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Abdominal obesity and metabolic syndrome

Abstract

Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance or full-blown diabetes, and increased risk of developing cardiovascular disease. Proposed criteria for identifying patients with metabolic syndrome have contributed greatly to preventive medicine, but the value of metabolic syndrome as a scientific concept remains controversial. The presence of metabolic syndrome alone cannot predict global cardiovascular disease risk. But abdominal obesity — the most prevalent manifestation of metabolic syndrome — is a marker of 'dysfunctional adipose tissue', and is of central importance in clinical diagnosis. Better risk assessment algorithms are needed to quantify diabetes and cardiovascular disease risk on a global scale.

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Figure 1: The lipid overflow–ectopic fat model.
Figure 2: Factors contributing to global cardiometabolic risk.

References

  1. Grundy, S. M. Metabolic syndrome: connecting and reconciling cardiovascular and diabetes worlds. J. Am. Coll. Cardiol. 47, 1093–1100 (2006).

    Article  CAS  PubMed  Google Scholar 

  2. Grundy, S. M. Does a diagnosis of metabolic syndrome have value in clinical practice? Am. J. Clin. Nutr. 83, 1248–1251 (2006).

    Article  CAS  PubMed  Google Scholar 

  3. Grundy, S. M. Drug therapy of the metabolic syndrome: minimizing the emerging crisis of polypharmacy. Nature Rev. Drug Discov. 5, 295–309 (2006).

    Article  CAS  Google Scholar 

  4. Moller, D. E. & Kaufman, K. D. Metabolic syndrome: a clinical and molecular perspective. Annu. Rev. Med. 56, 45–62 (2005).

    Article  CAS  PubMed  Google Scholar 

  5. Sattar, N. The metabolic syndrome: should current criteria influence clinical practice? Curr. Opin. Lipidol. 17, 404–411 (2006).

    Article  CAS  PubMed  Google Scholar 

  6. Eckel, R. H., Grundy, S. M. & Zimmet, P. Z. The metabolic syndrome. Lancet 365, 1415–1428 (2005).

    Article  CAS  PubMed  Google Scholar 

  7. Reaven, G. M. The metabolic syndrome: is this diagnosis necessary? Am. J. Clin. Nutr. 83, 1237–1247 (2006).

    Article  CAS  PubMed  Google Scholar 

  8. Ferrannini, E. Is insulin resistance the cause of the metabolic syndrome? Ann. Med. 38, 43–51 (2006).

    Article  CAS  Google Scholar 

  9. Gale, E. A. The myth of the metabolic syndrome. Diabetologia 48, 1679–1683 (2005).

    Article  PubMed  Google Scholar 

  10. Kahn, R., Buse, J., Ferrannini, E. & Stern, M. The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 28, 2289–2304 (2005).

    Article  PubMed  Google Scholar 

  11. Reaven, G. M. The metabolic syndrome: requiescat in pace. Clin. Chem. 51, 931–938 (2005).

    Article  CAS  PubMed  Google Scholar 

  12. Alberti, K. G. & Zimmet, P. Z. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet. Med. 15, 539–553 (1998).

    Article  CAS  PubMed  Google Scholar 

  13. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). J. Am. Med. Assoc. 285, 2486–2497 (2001).

  14. Alberti, K. G., Zimmet, P. & Shaw, J. The metabolic syndrome — a new worldwide definition. Lancet 366, 1059–1062 (2005).

    Article  PubMed  Google Scholar 

  15. Galassi, A., Reynolds, K. & He, J. Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am. J. Med. 119, 812–819 (2006).

    Article  CAS  PubMed  Google Scholar 

  16. Mokdad, A. H. et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. J. Am. Med. Assoc. 289, 76–79 (2003).

    Article  Google Scholar 

  17. Zimmet, P., Alberti, K. G. M. M. & Shaw, J. Global and societal implications of the diabetes epidemic. Nature 414, 782–787 (2001).

    Article  ADS  CAS  PubMed  Google Scholar 

  18. Astrup, A. & Finer, N. Redefining type 2 diabetes:'diabesity' or 'obesity dependent diabetes mellitus'? Obesity Rev. 1, 57–59 (2000).

    Article  CAS  Google Scholar 

  19. Shafrir, E. Development and consequences of insulin resistance: lessons from animals with hyperinsulinaemia. Diabetes Metab. 22, 122–131 (1996).

