Normal range albuminuria and metabolic syndrome in South Korea: the 2011-2012 Korean National Health and Nutrition Examination Survey
It is well-known that there is a close relationship between metabolic syndrome (MetS) and microalbuminuria. However, some recent studies have found that even normal range albuminuria was associated with MetS and cardiometabolic risk factors. The purpose of this study is to analyze the relationship b...
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| creator | Park, Si-Young Park, Yong-Kyu Cho, Kyung-Hwan Choi, Hee-Jeong Han, Jee-Hye Han, Kyung-Do Han, Byung-Duck Yoon, Yeo-Joon Kim, Yang-Hyun |
| description | It is well-known that there is a close relationship between metabolic syndrome (MetS) and microalbuminuria. However, some recent studies have found that even normal range albuminuria was associated with MetS and cardiometabolic risk factors. The purpose of this study is to analyze the relationship between MetS and normal range albuminuria and to calculate the cutoff value for albuminuria that correlates with MetS in the representative fraction of Korean population.
Data were obtained from the 2011-2012 Korea National Health and Nutrition Examination Survey and included 9,650 subjects aged ≥ 19 years. We measured metabolic parameters: fasting blood glucose, waist circumference, blood pressure, and lipids, and albumin-to-creatinine ratio (ACR). The optimal ACR cutoff points for MetS were examined by the receiver operating characteristic curve. Multivariate logistic regression was used to obtain the prevalence of MetS and its components according to the ACR levels.
The first cutoff value of ACR were 4.8 mg/g for subjects with ≥ 3 components of MetS. There was a graded association between ACR and prevalence of MetS and its components. If ACR was |
| doi_str_mv | 10.1371/journal.pone.0125615 |
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Data were obtained from the 2011-2012 Korea National Health and Nutrition Examination Survey and included 9,650 subjects aged ≥ 19 years. We measured metabolic parameters: fasting blood glucose, waist circumference, blood pressure, and lipids, and albumin-to-creatinine ratio (ACR). The optimal ACR cutoff points for MetS were examined by the receiver operating characteristic curve. Multivariate logistic regression was used to obtain the prevalence of MetS and its components according to the ACR levels.
The first cutoff value of ACR were 4.8 mg/g for subjects with ≥ 3 components of MetS. There was a graded association between ACR and prevalence of MetS and its components. If ACR was <4 mg/g, there was no significant increase in the prevalence of MetS or its components. From the ACR level of 4-5 mg/g, the prevalence of MetS significantly increased after adjusting for age, sex, body mass index, smoking, alcohol intake, exercise, and medications for diabetes mellitus and hypertension (odds ratio; 95% confidence intervals = 1.416; 1.041-1.926).
Albuminuria within the normal range (around 5 mg/g) was associated with prevalence of MetS in the Korean population.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0125615</identifier><identifier>PMID: 25978637</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Albuminuria ; Albuminuria - epidemiology ; Alcohol ; Alcohol use ; Alcoholic beverages ; Analysis ; Blood ; Blood Pressure ; Body mass ; Body mass index ; Body size ; Cardiovascular disease ; Cholesterol ; Chronic illnesses ; Confidence intervals ; Creatinine ; Demographic aspects ; Diabetes ; Diabetes mellitus ; Diagnosis ; Disease control ; Exercise ; Female ; Health risks ; Health surveys ; Heart ; Humans ; Hypertension ; Kidney diseases ; Lipid metabolism ; Lipids ; Male ; Mathematical analysis ; Medical statistics ; Medicine ; Mens health ; Metabolic disorders ; Metabolic syndrome ; Metabolic Syndrome - epidemiology ; Metabolic syndrome X ; Middle age ; Middle Aged ; Multivariate Analysis ; Nutrition ; Nutrition Surveys ; Physical fitness ; Population ; Questionnaires ; Regression analysis ; Republic of Korea - epidemiology ; Risk