메뉴 건너뛰기




Volumn 28, Issue 2, 2013, Pages 206-215

Is the frequency of metabolic syndrome higher in South Korean women with rheumatoid arthritis than in healthy subjects?

Author keywords

Arthritis; Cardiovascular diseases; Insulin resistance; Metabolic syndrome X; Rheumatoid

Indexed keywords

C REACTIVE PROTEIN; HIGH DENSITY LIPOPROTEIN CHOLESTEROL; BIOLOGICAL MARKER;

EID: 84875512504     PISSN: 12263303     EISSN: 20056648     Source Type: Journal    
DOI: 10.3904/kjim.2013.28.2.206     Document Type: Article
Times cited : (21)

References (45)
  • 1
    • 15444366991 scopus 로고    scopus 로고
    • Metabolic syndrome: A comprehensive perspective based on interactions between obesity, diabetes, and inflammation
    • Dandona P, Aljada A, Chaudhuri A, Mohanty P, Garg R. Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation 2005;111:1448-1454.
    • (2005) Circulation , vol.111 , pp. 1448-1454
    • Dandona, P.1    Aljada, A.2    Chaudhuri, A.3    Mohanty, P.4    Garg, R.5
  • 2
    • 0036637538 scopus 로고    scopus 로고
    • Homeostasis model assessment of insulin resistance in relation to the incidence of cardiovascular disease: The San Antonio Heart Study
    • Hanley AJ, Williams K, Stern MP, Haffner SM. Homeostasis model assessment of insulin resistance in relation to the incidence of cardiovascular disease: the San Antonio Heart Study. Diabetes Care 2002;25:1177-1184.
    • (2002) Diabetes Care , vol.25 , pp. 1177-1184
    • Hanley, A.J.1    Williams, K.2    Stern, M.P.3    Haffner, S.M.4
  • 3
    • 4143089058 scopus 로고    scopus 로고
    • Measures of insulin resistance add incremental value to the clinical diagnosis of metabolic syndrome in association with coronary atherosclerosis
    • Reilly MP, Wolfe ML, Rhodes T, Girman C, Mehta N, Rader DJ. Measures of insulin resistance add incremental value to the clinical diagnosis of metabolic syndrome in association with coronary atherosclerosis. Circulation 2004;110:803-809.
    • (2004) Circulation , vol.110 , pp. 803-809
    • Reilly, M.P.1    Wolfe, M.L.2    Rhodes, T.3    Girman, C.4    Mehta, N.5    Rader, D.J.6
  • 4
    • 77957198071 scopus 로고    scopus 로고
    • The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis
    • Mottillo S, Filion KB, Genest J, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 2010;56:1113-1132.
    • (2010) J Am Coll Cardiol , vol.56 , pp. 1113-1132
    • Mottillo, S.1    Filion, K.B.2    Genest, J.3
  • 6
    • 79952113242 scopus 로고    scopus 로고
    • Metabolic syndrome, inflammation and atherosclerosis: The role of adipokines in health and in systemic inflammatory rheumatic diseases
    • Santos MJ, Fonseca JE. Metabolic syndrome, inflammation and atherosclerosis: the role of adipokines in health and in systemic inflammatory rheumatic diseases. Acta Reumatol Port 2009;34:590-598.
    • (2009) Acta Reumatol Port , vol.34 , pp. 590-598
    • Santos, M.J.1    Fonseca, J.E.2
  • 7
    • 55449107811 scopus 로고    scopus 로고
    • Metabolic syndrome in rheumatic diseases: Epidemiology, pathophysiology, and clinical implications
    • Sidiropoulos PI, Karvounaris SA, Boumpas DT. Metabolic syndrome in rheumatic diseases: epidemiology, pathophysiology, and clinical implications. Arthritis Res Ther 2008;10:207.