    CAS  PubMed  Google Scholar 

  20. Pincock, S. Paul Zimmet: fighting the 'diabesity' pandemic. Lancet 368, 1643 (2006).

    Article  PubMed  Google Scholar 

  21. Després, J. P. et al. Race, visceral adipose tissue, plasma lipids, and lipoprotein lipase activity in men and women: the Health, Risk Factors, Exercise Training, and Genetics (HERITAGE) family study. Arterioscler. Thromb. Vasc. Biol. 20, 1932–1938 (2000).

    Article  PubMed  Google Scholar 

  22. Albu, J. B., Murphy, L., Frager, D. H., Johnson, J. A. & Pi-Sunyer, F. X. Visceral fat and race-dependent health risks in obese nondiabetic premenopausal women. Diabetes 46, 456–462 (1997).

    Article  CAS  PubMed  Google Scholar 

  23. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363, 157–163 (2004).

  24. Kadowaki, T. et al. Japanese men have larger areas of visceral adipose tissue than Caucasian men in the same levels of waist circumference in a population-based study. Int. J. Obes. (Lond.) 30, 1163–1165 (2006).

    Article  CAS  Google Scholar 

  25. Lovejoy, J. C., de la Bretonne, J. A., Klemperer, M. & Tulley, R. Abdominal fat distribution and metabolic risk factors: effects of race. Metabolism 45, 1119–1124 (1996).

    Article  CAS  PubMed  Google Scholar 

  26. Conway, J. M., Chanetsa, F. F. & Wang, P. Intrabdominal adipose tissue and anthropometric surrogates in African American women with upper- and lower-body obesity. Am. J. Clin. Nutr. 66, 1345–1351 (1997).

    Article  CAS  PubMed  Google Scholar 

  27. Abbasi, F., Brown, B. W., Lamendola, C., McLaughlin, T. & Reaven, G. M. Relationship between obesity, insulin resistance, and coronary heart disease risk. J. Am. Coll. Cardiol. 40, 937–943 (2002).

    Article  CAS  PubMed  Google Scholar 

  28. Després, J. P. et al. Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease. Arteriosclerosis 10, 497–511 (1990).

    Article  PubMed  Google Scholar 

  29. Després, J. P. Is visceral obesity the cause of the metabolic syndrome? Ann. Med. 38, 52–63 (2006).

    Article  PubMed  CAS  Google Scholar 

  30. Björntorp, P. Metabolic implications of body fat distribution. Diabetes Care 14, 1132–1143 (1991).

    Article  PubMed  Google Scholar 

  31. Kissebah, A. H. & Krakower, G. R. Regional adiposity and morbidity. Physiol. Rev. 74, 761–811 (1994).

    Article  CAS  PubMed  Google Scholar 

  32. Lebovitz, H. E. & Banerji, M. A. Point: visceral adiposity is causally related to insulin resistance. Diabetes Care 28, 2322–2325 (2005).

    Article  PubMed  Google Scholar 

  33. Mittelman, S. D., Van Citters, G. W., Kirkman, E. L. & Bergman, R. N. Extreme insulin resistance of the central adipose depot in vivo. Diabetes 51, 755–761 (2002).

    Article  CAS  PubMed  Google Scholar 

  34. Mauriège, P. et al. Regional variation in adipose tissue metabolism of severely obese premenopausal women. J. Lipid. Res. 36, 672–684 (1995).

    Article  PubMed  Google Scholar 

  35. Bergman, R. N. et al. Why visceral fat is bad: mechanisms of the metabolic syndrome. Obesity (Silver Spring) 14 (Suppl. 1), 16S–19S (2006).

    Article  CAS  Google Scholar 

  36. Jensen, M. D. Is visceral fat involved in the pathogenesis of the metabolic syndrome? Human model. Obesity (Silver Spring) 14 (Suppl. 1), 20S–24S (2006).

    Article  MathSciNet  CAS  Google Scholar 

  37. Weisberg, S. P. et al. Obesity is associated with macrophage accumulation in adipose tissue. J. Clin. Invest. 112, 1796–1808 (2003).

    Article  CAS  PubMed  PubMed Central  MathSciNet  Google Scholar 

  38. Yudkin, J. S., Stehouwer, C. D., Emeis, J. J. & Coppack, S. W. C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler. Thromb. Vasc. Biol. 19, 972–978 (1999).

    Article  CAS  PubMed  Google Scholar 

  39. Tsimikas, S., Willerson, J. T. & Ridker, P. M. C-reactive protein and other emerging blood biomarkers to optimize risk stratification of vulnerable patients. J. Am. Coll. Cardiol. 47, C19–C31 (2006).

