I
nte
rna
t
io
na
l J
o
urna
l o
f
P
u
bli
c
H
ea
lt
h Science
(
I
J
P
H
S)
Vo
l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
,
p
p
.
1
96
0
~
1
9
67
I
SS
N:
2
2
5
2
-
8
8
0
6
,
DOI
: 1
0
.
1
1
5
9
1
/ijp
h
s
.
v
1
3
i
4
.
2
4
4
6
8
1960
J
o
ur
na
l ho
m
ep
a
g
e
:
h
ttp
:
//
ijp
h
s
.
ia
esco
r
e.
co
m
Risk facto
rs o
f
m
etabo
lic sy
ndro
m
e in
wo
men
of r
ep
ro
ductive
a
g
e at mining
are
a
No
v
ia
L
uthv
ia
t
in
1
,
O
nn
y
Set
ia
ni
2
,
B
a
g
o
es Widj
a
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o
3
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o
ha
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m
a
d Z
en
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hfiludi
n
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rt
ini
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urs
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h
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icle
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nfo
AB
S
T
RAC
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A
r
ticle
his
to
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y:
R
ec
eiv
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J
an
1
2
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2
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2
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R
ev
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Ap
r
1
9
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2
0
2
4
Acc
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ted
Ap
r
2
4
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2
0
2
4
Lea
d
is
o
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e
o
f
th
e
f
o
u
r
m
o
st
d
a
n
g
e
ro
u
s
h
e
a
v
y
m
e
tal
p
o
ll
u
tan
ts
,
to
x
ic
t
o
h
u
m
a
n
h
e
a
lt
h
,
a
n
d
li
n
k
e
d
to
m
e
tab
o
li
c
sy
n
d
r
o
m
e
(M
e
tS
).
Th
is
re
se
a
rc
h
a
im
ed
to
a
n
a
ly
z
e
th
e
re
latio
n
s
h
ip
b
e
twe
e
n
re
sp
o
n
d
e
n
t
c
h
a
ra
c
teristi
c
s,
b
l
o
o
d
lea
d
lev
e
l
(BLL
)
,
n
u
tri
ti
o
n
i
n
ta
k
e
,
a
n
d
p
h
y
sic
a
l
a
c
ti
v
it
y
to
M
e
tS
a
n
d
it
s
c
o
m
p
o
n
e
n
ts
i
n
wo
m
e
n
o
f
re
p
ro
d
u
c
ti
v
e
a
g
e
a
t
P
e
m
a
li
District
M
i
n
in
g
Are
a
,
Ba
n
g
k
a
Be
li
t
u
n
g
Re
g
e
n
c
y
.
Th
is
r
e
se
a
rc
h
wa
s
c
o
n
d
u
c
ted
wi
th
a
c
a
se
-
c
o
n
tro
l
a
p
p
ro
a
c
h
i
n
v
o
lv
i
n
g
7
0
w
o
m
e
n
o
f
re
p
ro
d
u
c
ti
v
e
a
g
e
(3
5
c
a
se
s
a
n
d
3
5
c
o
n
tro
ls).
Da
ta
wa
s
a
n
a
ly
z
e
d
u
si
n
g
c
h
i
-
sq
u
a
re
a
n
d
M
a
n
n
-
Wi
t
n
e
y
tes
ts
f
o
r
b
iv
a
riate
a
n
a
l
y
sis
a
n
d
re
g
re
ss
io
n
tes
t
lo
g
isti
c
s
f
o
r
m
u
l
ti
v
a
riate
a
n
a
ly
sis.
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se
d
o
n
b
i
v
a
riate
a
n
a
ly
sis,
th
e
r
e
is
a
sig
n
ifi
c
a
n
t
re
latio
n
sh
ip
b
e
t
we
e
n
b
o
d
y
m
a
ss
in
d
e
x
(BM
I)
(p
=
0
.
0
0
0
),
sa
lt
in
tak
e
(p
=
0
.
0
1
7
),
a
n
d
se
a
so
n
i
n
g
in
tak
e
(p
=
0
.
0
1
7
)
to
M
e
tS
;
m
e
a
n
wh
i
le,
BLL
is
n
o
t
a
ss
o
c
iate
d
wit
h
M
e
tS
(p
=
0
.
4
7
3
)
b
u
t
a
re
a
ss
o
c
iate
d
with
h
i
g
h
-
d
e
n
sity
li
p
o
p
r
o
tein
c
h
o
les
tero
l
(HD
LC)
(p
=
0
.
0
1
9
)
.
M
u
l
ti
v
a
riate
tes
t
re
su
lt
s sh
o
w t
h
a
t
BM
I
(p
=
0
.
0
0
0
;
OR=
7
.
9
9
5
)
a
n
d
sa
lt
in
tak
e
(p
=
0
.
0
3
0
;
OR=
6
.
8
1
2
)
a
re
sig
n
ifi
c
a
n
t
risk
fa
c
to
rs
fo
r
M
e
tS
.
Wo
m
e
n
o
f
re
p
r
o
d
u
c
ti
v
e
a
g
e
m
u
st
m
a
in
tain
B
M
I
wit
h
in
n
o
rm
a
l
lev
e
ls
a
n
d
re
d
u
c
e
d
a
il
y
sa
lt
in
tak
e
to
p
re
v
e
n
t
th
e
o
c
c
u
rre
n
c
e
o
f
M
e
tS
.
BLL
m
u
st
b
e
c
o
n
tro
ll
e
d
t
o
p
re
v
e
n
t
d
e
c
re
a
se
d
HD
LC
lev
e
ls i
n
w
o
m
e
n
o
f
re
p
ro
d
u
c
ti
v
e
a
g
e
.
K
ey
w
o
r
d
s
:
B
lo
o
d
lead
lev
el
Me
tab
o
lic
s
y
n
d
r
o
m
e
Min
in
g
ar
ea
Nu
tr
itio
n
in
tak
e
Ph
y
s
ical
ac
tiv
ity
W
o
m
en
o
f
r
e
p
r
o
d
u
ctiv
e
ag
e
T
h
is i
s
a
n
o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
No
v
ia
L
u
th
v
iatin
Facu
lty
o
f
Pu
b
lic
Hea
lth
,
Un
i
v
er
s
itas
J
em
b
er
Kalim
an
tan
Stre
et
n
u
m
b
e
r
3
7
Kam
p
u
s
B
u
m
i
T
eg
alb
o
to
,
Su
m
b
er
s
ar
i,
J
em
b
er
-
6
8
1
2
1
,
I
n
d
o
n
esia
E
m
ail: n
o
v
ia@
u
n
ej.
ac
.
id
1.