analysis ; Risk Factors ; Smoking ; Statistical analysis ; Studies ; Surveys ; Urine ; Womens health</subject><ispartof>PloS one, 2015-05, Vol.10 (5), p.e0125615-e0125615</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Park et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://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>2015 Park et al 2015 Park et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-74205d47e4c1500b4fe077a2ad62b6498b501b06c3d37ef05ed165285795bbc03</citedby><cites>FETCH-LOGICAL-c692t-74205d47e4c1500b4fe077a2ad62b6498b501b06c3d37ef05ed165285795bbc03</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/PMC4433278/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4433278/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23871,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25978637$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Mischak, Harald</contributor><creatorcontrib>Park, Si-Young</creatorcontrib><creatorcontrib>Park, Yong-Kyu</creatorcontrib><creatorcontrib>Cho, Kyung-Hwan</creatorcontrib><creatorcontrib>Choi, Hee-Jeong</creatorcontrib><creatorcontrib>Han, Jee-Hye</creatorcontrib><creatorcontrib>Han, Kyung-Do</creatorcontrib><creatorcontrib>Han, Byung-Duck</creatorcontrib><creatorcontrib>Yoon, Yeo-Joon</creatorcontrib><creatorcontrib>Kim, Yang-Hyun</creatorcontrib><title>Normal range albuminuria and metabolic syndrome in South Korea: the 2011-2012 Korean National Health and Nutrition Examination Survey</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>It is well-known that there is a close relationship between metabolic syndrome (MetS) and microalbuminuria. However, some recent studies have found that even normal range albuminuria was associated with MetS and cardiometabolic risk factors. The purpose of this study is to analyze the relationship between MetS and normal range albuminuria and to calculate the cutoff value for albuminuria that correlates with MetS in the representative fraction of Korean population.
Data were obtained from the 2011-2012 Korea National Health and Nutrition Examination Survey and included 9,650 subjects aged ≥ 19 years. We measured metabolic parameters: fasting blood glucose, waist circumference, blood pressure, and lipids, and albumin-to-creatinine ratio (ACR). The optimal ACR cutoff points for MetS were examined by the receiver operating characteristic curve. Multivariate logistic regression was used to obtain the prevalence of MetS and its components according to the ACR levels.
The first cutoff value of ACR were 4.8 mg/g for subjects with ≥ 3 components of MetS. There was a graded association between ACR and prevalence of MetS and its components. If ACR was <4 mg/g, there was no significant increase in the prevalence of MetS or its components. From the ACR level of 4-5 mg/g, the prevalence of MetS significantly increased after adjusting for age, sex, body mass index, smoking, alcohol intake, exercise, and medications for diabetes mellitus and hypertension (odds ratio; 95% confidence intervals = 1.416; 1.041-1.926).
Albuminuria within the normal range (around 5 mg/g) was associated with prevalence of MetS in the Korean population.</description><subject>Adult</subject><subject>Albuminuria</subject><subject>Albuminuria - epidemiology</subject><subject>Alcohol</subject><subject>Alcohol use</subject><subject>Alcoholic beverages</subject><subject>Analysis</subject><subject>Blood</subject><subject>Blood Pressure</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Cardiovascular disease</subject><subject>Cholesterol</subject><subject>Chronic illnesses</subject><subject>Confidence intervals</subject><subject>Creatinine</subject><subject>Demographic aspects</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diagnosis</subject><subject>Disease control</subject><subject>Exercise</subject><subject>Female</subject><subject>Health risks</subject><subject>Health surveys</subject><subject>Heart</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Kidney diseases</subject><subject>Lipid metabolism</subject><subject>Lipids</subject><subject>Male</subject><subject>Mathematical