    Article  CAS  PubMed  Google Scholar 

  40. Lemieux, I. et al. Elevated C-reactive protein: another component of the atherothrombotic profile of abdominal obesity. Arterioscler. Thromb. Vasc. Biol. 21, 961–967 (2001).

    Article  CAS  PubMed  Google Scholar 

  41. Maeda, K. et al. cDNA cloning and expression of a novel adipose specific collagen-like factor, apM1 (adipose most abundant gene transcript 1). Biochem. Biophys. Res. Commun. 221, 286–289 (1996).

    Article  CAS  PubMed  Google Scholar 

  42. Scherer, P. E., Williams, S., Fogliano, M., Baldini, G. & Lodish, H. F. A novel serum protein similar to C1q, produced exclusively in adipocytes. J. Biol. Chem. 270, 26746–26749 (1995).

    Article  CAS  PubMed  Google Scholar 

  43. Côté, M. et al. Adiponectinemia in visceral obesity: impact on glucose tolerance and plasma lipoprotein and lipid levels in men. J. Clin. Endocrinol. Metab. 90, 1434–1439 (2005).

    Article  PubMed  CAS  Google Scholar 

  44. Berg, A. H. & Scherer, P. E. Adipose tissue, inflammation, and cardiovascular disease. Circ. Res. 96, 939–949 (2005).

    Article  CAS  PubMed  Google Scholar 

  45. Matsuzawa, Y. Therapy Insight: adipocytokines in metabolic syndrome and related cardiovascular disease. Nature Clin. Pract. Cardiovasc. Med. 3, 35–42 (2006).

    Article  CAS  Google Scholar 

  46. Lemieux, I. et al. Contribution of interleukin-6 and tumor necrosis factor-alpha to the elevated C-reactive protein levels found in abdominally obese men. Obes. Res. 9, 66S (2001).

    Google Scholar 

  47. Hotamisligil, G. S. Molecular mechanisms of insulin resistance and the role of the adipocyte. Int. J. Obes. Relat. Metab. Disord. 24 (Suppl. 4), S23–S27 (2000).

    Article  CAS  PubMed  Google Scholar 

  48. Havel, P. J. Control of energy homeostasis and insulin action by adipocyte hormones: leptin, acylation stimulating protein, and adiponectin. Curr. Opin. Lipidol. 13, 51–59 (2002).

    Article  CAS  PubMed  Google Scholar 

  49. Lemieux, I. Energy partitioning in gluteal-femoral fat: does the metabolic fate of triglycerides affect coronary heart disease risk? Arterioscler. Thromb. Vasc. Biol. 24, 795–797 (2004).

    Article  CAS  PubMed  Google Scholar 

  50. Miranda, P. J., DeFronzo, R. A., Califf, R. M. & Guyton, J. R. Metabolic syndrome: definition, pathophysiology, and mechanisms. Am. Heart J. 149, 33–45 (2005).

    Article  CAS  PubMed  Google Scholar 

  51. Gavrilova, O. et al. Surgical implantation of adipose tissue reverses diabetes in lipoatrophic mice. J. Clin. Invest. 105, 271–278 (2000).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Kim, J. K., Gavrilova, O., Chen, Y., Reitman, M. L. & Shulman, G. I. Mechanism of insulin resistance in A-ZIP/F-1 fatless mice. J. Biol. Chem. 275, 8456–8460 (2000).

    Article  CAS  PubMed  Google Scholar 

  53. Garg, A. & Misra, A. Lipodystrophies: rare disorders causing metabolic syndrome. Endocrinol. Metab. Clin. North Am. 33, 305–331 (2004).

    Article  CAS  PubMed  Google Scholar 

  54. Danforth, E. Failure of adipocyte differentiation causes type II diabetes mellitus? Nature Genet. 26, 13 (2000).

    Article  CAS  PubMed  Google Scholar 

  55. Miyazaki, Y. et al. Effect of pioglitazone on abdominal fat distribution and insulin sensitivity in type 2 diabetic patients. J. Clin. Endocrinol. Metab. 87, 2784–2791 (2002).

    Article  CAS  PubMed  Google Scholar 

  56. Wilson, P. W., D'Agostino, R. B., Parise, H., Sullivan, L. & Meigs, J. B. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 112, 3066–3072 (2005).

    Article  CAS  PubMed  Google Scholar 

  57. Laaksonen, D. E. et al. Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am. J. Epidemiol. 156, 1070–1077 (2002).

    Article  PubMed  Google Scholar 

  58. Stern, M. P., Williams, K. & Haffner, S. M. Identification of persons at high risk for type 2 diabetes mellitus: do we need the oral glucose tolerance test? Ann. Intern. Med. 136, 575–581 (2002).

