Inverse association of N-terminal pro-B-type natriuretic peptide with metabolic syndrome in patients with congestive heart failure
Metabolic syndrome has been shown to be associated with lower levels of plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP) in the general population. We sought to elucidate the relationship between Nt-proBNP and components of metabolic syndrome in patients with congestive heart failure (CH...
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| description | Metabolic syndrome has been shown to be associated with lower levels of plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP) in the general population. We sought to elucidate the relationship between Nt-proBNP and components of metabolic syndrome in patients with congestive heart failure (CHF).
Fasting blood samples were obtained from 93 patients in our institution. Plasma levels of Nt-proBNP and other biochemical data were measured. The New York Heart Association (NYHA) classification system (I-IV) was used to define the functional capacity of CHF. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation.
Forty-nine patients (52.7%) had CHF. There was a positive correlation between plasma Nt-proBNP levels and NYHA functional capacity in CHF patients. Plasma Nt-proBNP levels increased significantly with each increasing NYHA class of the disease. The prevalence of metabolic syndrome in CHF patients was higher than that in patients without CHF. Most importantly, we found that plasma Nt-proBNP levels were lower in CHF patients with metabolic syndrome attributable to inverse relationships between plasma Nt-proBNP and body mass index (β = -0.297), plasma triglyceride (β = -0.286) and homeostasis model assessment of insulin resistance (HOMA-IR; β = -0.346). Fasting glucose to insulin ratio (FGIR, an insulin sensitivity index) was positively associated with plasma Nt-proBNP levels (β = 0.491), and was the independent predictor of plasma Nt-proBNP levels in CHF patients.
Plasma Nt-proBNP levels are inversely associated with metabolic syndrome in CHF patients. Reduced plasma Nt-proBNP levels in CHF patients may lead to impaired lipolysis and metabolic function, and may contribute to the development of metabolic syndrome in CHF patients. |
| doi_str_mv | 10.1371/journal.pone.0079096 |
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Fasting blood samples were obtained from 93 patients in our institution. Plasma levels of Nt-proBNP and other biochemical data were measured. The New York Heart Association (NYHA) classification system (I-IV) was used to define the functional capacity of CHF. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation.
Forty-nine patients (52.7%) had CHF. There was a positive correlation between plasma Nt-proBNP levels and NYHA functional capacity in CHF patients. Plasma Nt-proBNP levels increased significantly with each increasing NYHA class of the disease. The prevalence of metabolic syndrome in CHF patients was higher than that in patients without CHF. Most importantly, we found that plasma Nt-proBNP levels were lower in CHF patients with metabolic syndrome attributable to inverse relationships between plasma Nt-proBNP and body mass index (β = -0.297), plasma triglyceride (β = -0.286) and homeostasis model assessment of insulin resistance (HOMA-IR; β = -0.346). Fasting glucose to insulin ratio (FGIR, an insulin sensitivity index) was positively associated with plasma Nt-proBNP levels (β = 0.491), and was the independent predictor of plasma Nt-proBNP levels in CHF patients.
Plasma Nt-proBNP levels are inversely associated with metabolic syndrome in CHF patients. Reduced plasma Nt-proBNP levels in CHF patients may lead to impaired lipolysis and metabolic function, and may contribute to the development of metabolic syndrome in CHF patients.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0079096</identifier><identifier>PMID: 24265747</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Analysis ; Blood Glucose - metabolism ; Body mass ; Body mass index ; Body size ; Brain natriuretic peptide ; Cardiovascular disease ; Care and treatment ; Congestive heart failure ; Diabetes mellitus ; Diagnostic systems ; Fasting ; Fasting - blood ; Female ; Glucose ; Heart ; Heart Failure - complications ; Homeostasis ; Humans ; Insulin ; Insulin - blood ; Insulin resistance ; Lipolysis ; Male ; Metabolic syndrome ; Metabolic Syndrome - blood ; Metabolic Syndrome - complications ; Middle Aged ; Multivariate Analysis ; Natriuretic Peptide, Brain - blood ; Natriuretic peptides ; Obesity ; Patients ; Peptide Fragments - blood ; Plasma levels ; Sampling methods ; Type 2 diabetes</subject><ispartof>PloS one, 2013-11, Vol.8 (11), p.e79096-e79096</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Chang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Chang et al 2013 Chang et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-4f89717542ab4918f9fc1db1181d7e36349d95a0f0b933db66676f1aae12856b3</citedby><cites>FETCH-LOGICAL-c692t-4f89717542ab4918f9fc1db1181d7e36349d95a0f0b933db66676f1aae12856b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827135/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827135/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24265747$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Katare, Rajesh Gopalrao</contributor><creatorcontrib>Chang, Huai-Ren</creatorcontrib><creatorcontrib>Hsieh, Jen-Che</creatorcontrib><creatorcontrib>Hsu, Bang-Gee</creatorcontrib><creatorcontrib>Wang, Ling-Yi</creatorcontrib><creatorcontrib>Chen, Michael Yu-Chih</creatorcontrib><creatorcontrib>Wang, Ji-Hung</creatorcontrib><title>Inverse association of N-terminal pro-B-type natriuretic peptide with metabolic syndrome in patients with congestive heart failure</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Metabolic syndrome has been shown to be associated with lower levels of plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP) in the general population. We sought to elucidate the relationship between Nt-proBNP and components of metabolic syndrome in patients with congestive heart failure (CHF).