I
NT
RO
D
UCT
I
O
N
Me
tab
o
lic
s
y
n
d
r
o
m
e
(
Me
tS
)
i
s
a
g
r
o
u
p
o
f
in
te
r
r
elate
d
m
eta
b
o
lic
d
is
o
r
d
er
s
,
in
clu
d
i
n
g
ce
n
t
r
al
o
b
esit
y
,
h
ig
h
b
lo
o
d
p
r
ess
u
r
e,
h
y
p
e
r
g
l
y
ce
m
ia,
a
n
d
d
y
s
lip
id
em
ia,
in
clu
d
in
g
h
ig
h
tr
ig
l
y
ce
r
id
es,
h
i
g
h
lev
els
o
f
lo
w
-
d
en
s
ity
lip
o
p
r
o
tein
ch
o
lest
er
o
l
(
L
DL
C
)
,
an
d
lo
w
lev
els
o
f
h
ig
h
-
d
e
n
s
ity
lip
o
p
r
o
tein
c
h
o
le
s
ter
o
l
(
HDL
C
)
[
1
]
.
B
ased
o
n
I
n
d
o
n
esian
b
asic
h
ea
lth
r
esear
ch
2
0
1
3
-
2
0
1
8
,
th
e
p
r
o
p
o
r
tio
n
o
f
ce
n
tr
al
o
b
esit
y
in
th
e
p
o
p
u
latio
n
ag
ed
≥
1
5
y
ea
r
s
in
cr
ea
s
ed
f
r
o
m
2
6
.
6
%
to
3
1
%,
th
e
p
r
ev
ale
n
ce
o
f
h
y
p
er
ten
s
io
n
in
th
e
p
o
p
u
latio
n
ag
ed
≥
1
8
y
ea
r
s
in
cr
ea
s
ed
f
r
o
m
2
5
.
8
%
to
3
4
.
1
1
%,
an
d
th
e
p
r
ev
alen
ce
o
f
d
iab
etes
m
ellitu
s
b
ased
o
n
a
d
o
cto
r
'
s
d
iag
n
o
s
is
in
th
e
p
o
p
u
latio
n
ag
ed
≥
1
5
y
e
ar
s
in
cr
ea
s
ed
f
r
o
m
1
.
5
%
to
2
%.
T
h
e
p
r
o
v
in
ce
o
f
B
an
g
k
a
B
elitu
n
g
I
s
lan
d
s
is
o
n
e
o
f
th
e
r
e
g
io
n
s
with
a
h
ig
h
p
r
o
p
o
r
tio
n
a
n
d
p
r
ev
alen
ce
o
f
ce
n
tr
al
o
b
esit
y
,
h
y
p
er
ten
s
io
n
,
an
d
d
iab
etes
m
ellitu
s
,
r
esp
ec
tiv
ely
:
f
r
o
m
3
1
.
8
%
to
3
3
.
8
%,
f
r
o
m
3
0
.
9
%
to
2
9
.
9
%,
an
d
f
r
o
m
2
.
1
%
to
2
.
5
%.
T
h
e
p
r
ev
alen
ce
o
f
ce
n
tr
al
o
b
esit
y
,
h
y
p
er
ten
s
io
n
,
a
n
d
d
i
ab
etes
m
ellitu
s
is
h
ig
h
er
in
wo
m
en
th
an
m
en
,
with
th
e
p
r
ev
alen
ce
o
f
ce
n
tr
al
o
b
esit
y
m
o
s
t in
th
e
a
g
e
g
r
o
u
p
o
f
3
5
-
4
4
y
ea
r
s
(
4
6
.
1
4
%)
[
2
]
,
[
3
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
R
is
k
fa
cto
r
s
o
f m
eta
b
o
lic
s
yn
d
r
o
me
in
w
o
men
o
f rep
r
o
d
u
cti
ve
a
g
e
a
t m
in
i
n
g
a
r
ea
(
N
o
via
Lu
th
vi
)
1961
T
h
e
ca
u
s
es
o
f
Me
tS
ar
e
l
if
est
y
le
f
ac
to
r
s
,
in
clu
d
in
g
p
h
y
s
ical
ac
tiv
ity
an
d
d
ietar
y
p
atter
n
s
,
g
en
etic,
an
d
en
v
ir
o
n
m
e
n
tal
f
ac
to
r
s
.
Hea
v
y
m
etal
ex
p
o
s
u
r
e
b
ec
o
m
es
an
en
v
ir
o
n
m
en
tal
f
ac
to
r
th
at
m
ay
b
e
ess
en
tial
in
d
ev
elo
p
in
g
Me
tS
[
4
]
.
L
ea
d
o
r
p
lu
m
b
u
m
(
Pb
)
is
o
n
e
o
f
th
e
f
o
u
r
m
o
s
t
d
a
n
g
er
o
u
s
h
ea
v
y
m
et
al
p
o
llu
tan
ts
,
to
x
ic
to
h
u
m
an
h
ea
lth
,
a
n
d
lin
k
e
d
to
Me
tS.
A
cr
o
s
s
-
s
ec
tio
n
al
s
tu
d
y
o
n
m
ale
an
d
f
em
ale
a
d
u
lts
s
tated
th
at
b
lo
o
d
lead
lev
el
(
B
L
L
)
is
p
o
s
itiv
ely
ass
o
ciate
d
with
th
e
p
r
e
v
alen
ce
o
f
Me
tS
[
5
]
.
B
L
L
was
s
ig
n
if
ican
tly
ass
o
ciate
d
with
s
y
s
to
lic
p
r
ess
u
r
e,
d
iast
o
lic
p
r
ess
u
r
e,
waist
cir
cu
m
f
er
en
ce
,
t
r
ig
ly
ce
r
id
e
lev
els,
a
n
d
f
asti
n
g
b
lo
o
d
s
u
g
ar
(
FB
S)
[
6
]
,
[
7
]
.
L
ea
d
b
u
ild
u
p
in
th
e
b
o
d
y
r
esu
lts
in
ac
u
te
an
d
c
h
r
o
n
ic
p
o
is
o
n
in
g
,
in
cl
u
d
in
g
g
en
etic
a
n
d
r
e
p
r
o
d
u
ctiv
e
p
r
o
b
lem
s
[
8
]
.
W
o
m
en
with
B
L
L
o
f
1
0
g
/
d
L
ar
e
at
r
is
k
f
o
r
co
m
p
licatio
n
s
s
u
ch
as
p
r
em
at
u
r
e
b
ir
th
,
lo
w
b
ir
t
h
weig
h
t,
in
f
er
tili
ty
,
m
is
ca
r
r
iag
e,
ea
r
ly
ch
ild
h
o
o
d
n
eu
r
o
lo
g
ic
al
d
ef
ec
ts
,
an
d
m
ater
n
al
h
y
p
e
r
ten
s
io
n
.
Stu
d
ies
in
wo
m
en
s
h
o
w
th
at
p
r
eg
n
an
t
w
o
m
en
ten
d
to
ex
p
e
r
ien
ce
m
o
r
e
co
m
p
licatio
n
s
d
u
e
to
lead
ac
cu
m
u
latio
n
.