    • (2008) Arthritis Res Ther , vol.10 , pp. 207
    • Sidiropoulos, P.I.1    Karvounaris, S.A.2    Boumpas, D.T.3
  • 8
    • 21644476354 scopus 로고    scopus 로고
    • Association between C-reactive protein and insulin resistance in a Japanese population: The Minoh Study
    • Nakanishi N, Shiraishi T, Wada M. Association between C-reactive protein and insulin resistance in a Japanese population: the Minoh Study. Intern Med 2005;44:542-547.
    • (2005) Intern Med , vol.44 , pp. 542-547
    • Nakanishi, N.1    Shiraishi, T.2    Wada, M.3
  • 9
    • 77956508972 scopus 로고    scopus 로고
    • An update on the relationships between rheumatoid arthritis and atherosclerosis
    • Ozbalkan Z, Efe C, Cesur M, et al. An update on the relationships between rheumatoid arthritis and atherosclerosis. Atherosclerosis 2010;212:377-382.
    • (2010) Atherosclerosis , vol.212 , pp. 377-382
    • Ozbalkan, Z.1    Efe, C.2    Cesur, M.3
  • 10
    • 79958242639 scopus 로고    scopus 로고
    • The metabolic syndrome: The crossroads between rheumatoid arthritis and cardiovascular risk
    • Gremese E, Ferraccioli G. The metabolic syndrome: the crossroads between rheumatoid arthritis and cardiovascular risk. Autoimmun Rev 2011;10:582-589.
    • (2011) Autoimmun Rev , vol.10 , pp. 582-589
    • Gremese, E.1    Ferraccioli, G.2
  • 11
    • 33846071577 scopus 로고    scopus 로고
    • Metabolic syndrome and subclinical atherosclerosis in rheumatoid arthritis
    • Dessein PH, Tobias M, Veller MG. Metabolic syndrome and subclinical atherosclerosis in rheumatoid arthritis. J Rheumatol 2006;33:2425-2432.
    • (2006) J Rheumatol , vol.33 , pp. 2425-2432
    • Dessein, P.H.1    Tobias, M.2    Veller, M.G.3
  • 12
    • 33846017969 scopus 로고    scopus 로고
    • Metabolic syndrome is common among middle-toolder aged Mediterranean patients with rheumatoid arthritis and correlates with disease activity: A retrospective, cross-sectional, controlled, study
    • Karvounaris SA, Sidiropoulos PI, Papadakis JA, et al. Metabolic syndrome is common among middle-toolder aged Mediterranean patients with rheumatoid arthritis and correlates with disease activity: a retrospective, cross-sectional, controlled, study. Ann Rheum Dis 2007;66:28-33.
    • (2007) Ann Rheum Dis , vol.66 , pp. 28-33
    • Karvounaris, S.A.1    Sidiropoulos, P.I.2    Papadakis, J.A.3
  • 13
    • 34547476492 scopus 로고    scopus 로고
    • Insulin resistance is an independent risk factor for atherosclerosis in rheumatoid arthritis
    • La Montagna G, Cacciapuoti F, Buono R, et al. Insulin resistance is an independent risk factor for atherosclerosis in rheumatoid arthritis. Diab Vasc Dis Res 2007;4:130-135.
    • (2007) Diab Vasc Dis Res , vol.4 , pp. 130-135
    • la Montagna, G.1    Cacciapuoti, F.2    Buono, R.3
  • 14
    • 38649111368 scopus 로고    scopus 로고
    • Prevalence of the metabolic syndrome is increased in rheumatoid arthritis and is associated with coronary atherosclerosis
    • Chung CP, Oeser A, Solus JF, et al. Prevalence of the metabolic syndrome is increased in rheumatoid arthritis and is associated with coronary atherosclerosis. Atherosclerosis 2008;196:756-763.
    • (2008) Atherosclerosis , vol.196 , pp. 756-763
    • Chung, C.P.1    Oeser, A.2    Solus, J.F.3
  • 15
    • 60849113129 scopus 로고    scopus 로고
    • Lack of association between glucocorticoid use and presence of the metabolic syndrome in patients with rheumatoid arthritis: A cross-sectional study
    • Toms TE, Panoulas VF, Douglas KM, Griffiths HR, Kitas GD. Lack of association between glucocorticoid use and presence of the metabolic syndrome in patients with rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther 2008;10:R145.
