International Journal of Obesity最新文献

{"title":"Role of subclinical hypothyroidism on kidney damage in children with obesity.","authors":"Anna Di Sessa, Josè Alberto D'Anna, Rosa Melone, Gianmario Forcina, Giusy Capasso, Giuseppina Rosaria Umano, Emanuele Miraglia Del Giudice, Pierluigi Marzuillo","doi":"10.1038/s41366-025-01752-2","DOIUrl":"https://doi.org/10.1038/s41366-025-01752-2","url":null,"abstract":"<p><strong>Background/objectives: </strong>The interplay of subclinical hypothyroidism (SH) with obesity has been well-documented, while an intriguing but still controversial association with kidney damage (KD) has recently emerged. Given the heightened cardiometabolic risk inherent to pediatric obesity, this might further impact on the overall health of children with obesity. Therefore, we aimed at evaluating the impact of SH on KD in children with obesity.</p><p><strong>Subjects/methods: </strong>We retrospectively examined 355 children with obesity stratified according to presence or absence of SH. KD was defined as reduced estimated glomerular filtration rate (eGFR<90 mL/min/1.73 m²) and/or hypertension, and/or albuminuria (≥30 mg/g urinary creatinine), while SH was defined by thyroid stimulating hormone (TSH) > 4.5μ UI/ml with normal free triiodothyronine and free thyroxine levels.</p><p><strong>Results: </strong>Children with SH showed a higher KD prevalence than those without SH (p = 0.004). They also had lower eGFR levels than their counterparts without SH (p = 0.001) and showed an adjusted OR to have KD of 2.04 (95% CI: 1.15-3.61; p = 0.015). A general linear model for eGFR variance showed an inverse association of eGFR with TSH levels (p < 0.0001).</p><p><strong>Conclusions: </strong>Although preliminary, our data suggested an increased risk of KD in children with obesity and SH.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 receptor agonists causing euglycemic ketoacidosis in patients without diabetes: a brief review.","authors":"Nikhil Sood, Venkata Buddhavarapu, Rohini Garg","doi":"10.1038/s41366-025-01749-x","DOIUrl":"https://doi.org/10.1038/s41366-025-01749-x","url":null,"abstract":"","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between metabolically healthy obesity and risk of depression: a systematic review and meta-analysis.","authors":"Jialin Deng, Lu He, Luokai Zhang, Jiaqi Wang, Qixiang Fu, Rongqi Ding, Yunhao Lv, Yimiao Jiang, Xinhua Xiao, Hong Zhou","doi":"10.1038/s41366-025-01741-5","DOIUrl":"10.1038/s41366-025-01741-5","url":null,"abstract":"<p><p>This review aimed to explore the association between metabolically healthy obesity (MHO) and the risk of depression. Databases (EMBASE, PubMed, Web of Science, Cochrane Library) were searched up to 20 June 2024. Observational studies were included if they compared groups with MHO, metabolically unhealthy nonobesity, and metabolically unhealthy obesity to groups with metabolically healthy nonobesity for the risk of depression. The random-effect model was used to calculate the pooled odds ratios (ORs). Subgroup analyses and meta-regressions were conducted according to age, study design, definition of MHO, BMI cut-off value, depression assessment method, geographic location, ethnicity, development status, and gender to explore the sources of heterogeneity. Three cohorts and 9 cross-sectional studies (N = 1,277,267 participants) were included in this review. Individuals with MHO (OR 1.08 [95% CI 1.04, 1.12], I² = 88.3%), metabolically unhealthy nonobesity (OR 1.15 [95% CI 1.04, 1.28], I² = 99.6%), and metabolically unhealthy obesity (OR 1.30 [95% CI 1.12, 1.51], I² = 99.8%) had an increased risk of depression than individuals with metabolically healthy nonobesity. The association between MHO and risk of depression was stronger in women (OR = 1.14; 95% CI: 1.08-1.20) and populations from North America (OR = 1.26; 95% CI: 1.01-1.58) and Europe (OR = 1.23; 95% CI: 1.07-1.41). Inconsistencies in MHO definitions and BMI cutoff values across studies were important sources of heterogeneity (subgroup analysis: P_Q = 29.87, p = 0.001; meta-regression: p = 0.015, R² = 100%). MHO was associated with an increased risk of depression, particularly among women and populations from North America and Europe. These high-risk groups need personalized interventions. Standardizing definition for MHO could enhance comparability across studies. Future prospective cohort studies are needed to validate our findings by including populations from developing nations and employing rigorous definitions.