Fetal
g
r
o
wth
is
d
i
r
ec
tly
af
f
ec
ted
b
y
th
e
b
io
ac
cu
m
u
latio
n
o
f
lead
i
n
th
e
b
lo
o
d
,
r
a
n
g
in
g
f
r
o
m
1
0
-
1
5
n
g
/d
L
i
n
wo
m
e
n
o
f
ch
il
d
b
ea
r
in
g
a
g
e
[
9
]
.
R
elate
d
r
esear
ch
s
till
n
ee
d
s
to
b
e
c
o
n
tin
u
ed
to
ascer
tain
th
e
ass
o
ciatio
n
o
f
B
L
L
with
Me
tS,
esp
ec
ially
with
f
em
ale
s
u
b
jects o
f
r
ep
r
o
d
u
ctiv
e
a
g
e.
I
n
I
n
d
o
n
esia,
d
ata
o
r
ex
am
in
atio
n
o
f
lead
lev
els
in
h
u
m
a
n
s
h
as
n
o
t
b
ec
o
m
e
a
s
er
v
ice
p
r
io
r
ity
,
in
clu
d
in
g
in
ar
ea
s
with
h
ig
h
e
x
p
o
s
u
r
e,
s
u
ch
as
in
Pem
ali
Dis
tr
ict,
B
an
g
k
a
B
elitu
n
g
I
s
lan
d
s
Pro
v
in
ce
.
B
an
g
k
a
B
elitu
n
g
I
s
lan
d
s
Pro
v
in
ce
is
I
n
d
o
n
esia'
s
lar
g
est
wh
ite
tin
p
r
o
d
u
ctio
n
ar
ea
,
wh
er
e
e
x
p
lo
r
ati
o
n
h
as
b
ee
n
ca
r
r
ied
o
u
t
s
in
ce
th
e
b
e
g
in
n
in
g
o
f
th
e
XVI
I
I
ce
n
tu
r
y
.
T
h
e
m
in
i
n
g
a
r
ea
r
ea
ch
es
5
1
2
,
3
6
9
h
ec
ta
r
es
o
n
lan
d
an
d
o
f
f
th
e
co
ast
o
f
B
an
g
k
a,
B
elitu
n
g
,
a
n
d
Ku
n
d
u
r
is
lan
d
s
[
1
0
]
.
T
h
e
p
o
ten
tial
o
f
tin
m
in
er
al
r
eso
u
r
c
es
is
in
all
r
eg
io
n
s
,
co
v
er
in
g
s
ix
d
is
tr
icts
an
d
o
n
e
city
:
B
eli
tu
n
g
R
eg
en
cy
,
B
an
g
k
a
R
eg
en
cy
,
W
est
B
an
g
k
a
R
eg
en
cy
,
C
en
tr
al
B
an
g
k
a
R
eg
en
cy
,
So
u
th
B
an
g
k
a
R
eg
en
cy
,
E
ast
B
elitu
n
g
R
eg
en
cy
,
an
d
Pan
g
k
al
p
in
an
g
C
ity
[
1
1
]
.
B
an
g
k
a
R
eg
en
cy
is
an
ar
ea
o
f
tin
e
x
p
l
o
r
atio
n
a
n
d
ex
p
lo
itatio
n
th
at
h
as
b
ee
n
g
o
i
n
g
o
n
f
o
r
h
u
n
d
r
ed
s
o
f
y
ea
r
s
,
in
clu
d
in
g
in
th
e
Pem
ali
Dis
tr
ict
[
1
2
]
.
T
h
e
p
r
ev
alen
ce
o
f
ce
n
tr
al
o
b
esit
y
,
h
y
p
er
ten
s
io
n
,
an
d
d
i
ab
etes
m
ellitu
s
in
B
an
g
k
a
R
eg
en
cy
is
3
5
.
3
3
%,
2
8
.
3
4
%,
an
d
2
.
6
7
%
,
r
esp
ec
tiv
ely
.
I
n
2
0
2
0
,
Pem
ali
Dis
tr
ict
b
ec
am
e
th
e
r
eg
io
n
with
th
e
h
i
g
h
est
p
er
ce
n
tag
e
o
f
o
b
esit
y
,
th
e
2
nd
h
ig
h
est
f
o
r
h
y
p
er
te
n
s
io
n
,
a
n
d
th
e
th
ir
d
h
ig
h
est
f
o
r
d
iab
etes
m
ellitu
s
[
1
3
]
.
T
h
er
ef
o
r
e,
th
is
r
esear
ch
aim
s
to
an
aly
ze
th
e
r
elatio
n
s
h
ip
b
e
twee
n
r
esp
o
n
d
en
t
c
h
ar
ac
ter
is
tics
,
B
L
L
,
n
u
tr
itio
n
in
tak
e,
an
d
p
h
y
s
ical
ac
tiv
ity
t
o
Me
tS
an
d
its
co
m
p
o
n
en
ts
i
n
wo
m
en
o
f
r
ep
r
o
d
u
ctiv
e
ag
e
at
Pem
ali
Dis
tr
ict
Min
in
g
Ar
ea
,
B
an
g
k
a
B
elitu
n
g
R
eg
en
cy
.
2.
M
E
T
H
O
D
2
.
1
.
Study
des
ig
n
T
h
is
ty
p
e
o
f
r
esear
ch
is
o
b
s
er
v
atio
n
al
a
n
aly
tics
with
a
c
ase
-
co
n
tr
o
l
a
p
p
r
o
ac
h
to
d
ete
r
m
in
e
th
e
r
elatio
n
s
h
ip
b
etwe
en
i
n
d
ep
e
n
d
en
t
(
r
esp
o
n
d
e
n
t
ch
ar
ac
ter
is
tics
,
B
L
L
,
n
u
tr
itio
n
in
ta
k
e,
an
d
p
h
y
s
ical
ac
tiv
ity
)
an
d
d
ep
e
n
d
en
t
v
ar
iab
les
(
Me
t
S
an
d
its
co
m
p
o
n
e
n
ts
)
.
T
h
is
ap
p
r
o
ac
h
was
ch
o
s
en
b
ec
au
s
e
m
ea
s
u
r
em
en
ts
o
f
in
d
ep
en
d
en
t
an
d
d
ep
en
d
en
t
v
ar
iab
les
ar
e
n
o
t
p
er
f
o
r
m
ed
s
i
m
u
ltan
eo
u
s
ly
.
T
h
e
r
esear
ch
w
as
co
n
d
u
cted
in
th
e
Pem
ali
Hea
lth
C
en
ter
ar
ea
,
B
an
g
k
a
R
eg
en
c
y
,
B
an
g
k
a
B
elitu
n
g
I
s
lan
d
s
Pro
v
in
ce
,
f
r
o
m
J
u
n
e
2
0
2
2
to
Dec
em
b
er
2
0
2
2
.
2
.
2
.
