Endocrinology and Metabolism

Original Articles

Association between the Triglyceride-Glucose Index and Cardiovascular Risk and Mortality across Different Diabetes Durations: A Nationwide Cohort Study: Jeongeun Kwak, Kyung-Do Han, Eun Young Lee, Seung-Hwan Lee, Dong-Jun Lim, Hyuk-Sang Kwon, Jeongmin Lee; Received October 15, 2024 Accepted January 3, 2025 Published online March 5, 2025; DOI: https://doi.org/10.3803/EnM.2024.2205 [Epub ahead of print]

489 View
40 Download

Abstract PDF Supplementary Material PubReader ePub: Background
We aimed to assess the association between triglyceride-glucose (TyG) index and cardiovascular disease (CVD) risk and mortality in a large cohort of diabetes patients.
Methods
A retrospective cohort study of 1,090,485 participants from the Korean National Health Insurance Service database was conducted. Participants were stratified into TyG quartiles.
Results
Higher TyG index quartiles were significantly associated with an increased CVD risk and mortality risk. In fully adjusted models, participants in the highest TyG quartile (Q4) had an 18% higher risk of CVD (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.13 to 1.23) and a 16% higher risk of mortality (HR, 1.16; 95% CI, 1.11 to 1.23) compared to those in the lowest quartile (Q1). The association was particularly pronounced in patients with fasting glucose ≥126 mg/dL (CVD [HR, 1.33; 95% CI, 1.29 to 1.37], mortality [HR, 1.23; 95% CI, 1.20 to 1.26]; P for interaction <0.001). Patients with a diabetes duration of ≥10 years showed the strongest association between the TyG index and CVD risk (HR, 1.44; 95% CI, 1.38 to 1.50), while the mortality risk was particularly elevated in those with a diabetes duration of less than 5 years (HR, 1.23; 95% CI, 1.18 to 1.30). Subgroup analyses revealed stronger associations between TyG index and CVD risk in younger participants, non-obese individuals, and non-smokers.
Conclusion
The TyG index is a significant predictor of CVD and mortality in diabetic patients, particularly in those with poor glycemic control or longer disease duration.

Diabetes, obesity and metabolism
Triglyceride-Glucose Index Predicts Future Atherosclerotic Cardiovascular Diseases: A 16-Year Follow-up in a Prospective, Community-Dwelling Cohort Study: Joon Ho Moon, Yongkang Kim, Tae Jung Oh, Jae Hoon Moon, Soo Heon Kwak, Kyong Soo Park, Hak Chul Jang, Sung Hee Choi, Nam H. Cho; Endocrinol Metab. 2023;38(4):406-417. Published online August 3, 2023; DOI: https://doi.org/10.3803/EnM.2023.1703

10,374 View
293 Download
17 Web of Science
18 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
While the triglyceride-glucose (TyG) index is a measure of insulin resistance, its association with cardiovascular disease (CVD) has not been well elucidated. We evaluated the TyG index for prediction of CVDs in a prospective large communitybased cohort.
Methods
Individuals 40 to 70 years old were prospectively followed for a median 15.6 years. The TyG index was calculated as the Ln [fasting triglycerides (mg/dL)×fasting glucose (mg/dL)/2]. CVDs included any acute myocardial infarction, coronary artery disease or cerebrovascular disease. We used a Cox proportional hazards model to estimate CVD risks according to quartiles of the TyG index and plotted the receiver operating characteristics curve for the incident CVD.
Results
Among 8,511 subjects (age 51.9±8.8 years; 47.5% males), 931 (10.9%) had incident CVDs during the follow-up. After adjustment for age, sex, body mass index, diabetes mellitus, hypertension, total cholesterol, smoking, alcohol, exercise, and C-reactive protein, subjects in the highest TyG quartile had 36% increased risk of incident CVD compared with the lowest TyG quartile (hazard ratio, 1.36; 95% confidence interval, 1.10 to 1.68). Carotid plaque, assessed by ultrasonography was more frequent in subjects in the higher quartile of TyG index (P for trend=0.049 in men and P for trend <0.001 in women). The TyG index had a higher predictive power for CVDs than the homeostasis model assessment of insulin resistance (HOMA-IR) (area under the curve, 0.578 for TyG and 0.543 for HOMA-IR). Adding TyG index on diabetes or hypertension alone gave sounder predictability for CVDs.
Conclusion
The TyG index is independently associated with future CVDs in 16 years of follow-up in large, prospective Korean cohort.