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum secreted EMC10 (scEMC10) levels are inversely associated with metabolically active brown adipose tissue in humans.","authors":"Qing Miao, Yahao Wang, Qiongyue Zhang, Wei Wu, Yifei Yu, Fangfang Zeng, Yehong Yang, Chuantao Zuo, Yihui Guan, Chong Wee Liew, Matthias Blüher, Yiming Li, Xuanchun Wang","doi":"10.1038/s41366-025-01744-2","DOIUrl":"https://doi.org/10.1038/s41366-025-01744-2","url":null,"abstract":"<p><strong>Background/objectives: </strong>Secreted endoplasmic reticulum membrane complex subunit 10 (scEMC10) has been implicated in obesity in mice and humans. In this study, the associations of serum scEMC10 levels with thermoneutrality-modulated brown adipose tissue (BAT) activity and thyroid hormone (TH)-dependent thermogenesis were investigated in humans.</p><p><strong>Subjects/methods: </strong>Serum scEMC10 levels were measured in participants from multiple cohorts using enzyme-linked immunosorbent assay, including participants with or without active BAT determined by PET-CT scanning, participants with positive BAT before and after thermoneutrality, and patients with hyperthyroidism before and after anti-thyroid drug (ATD) treatment. The difference in serum scEMC10 between participants with positive or negative BAT, and the changes of serum scEMC10 in participants with positive BAT before and after thermoneutrality and in patients with Grave's disease-caused hyperthyroidism before and after ATD treatment were determined.</p><p><strong>Results: </strong>PET-CT scan with ¹⁸F-FDG indicated participants with positive BAT were significantly younger and leaner than ones with negative BAT. There was, however, no significant difference in serum scEMC10 between the two groups. Serum scEMC10 levels in participants with positive BAT were significantly elevated by 2-h thermoneutrality (p = 0.0017), concomitant with disappearance of active BAT. No significant association of serum scEMC10 with serum levels of either TSH, FT3, or FT4 was observed in participants from both Chinese and White cohorts. ATD treatment normalized thyroid function and reduced the uptake of ¹⁸F-FDG into skeletal muscle of patients with hyperthyroidism. Serum scEMC10 concentration, however, remained unchanged in these patients before and after ATD treatment.</p><p><strong>Conclusions: </strong>Serum scEMC10 levels are inversely associated with BAT activity in humans.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of prenatal maternal sex steroid hormones in weight and adiposity at birth and growth trajectories during infancy.","authors":"Ying Meng, Loralei L Thornburg, Caitlin Dreisbach, Charlotte Orzolek, Amber Kautz, Hannah R Murphy, Zorimar Rivera-Núñez, Christina Wang, Richard K Miller, Thomas G O'Connor, Emily S Barrett","doi":"10.1038/s41366-025-01743-3","DOIUrl":"10.1038/s41366-025-01743-3","url":null,"abstract":"<p><strong>Objective: </strong>Intrauterine factors can impact fetal and child growth and may underlie the developmental origins of childhood obesity. Sex steroid hormone exposure during pregnancy is a plausible target because of the impact on placental vascularization, nutrient transportation, adipogenesis, and epigenetic modifications. In this study we assessed maternal sex steroid hormones in each trimester in relation to birthweight, neonatal adiposity, and infant growth trajectories, and evaluated sensitive windows of development.</p><p><strong>Methods: </strong>Participants from a prospective pregnancy cohort who delivered at term were included in the analysis (n = 252). Estrone, estradiol, and estriol, as well as total and free testosterone throughout gestation were assessed using high-performance liquid chromatography and tandem mass spectrometry. Path analyses were used to assess the direct associations of sex steroid hormones in each trimester with birth outcomes and infant growth trajectories (birth to 12 months) adjusting for covariates and considering moderation by sex.</p><p><strong>Results: </strong>The associations between prenatal sex steroid hormones and fetal/infant growth varied by sex and timing of hormone exposure. First-trimester estrone was associated with higher birthweight z-scores (β = 0.37, 95% CI: 0.02, 0.73) and truncal skinfold thickness (TST) at birth (β = 0.94, 95% CI: 0.34, 1.54) in female infants. Third-trimester total testosterone was associated with higher TST at birth (β = 0.47, 95% CI: 0.03, 0.86) in both sexes. First-trimester estrone and estradiol and first- and third-trimester testosterone were associated with lower probabilities of high stable weight trajectory compared to low stable weight trajectory (Estrone: β = -3.87, 95% CI: -6.59, -1.16; Estradiol: β = -4.36, 95% CI: -7.62, -1.11; First-trimester testosterone: β = -3.53, 95% CI: -6.63, -0.43; Third-trimester testosterone: β = -3.67, 95% CI: -6.66, -0.69) during infancy in male infants.</p><p><strong>Conclusions: </strong>We observed associations between prenatal sex steroid hormone exposure and birthweight, neonatal adiposity and infant growth that were sex and gestational timing dependent. Our findings suggest further investigation on additional mechanisms linking prenatal sex steroid exposure and fetal/postnatal growth is needed.