Sa
m
ple size
a
nd
s
a
m
pli
ng
t
ec
hn
iqu
e
T
h
e
r
esp
o
n
d
e
n
ts
wer
e
s
elec
ted
b
y
p
u
r
p
o
s
iv
e
s
am
p
lin
g
,
wh
er
e
th
e
r
esear
ch
er
s
elec
ted
r
esp
o
n
d
en
ts
f
o
r
th
e
ca
s
e
an
d
co
n
tr
o
l
g
r
o
u
p
s
b
ased
o
n
th
e
s
cr
ee
n
in
g
p
r
o
ce
s
s
o
f
th
e
af
f
o
r
d
ab
le
p
o
p
u
l
atio
n
.
T
h
e
s
am
p
le
co
n
s
is
ted
o
f
3
5
wo
m
e
n
o
f
r
ep
r
o
d
u
ctiv
e
ag
e
with
Me
tS
as
t
h
e
ca
s
e
g
r
o
u
p
an
d
3
5
with
o
u
t
Me
tS
as
th
e
co
n
tr
o
l
g
r
o
u
p
.
Dete
r
m
in
atio
n
o
f
Me
t
S
d
iag
n
o
s
is
u
s
in
g
th
e
n
atio
n
a
l
ch
o
lest
er
o
l
e
d
u
ca
tio
n
p
r
o
g
r
am
-
ad
u
lt
tr
ea
tm
e
n
t
p
an
el
I
I
I
(
NC
E
P
-
AT
P
I
I
I
)
s
tan
d
ar
d
,
n
am
ely
r
esp
o
n
d
en
ts
with
s
y
m
p
to
m
s
o
f
ce
n
tr
al
o
b
esit
y
an
d
ac
co
m
p
an
ied
b
y
two
o
t
h
er
s
y
m
p
to
m
s
o
f
h
i
g
h
b
lo
o
d
p
r
ess
u
r
e,
h
i
g
h
b
l
o
o
d
s
u
g
ar
lev
els,
h
i
g
h
tr
ig
l
y
ce
r
id
e
lev
els,
an
d
o
r
lo
w
HDL
C
lev
els.
T
h
e
cr
iter
ia
f
o
r
in
clu
s
io
n
o
f
r
esp
o
n
d
e
n
ts
ar
e
liv
in
g
in
th
e
r
esear
c
h
lo
ca
tio
n
ar
ea
o
r
o
th
e
r
ar
ea
s
in
B
an
g
k
a
B
elitu
n
g
Pro
v
in
ce
with
th
e
s
am
e
ex
p
o
s
u
r
e
f
o
r
≥
2
0
y
ea
r
s
an
d
willin
g
to
b
e
a
r
esear
ch
s
am
p
le.
T
h
e
r
esp
o
n
d
en
t
’
s
ex
clu
s
io
n
cr
iter
ia
wer
e
ac
tiv
e
o
r
p
ass
iv
e
s
m
o
k
er
s
,
th
r
o
u
g
h
a
d
iet
p
r
o
g
r
am
,
p
r
eg
n
a
n
t
o
r
b
r
ea
s
tf
ee
d
in
g
,
an
d
h
av
in
g
o
n
e
o
r
b
o
th
p
a
r
en
ts
s
u
f
f
er
i
n
g
f
r
o
m
Me
tS.
Data
was
co
llected
b
y
m
ea
s
u
r
in
g
ea
ch
s
y
m
p
to
m
o
f
Me
tS
o
n
d
ata
o
n
wo
m
en
'
s
p
ar
ticip
atio
n
in
ac
ti
v
ities
m
an
ag
ed
b
y
Pem
ali
Hea
lth
C
en
ter
in
2
0
2
1
s
o
th
at
r
esp
o
n
d
en
ts
wer
e
o
b
tai
n
ed
f
o
r
th
e
ca
s
e
an
d
co
n
tr
o
l
g
r
o
u
p
s
.
Af
ter
co
n
f
ir
m
in
g
th
at
r
esp
o
n
d
en
ts
en
ter
e
d
ea
ch
g
r
o
u
p
,
m
ea
s
u
r
em
en
ts
o
f
in
d
ep
en
d
en
t
v
ar
ia
b
les
wer
e
ca
r
r
ied
o
u
t.
T
h
e
s
am
p
le
s
elec
tio
n
f
lo
w
is
lis
ted
in
Fig
u
r
e
1
.
2
.
3
.
D
a
t
a
a
n
a
l
y
s
e
s
B
lo
o
d
s
am
p
lin
g
was
tak
en
f
r
o
m
r
esp
o
n
d
en
ts
ac
co
r
d
i
n
g
to
th
e
s
ch
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u
le
ag
r
ee
d
b
y
th
e
r
esea
r
ch
er
an
d
r
esp
o
n
d
en
ts
.
All
r
esp
o
n
d
en
ts
r
ec
eiv
ed
o
n
e
b
lo
o
d
d
r
aw
s
ch
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le.
B
lo
o
d
s
am
p
les
ar
e
t
ak
en
b
y
c
o
m
p
eten
t
lab
o
r
ato
r
y
s
taf
f
with
a
s
y
r
in
g
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o
r
v
ac
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e
r
an
d
i
n
s
er
ted
in
t
o
a
3
m
l r
e
d
v
ac
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u
m
tu
b
e.
T
h
e
r
esp
o
n
d
e
n
ts
'
b
lo
o
d
Evaluation Warning : The document was created with Spire.PDF for Python.
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lth
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3
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4
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Dec
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er
20
24
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6
7
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s
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s
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ed
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o
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d
eliv
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to
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e
lab
o
r
ato
r
y
o
f
Dep
a
ti
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ah
r
in
Ho
s
p
ital,
B
an
g
k
a
R
eg
en
cy
(
p
len
a
r
y
ac
c
r
ed
itatio
n
)
.
T
h
e
lab
o
r
ato
r
y
p
r
o
ce
s
s
es
b
lo
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s
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p
les
to
ch
ec
k
FB
S,
H
DL
C
,
an
d
ch
o
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er
o
l
lev
els.
T
h
e
r
esear
ch
er
r
ec
eiv
es
th
e
ex
am
in
ati
o
n
r
esu
lts
3
-
4
d
ay
s
af
ter
th
e
b
lo
o
d
s
am
p
le
is
d
ep
o
s
ited
.
T
h
e
C
hi
-
s
q
u
ar
e
s
tatis
tical
te
s
t
was
co
n
d
u
cted
to
an
aly
ze
th
e
r
elatio
n
s
h
ip
b
etwe
en
ag
e,
o
cc
u
p
atio
n
,
in
co
m
e,
B
L
L
,
an
d
n
u
t
r
itio
n
i
n
tak
e
with
Me
tS.
T
h
e
Ma
n
n
-
W
h
itn
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o
s
tly
h
ig
h
(
5
7
.
1
%).
