Endocrine journal最新文献

{"title":"Study of weight loss intervention to find an effective strategy for obesity management and the TARGET of weight loss amount for reducing health disorders (SLIM-TARGET): a randomized controlled trial.","authors":"Masaya Koshizaka, Hidetaka Yokoh, Ko Ishikawa, Aiko Hayashi, Yukari Maeda, Jin Kumagai, Kenji Takeda, Hiyori Kaneko, Tomohiro Ohno, Hiraku Ono, Yusuke Hirota, Takayoshi Sasako, Takashi Kato, Kengo Miyoshi, Toshimasa Yamauchi, Hirotaka Watanabe, Takaaki Sakaue, Mitsuyoshi Takahara, Iichiro Shimomura, Atsuhito Saiki, Ichiro Tatsuno, Kazuhisa Takahashi, Satoshi Kurose, Yutaka Kimura, Takeshi Onoue, Tomoko Handa, Hiroshi Arima, Jun Eguchi, Jun Wada, Aika Miya, Toru Kusakabe, Noriko Satoh-Asahara, Junichiro Irie, Nobuko Yamada-Goto, Masahiro Kondo, Kengo Nagashima, Yasunori Sato, Shigeru Miyazaki, Hiroko Yamamoto, Yoshie Kondo, Masako Waki, Hiroaki Ueno, Masamitsu Nakazato, Yoshiro Nakayama, Hiroaki Masuzaki, Takayuki Masaki, Masayuki Ohta, Masahiro Nishi, Makito Tanabe, Ryuya Iwamoto, Takafumi Senokuchi, Takuro Horikoshi, Kazuyo Tsushita, Takashi Kadowaki, Koutaro Yokote","doi":"10.1507/endocrj.EJ26-0217","DOIUrl":"https://doi.org/10.1507/endocrj.EJ26-0217","url":null,"abstract":"<p><p>This randomized controlled study aimed to clarify weight loss targets for improving obesity-related disorders in individuals with overweight or obesity. A total of 294 participants with six obesity-related conditions were assigned to either a standard or intensive treatment group, with 12-month weight loss targets of ≥3% and ≥7%, respectively. The standard group followed the Japanese Guidelines for the Management of Obesity Disease 2016. The intensive group received frequent nutritional guidance, enhanced diet and exercise therapy, and additional pharmacotherapy. The primary outcome was weight loss and improvement in at least two obesity-related disorders at 12 months. Secondary outcomes included remission of health disorders, improvement in at least one health disorder, and visceral fat reduction. At 12 months, the weight loss was -2.5% in the intensive group and -1.7% in the standard group, with no significant difference in the primary outcome. However, remission of health disorders was achieved in 16.9% of the intensive group compared with 6.2% of the standard group (adjusted odds ratio 3.079; 95% CI 1.075-8.823; p = 0.036). Visceral fat reduction was greater in the intensive group (-20.46 cm² vs. -8.9 cm²; p = 0.039). Intensive treatment significantly improved blood pressure early and increased treatment motivation scores by 10.9% (95% CI: 1.2-20.6) at 24 months (p = 0.004). In both groups, ≥60% of the participants showed improvement in at least one disorder. Despite not achieving the target weight loss, resulting in no significant difference in the primary outcome, the intensive treatment increased remission percentages, improved early blood pressure control, and enhanced long-term treatment motivation. The study was registered at UMIN Clinical Trials Registry (UMIN ID: UMIN000031862).</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iodothyronine deiodinases: biological roles and clinical implications.","authors":"Ichiro Yamauchi, Yoriko Sakane","doi":"10.1507/endocrj.EJ26-0178","DOIUrl":"https://doi.org/10.1507/endocrj.EJ26-0178","url":null,"abstract":"<p><p>Iodothyronine deiodinases (DIOs) are key regulators of thyroid hormone action. Three types of DIOs, including type 1 (D1), 2 (D2), and 3 (D3), coordinate the local and systemic availability of T3. D2 primarily catalyzes the activating conversion of T4 to T3, whereas D3 mainly catalyzes the inactivating conversion of T4 to reverse T3 (rT3) and T3 to diiodothyronine (T2). D1 has a relatively low affinity for T4 and contributes less to T4 activation but preferentially catalyzes the conversion of rT3 to T2. Thyroid hormones promote D1 and D3 expression, whereas D2 activity is transcriptionally regulated via several pathways such as cAMP and post-translationally through ubiquitin-dependent proteasomal degradation. Evidence from knockout and overexpressing mouse models and human genetic variants has clarified the physiological roles of DIOs in thyroid hormone economy. Reduced D1 activity increases serum rT3 levels, D2 enhances local thyroid hormone action and contributes to circulating T3 production, and D3 decreases circulating T3 and T4 levels while increasing rT3 levels. DIO dysregulation is implicated in several clinical conditions. GH-related disorders potentially alter thyroid function via D2-mediated mechanisms. In adrenal insufficiency, thyroid function may exhibit elevated serum fT3 levels without TSH suppression. Additionally, resistance to thyroid hormone β can be associated with bezafibrate-induced consumptive hypothyroidism through increased hepatic D3 expression. This review summarizes current knowledge on the biological properties and clinical implications of DIOs and highlights their significant role in the regulation of thyroid hormone action.