scholarly journals Environmental Exposure to Cooking Oil Fume and Fatty Liver Disease

2020 ◽  
Author(s):  
Shun Zhang ◽  
Jie Lin ◽  
Saili Ni ◽  
Qili Shi ◽  
Zi Xiong ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Fatty Liver ◽  
Heavy Oil ◽  
Fatty Liver Disease ◽  
Exposure Group ◽  
Odds Ratios ◽  
Disease Extent ◽  
Cooking Oil ◽  
Stratified Analysis

Abstract Background: Evidence on effect of cooking oil fume, which contains numerous carcinogens, on development of fatty liver disease is limited. The present study aims to investigate the association between exposure to cooking oil fume and the risk of fatty liver disease.Method: A total of 55959 participants aged between 40 and 75 years old participated in a community-based survey in Ningbo, China. Information on exposure to cooking oil fume and fatty liver disease were collected by face-to-face interview. Stratified analysis was used with participants being divided into two groups according to gender. Multiple logistic regression analyses were conducted to investigate the association between cooking oil fume exposure and fatty liver risk. Furthermore, ordered logistic regression was conducted to investigate the association between cooking oil fume exposure and the severity of fatty liver disease.Results: Fatty liver disease prevalence was 8.79% in none oil fume exposure group, 10.52% in light oil fume exposure group, 23.47% in moderate oil fume exposure group and 41.45% in heavy oil fume exposure group. After adjusting for confounding factors, participants in the light, moderate and heavy cooking oil fume exposure groups all had significantly higher odds ratios as compared with participants in the none oil fume exposure group. In addition, an interaction effect between cooking oil fume exposure and gender on the prevalence and severity of fatty liver disease was observed. Females with heavyoil fume exposure had the highest odds ratios of fatty liver disease and severer disease extent. In the stratified analysis, compared to participants in the smokeless group, males and females in light, moderate and heavy cooking oil fume exposure groups all had significantly higher risk of fatty liver disease and severer disease extent, while participants with heavier cooking oil fume exposure tended to have higher risk of fatty liver disease and severer disease extent.Conclusion: Exposure to cooking oil fume is associated with incident and severity of fatty liver disease in 40-75 years old Chinese. The associations might be dose-responsive. In addition, heavy oil fume exposure and female sex might have a synergistic effecton incident and severity of fatty liver disease.

scholarly journals Environmental Exposure to Cooking Oil Fume and Fatty Liver Disease: a cross-sectional study.

2020 ◽  
Author(s):  
Shun Zhang ◽  
Jie Lin ◽  
Saili Ni ◽  
Qili Shi ◽  
Zi Xiong ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Fatty Liver ◽  
Heavy Oil ◽  
Fatty Liver Disease ◽  
Cross Sectional Study ◽  
Disease Extent ◽  
Cross Sectional ◽  
Cooking Oil ◽  
Stratified Analysis

Abstract Background The effect of cooking oil fume on development of fatty liver disease is limited. The present study aims to investigate the association between exposure to cooking oil fume and the risk of fatty liver disease. Method A total of 55959 participants aged between 40 and 75 years old participated in a community-based survey in Ningbo, China. Multiple logistic regression analyses were conducted to investigate the association between cooking oil fume exposure and fatty liver risk. Furthermore, ordered logistic regression was conducted to investigate the association between cooking oil fume exposure and the severity of fatty liver disease. Results Cooking oil fume exposure were significantly associated with fatty liver disease after adjusting for confounding factors compared with participants in the none oil fume exposure group. Moreover, interaction analyses indicated that females with heavy oil fume exposure had the highest odds ratios of fatty liver disease and severer disease extent. In the stratified analysis, compared to participants in the smokeless group, males and females in light, moderate and heavy cooking oil fume exposure groups all had significantly higher risk of fatty liver disease and severer disease extent, while participants with heavier cooking oil fume exposure tended to have higher risk of fatty liver disease and severer disease extent. Conclusion Our findings indicated that exposure to cooking oil fume potentiated the risk of fatty liver disease, and the associations might be dose-responsive. Furthermore, heavy oil fume exposure and female sex might have a synergistic effect on fatty liver disease.