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk associated with planned mode of delivery in women with obesity: a large population-based retrospective cohort study.","authors":"Geneviève Horwood, Erica Erwin, Yanfang Guo, Brett Aston, Sara C S Souza, Laura M Gaudet","doi":"10.1038/s41366-024-01709-x","DOIUrl":"https://doi.org/10.1038/s41366-024-01709-x","url":null,"abstract":"<p><strong>Background/objective: </strong>As the pregnancy progresses, a decision about planned mode of delivery must be made. There is no consensus on optimal mode of delivery among pregnant women with obesity. We aimed to assess the risks associated with planned mode of delivery in women with obesity.</p><p><strong>Methods: </strong>This large population-based retrospective cohort study included 27472 nulliparous women with obesity who had live, singleton, and uncomplicated term gestations between April 1st 2012 and March 31st 2019. Planned mode of delivery included waiting for spontaneous labor, a plan for induction of labor, and planned non-labor cesarean section (NLCS). NLCS was defined as an elective CS that would happen before the pregnant woman goes into labor. The most common reasons for NLCS include maternal request, fetal position, and repeated CS. Adverse Outcome Index (AOI) was the primary outcome, a binary composite of 10 maternal-neonatal outcomes. Overall, maternal-specific, and neonatal-specific AOI scores were analyzed. Analyses were conducted using multivariable regression models and were stratified by each week of gestational age and by obesity class.</p><p><strong>Results: </strong>Planned NLCS was associated with reduced risk of overall, maternal-specific, and neonatal-specific AOI by 41% (adjusted risk ratio [aRR]: 0.59, 95% confidence interval [CI]: 0.50-0.70), 54% (aRR: 0.46, 95% CI: 0.35-0.60), and 30% (aRR: 0.70, 95% CI: 0.57-0.87) respectively when compared to spontaneous labor at term gestation. There was no statistically significant difference in overall AOI when comparing planned induction of labor to spontaneous labor (aRR: 1.03, 95% CI: 0.96-1.10).</p><p><strong>Conclusion: </strong>Among women with obesity, NLCS may be considered as an option for planned mode of delivery due to the decreased AOI risk. However, further research on the association between NLCS and severe outcomes is needed. Shared decision making between patient and practitioner regarding plan for delivery remains paramount in the provision of quality obstetrical care.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-year follow-up of a randomized weight loss trial on a digital health behaviour change support system.","authors":"Eero Turkkila, Taru Pekkala, Heta Merikallio, Marko Merikukka, Laura Heikkilä, Janne Hukkanen, Harri Oinas-Kukkonen, Tuire Salonurmi, Anna-Maria Teeriniemi, Terhi Jokelainen, Markku J Savolainen","doi":"10.1038/s41366-025-01742-4","DOIUrl":"https://doi.org/10.1038/s41366-025-01742-4","url":null,"abstract":"<p><strong>Background: </strong>The weight regain after successful weight loss is a common challenge. This study aimed to assess the long-term effectiveness of a web-based health behaviour change support system (HBCSS) utilizing persuasive systems design (PSD) and methods of cognitive behavioural therapy (CBT). We have previously demonstrated the two-year effectiveness of the HBCSS.</p><p><strong>Methods: </strong>In total, 532 participants with overweight or obesity (BMI 27-35 kg m^-2) were split into three groups with different intensities of intervention: CBT-based group counselling, self-help guidance (SHG), and usual care. These groups were further divided into HBCSS and non-HBCSS groups. The HBCSS was a 52-week programme. The follow-up took five years in total.</p><p><strong>Results: </strong>Mean weight change (%) (95% CI) from baseline among HBCSS and non-HBCSS users was 1.5 (-0.02 to 2.9), p = 0.056 and 1.9 (0.3-3.3), p = 0.005, respectively, at five years. Of the six groups, the SHG group without HBCSS had a statistically significant increase in weight (%) from baseline at five years (3.1, 95% CI 0.6 to 5.6, p = 0.010). The other groups did not have a significant increase in weight. There was no significant difference between groups at five years in weight. Fewer blood pressure medications were started over the five-year period in HBCSS group (p = 0.046).</p><p><strong>Conclusion: </strong>The 12-month HBCSS intervention was not able to maintain reduced weight better than non-HBCSS at 5 years. However, there were significant weight difference favouring HBCSS over the whole 5-year period. The decrease in the need for antihypertensives suggests that the significant weight loss by HBCSS at early years has a health-promoting legacy effect.