    • (2008) Arthritis Res Ther , vol.10
    • Toms, T.E.1    Panoulas, V.F.2    Douglas, K.M.3    Griffiths, H.R.4    Kitas, G.D.5
  • 16
    • 42049110219 scopus 로고    scopus 로고
    • Prevalence and factors associated with metabolic syndrome in patients with rheumatoid arthritis and systemic lupus erythematosus
    • Zonana-Nacach A, Santana-Sahagun E, Jimenez-Balderas FJ, Camargo-Coronel A. Prevalence and factors associated with metabolic syndrome in patients with rheumatoid arthritis and systemic lupus erythematosus. J Clin Rheumatol 2008;14:74-77.
    • (2008) J Clin Rheumatol , vol.14 , pp. 74-77
    • Zonana-Nacach, A.1    Santana-Sahagun, E.2    Jimenez-Balderas, F.J.3    Camargo-Coronel, A.4
  • 17
    • 63849101318 scopus 로고    scopus 로고
    • Rheumatoid cachexia is associated with dyslipidemia and low levels of atheroprotective natural antibodies against phosphorylcholine but not with dietary fat in patients with rheumatoid arthritis: A crosssectional study
    • Elkan AC, Hakansson N, Frostegard J, Cederholm T, Hafstrom I. Rheumatoid cachexia is associated with dyslipidemia and low levels of atheroprotective natural antibodies against phosphorylcholine but not with dietary fat in patients with rheumatoid arthritis: a crosssectional study. Arthritis Res Ther 2009;11:R37.
    • (2009) Arthritis Res Ther , vol.11
    • Elkan, A.C.1    Hakansson, N.2    Frostegard, J.3    Cederholm, T.4    Hafstrom, I.5
  • 18
    • 73349127171 scopus 로고    scopus 로고
    • Methotrexate therapy associates with reduced prevalence of the metabolic syndrome in rheumatoid arthritis patients over the age of 60- more than just an antiinflammatory effect? A cross sectional study
    • Toms TE, Panoulas VF, John H, Douglas KM, Kitas GD. Methotrexate therapy associates with reduced prevalence of the metabolic syndrome in rheumatoid arthritis patients over the age of 60- more than just an antiinflammatory effect? A cross sectional study. Arthritis Res Ther 2009;11:R110.
    • (2009) Arthritis Res Ther , vol.11
    • Toms, T.E.1    Panoulas, V.F.2    John, H.3    Douglas, K.M.4    Kitas, G.D.5
  • 19
    • 78650371576 scopus 로고    scopus 로고
    • Increased frequency of metabolic syndrome among Vietnamese women with early rheumatoid arthritis: A cross-sectional study
    • Dao HH, Do QT, Sakamoto J. Increased frequency of metabolic syndrome among Vietnamese women with early rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther 2010;12:R218.
    • (2010) Arthritis Res Ther , vol.12
    • Dao, H.H.1    Do, Q.T.2    Sakamoto, J.3
  • 20
    • 73449134123 scopus 로고    scopus 로고
    • The metabolic syndrome is amplified in hypothyroid rheumatoid arthritis patients: A cross-sectional study
    • Raterman HG, van Eijk IC, Voskuyl AE, et al. The metabolic syndrome is amplified in hypothyroid rheumatoid arthritis patients: a cross-sectional study. Ann Rheum Dis 2010;69:39-42.
    • (2010) Ann Rheum Dis , vol.69 , pp. 39-42
    • Raterman, H.G.1    van Eijk, I.C.2    Voskuyl, A.E.3
  • 21
    • 78650907040 scopus 로고    scopus 로고
    • Increased prevalence of metabolic syndrome associated with rheumatoid arthritis in patients without clinical cardiovascular disease
    • Crowson CS, Myasoedova E, Davis JM 3rd, et al. Increased prevalence of metabolic syndrome associated with rheumatoid arthritis in patients without clinical cardiovascular disease. J Rheumatol 2011;38:29-35.