Remnant Lipoprotein Cholesterol as a Factor Related to Adult Fatty Liver Disease

2021 ◽  
Author(s):  
Shuang Zhang ◽  
Shitong Cheng ◽  
Xue He ◽  
Wei Wang ◽  
Ke Yun ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Characteristic Curve ◽  
Health Check ◽  
Lipoprotein Cholesterol ◽  
Strong Positive Correlation ◽  
Variable Model ◽  
Remnant Lipoprotein

Abstract Context Dyslipidemia is related to fatty liver disease (FLD), whose relationship with remnant lipoprotein cholesterol (RLP-C), a component of blood lipids, remains unclear. Objective To clarify the correlation between RLP-C and the occurrence and severity of FLD and establish an FLD discriminant model based on health check indicators. Methods Retrospective study of participants who underwent health check-up in the First Affiliated Hospital of China Medical University (Shenyang, China) between January and December 2019. We categorized participants according to liver ultrasound results and analyzed the correlation between RLP-C and occurrence of FLD (n = 38 885) through logistic regression, restricted cubic spline, and receiver operating characteristic curve. We categorized the severity of FLD according to the control attenuation parameter and analyzed the correlation between RLP-C and FLD severity through multiple logistic regression; only males were included (n = 564). Results The adjusted OR (aOR) per SD between RLP-C and FLD was 2.33 (95% CI 2.21-2.46, P < .001), indicating a dose–response relationship (P < .0001). The optimal cut-off value of RLP-C was 0.45 mmol/L and the area under the curve (AUC) was 0.79. The AUC of the 8-variable model was 0.89 in both the training and the validation sets. FLD severity was related to the level of RLP-C (aOR per SD = 1.29, 95% CI 1.07-1.55, P = .008). Conclusion RLP-C has a strong positive correlation with FLD occurrence and FLD severity. These results may help clinicians identify and implement interventions in individuals with high FLD risk and reduce FLD prevalence.

Polymorphisms 677C > T and 1298A > C in the MTHFR gene and homocysteine levels in patients with non-alcoholic fatty liver disease as a component of the ontological model

2021 ◽  
Author(s):  
N. A. Nosko ◽  
O. M. Rud
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Mthfr Gene ◽  
Scientific Data ◽  
Multiple Logistic Regression ◽  
Alcoholic Fatty Liver ◽  
Significant Difference ◽  
Alcoholic Fatty Liver Disease