R
esp
o
n
d
e
n
t
’
s
s
u
g
ar
in
tak
e
was
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ain
ly
lo
w
in
th
e
ca
s
e
g
r
o
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p
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.
1
%)
an
d
co
n
tr
o
l
g
r
o
u
p
(
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1
.
4
%)
.
T
h
e
in
tak
e
o
f
s
alt
an
d
s
ea
s
o
n
in
g
in
t
h
e
ca
s
e
g
r
o
u
p
r
esp
o
n
d
en
ts
was
m
ain
ly
h
i
g
h
(
6
5
.
7
%),
wh
ile
in
th
e
co
n
tr
o
l
g
r
o
u
p
,
it
was
p
r
i
m
ar
ily
lo
w
(
6
5
.
7
%).
Mo
s
t
r
e
s
p
o
n
d
en
ts
in
th
e
ca
s
e
g
r
o
u
p
(
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5
.
7
%)
a
n
d
co
n
tr
o
l
g
r
o
u
p
s
en
g
ag
e
d
in
p
h
y
s
ical
ac
tiv
ity
in
th
e
lo
w
ca
teg
o
r
y
(
6
2
.
9
%).
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2
2
5
2
-
8
8
0
6
I
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t J Pu
b
lic
Hea
lth
Sci
,
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l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
:
1
9
6
0
-
1
9
6
7
1964
A
s
ig
n
if
ican
t
ass
o
ciatio
n
is
f
o
u
n
d
in
th
e
B
MI
(
p
=0
.
0
0
0
)
,
s
alt
in
tak
e
(
p
=0
.
0
1
7
)
,
a
n
d
s
ea
s
o
n
in
g
in
tak
e
(
p
=0
.
0
1
7
)
v
ar
iab
les,
w
h
ich
m
ea
n
s
a
s
ig
n
if
ican
t
ass
o
ciatio
n
ex
is
ts
b
etwe
en
B
MI
,
s
alt
in
tak
e,
an
d
s
ea
s
o
n
in
g
in
tak
e
with
Me
tS
in
cid
en
ce
.
T
h
e
s
ig
n
if
ican
t
v
alu
e
o
f
ag
e,
o
cc
u
p
atio
n
,
ed
u
ca
tio
n
,
in
co
m
e,
B
L
L
,
p
h
y
s
ical
ac
tiv
ity
,
an
d
ca
lo
r
ie,
p
r
o
tein
,
f
at,
ca
r
b
o
h
y
d
r
ate,
an
d
s
u
g
ar
i
n
tak
e
ar
e
>0
.
0
5
,
m
ea
n
in
g
th
e
r
e
is
n
o
s
ig
n
if
ican
t
r
elatio
n
s
h
ip
b
etwe
en
th
e
m
with
Me
tS in
cid
en
ce
.
Var
iab
les
th
at
q
u
alif
y
f
o
r
a
d
m
is
s
io
n
to
m
u
ltiv
ar
iate
test
s
ar
e
v
ar
iab
les
with
s
ig
n
if
ic
an
t
r
esu
lts
p
≤
0
.
2
5
.
B
ased
o
n
T
ab
le
2
,
th
e
ap
p
r
o
p
r
iate
v
ar
iab
les
f
o
r
m
u
ltiv
ar
iate
test
s
in
th
is
s
tu
d
y
wer
e
B
MI
,
s
alt
in
tak
e,
an
d
s
ea
s
o
n
in
g
in
tak
e.
M
u
ltiv
ar
iate
test
r
esu
lts
s
h
o
wed
th
at
th
e
m
ain
v
ar
iab
le
f
a
cto
r
s
in
Me
tS
ar
e
B
MI
(
p
=0
.
0
0
0
; O
R
=7
.
9
9
5
)
an
d
s
alt
in
tak
e
(
0
.
0
3
0
; O
R
=6
.
8
1
2
)
.
W
o
m
en
o
f
r
e
p
r
o
d
u
ctiv
e
ag
e
with
h
ig
h
er
B
MI
lev
els
h
av
e
a
7
,
9
9
5
tim
es
g
r
ea
ter
r
is
k
o
f
Me
tS
af
ter
co
n
tr
o
llin
g
f
o
r
an
o
th
e
r
v
ar
ia
b
le.
W
o
m
en
o
f
r
ep
r
o
d
u
ctiv
e
ag
e
in
th
e
h
ig
h
s
alt
in
tak
e
ca
te
g
o
r
y
h
av
e
a
6
,
8
1
2
tim
es g
r
ea
ter
r
is
k
o
f
Me
tS af
ter
co
n
tr
o
llin
g
f
o
r
a
n
o
th
er
v
ar
iab
le.
T
h
e
r
esu
lts
r
ev
ea
led
th
at
th
e
r
esp
o
n
d
en
t'
s
B
MI
wa
s
2
0
.
1
–
3
8
.
9
k
g
/m
2
an
d
was
ca
teg
o
r
ized
in
to
f
iv
e
lev
els,
n
am
ely
u
n
d
er
weig
h
t,
n
o
r
m
al,
o
v
er
weig
h
t,
o
b
esit
y
I
,
an
d
o
b
esit
y
I
I
[
1
4
]
.
T
h
e
B
MI
as
a
s
in
g
le
s
u
r
v
ey
m
ea
s
u
r
em
en
t
o
f
o
b
esit
y
o
f
f
e
r
s
a
h
ig
h
p
r
ed
icto
r
f
o
r
Me
t
S
an
d
ca
n
b
e
u
s
ed
b
y
p
h
y
s
ician
s
an
d
p
atien
ts
f
o
r
th
is
p
u
r
p
o
s
e
[
1
5
]
.
T
h
is
s
tu
d
y
s
h
o
ws
a
r
elatio
n
s
h
ip
b
etwe
en
B
MI
an
d
Me
tS
in
wo
m
en
o
f
r
ep
r
o
d
u
ctiv
e
ag
e
in
Pem
ali
Dis
tr
ict,
B
an
g
k
a
R
eg
en
cy
(
p
=0
.
0
0
0
;
OR
=7
.
9
9
5
)
.
T
h
ese
r
esu
lts
wer
e
r
ein
f
o
r
ce
d
b
y
a
s
tu
d
y
am
o
n
g
3
,
2
2
7
p
eo
p
le
ag
ed
1
8
y
ea
r
s
o
r
o
ld
er
i
n
th
e
No
r
th
wester
n
E
th
io
p
ian
C
ity
o
f
G
o
n
d
a
r
,
s
h
o
win
g
th
at
B
MI
was
s
ig
n
if
ican
tly
ass
o
ciate
d
with
Me
tS
[
1
6
]
.
Ad
u
lt
wo
m
en
with
a
h
i
g
h
B
MI
h
av
e
a
m
u
c
h
h
i
g
h
er
p
r
e
v
alen
ce
o
f
Me
tS
[
1
7
]
.
