Oxidative stress could precede endothelial dysfunction and insulin resistance in Indian Mauritians with impaired glucose metabolism

To measure oxidative stress, endothelial dysfunction and insulin resistance in Indian Mauritians at different stages of development of Type II (non-insulin-dependent) diabetes mellitus. Plasma total 8-epi-PGF2alpha, an indicator of oxidative stress, was determined in age-matched subjects with normal...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Diabetologia 2001-06, Vol.44 (6), p.706-712
Hauptverfasser: GOPAUL, N. K, MANRAJ, M. D, HEBE, A, LEE KWAI YAN, S, JOHNSTON, A, CARRIER, M. J, ÄNGGARD, E. E
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 712
container_issue 6
container_start_page 706
container_title Diabetologia
container_volume 44
creator GOPAUL, N. K
MANRAJ, M. D
HEBE, A
LEE KWAI YAN, S
JOHNSTON, A
CARRIER, M. J
ÄNGGARD, E. E
description To measure oxidative stress, endothelial dysfunction and insulin resistance in Indian Mauritians at different stages of development of Type II (non-insulin-dependent) diabetes mellitus. Plasma total 8-epi-PGF2alpha, an indicator of oxidative stress, was determined in age-matched subjects with normal glucose metabolism (n = 39), impaired glucose tolerance (n = 14), newly diagnosed diabetes (n = 8) and established diabetes (n = 14). Plasma glucose and insulin were measured at baseline and 2 h following an oral glucose tolerance test. Endothelial function was assessed by non-invasive digital pulse wave photoplethysmography. Plasma 8-epi-PGF2alpha increased in subjects with impaired glucose tolerance (p < 0.05) compared with control subjects, and was even higher in newly diagnosed diabetic patients (p < 0.01) and established (p < 0.01) diabetic patients. A tendency towards reduced endothelial function in subjects with impaired glucose tolerance became significant in patients with newly diagnosed and established diabetes (p < 0.01), and was correlated with 8-epi-PGF2alpha (r = 0.36, p < 0.01). Insulin resistance (homeostasis model assessment) did not change in subjects with impaired glucose tolerance compared with control subjects, but increased in newly diagnosed (p < 0.01) and established (p < 0.001) diabetic subjects. The 8-epi-PGF2alpha was correlated with fasting glucose (r = 0.50, p < 0.001), triglycerides (r = 0.40, p < 0.001) and insulin resistance (r = 0.35, p < 0.001). Oxidant stress is an early event in the evolution of Type II diabetes and could precede the development of endothelial dysfunction and insulin resistance.
doi_str_mv 10.1007/s001250051679
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70984052</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1265321891</sourcerecordid><originalsourceid>FETCH-LOGICAL-c384t-dad0bd42e76328cf05bf67ae8a78d0cef4da30d810262e1293a15010610802543</originalsourceid><addsrcrecordid>eNpdkctrVTEQxoMo9lpdupUg4u7UyeM87lKKj0JLNwruDrnJHJuSk1wzidp1_3FTekHtaoaZ33x8zMfYSwEnAmB8RwBC9gC9GMbtI7YRWskOtJwes83dqhPT8O2IPSO6BgDV6-EpOxJCa1CD2rDby9_emeJ_IqeSkYjbVIPj-4wWHXKMLpUrDN4E7m5oqdEWnyI30XEfqQYfeTvzVEy02Eb8LDpvIr8wNfvSOuK_fLnift0bn9Hx76HaRMhXLGaXgqf1OXuymED44lCP2dePH76cfu7OLz-dnb4_76yadOmccbBzWuI4KDnZBfrdMowGJzNODiwu2hkFbhIgB4lCbpURPQgYBEwge62O2dt73X1OPypSmVdPFkMwEVOleYTtpKGXDXz9ALxONcfmbZaieZFKjA3q7iGbE1HGZd5nv5p8MwuY76KZ_4um8a8OonW3ovtLH7JowJsDYMiasOT2UU__qI7NXq_-APbMl4w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>213842317</pqid></control><display><type>article</type><title>Oxidative stress could precede endothelial dysfunction and insulin resistance in Indian Mauritians with impaired glucose metabolism</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>GOPAUL, N. K ; MANRAJ, M. D ; HEBE, A ; LEE KWAI YAN, S ; JOHNSTON, A ; CARRIER, M. J ; ÄNGGARD, E. E</creator><creatorcontrib>GOPAUL, N. K ; MANRAJ, M. D ; HEBE, A ; LEE KWAI YAN, S ; JOHNSTON, A ; CARRIER, M. J ; ÄNGGARD, E. E</creatorcontrib><description><![CDATA[To measure oxidative stress, endothelial dysfunction and insulin resistance in Indian Mauritians at different stages of development of Type II (non-insulin-dependent) diabetes mellitus. Plasma total 8-epi-PGF2alpha, an indicator of oxidative stress, was determined in age-matched subjects with normal glucose metabolism (n = 39), impaired glucose tolerance (n = 14), newly diagnosed diabetes (n = 8) and established diabetes (n = 