Objective — to systematize literature data on the presence of 677C > T and 1298A > C polymorphisms in the MTHFR gene and homocysteine levels in patients with non‑alcoholic fatty liver disease (NAFLD); to calculate the frequencies 677C > T and 1298A > C polymorphisms combinations in the MTHFR gene and their impact on NAFLD development; to compare homocysteine levels in patients with and without NAFLD. Materials and methods. The analysis has been performed for the results of investigation of 49 patients, from them 17 subjects with NAFLD and 32 without it. Clinical, laboratory, statistical and ontological methods were used in the study. The MTHFR 677C > T and MTHFR 1298A > C polymorphisms in the MTHFR gene were investigated with the use of real time polymerase chain reaction (RT‑PCR) technique. Homocysteine levels were determined with chemiluminescent immunoassay with reference values 3.7 — 13.9 µmol/L. Multiple logistic regression method was used to evaluate the effects 677C > T and 1298A > C polymorphisms in the MTHFR gene on NAFLD development. Results. The variant of combination of 667С/С/1298А/А polymorphisms in the MTHFR gene (absence of mutation) was reveled in 6 (12 %) persons, that showed a widespread prevalence of variants with the presence of mutations. The correlation between variants of 677C > T and 1298A > C polymorphism in the MTHFR gene has been established (r = 0.429; p < 0.05). The results of multiple logistic regression demonstrated absence of the significant effects of 677C > T and 1298A > C polymorphisms in the MTHFR gen on NAFLD development (p > 0.05). Comparison of the homocysteine levels in patients with and without NAFLD didn’t reveal significant difference (р > 0.05), as well as comparison in the groups with combinations of 677C > T and 1298А > С polymorphisms in the MTHFR gen (р > 0.05). This can be explained by the fact that NAFLD group consisted of manly young patients without hypertension, type 2 diabetes mellitus and severe liver fibrosis. Conclusions. Ontological systematization of the scientific data on NAFLD revealed that 677C > T and 1298A > C polymorphisms in the MTHFR gen are pathogenetically associated with the significant increase in homocysteine levels as a marker of cardiovascular pathology. Giving the multifactorial nature of hyperhomocysteinemia and wide spread of 677C > T and 1298A > C polymorphisms in the MTHFR gen in population, it seems to be impractical to use genetic investigations for MTHFR gen polymorphism in NAFLD patients routinely, but only for the purpose of differential diagnosis of hyperhomocysteinemia.  

Serum SHBG Is Associated With the Development and Regression of Nonalcoholic Fatty Liver Disease: A Prospective Study

2019 ◽  
Vol 105 (3) ◽  
pp. e791-e804
Author(s):  
Xu Wang ◽  
Jiewen Xie ◽  
Juan Pang ◽  
Hanyue Zhang ◽  
Xu Chen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Prediction Models ◽  
Stepwise Logistic Regression ◽  
Stepwise Logistic Regression Analysis ◽  
Nonalcoholic Fatty Liver ◽  
Potential Biomarker

Abstract Context SHBG, a homodimeric glycoprotein produced by hepatocytes has been shown to be associated with metabolic disorders. Whether circulating SHBG levels are predictive of later risk of nonalcoholic fatty liver disease (NAFLD) remains unknown. In this study, we prospectively investigated the association between SHBG and NAFLD progression through a community-based cohort comprising 3389 Chinese adults. Methods NAFLD was diagnosed using abdominal ultrasonography. Serum SHBG levels were measured by chemiluminescent enzyme immunometric assay, and their relationship with NAFLD development and regression was investigated after a mean follow-up of 3.09 years using multivariable logistic regression. Results Basal SHBG was negatively associated with NAFLD development, with a fully adjusted odds ratio (OR) and its 95% confidence interval (CI) of 0.22 (0.12-0.40) (P &lt; .001). In contrast, basal SHBG was positively associated with NAFLD regression, with a fully adjusted OR of 4.83 (2.38-9.81) (P &lt; .001). Multiple-stepwise logistic regression analysis showed that SHBG concentration was an independent predictor of NAFLD development (OR, 0.28 [0.18-0.45]; P &lt; .001) and regression (OR, 3.89 [2.43-6.22]; P &lt; .001). In addition, the area under the receiver operating characteristic curves were 0.764 (95% CI, 0.740-0.787) and 0.762 (95% CI, 0.738-0.785) for the prediction models of NAFLD development and regression, respectively. Conclusions Serum SHBG concentration is associated with the development and regression of NAFLD; moreover, it can be a potential biomarker for predicting NAFLD progression, and also a novel preventive and therapeutic target for NAFLD.

scholarly journals Significant Burden of Nonalcoholic Fatty Liver Disease With Advanced Fibrosis in Iranian Population: A Cross-Sectional Analysis

2020 ◽  
Author(s):  
Behnam Hosseini Ahangar ◽  
Rojen Manouchehri ◽  
Bahareh Rezaei ◽  
Maryam Bahadori ◽  
Arefeh Ebrahimi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Fatty Liver ◽  
Chronic Liver Disease ◽  
Fatty Liver Disease ◽  
Advanced Fibrosis ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Significant Fibrosis