    • (2011) J Rheumatol , vol.38 , pp. 29-35
    • Crowson, C.S.1    Myasoedova, E.2    Davis III, J.M.3
  • 22
    • 79551512144 scopus 로고    scopus 로고
    • Prevalence of atherosclerotic risk factors and the metabolic syndrome in patients with chronic inf lammatory arthritis
    • Mok CC, Ko GT, Ho LY, Yu KL, Chan PT, To CH. Prevalence of atherosclerotic risk factors and the metabolic syndrome in patients with chronic inf lammatory arthritis. Arthritis Care Res (Hoboken) 2011;63:195-202.
    • (2011) Arthritis Care Res (Hoboken) , vol.63 , pp. 195-202
    • Mok, C.C.1    Ko, G.T.2    Ho, L.Y.3    Yu, K.L.4    Chan, P.T.5    To, C.H.6
  • 23
    • 79959666279 scopus 로고    scopus 로고
    • Investigation of the association between metabolic syndrome and disease activity in rheumatoid arthritis
    • Sahebari M, Goshayeshi L, Mirfeizi Z, et al. Investigation of the association between metabolic syndrome and disease activity in rheumatoid arthritis. Scientif icWorldJournal 2011;11:1195-1205.
    • (2011) Scientif IcWorldJournal , vol.11 , pp. 1195-1205
    • Sahebari, M.1    Goshayeshi, L.2    Mirfeizi, Z.3
  • 24
    • 79961167979 scopus 로고    scopus 로고
    • The frequency of metabolic syndrome in women with rheumatoid arthritis and in controls
    • Karimi M, Mazloomzadeh S, Kafan S, Amirmoghadami H. The frequency of metabolic syndrome in women with rheumatoid arthritis and in controls. Int J Rheum Dis 2011;14:248-254.
    • (2011) Int J Rheum Dis , vol.14 , pp. 248-254
    • Karimi, M.1    Mazloomzadeh, S.2    Kafan, S.3    Amirmoghadami, H.4
  • 25
    • 0023945481 scopus 로고
    • The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis
    • Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988;31:315-324.
    • (1988) Arthritis Rheum , vol.31 , pp. 315-324
    • Arnett, F.C.1    Edworthy, S.M.2    Bloch, D.A.3
  • 26
    • 0028815803 scopus 로고
    • Modified disease activity scores that include twenty-eight-joint counts: Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis
    • Prevoo ML, van 't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts: development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 1995;38:44-48.
    • (1995) Arthritis Rheum , vol.38 , pp. 44-48
    • Prevoo, M.L.1    van 't Hof, M.A.2    Kuper, H.H.3    van Leeuwen, M.A.4    van de Putte, L.B.5    van Riel, P.L.6
  • 27
    • 27444443876 scopus 로고    scopus 로고
    • Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement
    • Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-2752.
    • (2005) Circulation , vol.112 , pp. 2735-2752
    • Grundy, S.M.1    Cleeman, J.I.2    Daniels, S.R.3
  • 28
    • 33747740761 scopus 로고    scopus 로고
    • Modification of the NCEP ATP III definitions of the metabolic syndrome for use in Asians identifies individuals at risk of ischemic heart disease
    • Heng D, Ma S, Lee JJ, et al. Modification of the NCEP ATP III definitions of the metabolic syndrome for use in Asians identifies individuals at risk of ischemic heart disease. Atherosclerosis 2006;186:367-373.
    • (2006) Atherosclerosis , vol.186 , pp. 367-373
    • Heng, D.1    Ma, S.2    Lee, J.J.3
  • 29
    • 0021813187 scopus 로고
    • Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man
    • Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412-419.