B
MI
m
o
d
if
ies
th
e
r
elatio
n
s
h
ip
b
etwe
en
p
ar
ity
wi
th
Me
tS
an
d
its
f
o
u
r
co
m
p
o
n
e
n
ts
:
ab
d
o
m
in
al
o
b
esit
y
,
b
lo
o
d
p
r
ess
u
r
e,
in
cr
ea
s
ed
f
asti
n
g
g
lu
co
s
e
lev
els,
an
d
e
lev
ated
tr
ig
ly
ce
r
i
d
e
lev
els.
T
h
ese
co
n
clu
s
io
n
s
s
u
g
g
est
th
a
t
it
is
ess
en
tial
f
o
r
wo
m
en
to
c
o
n
tr
o
l th
ei
r
weig
h
t
to
av
o
id
th
e
r
is
k
o
f
Me
tS
[
1
8
]
.
Salt
in
tak
es
in
th
e
r
esp
o
n
d
en
ts
o
f
th
is
s
tu
d
y
wer
e
in
th
e
r
an
g
e
o
f
0
–
7
.
5
g
.
T
h
is
s
tu
d
y
s
h
o
ws
a
r
elatio
n
s
h
ip
b
etwe
en
s
alt
in
tak
e
with
Me
tS in
wo
m
en
o
f
r
ep
r
o
d
u
ctiv
e
ag
e
in
Pem
ali
Dis
tr
ict,
B
an
g
k
a
R
eg
en
cy
(
p
=0
.
0
1
7
;
OR
=6
.
8
1
2
)
.
T
h
e
r
es
u
lts
o
f
th
is
s
tu
d
y
s
tr
en
g
th
e
n
o
t
h
er
r
esear
ch
th
at
s
tates
a
s
ig
n
i
f
ican
t
r
elatio
n
s
h
ip
b
etwe
en
f
o
o
d
c
o
n
s
u
m
p
tio
n
i
n
s
alted
f
o
o
d
s
an
d
Me
tS
[
1
9
]
,
[
2
0
]
.
Salt
in
tak
e
in
cr
ea
s
ed
in
in
d
i
v
id
u
als
with
Me
tS
co
m
p
ar
ed
to
th
o
s
e
with
o
u
t
[
2
1
]
.
An
o
th
e
r
m
eta
-
an
aly
s
is
r
ev
ea
led
th
at
h
ig
h
er
s
o
d
iu
m
in
p
u
t
in
to
th
e
b
o
d
y
is
d
ir
ec
tly
ass
o
ciate
d
with
th
e
lik
elih
o
o
d
of
Me
tS
[
2
2
]
.
Hig
h
s
alt
in
tak
e
in
Me
tS
p
ar
ticip
an
ts
was
o
b
s
er
v
ed
with
in
cr
ea
s
ed
waist
cir
cu
m
f
e
r
en
ce
an
d
b
lo
o
d
p
r
ess
u
r
e,
s
o
it
is
clo
s
ely
lin
k
ed
to
h
y
p
er
te
n
s
io
n
th
r
o
u
g
h
s
ev
er
al
well
-
s
tu
d
ied
m
ec
h
an
is
m
s
[
2
3
]
,
[
2
4
]
.
Pre
v
io
u
s
s
tu
d
ies
r
ev
ea
led
th
at
th
e
p
r
ev
alen
ce
o
f
life
s
ty
le
-
r
el
ated
d
is
ea
s
es
in
cr
ea
s
ed
with
h
ig
h
er
s
alt
in
tak
e.
B
lo
o
d
g
lu
co
s
e
an
d
h
e
m
o
g
lo
b
i
n
A1
c
(
Hb
A1
c)
in
cr
ea
s
e
with
in
cr
ea
s
ed
s
al
t in
tak
e
a
n
d
th
e
p
r
ev
ale
n
ce
o
f
d
iab
etes
[
2
5
]
.
A
d
iet
with
a
h
ig
h
f
at
co
n
ten
t
a
n
d
an
in
cr
e
ased
in
tak
e
o
f
f
r
u
cto
s
e
an
d
s
alt
ac
ce
ler
ates
th
e
d
ev
elo
p
m
e
n
t
o
f
Me
tS
[
2
6
]
.
L
o
n
g
-
ter
m
h
ig
h
s
alt
in
tak
e
im
p
ac
ts
th
e
d
ev
elo
p
m
en
t
o
f
m
eta
b
o
lic
d
is
o
r
d
er
s
b
y
in
d
u
cin
g
f
r
u
cto
s
e
o
v
er
p
r
o
d
u
c
tio
n
,
lep
tin
r
esis
tan
ce
,
g
h
r
elin
o
v
er
p
r
o
d
u
cti
o
n
,
an
d
in
s
u
lin
r
esis
tan
ce
,
th
er
eb
y
alter
in
g
n
atr
iu
r
etic
p
ep
tid
es a
n
d
o
th
er
m
etab
o
lis
m
-
r
elate
d
h
o
r
m
o
n
es
[
2
3
]
.
B
L
L
in
th
is
s
tu
d
y
'
s
r
esp
o
n
d
en
ts
wer
e
1
1
–
94
μ
g
/d
l
.
B
lo
o
d
lea
d
co
n
ce
n
tr
atio
n
with
n
o
n
eg
ati
v
e
ef
f
ec
ts
o
n
h
ea
lth
h
as
n
o
t
b
ee
n
id
e
n
tif
ied
;
b
lo
o
d
lead
co
n
ce
n
tr
atio
n
s
as
lo
w
as
5
µ
g
/d
L
a
n
d
1
0
µg
/d
L
ar
e
ass
o
ciate
d
with
v
ar
io
u
s
ef
f
ec
ts
,
in
clu
d
i
n
g
ca
r
d
io
v
ascu
lar
d
is
ea
s
e
in
ad
u
lts
[
2
7
]
.
T
h
is
s
tu
d
y
s
h
o
wed
n
o
r
elatio
n
s
h
ip
b
etwe
en
B
L
L
an
d
Me
tS
(
p
=
0
.
4
7
3
)
.
T
h
ese
r
esu
lts
r
ein
f
o
r
ce
p
r
ev
io
u
s
r
esear
ch
s
u
g
g
esti
n
g
n
o
s
ig
n
if
ican
t
ass
o
ciatio
n
b
etwe
en
B
L
L
an
d
Me
tS
in
Un
ited
States
(
US)
ad
u
lts
ag
ed
2
0
[
2
8
]
.
Oth
er
s
tu
d
ies
also
s
tate
th
at
th
er
e
ar
e
n
o
s
ig
n
if
ican
t
d
if
f
er
en
ce
s
in
B
L
L
p
r
e
-
Me
tS
an
d
co
n
tr
o
l
g
r
o
u
p
s
an
d
b
etwe
en
p
r
e
-
Me
tS
an
d
Me
tS
g
r
o
u
p
s
,
s
o
it c
an
n
o
t
b
e
s
tated
t
h
at
lead
ex
p
o
s
u
r
e
is
an
en
v
ir
o
n
m
en
tal
r
is
k
f
ac
to
r
f
o
r
Me
tS
[
2
9
]
.