The main cause of chronic liver disease in Iran is Non-alcoholic fatty liver disease (NAFLD). A common pathological feature of chronic liver disease is fibrosis, so particular vigilance against patients with liver fibrosis is necessary to lead healthcare resource planning. The aims of the current study were to determine the prevalence and predictors of significant fibrosis and advanced ones among individuals with NAFLD. In the current cross-sectional study conducted during 2013-2016, the presence of fibrosis among NAFLD patients was assessed using the NAFLD fibrosis score (NFS) and AST to Platelet Ratio Index (APRI) systems. Multivariate logistic regression models were used to predict significant fibrosis or advanced fibrosis among NAFLD patients. Analysis of the results of over 999 patients (569 females and 430 males) with the mean age of 43.28±14.034 years in Iran during 2015-2016 showed that the overall prevalence of NAFLD among Iranian adults was 19.6%. NAFLD prevalence was not significantly higher in males compared to females (51.5% vs. 48.5%, P=0.66). On multivariate logistic regression analyses, females were less likely to have NAFLD compared to males (OR 0.32, 95% CI 0.24-0.42, P<0.001). The overall prevalence of liver fibrosis among NAFLD patients was 38.8%.20.4% and 6.12% of NAFLD patients had evidence of significant and advanced fibrosis, respectively. Our most recent dataset analysis emphasized the major burden of NAFLD among people of Iranian origin. A high prevalence of individuals with NAFLD and advanced fibrosis was observed.

scholarly journals Liver Steatosis: Better Predictor of CKD in MAFLD Than Liver Fibrosis as Determined by Transient Elastography With Controlled Attenuation Parameter

2022 ◽  
Vol 8 ◽  
Author(s):  
Luciana Marc ◽  
Adelina Mihaescu ◽  
Raluca Lupusoru ◽  
Iulia Grosu ◽  
Florica Gadalean ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Transient Elastography ◽  
Renal Involvement ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Atherogenic Dyslipidemia ◽  
Alcoholic Fatty Liver

Background: Changing the term/concept of the non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction associated fatty liver disease (MAFLD) may broaden the pathological definition that can include chronic renal involvement, and, possibly, changes chronic kidney disease's (CKD's) epidemiological association with liver disease, because CKD is associated with metabolic disorders and almost all patients with CKD present some form of an atherogenic dyslipidemia. Our study explores the relationship between MAFLD and CKD using Transient Elastography (TE) with a Controlled Attenuated Parameter (CAP).Methods: We evaluated 335 patients with diabetes with MAFLD and with high CKD risk using TE with CAP (FibroScan®). The CKD was defined according to Kidney Disease Improving Global Outcomes (KDIGO) 2012 guidelines. Logistic regression and stepwise multiple logistic regression were used to evaluate the factors associated with CKD. In addition, a receiver operating characteristic curve (ROC) analysis was used to assess the performance of CAP and TE in predicting CKD and its optimal threshold.Results: The prevalence of CKD in our group was 60.8%. Patients with CKD had higher mean liver stiffness measurements (LSM) and CAP values than those without CKD. We found that hepatic steatosis was a better predictor of CKD than fibrosis. Univariate regression showed that CAP values &gt;353 dB/m were predictive of CKD; while the multivariate regression analysis (after adjustment according to sex, body mass index (BMI), low-density lipoprotein cholesterol (LDLc), and high-density lipoprotein cholesterol (HDLc), and fasting glucose) showed that CAP values &gt;353 dB/m were more strongly associated with the presence of CKD compared to the LSM (fibrosis) values.Conclusion: In patients with MAFLD, CAP-assessed steatosis appears to be a better predictor of CKD compared to LSM-assessed hepatic fibrosis.

scholarly journals The role of anthropometric indices in the prediction of non-alcoholic fatty liver disease in the PERSIAN Guilan Cohort study (PGCS)