    Article  PubMed  Google Scholar 

  59. Klein, B. E., Klein, R. & Lee, K. E. Components of the metabolic syndrome and risk of cardiovascular disease and diabetes in beaver dam. Diabetes Care 25, 1790–1794 (2002).

    Article  PubMed  Google Scholar 

  60. Macchia, A. et al. A clinically practicable diagnostic score for metabolic syndrome improves its predictivity of diabetes mellitus: the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico (GISSI)-Prevenzione scoring. Am. Heart J. 151, 754.e7–754.e17 (2006).

    Article  Google Scholar 

  61. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 352, 854–865 (1998).

  62. Libby, P. & Plutzky, J. Diabetic macrovascular disease: the glucose paradox? Circulation 106, 2760–2763 (2002).

    Article  PubMed  Google Scholar 

  63. Laakso, M. Hyperglycemia and cardiovascular disease in type 2 diabetes. Diabetes 48, 937–942 (1999).

    Article  CAS  PubMed  Google Scholar 

  64. Grundy, S. M. et al. Definition of metabolic syndrome. Report of the National Heart, Lung and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 109, 433–438 (2004).

    Article  PubMed  Google Scholar 

  65. Golden, S. H. et al. Risk factor groupings related to insulin resistance and their synergistic effects on subclinical atherosclerosis: the atherosclerosis risk in communities study. Diabetes 51, 3069–3076 (2002).

    Article  CAS  PubMed  Google Scholar 

  66. Wilson, P. W. et al. Prediction of coronary heart disease using risk factor categories. Circulation 97, 1837–1847 (1998).

    Article  CAS  PubMed  Google Scholar 

  67. Wannamethee, S. G., Shaper, A. G., Lennon, L. & Morris, R. W. Metabolic syndrome vs Framingham Risk Score for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus. Arch. Intern. Med. 165, 2644–2650 (2005).

    Article  PubMed  Google Scholar 

  68. Stern, M. P., Williams, K., Gonzalez-Villalpando, C., Hunt, K. J. & Haffner, S. M. Does the metabolic syndrome improve identification of individuals at risk of type 2 diabetes and/or cardiovascular disease? Diabetes Care 27, 2676–2681 (2004).

    Article  PubMed  Google Scholar 

  69. Assmann, G., Cullen, P. & Schulte, H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Munster (PROCAM) study. Circulation 105, 310–315 (2002).

    Article  PubMed  Google Scholar 

  70. Girman, C. J. et al. The metabolic syndrome and risk of major coronary events in the Scandinavian Simvastatin Survival Study (4S) and the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS). Am. J. Cardiol. 93, 136–141 (2004).

    Article  CAS  PubMed  Google Scholar 

  71. Lamarche, B. et al. Fasting insulin and apolipoprotein B levels and low-density lipoprotein particle size as risk factors for ischemic heart disease. J. Am. Med. Assoc. 279, 1955–1961 (1998).

    Article  CAS  Google Scholar 

  72. Hegele, R. A. Insulin resistance in human partial lipodystrophy. Curr. Atheroscler. Rep. 2, 397–404 (2000).

    Article  CAS  PubMed  Google Scholar 

  73. Barrett-Connor, E. & Khaw, K. T. Cigarette smoking and increased central adiposity. Ann. Intern. Med. 111, 783–787 (1989).

    Article  CAS  PubMed  Google Scholar 

  74. Shimokata, H., Muller, D. C. & Andres, R. Studies in the distribution of body fat. III. Effects of cigarette smoking. J. Am. Med. Assoc. 261, 1169–1173 (1989).

    Article  CAS  Google Scholar 

  75. Reaven, G. & Tsao, P. S. Insulin resistance and compensatory hyperinsulinemia: the key player between cigarette smoking and cardiovascular disease? J. Am. Coll. Cardiol. 41, 1044–1047 (2003).

    Article  CAS  PubMed  Google Scholar 

  76. Pouliot, M. C. et al. Visceral obesity in men. Associations with glucose tolerance, plasma insulin, and lipoprotein levels. Diabetes 41, 826–834 (1992).

    Article  CAS  PubMed  Google Scholar 

  77. Després, J. P., Lemieux, I. & Prud'homme, D. Treatment of obesity: need to focus on high risk abdominally obese patients. Brit. Med. J. 322, 716–720 (2001).

    Article  PubMed  PubMed Central  Google Scholar 

  78. Jorgensen, M. E. et al. Obesity and central fat pattern among Greenland Inuit and a general population of Denmark (Inter99): relationship to metabolic risk factors. Int. J. Obes. Relat. Metab. Disord. 27, 1507–1515 (2003).