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skeletal assessment in giant prolactinoma: a reply.","authors":"Aysel Unver Ozkahraman, Esra Hatipoglu","doi":"10.1507/endocrj.EJ26-0400","DOIUrl":"10.1507/endocrj.EJ26-0400","url":null,"abstract":"","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"1093"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender distribution in membership, leadership, and conference participation in the Japanese Society for Hypothalamic and Pituitary Tumors.","authors":"Naoko Inoshita, Noriko Makita, Takayuki Matsuo, Masaaki Taniguchi, Hidetaka Suga, Hidenori Fukuoka, Hiroshi Nishioka","doi":"10.1507/endocrj.EJ26-0154","DOIUrl":"10.1507/endocrj.EJ26-0154","url":null,"abstract":"<p><p>Gender equity has become an important issue in academic medicine, but data on gender distribution in subspecialty medical societies remain limited. We analyzed gender distribution in membership, leadership positions, and conference participation in the Japanese Society for Hypothalamic and Pituitary Tumors (JSHPT). Membership data as of March 2025 (n = 860) were examined, and gender distribution among speakers and session chairs at the 36th Annual Meeting of the JSHPT was evaluated using the publicly available abstract book. Among all members, 128 (14.9%) were women. Women accounted for 6.6% of councilors and 5.6% of board members and auditors, and only one woman has served as Annual Meeting president among the first 36 annual meetings. At the 36th Annual Meeting, women represented 18.6% of presenters in general oral sessions, but only 5.0% of session chairs in general oral sessions and 3.7% of chairs in other sessions. Women also accounted for 36.4% of members with less than 1 year of membership. These findings suggest that, although women remain underrepresented in leadership positions within the society, female participation may be increasing among newer members, and women are actively participating as conference presenters. Continued efforts to increase opportunities for women to serve as session chairs and to encourage qualified women to apply for councilor positions may contribute not only to a more equitable academic environment, but also to the vitality and future leadership of the field.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"1055-1059"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating TRAb-positive painless thyroiditis from Graves' disease using biochemical and ultrasound findings.","authors":"Yoshiki Furumura, Mitsuru Ito, Itaru Monno, Keitaro Miyamura, Shuji Fukata, Eijun Nishihara, Mitsushige Nishikawa, Akira Miyauchi, Takashi Akamizu","doi":"10.1507/endocrj.EJ26-0047","DOIUrl":"10.1507/endocrj.EJ26-0047","url":null,"abstract":"<p><p>Differentiating painless thyroiditis (PT) from Graves' disease (GD) is important for appropriate management. This study evaluated whether thyroid-stimulating hormone (TSH) receptor antibody (TRAb)-positive PT can be differentiated from GD using biochemical and ultrasound findings. This retrospective study included 1,924 patients with thyrotoxicosis associated with PT or GD who visited Kuma Hospital between November 2020 and September 2023. TRAb titers and radioactive iodine uptake (RAIU) or technetium-99m pertechnetate (^99mTc) uptake were measured in all patients. Patients were classified into TRAb-positive PT (n = 16), TRAb-negative PT (n = 222), and GD (n = 1,686). Serum alkaline phosphatase (ALP), TSH, free triiodothyronine (FT3)/free thyroxine (FT4) ratio, and thyroid blood flow were analyzed. No significant differences were observed between TRAb-positive and TRAb-negative PT in any single parameter. TRAb-positive PT significantly differed from GD in ALP (mean: 74.6 vs. 111.5 IU/L, p < 0.05), TSH (median: 0.037 vs. 0.007 μIU/mL, p < 0.001), FT3/FT4 ratio (mean: 2.54 vs. 3.30, p < 0.001), and blood flow (mean: 2.11% vs. 11.60%, p < 0.05). A scoring system assigned one point to each parameter-ALP above the upper limit, TSH below the detection limit, FT3/FT4 ratio >3.00, and blood flow >4.00%. None of the patients with TRAb-positive PT scored ≥3, compared with 65.7% of patients with GD. TRAb-positive PT can be differentiated from GD using combined biochemical and ultrasound markers. Our practical scoring system supports clinical decision-making when RAIU is not readily available or contraindicated and may help avoid unnecessary antithyroid therapy.