2018 ◽  
Vol 11 (3) ◽  
pp. 194-202 ◽  
Author(s):  
Roya Mansour-Ghanaei ◽  
◽  
Fariborz Mansour-Ghanaei ◽  
Mohammadreza Naghipour ◽  
Farahnaz Joukar ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Liver Disease ◽  
Fatty Liver ◽  
Significant Relationship ◽  
Fatty Liver Disease ◽  
Abdominal Ultrasound ◽  
Anthropometric Indices ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Introduction:Non-alcoholic fatty liver disease (NAFLD) is an obesity-associated health problem that causes other liver diseases for the patient. Four anthropometric indices: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were analyzed as NAFLD predictors in the present study.Methods:From the total number of individuals who referred to the PERSIAN Guilan Cohort study (PGCS) located in the north of Iran during the period of study, a total of 960 people were enrolled in the present study. NAFLD was diagnosed using through an abdominal ultrasound exam. Height, weight, WC, BMI, WHR and WHtR were later calculated. Chi-square, ANOVA and logistic regression analyses were used to analyze the risk factors.Results:Out of the 960 individuals who were enrolled in the study, 597 (62.2%) were male and 363 (37.8%) were female (with an average age of 47.21 ± 7.29 years). There was a significant relationship between weight and NAFLD (P<0.001). There was also a significant relationship between BMI (OR= 8.41; 95% CI = 5.59–12.75), WC (OR= 2.67; 95% CI = 2.05–3.48), WHR (OR= 3.84; 95% CI = 2.26–6.52), WHtR (OR= 28.53; 95% CI = 6.94–117.31) and NAFLD (P<0.001). The results of the logistic regression analysis showed that WHtR, BMI and WC were effective predictors for the risk of NAFLD while WHtR played a more important role in the prediction of NAFLD.Conclusion:Anthropometric indices, especially WHtR, as a simple screening tool, seem to be an important criterion for the detection of NAFLD.

scholarly journals Investigating the Relationship Between Insulin Resistance and Fatty Liver in a Random Population of Tehran

2020 ◽  
Vol 20 (10) ◽  
Author(s):  
Hossein Moameri ◽  
Zahra Akbarzade ◽  
Elmira Khamisi ◽  
Saeed Osati ◽  
Alireza Ghaemi ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Logistic Regression ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cell Activity ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Adjusted Risk ◽  
Unit Increase

Background: Insulin resistance can be a predictor of adverse fatty liver disease and health problems. Objectives: The present study aimed to investigate the effect of insulin resistance on fatty liver disease. Methods: This study used the data of 2,160 individuals registered in a cross-sectional study who were randomly selected from among clients of a nutrition clinic in Tehran from April to December 2019. Insulin resistance and beta-cell activity were calculated by the homeostasis model assessment formula. The study outcome was defined as having fatty liver disease. The odds ratio (95% CI) was calculated using logistic regression models. Results: The mean age was 35 (± 9) in healthy subjects and 49 (± 8) in fatty liver disease patients (age range: 16 to 42 years). Nearly 34.5% of the individuals had fatty liver disease. According to the adjusted results of the logistic regression model, the risk of NAFLD was 1.05 (P < 0.001) for one unit increase in fasting insulin and 1.01 (P < 0.001) for one unit increase in 2-h insulin, which indicated the statistically significant relationship of NAFLD with fasting insulin and 2-h insulin. Also, the risk of NAFLD was 1.01 P < 0.001) for one unit increase in FPG, which was statistically significant. Moreover, the adjusted risk of NAFLD was 1.00 (P < 0.001) for one unit increase in 2-h glucose, which was not statistically significant. Finally, the adjusted risk of NAFLD was 1.29 (P < 0.001) for one unit increase in HOMA-IR, which was statistically significant. Conclusions: The findings of the present study demonstrated that insulin resistance could increase the risk of fatty liver disease. Also, each one-unit increase in fasting blood sugar, fasting insulin, and 2-h insulin increased the risk of fatty liver disease. Therefore, the results of this study may be useful for health policymakers to design suitable preventive and therapeutic interventions for those with NAFLD to prevent and control this disease.