14). Plasma glucose and insulin were measured at baseline and 2 h following an oral glucose tolerance test. Endothelial function was assessed by non-invasive digital pulse wave photoplethysmography. Plasma 8-epi-PGF2alpha increased in subjects with impaired glucose tolerance (p < 0.05) compared with control subjects, and was even higher in newly diagnosed diabetic patients (p < 0.01) and established (p < 0.01) diabetic patients. A tendency towards reduced endothelial function in subjects with impaired glucose tolerance became significant in patients with newly diagnosed and established diabetes (p < 0.01), and was correlated with 8-epi-PGF2alpha (r = 0.36, p < 0.01). Insulin resistance (homeostasis model assessment) did not change in subjects with impaired glucose tolerance compared with control subjects, but increased in newly diagnosed (p < 0.01) and established (p < 0.001) diabetic subjects. The 8-epi-PGF2alpha was correlated with fasting glucose (r = 0.50, p < 0.001), triglycerides (r = 0.40, p < 0.001) and insulin resistance (r = 0.35, p < 0.001). Oxidant stress is an early event in the evolution of Type II diabetes and could precede the development of endothelial dysfunction and insulin resistance.]]></description><identifier>ISSN: 0012-186X</identifier><identifier>EISSN: 1432-0428</identifier><identifier>DOI: 10.1007/s001250051679</identifier><identifier>PMID: 11440363</identifier><language>eng</language><publisher>Berlin: Springer</publisher><subject>Anticoagulants ; Antioxidants ; Biological and medical sciences ; Blood Glucose - analysis ; Blood pressure ; Dentistry ; Diabetes ; Diabetes Mellitus, Type 2 - physiopathology ; Diabetes. Impaired glucose tolerance ; Dinoprost - analogs &amp; derivatives ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Endothelium ; Endothelium, Vascular - physiopathology ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; F2-Isoprostanes - blood ; Fasting - blood ; Female ; Free radicals ; Glucose ; Glucose - metabolism ; Glucose Intolerance ; Humans ; Hypertension ; India - ethnology ; Insulin Resistance ; Male ; Mauritius ; Medical research ; Medical sciences ; Metabolism ; Middle Aged ; Oxidative Stress ; Plasma ; Reference Values ; Triglycerides ; Triglycerides - blood</subject><ispartof>Diabetologia, 2001-06, Vol.44 (6), p.706-712</ispartof><rights>2001 INIST-CNRS</rights><rights>Springer-Verlag Berlin Heidelberg 2001</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-dad0bd42e76328cf05bf67ae8a78d0cef4da30d810262e1293a15010610802543</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=1079845$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11440363$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GOPAUL, N. K</creatorcontrib><creatorcontrib>MANRAJ, M. D</creatorcontrib><creatorcontrib>HEBE, A</creatorcontrib><creatorcontrib>LEE KWAI YAN, S</creatorcontrib><creatorcontrib>JOHNSTON, A</creatorcontrib><creatorcontrib>CARRIER, M. J</creatorcontrib><creatorcontrib>ÄNGGARD, E. E</creatorcontrib><title>Oxidative stress could precede endothelial dysfunction and insulin resistance in Indian Mauritians with impaired glucose metabolism</title><title>Diabetologia</title><addtitle>Diabetologia</addtitle><description><![CDATA[To measure oxidative stress, endothelial dysfunction and insulin resistance in Indian Mauritians at different stages of development of Type II (non-insulin-dependent) diabetes mellitus. Plasma total 8-epi-PGF2alpha, an indicator of oxidative stress, was determined in age-matched subjects with normal glucose metabolism (n = 39), impaired glucose tolerance (n = 14), newly diagnosed diabetes (n = 8) and established diabetes (n = 14). Plasma glucose and insulin were measured at baseline and 2 h following an oral glucose tolerance test. Endothelial function was assessed by non-invasive digital pulse wave photoplethysmography. Plasma 8-epi-PGF2alpha increased in subjects with impaired glucose tolerance (p < 0.05) compared with control subjects, and was even higher in newly diagnosed diabetic patients (p < 0.01) and established (p < 0.01) diabetic patients. A tendency towards reduced endothelial function in subjects with impaired glucose tolerance became significant in patients with newly diagnosed and established diabetes (p < 0.01), and was correlated with 8-epi-PGF2alpha (r = 0.36, p < 0.01). Insulin resistance (homeostasis model assessment) did not change in subjects with impaired glucose tolerance compared with control subjects, but increased in newly diagnosed (p < 0.01) and established (p < 0.001) diabetic subjects. The 8-epi-PGF2alpha was correlated with fasting glucose (r = 0.50, p < 0.001), triglycerides (r = 0.40, p < 0.001) and insulin resistance (r = 0.35, p < 0.001). Oxidant stress is an early event in the evolution of Type II diabetes and could precede the development of endothelial dysfunction and insulin resistance.]]