Fasting blood samples were obtained from 93 patients in our institution. Plasma levels of Nt-proBNP and other biochemical data were measured. The New York Heart Association (NYHA) classification system (I-IV) was used to define the functional capacity of CHF. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation.
Forty-nine patients (52.7%) had CHF. There was a positive correlation between plasma Nt-proBNP levels and NYHA functional capacity in CHF patients. Plasma Nt-proBNP levels increased significantly with each increasing NYHA class of the disease. The prevalence of metabolic syndrome in CHF patients was higher than that in patients without CHF. Most importantly, we found that plasma Nt-proBNP levels were lower in CHF patients with metabolic syndrome attributable to inverse relationships between plasma Nt-proBNP and body mass index (β = -0.297), plasma triglyceride (β = -0.286) and homeostasis model assessment of insulin resistance (HOMA-IR; β = -0.346). Fasting glucose to insulin ratio (FGIR, an insulin sensitivity index) was positively associated with plasma Nt-proBNP levels (β = 0.491), and was the independent predictor of plasma Nt-proBNP levels in CHF patients.
Plasma Nt-proBNP levels are inversely associated with metabolic syndrome in CHF patients. Reduced plasma Nt-proBNP levels in CHF patients may lead to impaired lipolysis and metabolic function, and may contribute to the development of metabolic syndrome in CHF patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Blood Glucose - metabolism</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Brain natriuretic peptide</subject><subject>Cardiovascular disease</subject><subject>Care and treatment</subject><subject>Congestive heart failure</subject><subject>Diabetes mellitus</subject><subject>Diagnostic systems</subject><subject>Fasting</subject><subject>Fasting - blood</subject><subject>Female</subject><subject>Glucose</subject><subject>Heart</subject><subject>Heart Failure - complications</subject><subject>Homeostasis</subject><subject>Humans</subject><subject>Insulin</subject><subject>Insulin - blood</subject><subject>Insulin resistance</subject><subject>Lipolysis</subject><subject>Male</subject><subject>Metabolic syndrome</subject><subject>Metabolic Syndrome - blood</subject><subject>Metabolic Syndrome - complications</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Natriuretic peptides</subject><subject>Obesity</subject><subject>Patients</subject><subject>Peptide Fragments - blood</subject><subject>Plasma levels</subject><subject>Sampling methods</subject><subject>Type 2 diabetes</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk12P1CAUhhujcdfVf2CUxMToRUcoFNobk3XjxyQbN_HrltD2MMOkLV2go3PrL5dxupup2QvDBeTwnPfACydJnhK8IFSQNxs7ul61i8H2sMBYlLjk95JTUtIs5Rmm94_WJ8kj7zcY57Tg_GFykrGM54KJ0-T3st-C84CU97Y2KhjbI6vR5zSA60wsgAZn03dp2A2AehWcGR0EU6MBhmAaQD9NWKMOgqpsG8N-1zfOdoBMj4YoB33wB6a2_Qp8MFtAa1AuIK1MG8UeJw-0aj08meaz5PuH998uPqWXVx-XF-eXac3LLKRMF6UgImeZqlhJCl3qmjQVIQVpBFBOWdmUucIaVyWlTcU5F1wTpYBkRc4repY8P-gOrfVyss9LwnKcMZFnPBLLA9FYtZGDM51yO2mVkX8D1q1kPLepW5A1ZzqjLKprwpomq5QoK2BAcKGYoPtqb6dqY9VBU0cfnGpnovOd3qzlym4lLTJBaB4FXk0Czl6P0TjZGV9D26oe7Lg_NyeFKJjAEX3xD3r37SZqpeIFTK9trFvvReU5EwXFuGBlpBZ3UHE00Jn4hKBNjM8SXs8SIhPgV1ip0Xu5_Prl_9mrH3P25REbf0wb1t624_6H-jnIDmDtrPcO9K3JBMt9q9y4IfetIqdWiWnPjh_oNummN-gfFmoQpg</recordid><startdate>20131112</startdate><enddate>20131112</enddate><creator>Chang, Huai-Ren</creator><creator>Hsieh, Jen-Che</creator><creator>Hsu, Bang-Gee</creator><creator>Wang, Ling-Yi</creator><creator>Chen, Michael Yu-Chih</creator><creator>Wang, Ji-Hung</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20131112</creationdate><title>Inverse association of N-terminal pro-B-type natriuretic peptide with metabolic syndrome in patients with congestive heart failure</title><author>Chang, Huai-Ren ; Hsieh, Jen-Che ; Hsu, Bang-Gee ; Wang, Ling-Yi ; Chen, Michael Yu-Chih ; Wang, Ji-Hung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-4f89717542ab4918f9fc1db1181d7e36349d95a0f0b933db66676f1aae12856b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Blood Glucose - metabolism</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Brain natriuretic peptide</topic><topic>Cardiovascular disease</topic><topic>Care and treatment</topic><topic>Congestive heart failure</topic><topic>Diabetes mellitus</topic><topic>Diagnostic systems</topic><topic>Fasting</topic><topic>Fasting - blood</topic><topic>Female</topic><topic>Glucose</topic><topic>Heart</topic><topic>Heart Failure - complications</topic><topic>Homeostasis</topic><topic>Humans</topic><topic>Insulin</topic><topic>Insulin - blood</topic><topic>Insulin resistance</topic><topic>Lipolysis</topic><topic>Male</topic><topic>Metabolic