Journal of diabetes and its complications最新文献

{"title":"Contents/Barcode","authors":"","doi":"10.1016/S1056-8727(25)00239-9","DOIUrl":"10.1016/S1056-8727(25)00239-9","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 11","pages":"Article 109186"},"PeriodicalIF":3.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of matrix metalloproteinase-10 levels and genetic variant rs17860955 with severe vascular complications in patients with type 1 diabetes: prospective cohort.","authors":"J M Zubiria, E Molina, E Toledo, L Forga, J Hermida","doi":"10.1016/j.jdiacomp.2025.109200","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2025.109200","url":null,"abstract":"<p><strong>Aims/hypothesis: </strong>The role of matrix metalloproteinase-10 (MMP-10) in the development of severe complications in patients with type 1 diabetes is not fully understood. The hypothesis is that elevated MMP-10 levels are associated with increased risk of severe complications and that genetic variants leading to reduced or non-functional MMP-10 may confer cardiovascular protection.</p><p><strong>Methods: </strong>195 patients with type 1 diabetes were recruited between 2007 and 2010. Serum MMP-10 concentrations were measured at baseline, and participants were prospectively followed until 2020. The association between baseline MMP-10 levels and a composite endpoint of severe complications of diabetes was analysed. In addition, genetic analysis of the MMP10 gene was performed to identify mutations that can result in a non-functional MMP-10 and lead to cardiovascular protection.</p><p><strong>Results: </strong>Participants in the highest quartile of MMP-10 levels had a threefold higher risk of reaching the composite endpoint compared to those in the lowest quartile (p = 0.038). Moreover, there was a common polymorphism rs17860955 (minor allele frequency: 12 %) that lead to a non-functional MMP-10. These variant carriers showed significantly lower MMP-10 concentration (457.8 ± 309.9 pg/ml vs 942.1 ± 519.6 pg/ml; p < 0.0001) and non-significantly lower composite endpoint events.</p><p><strong>Conclusions: </strong>Low MMP-10 concentration is associated to protection against severe vascular complications in patients with type 1 diabetes. There is a frequent polymorphism (rs17860955) that leads to lower MMP-10 levels and may offer a degree of cardiovascular protection.</p>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"109200"},"PeriodicalIF":3.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levels of diabetes distress and its sources among older adults with type 1 diabetes and relationships to diabetes duration.","authors":"Adriana Wisniewski, Justin DeMonte, Angelica Cristello Sarteau, Angela Fruik, Ruth S Weinstock, Anna R Kahkoska","doi":"10.1016/j.jdiacomp.2025.109198","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2025.109198","url":null,"abstract":"<p><strong>Objective: </strong>Characterize diabetes distress (DD) in older adults with type 1 diabetes (T1D) and explore associations with individual-level characteristics.</p><p><strong>Research design & methods: </strong>Adults ≥65 years with T1D (n = 337; mean 70.7 years) were recruited from the T1D Exchange (08/27/2024-11/05/2024) to complete an electronic survey, including the Type 1 Diabetes Distress Assessment System. Univariable linear regressions were used to assess cross-sectional associations between DD and self-reported sociodemographic, clinical, and diabetes-related variables. Select variables were explored further using bar graphs of DD core and source scores.</p><p><strong>Results: </strong>The median (IQR) DD core score was 1.75 (1.375-2.5), and 36.5 % of respondents had a clinically significant DD core score. DD was positively associated with being female (β = 0.37; 95 % CI: 0.20-0.55), higher HbA1c (β = 0.32; 95 % CI: 0.21-0.43), and an emergency room (ER) visit in the past year (β = 0.33; 95 % CI: 0.12-0.53). DD was negatively associated with longer T1D duration (β = -0.01; 95 % CI: -0.02 to -0.01). The most prominent sources of DD were financial, management, and complication worries, and the least prominent were interpersonal, shame, and resources.</p><p><strong>Conclusions: </strong>In addition to known correlates of DD among individuals with T1D (e.g., HbA1c), this study revealed novel correlates of DD among older adults, including older age at diagnosis, at least one ER visit within the last 12 months, and shorter T1D duration. Limitations include self-reported variables, the cross-sectional nature, and a relatively homogeneous sample by race, high prevalence of technology use, and HbA1c levels largely at goal.</p>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"109198"},"PeriodicalIF":3.