scholarly journals Effects of sleep quality on non-alcoholic fatty liver disease: a cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e039947
Author(s):  
Atsushi Takahashi ◽  
Yukio Anzai ◽  
Masahito Kuroda ◽  
Masae Kokubun ◽  
Yuichiro Kondo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Liver Disease ◽  
Sleep Quality ◽  
Fatty Liver ◽  
Logistic Regression Analysis ◽  
Fatty Liver Disease ◽  
Medication Use ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

BackgroundThe effects of sleep quality on the risk of developing non-alcoholic fatty liver disease (NAFLD) remain uncertain. The purpose of this study was to clarify the association between sleep quality and NAFLD.MethodsThe data of 4828 participants who underwent health check-ups at four hospitals were analysed. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), which comprised seven elements scored from 0 to 3. The global PSQI score and the score for each element were compared between NAFLD and non-NAFLD groups separately by sex. Logistic regression analysis was performed to determine the association between NAFLD and each PSQI score.ResultsIn both men and women, the mean PSQI score for sleep medication use was significantly higher in non-NAFLD than in NAFLD. With regard to sleep medication use in men, the OR (95% CI) for NAFLD was lower with a score of 3 (OR 0.60, 95% CI 0.38–0.95) than with a score of 0 on multivariate logistic regression analysis adjusted for age, smoking habits and physical activity. The OR for NAFLD based on daytime dysfunction was also higher with a score of 3 than with a score of 0 in both men (OR 2.82, 95% CI 1.39–5.75) and women (OR 2.08, 95% CI 1.10–3.92). After adjustment for body mass index, the sleep latency scores in men and daytime dysfunction in women were associated with NAFLD.ConclusionSleep quality was associated with NAFLD, and there were sex differences.

scholarly journals Diagnosis of Fibrosis Using Blood Markers and Logistic Regression in Southeast Asian Patients With Non-alcoholic Fatty Liver Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Chao Sang ◽  
Hongmei Yan ◽  
Wah Kheong Chan ◽  
Xiaopeng Zhu ◽  
Tao Sun ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Liver Biopsy ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Advanced Fibrosis ◽  
Alcoholic Fatty Liver ◽  
Nafld Fibrosis Score ◽  
Glutamyl Transferase ◽  
Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is one of the main causes of fibrosis. Liver biopsy remains the gold standard for the confirmation of fibrosis in NAFLD patients. Effective and non-invasive diagnosis of advanced fibrosis is essential to disease surveillance and treatment decisions. Herein we used routine medical test markers and logistic regression to differentiate early and advanced fibrosis in NAFLD patients from China, Malaysia, and India (n1 = 540, n2 = 147, and n3 = 97) who were confirmed by liver biopsy. Nine parameters, including age, body mass index, fasting blood glucose, presence of diabetes or impaired fasting glycemia, alanine aminotransferase, γ-glutamyl transferase, triglyceride, and aspartate transaminase/platelet count ratio, were selected by stepwise logistic regression, receiver operating characteristic curve (ROC), and hypothesis testing and were used for model construction. The area under the ROC curve (auROC) of the model was 0.82 for differentiating early and advanced fibrosis (sensitivity = 0.69, when specificity = 0.80) in the discovery set. Its diagnostic ability remained good in the two independent validation sets (auROC = 0.89 and 0.71) and was consistently superior to existing panels such as the FIB-4 and NAFLD fibrosis score. A web-based tool, LiveFbr, was developed for fast access to our model. The new model may serve as an attractive tool for fibrosis classification in NAFLD patients.

Sign in / Sign up

Export Citation Format

Share Document