    • (1985) Diabetologia , vol.28 , pp. 412-419
    • Matthews, D.R.1    Hosker, J.P.2    Rudenski, A.S.3    Naylor, B.A.4    Treacher, D.F.5    Turner, R.C.6
  • 30
    • 80053913306 scopus 로고    scopus 로고
    • Ethnic differences in cardiovascular risk in rheumatic disease: Focus on Asians
    • Yiu KH, Tse HF, Mok MY, Lau CS. Ethnic differences in cardiovascular risk in rheumatic disease: focus on Asians. Nat Rev Rheumatol 2011;7:609-618.
    • (2011) Nat Rev Rheumatol , vol.7 , pp. 609-618
    • Yiu, K.H.1    Tse, H.F.2    Mok, M.Y.3    Lau, C.S.4
  • 31
    • 75649095701 scopus 로고    scopus 로고
    • Use of methotrexate therapy is not associated with decreased prevalence of metabolic syndrome
    • Raterman HG, Voskuyl AE, Dijkmans BA, Nurmohamed MT. Use of methotrexate therapy is not associated with decreased prevalence of metabolic syndrome. Arthritis Res Ther 2009;11:413.
    • (2009) Arthritis Res Ther , vol.11 , pp. 413
    • Raterman, H.G.1    Voskuyl, A.E.2    Dijkmans, B.A.3    Nurmohamed, M.T.4
  • 32
    • 0028606887 scopus 로고
    • Corticosteroids: Do they damage the cardiovascular system?
    • Maxwell SR, Moots RJ, Kendall MJ. Corticosteroids: do they damage the cardiovascular system? Postgrad Med J 1994;70:863-870.
    • (1994) Postgrad Med J , vol.70 , pp. 863-870
    • Maxwell, S.R.1    Moots, R.J.2    Kendall, M.J.3
  • 33
    • 34247869055 scopus 로고    scopus 로고
    • Glucocorticoid-related cardiovascular and cerebrovascular events in rheumatic diseases: Myth or reality?
    • Gonzalez-Gay MA. Glucocorticoid-related cardiovascular and cerebrovascular events in rheumatic diseases: myth or reality? Arthritis Rheum 2007;57:191-192.
    • (2007) Arthritis Rheum , vol.57 , pp. 191-192
    • Gonzalez-Gay, M.A.1
  • 34
    • 77955450823 scopus 로고    scopus 로고
    • Current view of glucocorticoid co-therapy with DMARDs in rheumatoid arthritis
    • Hoes JN, Jacobs JW, Buttgereit F, Bijlsma JW. Current view of glucocorticoid co-therapy with DMARDs in rheumatoid arthritis. Nat Rev Rheumatol 2010;6:693-702.
    • (2010) Nat Rev Rheumatol , vol.6 , pp. 693-702
    • Hoes, J.N.1    Jacobs, J.W.2    Buttgereit, F.3    Bijlsma, J.W.4
  • 35
    • 80053632228 scopus 로고    scopus 로고
    • Surrogate markers of insulin resistance: A review
    • Singh B, Saxena A. Surrogate markers of insulin resistance: a review. World J Diabetes 2010;1:36-47.
    • (2010) World J Diabetes , vol.1 , pp. 36-47
    • Singh, B.1    Saxena, A.2
  • 36
    • 33749323030 scopus 로고    scopus 로고
    • Insulin resistance and impaired beta cell function in rheumatoid arthritis
    • Dessein PH, Joffe BI. Insulin resistance and impaired beta cell function in rheumatoid arthritis. Arthritis Rheum 2006;54:2765-2775.
    • (2006) Arthritis Rheum , vol.54 , pp. 2765-2775
    • Dessein, P.H.1    Joffe, B.I.2
  • 37
    • 47249158092 scopus 로고    scopus 로고
    • Inflammation-associated insulin resistance: Differential effects in rheumatoid arthritis and systemic lupus erythematosus define potential mechanisms
    • Chung CP, Oeser A, Solus JF, et al. Inflammation-associated insulin resistance: differential effects in rheumatoid arthritis and systemic lupus erythematosus define potential mechanisms. Arthritis Rheum 2008;58:2105-2112.