analysis</subject><subject>Medical statistics</subject><subject>Medicine</subject><subject>Mens health</subject><subject>Metabolic disorders</subject><subject>Metabolic syndrome</subject><subject>Metabolic Syndrome - epidemiology</subject><subject>Metabolic syndrome X</subject><subject>Middle age</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Nutrition</subject><subject>Nutrition Surveys</subject><subject>Physical fitness</subject><subject>Population</subject><subject>Questionnaires</subject><subject>Regression analysis</subject><subject>Republic of Korea - epidemiology</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Smoking</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>Surveys</subject><subject>Urine</subject><subject>Womens health</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</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>eNqNk99v0zAQxyMEYmPwHyCwhITgocW_nfCANE2DVUydRIFX6-K4rack7uxkWv8A_m-ctptatAdkKY7On_ve-XyXZa8JHhOmyKdr34cW6vHKt3aMCRWSiCfZMSkYHUmK2dO9_6PsRYzXGAuWS_k8O6KiULlk6jj7M_WhgRoFaBcWQV32jWv74ABBW6HGdlD62hkU120VfGORa9HM990SfffBwmfULS2imJBR-tCtsUVT6JxPyaELC3ViB61p3wU3mNH5HaQgGwTN-nBr1y-zZ3Ooo32120-yX1_Pf55djC6vvk3OTi9HRha0GylOsai4stwQgXHJ5xYrBRQqSUvJi7wUmJRYGlYxZedY2IpIQXOhClGWBrOT7O1Wd1X7qHcVjJrInOCCKy4SMdkSlYdrvQqugbDWHpzeGHxYaAidM7XVBoiRXJSKQckZo3lJqlRrKpjNmQKetL7sovVlYytj2y5AfSB6eNK6pV74W80HOZUngQ87geBvehs73bhobF1Da32_yZtSLCVmCX33D_r47XbUAtIFXDv3Ka4ZRPUpZ5RgTtWQ9_gRKq3KNs6kdpu7ZD9w-HjgkJjO3nUL6GPUk9mP_2evfh-y7_fY5aaXoq_7oXPiIci3oAk-xmDnD0UmWA_Tcl8NPUyL3k1Lcnuz_0APTvfjwf4CRoYNdQ</recordid><startdate>20150515</startdate><enddate>20150515</enddate><creator>Park, Si-Young</creator><creator>Park, Yong-Kyu</creator><creator>Cho, Kyung-Hwan</creator><creator>Choi, Hee-Jeong</creator><creator>Han, Jee-Hye</creator><creator>Han, Kyung-Do</creator><creator>Han, Byung-Duck</creator><creator>Yoon, Yeo-Joon</creator><creator>Kim, Yang-Hyun</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>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>20150515</creationdate><title>Normal range albuminuria and metabolic syndrome in South Korea: the 2011-2012 Korean National Health and Nutrition Examination Survey</title><author>Park, Si-Young ; Park, Yong-Kyu ; Cho, Kyung-Hwan ; Choi, Hee-Jeong ; Han, Jee-Hye ; Han, Kyung-Do ; Han, Byung-Duck ; Yoon, Yeo-Joon ; Kim, Yang-Hyun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-74205d47e4c1500b4fe077a2ad62b6498b501b06c3d37ef05ed165285795bbc03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Albuminuria</topic><topic>Albuminuria - epidemiology</topic><topic>Alcohol</topic><topic>Alcohol use</topic><topic>Alcoholic beverages</topic><topic>Analysis</topic><topic>Blood</topic><topic>Blood Pressure</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Cardiovascular disease</topic><topic>Cholesterol</topic><topic>Chronic illnesses</topic><topic>Confidence intervals</topic><topic>Creatinine</topic><topic>Demographic aspects</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diagnosis</topic><topic>Disease control</topic><topic>Exercise</topic><topic>Female</topic><topic>Health risks</topic><topic>Health surveys</topic><topic>Heart</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Kidney diseases</topic><topic>Lipid metabolism</topic><topic>Lipids</topic><topic>Male</topic><topic>Mathematical analysis</topic><topic>Medical statistics</topic><topic>Medicine</topic><topic>Mens health</topic><topic>Metabolic disorders</topic><topic>Metabolic syndrome</topic><topic>Metabolic Syndrome - epidemiology</topic><topic>Metabolic syndrome X</topic><topic>Middle age</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Nutrition</topic><topic>Nutrition Surveys</topic><topic>Physical fitness</topic><topic>Population</topic><topic>Questionnaires</topic><topic>Regression analysis</topic><topic>Republic of Korea - epidemiology</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Smoking</topic><topic>Statistical