Citations

Citations to this article as recorded by

Elevated triglyceride-glucose index as a predictor of carotid plaque incidence: Insights from a comprehensive meta-analysis
Arankesh Mahadevan, Bhavin A. Patel, Sashwath Srikanth, Raja Godasi, Rupak Desai
The American Journal of the Medical Sciences.2025; 369(2): 197. CrossRef
Analysis of the correlation between the serum triglyceride glucose index and the risk of death in patients on maintenance hemodialysis: a retrospective cohort study
Xiaokeng Chi, Shuxin Chen, Zhe Huang, Rong Zhou, Zhicheng Su, Qiujun Mai, Yilin Xu, Jianxin Wan
PeerJ.2025; 13: e18781. CrossRef
Assessing the predictive value of elevated triglycerides, triglyceride-glucose index (TyG), and TG/HDL ratios for cardiovascular disease and mortality during 20 years of follow-up: Tehran lipid and glucose study
Shayesteh Khalili, Atieh Amouzegar, Seyed Sattar Dorost, Fereidoun Azizi, Aryan Salahi-Niri
Clinical Biochemistry.2025; 136: 110891. CrossRef
Association between triglyceride-glucose index and carotid atherosclerosis in Chinese steelworkers: a cross-sectional study
Haoyue Cao, Qinglin Li, Juxiang Yuan
Scientific Reports.2025;[Epub] CrossRef
Association between the triglyceride-glucose index and silent myocardial infarction in the general population
Min Dai, Dongze Li, Jing Yu, Yi Liu, Qin Zhang, Wei Zhang, Yan Zhong, Zhi Wan, Menglin Tang, Yongli Gao, Li Rao
Scientific Reports.2025;[Epub] CrossRef
Integrative Multi‐Omics and Routine Blood Analysis Using Deep Learning: Cost‐Effective Early Prediction of Chronic Disease Risks
Zhibin Dong, Pei Li, Yi Jiang, Zhihan Wang, Shihui Fu, Hebin Che, Meng Liu, Xiaojing Zhao, Chunlei Liu, Chenghui Zhao, Qin Zhong, Chongyou Rao, Siwei Wang, Suyuan Liu, Dayu Hu, Dongjin Wang, Juntao Gao, Kai Guo, Xinwang Liu, En Zhu, Kunlun He
Advanced Science.2025;[Epub] CrossRef
Impact of steatotic liver disease categories on atrial fibrillation in type 2 diabetes: a nationwide study
So Hyun Cho, Gyuri Kim, Kyu-na Lee, Rosa Oh, Ji Yoon Kim, Myunghwa Jang, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Kyungdo Han, Jae Hyeon Kim
Scientific Reports.2025;[Epub] CrossRef
Construction and validation of a nomogram for predicting diabetes remission at 3 months after bariatric surgery in patients with obesity combined with type 2 diabetes mellitus
Kaisheng Yuan, Bing Wu, Ruiqi Zeng, Fuqing Zhou, Ruixiang Hu, Cunchuan Wang
Diabetes, Obesity and Metabolism.2024; 26(1): 169. CrossRef
Association between the triglyceride glucose index and chronic total coronary occlusion: A cross-sectional study from southwest China
Kaiyong Xiao, Huili Cao, Bin Yang, Zhe Xv, Lian Xiao, Jianping Wang, Shuiqing Ni, Hui Feng, Zhongwei He, Lei Xv, Juan Li, Dongmei Xv
Nutrition, Metabolism and Cardiovascular Diseases.2024; 34(4): 850. CrossRef
The association between TyG and all-cause/non-cardiovascular mortality in general patients with type 2 diabetes mellitus is modified by age: results from the cohort study of NHANES 1999–2018
Younan Yao, Bo Wang, Tian Geng, Jiyan Chen, Wan Chen, Liwen Li
Cardiovascular Diabetology.2024;[Epub] CrossRef
Comparison of triglyceride glucose index and modified triglyceride glucose indices in prediction of cardiovascular diseases in middle aged and older Chinese adults
Cancan Cui, Yitian Qi, Jiayin Song, Xinyun Shang, Tianjiao Han, Ning Han, Siqi Yue, Yining Zha, Zhonghang Xu, Jiannan Li, Lin Liu
Cardiovascular Diabetology.2024;[Epub] CrossRef
Triglyceride-glucose index predicts type 2 diabetes mellitus more effectively than oral glucose tolerance test-derived insulin sensitivity and secretion markers
Min Jin Lee, Ji Hyun Bae, Ah Reum Khang, Dongwon Yi, Mi Sook Yun, Yang Ho Kang
Diabetes Research and Clinical Practice.2024; 210: 111640. CrossRef
Prognostic value of triglyceride-glucose index for left ventricular remodeling in nondiabetic ST-elevation myocardial infarction patients
Tolga Han Efe, Engin Algül
Biomarkers in Medicine.2024; 18(6): 243. CrossRef
Triglyceride-Glucose Index as Predictor for Hypertension, CHD and STROKE Risk among Non-Diabetic Patients: A NHANES Cross-Sectional Study 2001–2020
Bisher Sawaf, Sarya Swed, Hidar Alibrahim, Haidara Bohsas, Tirth Dave, Mohamad Nour Nasif, Wael Hafez, Fatema Ali Asgar Tashrifwala, Yazan Khair Eldien Jabban, Safwan Al-Rassas, Heba haj Saleh, Abdul Rehman Zia Zaidi, Baraa Alghalyini, Shaymaa Abdelmaboud
Journal of Epidemiology and Global Health.2024; 14(3): 1152. CrossRef
An Increasing Triglyceride–Glucose Index Is Associated with a Pro-Inflammatory and Pro-Oxidant Phenotype
Beverley Adams-Huet, Ishwarlal Jialal
Journal of Clinical Medicine.2024; 13(13): 3941. CrossRef
Inflammatory and Metabolic Predictors of Mortality in Pulmonary Thromboembolism: A Focus on the Triglyceride–Glucose Index and Pan-Immune Inflammation Value
Murat Bilgin, Emre Akkaya, Recep Dokuyucu
Journal of Clinical Medicine.2024; 13(19): 6008. CrossRef
The role of the triglyceride-glucose index as a biomarker of cardio-metabolic syndromes
Verena Gounden, Sridevi Devaraj, Ishwarlal Jialal
Lipids in Health and Disease.2024;[Epub] CrossRef
Evaluation of the novel three lipid indices for predicting five- and ten-year incidence of cardiovascular disease: findings from Kerman coronary artery disease risk factors study (KERCADRS)
Alireza Jafari, Hamid Najafipour, Mitra Shadkam, Sina Aminizadeh
Lipids in Health and Disease.2023;[Epub] CrossRef