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"1017-1026"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telomere length in patients with non-functional adrenal incidentalomas.","authors":"Nilufer Ozdemir, Seda Sabah Ozcan, Ayse Ece Turkmen, Sedat Can Guney, Zeliha Hekimsoy, Mehmet Korkmaz","doi":"10.1507/endocrj.EJ26-0033","DOIUrl":"10.1507/endocrj.EJ26-0033","url":null,"abstract":"<p><p>Telomeres maintain genomic integrity during cell replication by preventing chromosomal fusions. Beside genetic influences, telomere length is affected by environmental factors such as oxidative stress and inflammation. These mechanisms also contribute to metabolic syndrome components linked to cellular aging. We aim to evaluate whether telomere length is shortened in patients with non-functional adrenal incidentaloma (NFAI) compared to the control group. This study was designed as a prospective, single-center study. The total of 88 participants included were 44 patients aged between 40 and 60 years with NFAI in our endocrinology clinic and 44 control subjects. An Absolute Human Telomere Lengths Quantification qPCR Assay kit (Nucleotestbio, Budapest, Hungary) was used for analyses. There was no significant difference between the NFAI and control groups regarding age and sex distribution. Telomere length was significantly shorter in the NFAI group (NFAI group: 3.680 ± 1.970 kb; control group: 4.469 ± 1.672 kb; p = 0.046). While no significant difference was found in telomere lengths in subgroup analyses, patients with basal adrenocorticotropic hormone (ACTH) levels <15 pg/mL had significantly shorter telomeres than those with basal ACTH levels ≥15 pg/mL (p = 0.034). A strong positive correlation was observed only between telomere length and ACTH level (p = 0.001). This study demonstrated that telomere length is significantly shortened in NFAI patients. Here, we propose that the underlying cause of telomere length shortening in the NFAI group may be related to increased cardiovascular risk and an elevated inflammatory state, even in the presence of cortisol levels within the normal range.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"1027-1035"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148041714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracrine androgen metabolism in the meibomian gland: regulation, circadian control, and implications in dry eye disease.","authors":"Takahito Miyake, Masao Doi","doi":"10.1507/endocrj.EJ26-0148","DOIUrl":"10.1507/endocrj.EJ26-0148","url":null,"abstract":"<p><p>The meibomian glands play a central role in maintaining ocular surface homeostasis by producing meibum, which is the lipid layer of the tear film that suppresses tear evaporation. Dysregulation of the secretion of this lipid leads to meibomian gland dysfunction (MGD), the most common cause of evaporative dry eye disease. Accumulating evidence indicates that androgen signaling is a critical regulator of meibomian gland structure and function. In contrast to classical endocrine mechanisms, androgen action in this tissue is largely mediated by intracrine steroid metabolism, whereby circulating adrenal precursors are locally converted to active androgens within the gland. Key steroidogenic enzymes, including 3β-hydroxysteroid dehydrogenase (3β-HSD), are expressed in the meibomian acinar cells, thereby enabling local testosterone production. Simultaneously, the gland exhibits robust metabolic pathways that convert testosterone to downstream androstane derivatives, providing a mechanism for the spatially restricted control of androgen signaling. Recent study has revealed that the intracrine steroidogenic system is affected by circadian rhythms. In particular, 3β-HSD activity exhibits daily rhythmicity that parallels fluctuations in nicotinamide adenine dinucleotide (NAD⁺), suggesting that NAD⁺-dependent metabolic processes contribute to temporal control of local androgen production. Importantly, administration of NAD⁺ precursors improves meibomian gland morphology in experimental models of aging-associated MGD. This review summarizes the current knowledge on intracrine androgen metabolism in the meibomian gland and highlights emerging metabolic and circadian mechanisms that may provide novel therapeutic targets for dry eye disease.