syndrome</topic><topic>Metabolic Syndrome - blood</topic><topic>Metabolic Syndrome - complications</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Natriuretic peptides</topic><topic>Obesity</topic><topic>Patients</topic><topic>Peptide Fragments - blood</topic><topic>Plasma levels</topic><topic>Sampling methods</topic><topic>Type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, Huai-Ren</creatorcontrib><creatorcontrib>Hsieh, Jen-Che</creatorcontrib><creatorcontrib>Hsu, Bang-Gee</creatorcontrib><creatorcontrib>Wang, Ling-Yi</creatorcontrib><creatorcontrib>Chen, Michael Yu-Chih</creatorcontrib><creatorcontrib>Wang, Ji-Hung</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, Huai-Ren</au><au>Hsieh, Jen-Che</au><au>Hsu, Bang-Gee</au><au>Wang, Ling-Yi</au><au>Chen, Michael Yu-Chih</au><au>Wang, Ji-Hung</au><au>Katare, Rajesh Gopalrao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inverse association of N-terminal pro-B-type natriuretic peptide with metabolic syndrome in patients with congestive heart failure</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-11-12</date><risdate>2013</risdate><volume>8</volume><issue>11</issue><spage>e79096</spage><epage>e79096</epage><pages>e79096-e79096</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Metabolic syndrome has been shown to be associated with lower levels of plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP) in the general population. We sought to elucidate the relationship between Nt-proBNP and components of metabolic syndrome in patients with congestive heart failure (CHF).
Fasting blood samples were obtained from 93 patients in our institution. Plasma levels of Nt-proBNP and other biochemical data were measured. The New York Heart Association (NYHA) classification system (I-IV) was used to define the functional capacity of CHF. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation.
Forty-nine patients (52.7%) had CHF. There was a positive correlation between plasma Nt-proBNP levels and NYHA functional capacity in CHF patients. Plasma Nt-proBNP levels increased significantly with each increasing NYHA class of the disease. The prevalence of metabolic syndrome in CHF patients was higher than that in patients without CHF. Most importantly, we found that plasma Nt-proBNP levels were lower in CHF patients with metabolic syndrome attributable to inverse relationships between plasma Nt-proBNP and body mass index (β = -0.297), plasma triglyceride (β = -0.286) and homeostasis model assessment of insulin resistance (HOMA-IR; β = -0.346). Fasting glucose to insulin ratio (FGIR, an insulin sensitivity index) was positively associated with plasma Nt-proBNP levels (β = 0.491), and was the independent predictor of plasma Nt-proBNP levels in CHF patients.
Plasma Nt-proBNP levels are inversely associated with metabolic syndrome in CHF patients. Reduced plasma Nt-proBNP levels in CHF patients may lead to impaired lipolysis and metabolic function, and may contribute to the development of metabolic syndrome in CHF patients.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24265747</pmid><doi>10.1371/journal.pone.0079096</doi><tpages>e79096</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Aged Aged, 80 and over Analysis Blood Glucose - metabolism Body mass Body mass index Body size Brain natriuretic peptide Cardiovascular disease Care and treatment Congestive heart failure Diabetes mellitus Diagnostic systems Fasting Fasting - blood Female Glucose Heart Heart Failure - complications Homeostasis Humans Insulin Insulin - blood Insulin resistance Lipolysis Male Metabolic syndrome Metabolic Syndrome - blood Metabolic Syndrome - complications Middle Aged Multivariate Analysis Natriuretic Peptide, Brain - blood Natriuretic peptides Obesity Patients Peptide Fragments - blood Plasma levels Sampling methods Type 2 diabetes |
| title | Inverse association of N-terminal pro-B-type natriuretic peptide with metabolic syndrome in patients with congestive heart failure |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T09%3A43%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Inverse%20association%20of%20N-terminal%20pro-B-type%20natriuretic%20peptide%20with%20metabolic%20syndrome%20in%20patients%20with%20congestive%20heart%20failure&rft.jtitle=PloS%20one&rft.au=Chang,%20Huai-Ren&rft.date=2013-11-12&rft.volume=8&rft.issue=11&rft.spage=e79096&rft.epage=e79096&rft.pages=e79096-e79096&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0079096&rft_dat=%3Cgale_plos_%3EA478300849%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1450247526&rft_id=info:pmid/24265747&rft_galeid=A478300849&rft_doaj_id=oai_doaj_org_article_c64f234aaef14dd2ba79be4e108a473b&rfr_iscdi=true |