Review Article

Diabetes, Obesity and Metabolism
Lipoprotein Lipase: Is It a Magic Target for the Treatment of Hypertriglyceridemia: Joon Ho Moon, Kyuho Kim, Sung Hee Choi; Endocrinol Metab. 2022;37(4):575-586. Published online August 29, 2022; DOI: https://doi.org/10.3803/EnM.2022.402

36,979 View
713 Download
26 Web of Science
28 Crossref

Abstract PDF PubReader ePub

High levels of triglycerides (TG) and triglyceride-rich lipoproteins (TGRLs) confer a residual risk of cardiovascular disease after optimal low-density lipoprotein cholesterol (LDL-C)–lowering therapy. Consensus has been made that LDL-C is a non-arguable primary target for lipid lowering treatment, but the optimization of TGRL for reducing the remnant risk of cardiovascular diseases is urged. Omega-3 fatty acids and fibrates are used to reduce TG levels, but many patients still have high TG and TGRL levels combined with low high-density lipoprotein concentration that need to be ideally treated. Lipoprotein lipase (LPL) is a key regulator for TGs that hydrolyzes TGs to glycerol and free fatty acids in lipoprotein particles for lipid storage and consumption in peripheral organs. A deeper understanding of human genetics has enabled the identification of proteins regulating the LPL activity, which include the apolipoproteins and angiopoietin-like families. Novel therapeutic approach such as antisense oligonucleotides and monoclonal antibodies that regulate TGs have been developed in recent decades. In this article, we focus on the biology of LPL and its modulators and review recent clinical application, including genetic studies and clinical trials of novel therapeutics. Optimization of LPL activity to lower TG levels could eventually reduce incident atherosclerotic cardiovascular disease in conjunction with successful LDL-C reduction.