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"1003-1015"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical significance of SIGLEC1 mRNA levels derived from peripheral leukocytes in autoimmune thyroid diseases and type 1 diabetes.","authors":"Mami Gamo-Kawasaki, Shiori Kawai, Ayano Takei, Kazunori Fukuda, Mototaka Yamauchi, Kenji Hara, Takafumi Tsuchiya, Kohzo Takebayashi, Koshi Hashimoto","doi":"10.1507/endocrj.EJ25-0639","DOIUrl":"10.1507/endocrj.EJ25-0639","url":null,"abstract":"<p><p>Autoimmune thyroid diseases (AITD), including Graves' disease (GD) and Hashimoto's thyroiditis (HT), may coexist with Type 1 diabetes mellitus (T1DM) as autoimmune polyglandular syndrome type 3 (APS3). Sialic acid-binding immunoglobulin-like lectin (SIGLEC) 1 is an interferon-inducible molecule implicated in autoimmune disorders, but its clinical significance across AITD, T1DM, and APS3 remains unclear. In this cross-sectional study, 219 patients with AITD, T1DM, or APS3 were enrolled. SIGLEC1 mRNA levels derived from peripheral blood cells were quantified using quantitative reverse transcription PCR. In the primary analysis, 213 patients with SIGLEC1 mRNA levels were included (AITD-only, n = 127; T1DM-only, n = 59; APS3, n = 27). SIGLEC1 mRNA levels differed significantly among the three groups (p = 0.00086). Holm-adjusted post hoc comparisons showed significantly higher SIGLEC1 mRNA levels in the T1DM-only group and APS3 group than in the AITD-only group (p = 0.0099 and p = 0.0099, respectively), whereas the T1DM-only and APS3 groups did not differ significantly (p = 0.289). Within the AITD-only cohort, thyroid autoantibody-positive patients had higher SIGLEC1 mRNA levels than antibody-negative patients (median 130.1 vs. 74.4 copies, p = 0.034). SIGLEC1 mRNA levels showed a modest positive correlation with HbA1c (r = 0.210, p = 0.0060) but not with thyroid function parameters. In multivariable models, APS3 remained independently associated with higher SIGLEC1 mRNA levels after adjustment for age, sex, and HbA1c. Elevated SIGLEC1 mRNA levels were associated with coexisting endocrine autoimmunity and thyroid autoantibody positivity in this cohort. Longitudinal studies are required to determine whether SIGLEC1 mRNA levels have prognostic or predictive utility.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"1061-1068"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-pituitary-specific transcription factor-1 hypophysitis developing after thymoma resection: a case report with review of literature.","authors":"Hitomi Konishi, Yui Yamashita, Yuma Motomura, Shin Urai, Yumiko Sasai, Keiko Yamagami, Hironori Bando, Naotetsu Kanamoto","doi":"10.1507/endocrj.EJ26-0108","DOIUrl":"10.1507/endocrj.EJ26-0108","url":null,"abstract":"<p><p>Anti-pituitary-specific transcription factor-1 (PIT-1) hypophysitis is an acquired autoimmune disorder characterized by selective deficiencies of growth hormone (GH), prolactin (PRL), and thyrotropin (TSH). It is typically driven by ectopic PIT-1 expression in thymomas or other malignancies, and in previously reported cases, thymectomy has been shown to attenuate autoimmunity. In contrast, we report a novel case that developed after thymectomy. A 42-year-old woman with normal preoperative thyroid function underwent resection of a WHO type B2 thymoma. Eleven months later, she developed specific deficiencies of GH, PRL, and TSH. The diagnosis of anti-PIT-1 hypophysitis was confirmed by the presence of serum anti-PIT-1 antibodies and PIT-1-reactive cytotoxic T lymphocytes. Immunohistochemistry revealed ectopic PIT-1 expression in the resected tumor. Replacement therapy with levothyroxine and recombinant human GH was initiated. Serum FT4 and IGF-1 levels subsequently improved to normal. Two-year post-thymectomy chest computed tomography revealed no tumor recurrence. This unique clinical course challenges the conventional view that the presence of the tumor alone is sufficient to drive autoimmunity. Instead, it suggests a multifactorial pathogenesis requiring the convergence of ectopic antigen expression, genetic predisposition, and a potential trigger. We hypothesize that thymectomy itself acted as the trigger disrupting immune tolerance, potentially through immunogenic cell death or alterations in the immune milieu. This case highlights anti-PIT-1 hypophysitis as a potential post-thymectomy autoimmune complication and that central hypothyroidism should be considered in patients presenting with nonspecific symptoms after thymectomy. Further research is needed to delineate risk factors for susceptibility and to develop preventive strategies.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"1069-1079"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond tumor control: skeletal morbidity in giant prolactinoma.","authors":"Taner Dandinoğlu","doi":"10.1507/endocrj.EJ26-0353","DOIUrl":"10.1507/endocrj.EJ26-0353","url":null,"abstract":"","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"1091"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}