I
n
an
o
th
e
r
s
tu
d
y
,
B
L
L
was
n
o
t
co
r
r
elate
d
with
Me
tS
co
m
p
o
n
en
ts
s
u
ch
as
h
y
p
er
ten
s
io
n
,
d
y
s
lip
id
em
ia,
an
d
d
y
s
g
ly
ce
m
ia.
Ho
wev
er
,
f
u
r
t
h
er
r
esear
c
h
p
r
o
v
ed
t
h
e
co
m
b
in
ed
to
x
icit
y
o
f
h
ea
v
y
m
etals
(
lead
,
m
er
cu
r
y
,
an
d
ca
d
m
iu
m
)
ev
en
if
th
ey
ar
e
b
elo
w
to
x
ic
lev
els.
T
h
is
s
tu
d
y
s
h
o
wed
th
at
th
e
ac
cu
m
u
latio
n
o
f
ea
ch
h
ea
v
y
m
etal
th
at
im
p
air
s
th
e
f
u
n
ctio
n
in
g
o
f
th
e
en
d
o
cr
in
e
s
y
s
tem
m
ay
h
av
e
an
ad
d
itiv
e
o
r
s
y
n
er
g
ic
ef
f
ec
t
o
n
th
e
d
ev
elo
p
m
en
t
o
f
p
ar
ticu
lar
m
etab
o
lic
d
is
o
r
d
er
s
,
ev
en
if
th
is
h
ea
v
y
m
etal
al
o
n
e
d
o
es
n
o
t
s
h
o
w
s
u
ch
an
ef
f
ec
t
[
3
0
]
.
T
ab
le
2
.
Mu
ltiv
ar
iate
a
n
aly
s
is
r
esu
lts
V
a
r
i
a
b
l
e
B
S
i
g
.
OR
9
5
%
C
.
I
f
o
r
EX
P
(
B
)
Lo
w
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r
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p
p
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r
B
M
I
2
.
0
7
9
0
.
0
0
0
7
.
9
9
5
2
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8
1
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2
2
.
6
7
8
S
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1
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1
9
0
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0
3
0
6
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8
1
2
1
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1
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3
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3
3
3
.
2
.
Ass
o
cia
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io
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f
B
L
L
a
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M
et
S
c
o
m
po
nents
T
h
e
co
m
p
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n
ts
o
f
Me
tS
in
cl
u
d
e
a
b
d
o
m
i
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al
cir
cu
m
f
er
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ce
,
h
y
p
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ten
s
io
n
,
FB
S
lev
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HDL
C
,
an
d
tr
ig
ly
ce
r
id
e
le
v
els.
B
ased
o
n
T
ab
le
3
,
r
esp
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n
d
en
ts
with
h
y
p
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ten
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io
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m
o
s
tly
h
a
d
lo
w
B
L
L
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5
3
.
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5
%).
Mo
s
t
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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8
8
0
6
R
is
k
fa
cto
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s
o
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lic
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yn
d
r
o
me
in
w
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f rep
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u
cti
ve
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t m
in
i
n
g
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r
ea
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o
via
Lu
th
vi
)
1965
r
esp
o
n
d
en
ts
with
ab
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o
m
in
al
c
ir
cu
m
f
er
en
ce
>
8
0
cm
(
5
2
.
7
8
%),
GDP
>1
0
0
m
g
/d
L
(
6
0
%),
HDL
C
<5
0
m
g
/d
L
(
6
0
.
6
1
%),
an
d
tr
i
g
ly
ce
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es
≥
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5
0
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g
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d
L
(
5
3
.
3
3
%)
h
ad
h
i
g
h
B
L
L
.
T
h
e
r
esu
lts
o
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th
e
ch
i
-
s
q
u
ar
e
test
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aly
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tated
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ig
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r
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n
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ip
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en
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L
L
an
d
HDL
C
(
p
=0
.
0
1
9
;
OR
=2
.
5
2
7
)
.
R
esp
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en
ts
with
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ig
h
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L
L
ar
e
at
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is
k
o
f
2
,
5
2
7
tim
es
lo
wer
HDL
C
lev
els
th
an
r
esp
o
n
d
en
ts
wh
o
h
a
v
e
lo
w
B
L
L
.
Oth
er
co
m
p
o
n
e
n
ts
o
f
Me
tS,
s
u
ch
as
h
y
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er
ten
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io
n
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ab
d
o
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in
al
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cu
m
f
e
r
en
ce
,
FB
S
lev
el
s
,
an
d
tr
ig
ly
ce
r
id
e
lev
els,
wer
e
n
o
t
ass
o
ciate
d
with
B
L
L
(
p
>0
.
0
5
)
.
T
ab
le
3
.
Ass
o
ciatio
n
o
f
B
L
L
an
d
Me
tS
co
m
p
o
n
en
ts
M
e
t
S
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o
m
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o
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B
l
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sy
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w
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%
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%
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l
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r
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u
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≤
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19
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5
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8
8
17
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7
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2
2
0
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5
6
4
1
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6
>
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15
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3
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8
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6
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5
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8
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1
0
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8
0
4
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F
a
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g
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d
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32
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g
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28
4
6
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6
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6
60
H
D
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5
0
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d
L
23
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6
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9
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3
9
0
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0
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2
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5
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7
>
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0
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g
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d
L
14
3
7
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8
4
20
6
0
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6
1
Tr
i
g
l
y
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e
r
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d
e
l
e
v
e
l
s
<
1
5
0
m
g
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d
L
29
5
2
.
7
3
7
4
6
.
6
7
0
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2
6
2
1
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7
5
≥
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5
0
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g
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d
L
26
4
7
.
2
7
8
5
3
.
3
3
Alth
o
u
g
h
s
o
m
e
s
tu
d
ies
s
tate
n
o
r
elatio
n
s
h
ip
b
etwe
en
B
L
L
an
d
HDL
C
[
6
]
,
a
s
tu
d
y
s
tates
th
at
m
o
s
t
r
esp
o
n
d
en
ts
with
h
ig
h
er
B
L
L
h
ad
lo
w
HDL
C
lev
els
[
2
9
]
.
L
ea
d
-
ex
p
o
s
ed
p
e
r
s
o
n
s
h
a
v
e
al
ter
ed
lip
id
p
r
o
f
iles
,
in
cr
ea
s
ed
to
tal
ch
o
lest
er
o
l,
an
d
d
ec
r
ea
s
ed
HDL
[
3
1
]
.
Hig
h
er
lead
co
n
ce
n
tr
atio
n
s
wer
e
s
ig
n
if
ican
tly
ass
o
ciate
d
with
d
ec
r
ea
s
ed
HDL
C
lev
els
[
3
2
]
.