Citations

Citations to this article as recorded by

The Relationship Between Remnant Cholesterol and Visceral Adipose Tissue: A National Cross-Sectional Study
Zhaoxiang Wang, Shao Zhong, Menghuan Wu, Xuejing Shao, Tian Gu, Mengjiao Xu, Qichao Yang
Hormone and Metabolic Research.2025; 57(01): 47. CrossRef
Current and Emerging Treatment Options for Hypertriglyceridemia: State-of-the-Art Review
Jakub Michal Zimodro, Manfredi Rizzo, Ioanna Gouni-Berthold
Pharmaceuticals.2025; 18(2): 147. CrossRef
Insights into Causal Associations of Lipid Traits and Lipid-modifying Drug Targets with Uric Acid and Risk of Gout
Chenfeng Zou, Bei Yang, Jiaying Zhang, Yuying Zhang, Dewei Ye, Hanyu Zhu, Tao Bai, Guozhi Jiang
Phenomics.2025;[Epub] CrossRef
Associations of intra‐pancreatic fat deposition with triglyceride‐rich lipoproteins and lipoprotein lipase
Yutong Liu, Loren Skudder‐Hill, Wandia Kimita, Xiatiguli Shamaitijiang, Ivana R. Sequeira‐Bisson, Maxim S. Petrov
Diabetes, Obesity and Metabolism.2025;[Epub] CrossRef
Association between atherogenic index of plasma level and cardiovascular events in patients with obstructive sleep apnea: The sleep heart health study
Lixia Wang, Xinjie Hui, Rong Huang, Yi Xiao
Sleep Medicine.2025; 129: 375. CrossRef
HDL-Cholesterol and Triglycerides Dynamics: Essential Players in Metabolic Syndrome
Sebastià Alcover, Lisaidy Ramos-Regalado, Gabriela Girón, Natàlia Muñoz-García, Gemma Vilahur
Antioxidants.2025; 14(4): 434. CrossRef
The chylomicron saga: time to focus on postprandial metabolism
Alejandro Gugliucci
Frontiers in Endocrinology.2024;[Epub] CrossRef
Sanghuangporus vaninii extract ameliorates hyperlipidemia in rats by mechanisms identified with transcriptome analysis
Ning Gao, Yuanzhen Liu, Guangjie Liu, Bo Liu, Yupeng Cheng
Food Science & Nutrition.2024; 12(5): 3360. CrossRef
Targeting host-specific metabolic pathways—opportunities and challenges for anti-infective therapy
Monika I. Konaklieva, Balbina J. Plotkin
Frontiers in Molecular Biosciences.2024;[Epub] CrossRef
Obesity, dyslipidemia, and cardiovascular disease: A joint expert review from the Obesity Medicine Association and the National Lipid Association 2024
Harold Edward Bays, Carol Kirkpatrick, Kevin C. Maki, Peter P. Toth, Ryan T. Morgan, Justin Tondt, Sandra Michelle Christensen, Dave Dixon, Terry A. Jacobson
Obesity Pillars.2024; 10: 100108. CrossRef
Role of Fenofibrate Use in Dyslipidemia and Related Comorbidities in the Asian Population: A Narrative Review
Chaicharn Deerochanawong, Sin Gon Kim, Yu-Cheng Chang
Diabetes & Metabolism Journal.2024; 48(2): 184. CrossRef
Xanthohumol, a prenylated chalcone, regulates lipid metabolism by modulating the LXRα/RXR-ANGPTL3-LPL axis in hepatic cell lines and high-fat diet-fed zebrafish models
Wan-Yun Gao, Pei-Yi Chen, Hao-Jen Hsu, Je-Wen Liou, Chia-Ling Wu, Ming-Jiuan Wu, Jui-Hung Yen
Biomedicine & Pharmacotherapy.2024; 174: 116598. CrossRef
Obesity, dyslipidemia, and cardiovascular disease: A joint expert review from the Obesity Medicine Association and the National Lipid Association 2024
Harold Edward Bays, Carol F. Kirkpatrick, Kevin C. Maki, Peter P. Toth, Ryan T. Morgan, Justin Tondt, Sandra Michelle Christensen, Dave L. Dixon, Terry A. Jacobson
Journal of Clinical Lipidology.2024; 18(3): e320. CrossRef
Factors associated with treatment responses to pioglitazone in patients with steatotic liver disease: A 3‐year prospective cohort study
Ming‐Ling Chang, Jennifer Tai, Jur‐Shan Cheng, Wei‐Ting Chen, Sien‐Sing Yang, Cheng‐Hsun Chiu, Rong‐Nan Chien
Diabetes, Obesity and Metabolism.2024; 26(7): 2969. CrossRef
Efficacy and safety of omega‐3‐acid ethyl acetate 90 capsules in severe hypertriglyceridemia: A randomized, controlled, multicenter study
Wang Zhao, Yangang Wang, Jin Li, Tao Chen, Delu Yin, Hailong Dai, Zhuhua Yao, Shuiping Zhao