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Criteria of frail older people with type 2 diabetes who are suitable for SGLT-2 inhibitors and GLP-1RA therapy.","authors":"A H Abdelhafiz, I Siqueira, A J Sinclair","doi":"10.1016/j.jdiacomp.2025.109193","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2025.109193","url":null,"abstract":"<p><p>Frailty is a metabolically heterogeneous condition and therefore, frail older people with diabetes are metabolically diverse. Diversity is caused by the varying degrees of insulin resistance, determined by the variability in muscle mass/visceral fat ratio and the overall body weight. This creates a frailty spectrum with sarcopenic/obese at one end to malnourished anorexic individuals at the other end. The sarcopenic obese are likely to have increased insulin resistance and progression of the metabolic syndrome. On the other hand, the anorexic malnourished are likely to have decreased insulin resistance due to significant weight loss and regression of the metabolic syndrome. The current evidence showed benefits of SGLT-2 inhibitors and GLP-1RA in frail older people with diabetes, and these benefits increased with increasing frailty. However, the majority of the population who benefited from this therapy were either overweight or obese. There is no evidence of benefits of such therapy in the anorexic malnourished end of the frailty spectrum such as people residents in care homes who were likely excluded from clinical trials. As the sarcopenic obese frail individuals are likely to have high burden of atherosclerotic vascular disease, we suggest that triple therapy of metformin, SGLT-2 inhibitors and GLP-1RA to be initiated as first line therapy in this group of patients if tolerated. On the other hand, this therapy is better avoided in the malnourished frail individuals due to significant weight loss, high risk of adverse events and, due to regression of the metabolic syndrome, the cardiovascular benefits are uncertain.</p>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"109193"},"PeriodicalIF":3.1,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between serum glycated albumin and the risk of sarcopenia and dynapenia in a community-dwelling older Japanese population: the Hisayama Study.","authors":"Toshiharu Ninomiya, Hidekazu Konishi, Emi Ueda, Satoko Sakata, Emi Oishi, Yoshihiko Furuta, Saori Ohmae, Hiroyuki Hoshiko, Norifumi Tateishi, Mao Shibata, Jun Hata","doi":"10.1016/j.jdiacomp.2025.109199","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2025.109199","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia, characterized by a progressive decline in skeletal muscle mass and strength, is increasingly recognized as a major public health concern. Several epidemiological studies have reported that diabetes mellitus is associated with the risk of sarcopenia. The aim of this study is to investigate the association between serum glycated albumin (GA) levels and the risk of developing sarcopenia and dynapenia in a community-dwelling older Japanese population.</p><p><strong>Methods: </strong>A total of 905 participants aged ≥65 years without sarcopenia at baseline were followed for 5 years. Serum GA levels were categorized into quartiles. Sarcopenia was defined by the Asian Working Group for Sarcopenia 2019 criteria, and dynapenia was defined as low grip strength or low gait speed. The odds ratios (ORs) of developing sarcopenia and dynapenia and the mean values of percent change of muscle indices with 95 % confidential intervals (CIs) were estimated by logistic regression analysis and analysis of covariance, respectively.</p><p><strong>Results: </strong>During the follow-up, 73 participants developed sarcopenia. Higher serum GA levels were significantly associated with greater risks of developing sarcopenia (OR 2.65, 95 %CI 0.95-2.65 in the highest vs. the lowest quartile) and dynapenia (OR 4.15, 95 %CI 2.13-4.15). Higher serum GA levels were related to declines in grip strength and gait speed. This association remained significant even among participants without diabetes or with hemoglobin A1c of <6.0 %.</p><p><strong>Conclusions: </strong>Higher serum GA is a significant risk factor for both sarcopenia and dynapenia, with a stronger association observed for dynapenia, even in the absence of diabetes.</p>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"109199"},"PeriodicalIF":3.1,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of Bifidobacterium animalis subsp. lactis BLa80 on glycemic control and gut microbiota in patients with T2DM: a randomized, double-blind, placebo-controlled trial","authors":"Chao Zhao ,&nbsp;Xin Lu ,&nbsp;Xiaoling Deng ,&nbsp;Wenbo Xia ,&nbsp;Tingting Sun ,&nbsp;Di Huo ,&nbsp;Lili Shi","doi":"10.1016/j.jdiacomp.2025.109195","DOIUrl":"10.1016/j.jdiacomp.2025.109195","url":null,"abstract":"<div><div>To evaluate the effect of <em>Bifidobacterium</em> subsp. <em>lactis</em> BLa80 on glycemic control and gut microbiota composition in patients with type 2 diabetes mellitus (T2DM), a randomized, placebo-controlled clinical trial was conducted in 80 patients. Participants were randomly assigned to receive either BLa80 supplementation or placebo (<em>n</em> = 40 per group) in addition to standard metformin therapy for 12 weeks. Fasting blood and stool samples were collected at baseline and at the end of the intervention. The results showed that BLa80 supplementation significantly reduced fasting blood glucose and high-density lipoprotein cholesterol (HDL-C) levels, while low-density lipoprotein cholesterol (LDL-C) levels were increased. Furthermore, BLa80 modulated the diversity and composition of the gut microbiota after 12 weeks of intervention. In conclusion, BLa80 supplementation may improve glycemic control and modulate the gut microbiota in patients with T2DM, suggesting its potential as an adjunctive therapy in diabetes management.