    • (2008) Arthritis Rheum , vol.58 , pp. 2105-2112
    • Chung, C.P.1    Oeser, A.2    Solus, J.F.3
  • 38
    • 77951209267 scopus 로고    scopus 로고
    • Insulin resistance in early untreated rheumatoid arthritis patients
    • Shahin D, Eltoraby E, Mesbah A, Houssen M. Insulin resistance in early untreated rheumatoid arthritis patients. Clin Biochem 2010;43:661-665.
    • (2010) Clin Biochem , vol.43 , pp. 661-665
    • Shahin, D.1    Eltoraby, E.2    Mesbah, A.3    Houssen, M.4
  • 39
    • 79957521966 scopus 로고    scopus 로고
    • Diabetes mellitus and insulin resistance in patients with rheumatoid arthritis: Risk reduction in a chronic inflammatory disease
    • Wasko MC, Kay J, Hsia EC, Rahman MU. Diabetes mellitus and insulin resistance in patients with rheumatoid arthritis: risk reduction in a chronic inflammatory disease. Arthritis Care Res (Hoboken) 2011;63:512-521.
    • (2011) Arthritis Care Res (Hoboken) , vol.63 , pp. 512-521
    • Wasko, M.C.1    Kay, J.2    Hsia, E.C.3    Rahman, M.U.4
  • 40
    • 0036918943 scopus 로고    scopus 로고
    • The metabolic syndrome, type 2 diabetes, and cardiovascular disease: Understanding the role of insulin resistance
    • Kendall DM, Harmel AP. The metabolic syndrome, type 2 diabetes, and cardiovascular disease: understanding the role of insulin resistance. Am J Manag Care 2002;8(20 Suppl):S635-S653.
    • (2002) Am J Manag Care , vol.8 , Issue.20 SUPPL.
    • Kendall, D.M.1    Harmel, A.P.2
  • 41
    • 0032709705 scopus 로고    scopus 로고
    • Comment on the provisional report from the WHO consultation: European Group for the Study of Insulin Resistance (EGIR)
    • Balkau B, Charles MA. Comment on the provisional report from the WHO consultation: European Group for the Study of Insulin Resistance (EGIR). Diabet Med 1999;16:442-443.
    • (1999) Diabet Med , vol.16 , pp. 442-443
    • Balkau, B.1    Charles, M.A.2
  • 43
    • 0042887347 scopus 로고    scopus 로고
    • Influence of glucocorticoids and disease activity on total and high density lipoprotein cholesterol in patients with rheumatoid arthritis
    • Boers M, Nurmohamed MT, Doelman CJ, et al. Influence of glucocorticoids and disease activity on total and high density lipoprotein cholesterol in patients with rheumatoid arthritis. Ann Rheum Dis 2003;62:842-845.
    • (2003) Ann Rheum Dis , vol.62 , pp. 842-845
    • Boers, M.1    Nurmohamed, M.T.2    Doelman, C.J.3
  • 44
    • 58549087935 scopus 로고    scopus 로고
    • Comparison of alanine aminotransferase, white blood cell count, and uric acid in their association with metabolic syndrome: A study of Korean adults
    • Kang YH, Min HG, Kim IJ, Kim YK, Son SM. Comparison of alanine aminotransferase, white blood cell count, and uric acid in their association with metabolic syndrome: a study of Korean adults. Endocr J 2008;55:1093-1102.
    • (2008) Endocr J , vol.55 , pp. 1093-1102
    • Kang, Y.H.1    Min, H.G.2    Kim, I.J.3    Kim, Y.K.4    Son, S.M.5
  • 45
    • 18644363879 scopus 로고    scopus 로고
    • The prevalence of the metabolic syndrome in Korean adults: Comparison of WHO and NCEP criteria
    • Choi SH, Ahn CW, Cha BS, et al. The prevalence of the metabolic syndrome in Korean adults: comparison of WHO and NCEP criteria. Yonsei Med J 2005;46:198-205.
    • (2005) Yonsei Med J , vol.46 , pp. 198-205
    • Choi, S.H.1    Ahn, C.W.2    Cha, B.S.3


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.