    Article  CAS  PubMed  Google Scholar 

  79. Ross, R. et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. A randomized, controlled trial. Ann. Intern. Med. 133, 92–103 (2000).

    Article  CAS  PubMed  Google Scholar 

  80. Orchard, T. J. et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann. Intern. Med. 142, 611–619 (2005).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Katzmarzyk, P. T. et al. Targeting the metabolic syndrome with exercise: evidence from the HERITAGE Family Study. Med. Sci. Sports Exerc. 35, 1703–1709 (2003).

    Article  CAS  PubMed  Google Scholar 

  82. Dumont, M., Mauriège, P., Bergeron, J., Després, J. P. & Prud'homme, D. Effect of a six month gemfibrozil treatment and dietary recommendations on the metabolic risk profile of visceral obese men. Int. J. Obes. Relat. Metab. Disord. 25, 1136–1143 (2001).

    Article  CAS  PubMed  Google Scholar 

  83. Leon, A. S. & Sanchez, O. A. Response of blood lipids to exercise training alone or combined with dietary intervention. Med. Sci. Sports Exerc. 33, S502–S515 (2001).

    Article  CAS  PubMed  Google Scholar 

  84. Lemieux, I. et al. Waist girth does not predict metabolic complications in severely obese men. Diabetes Care 29, 1417–1419 (2006).

    Article  PubMed  Google Scholar 

  85. Lemieux, I. et al. Hypertriglyceridemic waist. A marker of the atherogenic metabolic triad (hyperinsulinemia, hyperapolipoprotein B, small, dense LDL) in men? Circulation 102, 179–184 (2000).

    Article  CAS  PubMed  Google Scholar 

  86. Underwood, P. M. Cardiovascular risk, the metabolic syndrome and the hypertriglyceridaemic waist. Curr. Opin. Lipidol. 15, 495–497 (2004).

    Article  CAS  PubMed  Google Scholar 

  87. Kahn, H. S. & Valdez, R. Metabolic risks identified by the combination of enlarged waist and elevated triacylglycerol concentration. Am. J. Clin. Nutr. 78, 928–934 (2003).

    Article  CAS  PubMed  Google Scholar 

  88. Lean, M. E., Han, T. S. & Morrison, C. E. Waist circumference as a measure for indicating need for weight management. Br. Med. J. 311, 158–161 (1995).

    Article  CAS  Google Scholar 

  89. Zhu, S. et al. Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds. Am. J. Clin. Nutr. 76, 743–749 (2002).

    Article  CAS  PubMed  Google Scholar 

  90. Beckley, E. T. New ADA initiative moves beyond 'metabolic syndrome'. 'Cardiometabolic risk' proposed as umbrella term for diabetes risk factors. DOC News 3, 1–3 (2006).

    Google Scholar 

  91. Eckel, R. H., Kahn, R., Robertson, R. M. & Rizza, R. A. Preventing cardiovascular disease and diabetes: a call to action from the American Diabetes Association and the American Heart Association. Circulation 113, 2943–2946 (2006).

    Article  PubMed  Google Scholar 

  92. Després, J. P. From CVD risk to cardiometabolic risk. Presented at the Symposium of the International Chair on Cardiometabolic Risk. XIV International Symposium on Atherosclerosis (Rome, 18–22 June 2006).

  93. Després, J. P. Visceral adiposity. Presented at the 66th Scientific Sessions, American Diabetes Association (Washington, DC, 9–13 June 2006).

  94. Bouchard, C. et al. The response to long-term overfeeding in identical twins. N. Engl. J. Med. 322, 1477–1482 (1990).

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The work of the authors has been supported by research grants from the Canadian Institutes of Health Research, the Canadian Diabetes Association, the Heart and Stroke Foundation and by the Foundation of the Québec Heart Institute. J.-P.D. is Scientific Director of the International Chair on Cardiometabolic Risk, which is supported by an unrestricted grant from Sanofi Aventis awarded to Université Laval.

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Jean-Pierre Després has received honoraria payments from the following pharmaceutical companies as a consultant or lecturer: Abbott Laboratories, AstraZeneca, Fournier Pharma/Solvay Pharma, GlaxoSmithKline, MSD, Pfizer Canada/Pharmacia, Sanofi-Aventis and Novartis.

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Després, JP., Lemieux, I. Abdominal obesity and metabolic syndrome. Nature 444, 881–887 (2006). https://doi.org/10.1038/nature05488

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