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and metabolic health: Is it all in the timing?","authors":"Joseph Henson, Melanie J Davies, Andrew P Hall, Thomas Yates","doi":"10.1038/s41366-025-01736-2","DOIUrl":"https://doi.org/10.1038/s41366-025-01736-2","url":null,"abstract":"","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the roles of body composition, energy expenditure and substrate metabolism in the control of daily energy intake in adolescents with obesity.","authors":"D Thivel, M Hopkins, S Lazzer, C Montaurier, H Moore, B Pereira, J E Blundell, L Isacco, Y Boirie","doi":"10.1038/s41366-025-01740-6","DOIUrl":"https://doi.org/10.1038/s41366-025-01740-6","url":null,"abstract":"<p><strong>Background: </strong>The implication of body composition and energy metabolism in the control of human energy intake (EI) has been well described in adults, remaining however unexplored in adolescents with obesity. The aim of this study was to question the role of body composition, energy expenditure (EE) and substrate metabolism in the control of EI of adolescents with obesity.</p><p><strong>Methods: </strong>Ad libitum 24-h EI, body composition (Dual X-ray absorptiometry), Resting Metabolic Rate (RMR, indirect calorimeter) where measured and Total EE obtained during a 36-h stay in metabolic chambers in 26 adolescents (14.1 ± 1.5 years; 14 girls) with severe obesity.</p><p><strong>Results: </strong>The mean body weight and Body Mass index were 92.2 ± 17.2 kg and 33.98 ± 4.14 kg.m^-2 respectively. 24-h EI was positively correlated with body weight (rho = 0.597, p = 0.014), Fat Free Mass (FFM) kg (rho = 0.576, p = 0.019), 24-h Total EE (TEE (rho =0.675, p < 0.001)), RMR (rho =0.632, p = 0.005), 24-h Carbohydrate (CHO) oxidation rates (rho = 0.716, p < 0.001), and urinary nitrogen excretion (rho =0.28, p < 0.001). According to the path analysis FFM (kg) but not Fat Mass (FM) (kg) was positively correlated with RMR, with direct effects of 0.87 (p < 0.001) and 0.027 (p = 0.74) respectively. The effect of FFM on 24-h EI was mediated by RMR (96% of the effect), while the effect of FM on 24-h EI was also mediated by RMR (67% of the effect).</p><p><strong>Conclusions: </strong>The present study provides the first evidence regarding the role of RMR as a main tonic signal of appetite control mediating the effect of body composition and mainly FFM (over FM) on daily EI in adolescents with obesity. It also suggests for the first-time relationships between 24-h CHO and protein oxidation and daily EI in this population.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Irisin reverses high-fat diet-induced metabolic dysfunction via activation of brown adipose tissue in mice.","authors":"Jingyue Dai, Yufei Zhao, Yue Chen, Yang Jiang, Rui Sun, Xingzhe Tang, Ying Cui, Hui Mao, Xin-Gui Peng","doi":"10.1038/s41366-025-01739-z","DOIUrl":"https://doi.org/10.1038/s41366-025-01739-z","url":null,"abstract":"<p><strong>Background: </strong>High-fat diet (HFD) induces negative effects on the activity of interscapular brown adipose tissue (iBAT) and systemic energy metabolism. Irisin, a small hormonal agent known to modulate metabolism has been used for intervening HFD-induced obesity. However, its mechanism of action on iBAT function remains to be fully elucidated. This study sought to investigate whether irisin intervention could restore the thermogenic function of iBAT in mice with HFD-induced obesity, thereby regulating systemic metabolism.</p><p><strong>Methods: </strong>Magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) were used to monitor changes of thermogenic capacity of iBAT and systemic metabolism in mice with HFD-induced obesity and iBAT deficiency during 2-week or 4-week irisin intervention. Pathological and molecular biology analyses were performed on tissue and blood samples.</p><p><strong>Results: </strong>Prolonged HFD feeding in mice induced obesity and impaired the thermogenic capacity of iBAT. MRI results showed that irisin intervention for 4-week reduced lipid content in iBAT, increased uncoupling protein 1 (UCP 1) expression and enhanced glucose analogue uptake capacity. These improvements of functions in iBAT activity were accompanied by an improvement in systemic metabolism. The positive effects of irisin appears to be dependent on the length of intervention time. When iBAT was removed, the beneficial effects of irisin were partially suppressed, suggesting that irisin regulates metabolism through the restoration of the thermogenic function of iBAT.</p><p><strong>Conclusions: </strong>HFD results in reduced thermogenic capacity of iBAT, while irisin intervention can effectively restore iBAT function, leading to improvement in overall glucose and lipid metabolism.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}