Methods We conducted a retrospective cohort study enrolling 2067 participants from the Urumqi Research on Sleep Apnea and Hypertension study. The CMI was calculated as triglyceride to high‐density lipoprotein cholesterol ratio × waist‐to‐height ratio. Participants were divided into three groups (T1, T2, and T3) according to the tertile of CMI. The Kaplan-Meier method helped to calculate the cumulative incidence of CVD in different groups. We assessed the association of CMI with the risk of CVD and CVD subtypes by estimating hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox models. Results During a median follow-up of 6.83 years (interquartile range: 5.92-8.00 years), 326 incident CVD were identified, including 121 incident stroke and 205 incident coronary heart disease (CHD). Overall, after adjusting for confounding variables, CMI was positively associated with the risk of new-onset CVD (per SD increment, adjusted HR: 1.31; 95% CI: 1.20, 1.43), new-onset CHD (per SD increment, adjusted HR: 1.33; 95% CI: 1.20, 1.48), and new-onset stroke (per SD increment, adjusted HR: 1.27; 95% CI: 1.10, 1.47). Similar results were obtained in various subgroup and sensitivity analyses. Adding CMI to the baseline risk model for CVD improved the C-index (P < 0.001), continuous net reclassification improvement (P < 0.001), and integrated discrimination index (P < 0.001). Similar results were observed for CHD and stroke. Conclusion There was a positive association between CMI levels and the risk of new-onset CVD in patients with hypertension and OSA. This finding suggests that CMI may help identify people at high risk of developing CVD.
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