></description><subject>Anticoagulants</subject><subject>Antioxidants</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - analysis</subject><subject>Blood pressure</subject><subject>Dentistry</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Dinoprost - analogs &amp; derivatives</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Endothelium</subject><subject>Endothelium, Vascular - physiopathology</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>F2-Isoprostanes - blood</subject><subject>Fasting - blood</subject><subject>Female</subject><subject>Free radicals</subject><subject>Glucose</subject><subject>Glucose - metabolism</subject><subject>Glucose Intolerance</subject><subject>Humans</subject><subject>Hypertension</subject><subject>India - ethnology</subject><subject>Insulin Resistance</subject><subject>Male</subject><subject>Mauritius</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Oxidative Stress</subject><subject>Plasma</subject><subject>Reference Values</subject><subject>Triglycerides</subject><subject>Triglycerides - blood</subject><issn>0012-186X</issn><issn>1432-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkctrVTEQxoMo9lpdupUg4u7UyeM87lKKj0JLNwruDrnJHJuSk1wzidp1_3FTekHtaoaZ33x8zMfYSwEnAmB8RwBC9gC9GMbtI7YRWskOtJwes83dqhPT8O2IPSO6BgDV6-EpOxJCa1CD2rDby9_emeJ_IqeSkYjbVIPj-4wWHXKMLpUrDN4E7m5oqdEWnyI30XEfqQYfeTvzVEy02Eb8LDpvIr8wNfvSOuK_fLnift0bn9Hx76HaRMhXLGaXgqf1OXuymED44lCP2dePH76cfu7OLz-dnb4_76yadOmccbBzWuI4KDnZBfrdMowGJzNODiwu2hkFbhIgB4lCbpURPQgYBEwge62O2dt73X1OPypSmVdPFkMwEVOleYTtpKGXDXz9ALxONcfmbZaieZFKjA3q7iGbE1HGZd5nv5p8MwuY76KZ_4um8a8OonW3ovtLH7JowJsDYMiasOT2UU__qI7NXq_-APbMl4w</recordid><startdate>20010601</startdate><enddate>20010601</enddate><creator>GOPAUL, N. K</creator><creator>MANRAJ, M. D</creator><creator>HEBE, A</creator><creator>LEE KWAI YAN, S</creator><creator>JOHNSTON, A</creator><creator>CARRIER, M. J</creator><creator>ÄNGGARD, E. E</creator><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><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>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20010601</creationdate><title>Oxidative stress could precede endothelial dysfunction and insulin resistance in Indian Mauritians with impaired glucose metabolism</title><author>GOPAUL, N. K ; MANRAJ, M. D ; HEBE, A ; LEE KWAI YAN, S ; JOHNSTON, A ; CARRIER, M. J ; ÄNGGARD, E. E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-dad0bd42e76328cf05bf67ae8a78d0cef4da30d810262e1293a15010610802543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Anticoagulants</topic><topic>Antioxidants</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose - analysis</topic><topic>Blood pressure</topic><topic>Dentistry</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Dinoprost - analogs &amp; derivatives</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Endothelium</topic><topic>Endothelium, Vascular - physiopathology</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>F2-Isoprostanes - blood</topic><topic>Fasting - blood</topic><topic>Female</topic><topic>Free radicals</topic><topic>Glucose</topic><topic>Glucose - metabolism</topic><topic>Glucose Intolerance</topic><topic>Humans</topic><topic>Hypertension</topic><topic>India - ethnology</topic><topic>Insulin Resistance</topic><topic>Male</topic><topic>Mauritius</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Oxidative Stress</topic><topic>Plasma</topic><topic>Reference Values</topic><topic>Triglycerides</topic><topic>Triglycerides - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GOPAUL, N. K</creatorcontrib><creatorcontrib>MANRAJ, M. D</creatorcontrib><creatorcontrib>HEBE, A</creatorcontrib><creatorcontrib>LEE KWAI YAN, S</creatorcontrib><creatorcontrib>JOHNSTON, A</creatorcontrib><creatorcontrib>CARRIER, M. J</creatorcontrib><creatorcontrib>ÄNGGARD, E. E</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health &amp; 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>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetologia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GOPAUL, N. K</au><au>MANRAJ, M. D</au><au>HEBE, A</au><au>LEE KWAI YAN, S</au><au>JOHNSTON, A</au><au>CARRIER, M. J</au><au>ÄNGGARD, E. E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oxidative stress could precede endothelial dysfunction and insulin resistance in Indian Mauritians with impaired glucose metabolism</atitle><jtitle>Diabetologia</jtitle><addtitle>Diabetologia</addtitle><date>2001-06-01</date><risdate>2001</risdate><volume>44</volume><issue>6</issue><spage>706</spage><epage>712</epage><pages>706-712</pages><issn>0012-186X</issn><eissn>1432-0428</eissn><abstract><![CDATA[To measure oxidative stress, endothelial dysfunction and insulin resistance in Indian Mauritians at different stages of development of Type II (non-insulin-dependent) diabetes mellitus. Plasma total 8-epi-PGF2alpha, an indicator of oxidative stress, was determined in age-matched subjects with normal glucose metabolism (n = 39), impaired glucose tolerance (n = 14), newly diagnosed diabetes (n = 8) and established diabetes (n = 14). Plasma glucose and insulin were measured at baseline and 2 h following an oral glucose tolerance test. Endothelial function was assessed by non-invasive digital pulse wave photoplethysmography. Plasma 8-epi-PGF2alpha increased in subjects with impaired glucose tolerance (p < 0.05) compared with control subjects, and was even higher in newly diagnosed diabetic patients (p < 0.01) and established (p < 0.01) diabetic patients. A tendency towards reduced endothelial function in subjects with impaired glucose tolerance became significant in patients with newly diagnosed and established diabetes (p < 0.01), and was correlated with 8-epi-PGF2alpha (r = 0.36, p < 0.01). Insulin resistance (homeostasis model assessment) did not change in subjects with impaired glucose tolerance compared with control subjects, but increased in newly diagnosed (p < 0.01) and established (p < 0.001) diabetic subjects. The 8-epi-PGF2alpha was correlated with fasting glucose (r = 0.50, p < 0.001), triglycerides (r = 0.40, p < 0.001) and insulin resistance (r = 0.35, p < 0.001). Oxidant stress is an early event in the evolution of Type II diabetes and could precede the development of endothelial dysfunction and insulin resistance.]]></abstract><cop>Berlin</cop><pub>Springer</pub><pmid>11440363</pmid><doi>10.1007/s001250051679</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0012-186X
ispartof Diabetologia, 2001-06, Vol.44 (6), p.706-712
issn 0012-186X
1432-0428
language eng
recordid cdi_proquest_miscellaneous_70984052
source MEDLINE; SpringerLink Journals - AutoHoldings
subjects Anticoagulants
Antioxidants
Biological and medical sciences
Blood Glucose - analysis
Blood pressure
Dentistry
Diabetes
Diabetes Mellitus, Type 2 - physiopathology
Diabetes. Impaired glucose tolerance
Dinoprost - analogs & derivatives
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Endothelium
Endothelium, Vascular - physiopathology
Etiopathogenesis. Screening. Investigations. Target tissue resistance
F2-Isoprostanes - blood
Fasting - blood
Female
Free radicals
Glucose
Glucose - metabolism
Glucose Intolerance
Humans
Hypertension
India - ethnology
Insulin Resistance
Male
Mauritius
Medical research
Medical sciences
Metabolism
Middle Aged
Oxidative Stress
Plasma
Reference Values
Triglycerides
Triglycerides - blood
title Oxidative stress could precede endothelial dysfunction and insulin resistance in Indian Mauritians with impaired glucose metabolism
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-21T16%3A12%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Oxidative%20stress%20could%20precede%20endothelial%20dysfunction%20and%20insulin%20resistance%20in%20Indian%20Mauritians%20with%20impaired%20glucose%20metabolism&rft.jtitle=Diabetologia&rft.au=GOPAUL,%20N.%20K&rft.date=2001-06-01&rft.volume=44&rft.issue=6&rft.spage=706&rft.epage=712&rft.pages=706-712&rft.issn=0012-186X&rft.eissn=1432-0428&rft_id=info:doi/10.1007/s001250051679&rft_dat=%3Cproquest_cross%3E1265321891%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=213842317&rft_id=info:pmid/11440363&rfr_iscdi=true