Lipids.2024; 59(5): 145. CrossRef
Lipoprotein lipase as a target for obesity/diabetes related cardiovascular disease
Rui Shang, Brian Rodrigues
Journal of Pharmacy & Pharmaceutical Sciences.2024;[Epub] CrossRef
Targeting Apolipoprotein C-III for the Management of Severe Hypertriglyceridemia: Current Research and Future Directions
Mili Shah, Abisheikh Sharma, Mohammed Ayyad, Ethan Swartz, Danyaal Jafrani, Dhir Gala
Cureus.2024;[Epub] CrossRef
Angiopoietin-like Proteins and Lipoprotein Lipase: The Waltz Partners That Govern Triglyceride-Rich Lipoprotein Metabolism? Impact on Atherogenesis, Dietary Interventions, and Emerging Therapies
Alejandro Gugliucci
Journal of Clinical Medicine.2024; 13(17): 5229. CrossRef
Proteo-genomic analyses in relatively lean Chinese adults identify proteins and pathways that affect general and central adiposity levels
Andri Iona, Pang Yao, Alfred Pozarickij, Christiana Kartsonaki, Saredo Said, Neil Wright, Kuang Lin, Iona Millwood, Hannah Fry, Mohsen Mazidi, Baihan Wang, Yiping Chen, Huaidong Du, Ling Yang, Daniel Avery, Dan Schmidt, Dianjianyi Sun, Pei Pei, Jun Lv, Ca
Communications Biology.2024;[Epub] CrossRef
Molecular Pathways Linking High-Fat Diet and PM2.5 Exposure to Metabolically Abnormal Obesity: A Systematic Review and Meta-Analysis
Sagrario Lobato, Víctor Manuel Salomón-Soto, Claudia Magaly Espinosa-Méndez, María Nancy Herrera-Moreno, Beatriz García-Solano, Ernestina Pérez-González, Facundo Comba-Marcó-del-Pont, Mireya Montesano-Villamil, Marco Antonio Mora-Ramírez, Claudia Mancilla
Biomolecules.2024; 14(12): 1607. CrossRef
High producer variant of lipoprotein lipase may protect from hepatocellular carcinoma in alcohol-associated cirrhosis
Franziska Schmalz, Janett Fischer, Hamish Innes, Stephan Buch, Christine Möller, Madlen Matz-Soja, Witigo von Schönfels, Benjamin Krämer, Bettina Langhans, Alexandra Klüners, Michael Soyka, Felix Stickel, Jacob Nattermann, Christian P. Strassburg, Thomas
JHEP Reports.2023; 5(4): 100684. CrossRef
Measurement of Serum Low Density Lipoprotein Cholesterol and Triglyceride-Rich Remnant Cholesterol as Independent Predictors of Atherosclerotic Cardiovascular Disease: Possibilities and Limitations
Dieter Lütjohann, Hans-Ulrich Klör, Frans Stellaard
Nutrients.2023; 15(9): 2202. CrossRef
Influence of antipsychotic medications on hyperlipidemia risk in patients with schizophrenia: evidence from a population-based cohort study and in vitro hepatic lipid homeostasis gene expression
Tien-Yuan Wu, Ni Tien, Cheng-Li Lin, Yu-Cun Cheah, Chung Y. Hsu, Fuu-Jen Tsai, Yi-Jen Fang, Yun-Ping Lim
Frontiers in Medicine.2023;[Epub] CrossRef
Triglyceride-Rich Lipoprotein Metabolism: Key Regulators of Their Flux
Alejandro Gugliucci
Journal of Clinical Medicine.2023; 12(13): 4399. CrossRef
Sugar and Dyslipidemia: A Double-Hit, Perfect Storm
Alejandro Gugliucci
Journal of Clinical Medicine.2023; 12(17): 5660. CrossRef
Dyslipidemia in Patients with Chronic Kidney Disease: An Updated Overview
Sang Heon Suh, Soo Wan Kim
Diabetes & Metabolism Journal.2023; 47(5): 612. CrossRef
Peroxisome Proliferator-Activated Receptor α in Lipoprotein Metabolism and Atherosclerotic Cardiovascular Disease
Elena Valeria Fuior, Evangelia Zvintzou, Theodosios Filippatos, Katerina Giannatou, Victoria Mparnia, Maya Simionescu, Anca Violeta Gafencu, Kyriakos E. Kypreos
Biomedicines.2023; 11(10): 2696. CrossRef
Developing a model to predict the early risk of hypertriglyceridemia based on inhibiting lipoprotein lipase (LPL): a translational study
Julia Hernandez-Baixauli, Gertruda Chomiciute, Juan María Alcaide-Hidalgo, Anna Crescenti, Laura Baselga-Escudero, Hector Palacios-Jordan, Elisabet Foguet-Romero, Anna Pedret, Rosa M. Valls, Rosa Solà, Miquel Mulero, Josep M. Del Bas
Scientific Reports.2023;[Epub] CrossRef