I
n
an
o
th
e
r
s
tu
d
y
,
r
esp
o
n
d
en
ts
with
h
ig
h
lead
lev
els
h
av
e
a
2
2
%
ch
an
ce
o
f
h
av
in
g
h
ig
h
L
DL
C
lev
els/
lo
w
HDL
C
[
3
3
]
.
Fu
r
th
e
r
r
esear
c
h
f
o
u
n
d
th
at
th
e
r
e
is
a
s
tr
o
n
g
a
s
s
o
ciatio
n
b
etwe
en
lead
ex
p
o
s
u
r
e
an
d
d
y
s
lip
id
em
i
a,
a
d
is
ea
s
e
with
lo
w
HDL
C
[
3
4
]
.
4.
CO
NCLU
SI
O
N
T
h
is
s
tu
d
y
c
o
n
clu
d
ed
th
at
th
e
r
is
k
f
ac
to
r
s
v
ar
iab
le
f
o
r
Me
tS
in
cid
en
ce
a
r
e
B
MI
a
n
d
s
alt
in
t
ak
e.
B
L
L
is
n
o
t
a
r
is
k
f
ac
to
r
f
o
r
th
e
in
ci
d
en
ce
o
f
Me
tS
b
u
t
is
ass
o
ciate
d
with
HDL
C
in
wo
m
en
o
f
r
ep
r
o
d
u
ctiv
e
ag
e
in
Pem
ali
Dis
tr
ict,
B
an
g
k
a
B
elit
u
n
g
R
eg
en
c
y
.
W
o
m
en
o
f
r
ep
r
o
d
u
ctiv
e
ag
e
m
u
s
t
m
ain
tain
B
MI
with
in
n
o
r
m
al
lev
els
an
d
r
ed
u
ce
d
aily
s
alt
in
tak
e
to
p
r
e
v
en
t
th
e
o
cc
u
r
r
en
ce
o
f
Me
tS.
B
L
L
m
u
s
t
b
e
co
n
tr
o
lled
to
p
r
ev
en
t
d
ec
r
ea
s
ed
HDL
C
lev
els in
wo
m
en
o
f
r
ep
r
o
d
u
ctiv
e
a
g
e.
RE
F
E
R
E
NC
E
S
[
1
]
D
.
H
.
S
h
e
r
l
i
n
g
,
P
.
P
e
r
u
m
a
r
e
d
d
i
,
a
n
d
C
.
H
.
H
e
n
n
e
k
e
n
s
,
“
M
e
t
a
b
o
l
i
c
s
y
n
d
r
o
m
e
,
”
J
o
u
r
n
a
l
o
f
C
a
r
d
i
o
v
a
s
c
u
l
a
r
P
h
a
r
m
a
c
o
l
o
g
y
a
n
d
T
h
e
r
a
p
e
u
t
i
c
s
,
v
o
l
.
2
2
,
n
o
.
4
,
p
p
.
3
6
5
–
3
6
7
,
J
u
l
.
2
0
1
7
,
d
o
i
:
1
0
.
1
1
7
7
/
1
0
7
4
2
4
8
4
1
6
6
8
6
1
8
7
.
[
2
]
I
n
d
o
n
e
s
i
a
n
H
e
a
l
t
h
M
i
n
i
s
t
r
y
,
“
B
a
s
i
c
h
e
a
l
t
h
r
e
s
e
a
r
c
h
2
0
1
3
,
”
(
I
n
I
n
d
o
n
e
s
i
a
:
R
i
s
e
t
k
e
s
e
h
a
t
a
n
d
a
s
a
r
2
0
1
3
),
2
0
1
3
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
r
e
p
o
s
i
t
o
r
y
.
b
a
d
a
n
k
e
b
i
j
a
k
a
n
.
k
e
m
k
e
s
.
g
o
.
i
d
/
i
d
/
e
p
r
i
n
t
/
4
4
6
7
/
1
/
L
a
p
o
r
a
n
_
r
i
s
k
e
s
d
a
s
_
2
0
1
3
_
f
i
n
a
l
.
p
d
f
.
[
3
]
I
n
d
o
n
e
s
i
a
n
H
e
a
l
t
h
M
i
n
i
s
t
r
y
,
“
B
a
s
i
c
H
e
a
l
t
h
R
i
s
e
t
2
0
1
8
,
”
(
I
n
I
n
d
o
n
e
s
i
a
:
R
i
s
e
t
k
e
s
e
h
a
t
a
n
d
a
s
a
r
2
0
1
8
)
,
2
0
1
8
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
d
i
n
k
e
s
.
b
a
b
e
l
p
r
o
v
.
g
o
.
i
d
/
s
i
t
e
s
/
d
e
f
a
u
l
t
/
f
i
l
e
s
/
d
o
k
u
m
e
n
/
b
a
n
k
_
d
a
t
a
/
2
0
1
8
1
2
2
8
%
2
0
%
2
0
L
a
p
o
r
a
n
%
2
0
R
i
s
k
e
s
d
a
s
%
2
0
2
0
1
8
%
2
0
N
a
s
i
o
n
a
l
-
1
.
p
d
f
.
[
4
]
A
.
P
l
a
n
c
h
a
r
t
,
A
.
G
r
e
e
n
,
C
.
H
o
y
o
,
a
n
d
C
.
J
.
M
a
t
t
i
n
g
l
y
,
“
H
e
a
v
y
m
e
t
a
l
e
x
p
o
s
u
r
e
a
n
d
m
e
t
a
b
o
l
i
c
s
y
n
d
r
o
m
e
:
e
v
i
d
e
n
c
e
f
r
o
m
h
u
m
a
n
a
n
d
m
o
d
e
l
s
y
s
t
e
m
s
t
u
d
i
e
s
,
”
C
u
r
r
e
n
t
E
n
v
i
r
o
n
m
e
n
t
a
l
H
e
a
l
t
h
R
e
p
o
r
t
s
,
v
o
l
.
5
,
n
o
.
1
,
p
p
.
1
1
0
–
1
2
4
,
2
0
1
8
,
d
o
i
:
1
0
.
1
0
0
7
/
s
4
0
5
7
2
-
018
-
0
1
8
2
-
3.
[
5
]
Y
.
P
a
r
k
,
Y
.
J
u
n
g
,
a
n
d
C
.
O
h
,
“
R
e
l
a
t
i
o
n
s
b
e
t
w
e
e
n
t
h
e
b
l
o
o
d
l
e
a
d
l
e
v
e
l
a
n
d
m
e
t
a
b
o
l
i
c
s
y
n
d
r
o
m
e
r
i
s
k
f
a
c
t
o
r
s
,
”
P
u
b
l
i
c
H
e
a
l
t
h
N
u
r
s
i
n
g
,
v
o
l
.
3
6
,
n
o
.
2
,
p
p
.
1
1
8
–
1
2
5
,
M
a
r
.
2
0
1
9
,
d
o
i
:
1
0
.
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