analysis</topic><topic>Studies</topic><topic>Surveys</topic><topic>Urine</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Si-Young</creatorcontrib><creatorcontrib>Park, Yong-Kyu</creatorcontrib><creatorcontrib>Cho, Kyung-Hwan</creatorcontrib><creatorcontrib>Choi, Hee-Jeong</creatorcontrib><creatorcontrib>Han, Jee-Hye</creatorcontrib><creatorcontrib>Han, Kyung-Do</creatorcontrib><creatorcontrib>Han, Byung-Duck</creatorcontrib><creatorcontrib>Yoon, Yeo-Joon</creatorcontrib><creatorcontrib>Kim, Yang-Hyun</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 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 (ProQuest)</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>Park, Si-Young</au><au>Park, Yong-Kyu</au><au>Cho, Kyung-Hwan</au><au>Choi, Hee-Jeong</au><au>Han, Jee-Hye</au><au>Han, Kyung-Do</au><au>Han, Byung-Duck</au><au>Yoon, Yeo-Joon</au><au>Kim, Yang-Hyun</au><au>Mischak, Harald</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Normal range albuminuria and metabolic syndrome in South Korea: the 2011-2012 Korean National Health and Nutrition Examination Survey</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-05-15</date><risdate>2015</risdate><volume>10</volume><issue>5</issue><spage>e0125615</spage><epage>e0125615</epage><pages>e0125615-e0125615</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>It is well-known that there is a close relationship between metabolic syndrome (MetS) and microalbuminuria. However, some recent studies have found that even normal range albuminuria was associated with MetS and cardiometabolic risk factors. The purpose of this study is to analyze the relationship between MetS and normal range albuminuria and to calculate the cutoff value for albuminuria that correlates with MetS in the representative fraction of Korean population.
Data were obtained from the 2011-2012 Korea National Health and Nutrition Examination Survey and included 9,650 subjects aged ≥ 19 years. We measured metabolic parameters: fasting blood glucose, waist circumference, blood pressure, and lipids, and albumin-to-creatinine ratio (ACR). The optimal ACR cutoff points for MetS were examined by the receiver operating characteristic curve. Multivariate logistic regression was used to obtain the prevalence of MetS and its components according to the ACR levels.
The first cutoff value of ACR were 4.8 mg/g for subjects with ≥ 3 components of MetS. There was a graded association between ACR and prevalence of MetS and its components. If ACR was <4 mg/g, there was no significant increase in the prevalence of MetS or its components. From the ACR level of 4-5 mg/g, the prevalence of MetS significantly increased after adjusting for age, sex, body mass index, smoking, alcohol intake, exercise, and medications for diabetes mellitus and hypertension (odds ratio; 95% confidence intervals = 1.416; 1.041-1.926).
Albuminuria within the normal range (around 5 mg/g) was associated with prevalence of MetS in the Korean population.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25978637</pmid><doi>10.1371/journal.pone.0125615</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Albuminuria Albuminuria - epidemiology Alcohol Alcohol use Alcoholic beverages Analysis Blood Blood Pressure Body mass Body mass index Body size Cardiovascular disease Cholesterol Chronic illnesses Confidence intervals Creatinine Demographic aspects Diabetes Diabetes mellitus Diagnosis Disease control Exercise Female Health risks Health surveys Heart Humans Hypertension Kidney diseases Lipid metabolism Lipids Male Mathematical analysis Medical statistics Medicine Mens health Metabolic disorders Metabolic syndrome Metabolic Syndrome - epidemiology Metabolic syndrome X Middle age Middle Aged Multivariate Analysis Nutrition Nutrition Surveys Physical fitness Population Questionnaires Regression analysis Republic of Korea - epidemiology Risk analysis Risk Factors Smoking Statistical analysis Studies Surveys Urine Womens health |
| title | Normal range albuminuria and metabolic syndrome in South Korea: the 2011-2012 Korean National Health and Nutrition Examination Survey |
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