Original Article

APOA5 Polymorphism Is Associated with Metabolic Syndrome in Korean Postmenopausal Women.: Doh Hee Kim, Seung Hee Lee, Kyung Hoon Han, Chae Bong Kim, Kwan Young Song, Sook Cho, Kye Heui Lee; Endocrinol Metab. 2012;27(4):276-281. Published online December 20, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.4.276

5,243 View
24 Download
2 Crossref

Abstract PDF

BACKGROUND
Menopause is an independent risk factor in metabolic syndrome which induced an alteration of the lipid metabolism by hormonal changes. Apolipoprotein A5 gene (APOA5) was related to the regulation of triglyceride and high density lipoprotein cholesterol (HDL-C) level with biosynthesis and decomposition. This study was conducted to investigate the relationship between APOA5 polymorphism and metabolic syndrome in Korean postmenopausal women. METHODS: This study included 307 postmenopausal women with anthropometric and biochemical measurement in 2010-2011. The polymorphism of APOA5 was analyzed by polymerase chain reaction-restriction fragment length polymorphism method with MseI restriction enzyme. RESULTS: The metabolic syndrome prevalence with TT genotype was significantly lower than the frequency in those with TC/CC (27.09%, 38.46%, and 45.71% for TT, TC, and CC, respectively; P < 0.05). Multiple regression analysis of metabolic syndrome risk factors indicated that postmenopausal women with CC genotype had a higher risk with 3 times than that in TT genotype (P < 0.05). APOA5 C carriers showed an increased risk of triglyceride level (odd ratio, 2.93 and 1.85 for CC and TC+CC, respectively; P < 0.05). Interestingly, HDL-C was related to triglyceride directly in comparison to APOA5. CONCLUSION: The results of this study indicate that APOA5 has an influence on serum triglyceride and HDL-C, which contribute to metabolic syndrome in Korean postmenopausal women.

Citations

Citations to this article as recorded by

Effects of a 3-year dietary intervention on age-related changes in triglyceride and apolipoprotein A-V levels in patients with impaired fasting glucose or new-onset type 2 diabetes as a function of the APOA5 -1131 T > C polymorphism
Minjoo Kim, Jey Sook Chae, Miri Kim, Sang-Hyun Lee, Jong Ho Lee
Nutrition Journal.2014;[Epub] CrossRef
APOA5Polymorphism Is Associated with Metabolic Syndrome in Korean Postmenopausal Women
Mi Hae Seo, Won Young Lee
Endocrinology and Metabolism.2012; 27(4): 274. CrossRef

First
Prev
Page of 1
Next
Last

Search