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"Article 109195"},"PeriodicalIF":3.1,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145322617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestational diabetes mellitus and the subsequent risk of chronic kidney disease: A systematic review and meta-analysis","authors":"Qin Zhou,&nbsp;Hao Yang,&nbsp;Xi-shao Xie,&nbsp;Ren-ding Wang","doi":"10.1016/j.jdiacomp.2025.109197","DOIUrl":"10.1016/j.jdiacomp.2025.109197","url":null,"abstract":"<div><h3>Aims</h3><div>The evidence regarding a relationship between gestational diabetes mellitus (GDM) and the risk of chronic kidney disease (CKD) in later life has been inconsistent. We systematically evaluated whether such an association exists.</div></div><div><h3>Methods</h3><div>We searched the PubMed, Embase, and Cochrane Library databases from their inception to 18 May 2025. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated to assess the association between GDM and subsequent CKD.</div></div><div><h3>Results</h3><div>Eight articles involving 21,806,683 pregnant women were included in our meta-analysis. The overall risk of CKD in the GDM group was significantly higher than in the control group (OR = 1.79, 95 % CI = 1.16–2.78, <em>P</em> = 0.009). Further analyses restricted to high-quality studies (OR = 2.75, 95 % CI = 1.68–4.52, <em>P</em> &lt; 0.01, I² = 96.8 %) or to studies adjusting for key confounders (OR = 2.76, 95 % CI = 1.67–4.52, <em>P</em> = 0.001, I² = 65.9 %) also demonstrated a significant association. Most subgroup analysis results were consistent with the overall findings.</div></div><div><h3>Conclusions</h3><div>This systematic review and meta-analysis support a significant association between GDM and future CKD risk, suggesting that GDM may serve as an early warning sign for renal disease. However, confidence in the results was reduced by the considerable heterogeneity and more work is needed to understand this variability.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"Article 109197"},"PeriodicalIF":3.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes, anxiety, and mortality risk among middle and older-aged Americans","authors":"Srikanta Banerjee ,&nbsp;Jagdish Khubchandani ,&nbsp;Rafael Gonzales-Lagos","doi":"10.1016/j.jdiacomp.2025.109194","DOIUrl":"10.1016/j.jdiacomp.2025.109194","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 Diabetes (T2D) continues to be a major cause of morbidity and a leading cause of mortality in the United States. Also, anxiety ranks among the topmost common mental health problems in the U.S. While the burden of anxiety among individuals with T2D is well known, the long-term impact of anxiety among adults with T2D has not been well explored. Thus, the purpose of this national study was to ascertain the impact of anxiety on mortality among Americans with T2D.</div></div><div><h3>Methods</h3><div>Data from the U.S. National Health and Nutrition Examination Survey (years 2007–2012) were linked with mortality data from the National Death Index up to December 31st, 2019.</div></div><div><h3>Results</h3><div>A total of 14,137 adults (aged 50 years and older) were included in the study sample, with more than a tenth (12.8 %) having T2D and more than a fifth (22.6 %) having anxiety. The unadjusted hazard ratio (HR) for all-cause mortality risk among those with T2D was 2.08 (95 % confidence interval [CI], 1.83–2.35, <em>p</em> &lt; 0.01) compared to those without T2D. In the adjusted analysis, the risk of all-cause mortality was highest among individuals with both anxiety and T2D [AHR = 1.81 (95 % CI 1.37–2.40, p &lt; 0.01)] compared to those with anxiety or T2D alone.</div></div><div><h3>Conclusions</h3><div>Our analysis provides vital information on factors that could be helpful for interventions to reduce mortality risk among those with T2D and anxiety. Also, given the higher risk of mortality with co-occurring T2D and anxiety, collaborative healthcare practices should help with widespread screening for and treatment of anxiety among middle and older-age adults with Type 2 Diabetes.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"Article 109194"},"PeriodicalIF":3.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term effects of low-dose tirzepatide on lipid profile, glucose homeostasis and hepatic steatosis index in adults with obesity, but without diabetes mellitus: a prospective observational study","authors":"Nikolaos Angelopoulos ,&nbsp;Sarantis Livadas ,&nbsp;Ioannis Androulakis ,&nbsp;Valentina Petkova ,&nbsp;Andreas Rizoulis ,&nbsp;Anastasios Boniakos ,&nbsp;Rodis Paparodis ,&nbsp;Ploutarchos Tzoulis ,&nbsp;Voula Mentzelopoulou ,&nbsp;Dimos Florakis ,&nbsp;Evangelos Fousteris ,&nbsp;Areti Korakovouni ,&nbsp;Dimitra Zianni ,&nbsp;Zadalla Mouslech ,&nbsp;Manfredi Rizzo ,&nbsp;Dimitri P. Mikhailidis ,&nbsp;Panagiotis Anagnostis","doi":"10.1016/j.jdiacomp.2025.109181","DOIUrl":"10.1016/j.jdiacomp.2025.109181","url":null,"abstract":"<div><h3>Background/aims</h3><div>Tirzepatide has been approved for weight loss in adults with obesity. However, real-world data are still needed. This real-world prospective study is among the first to evaluate the short-term metabolic effects of low-dose tirzepatide in adults with obesity but without diabetes mellitus (DM). Secondary endpoints included associations between these changes and anthropometric or baseline metabolic parameters.</div></div><div><h3>Methods</h3><div>In this prospective observational study, adults with obesity but without diabetes mellitus received tirzepatide (2.5 mg/week, escalating to 5 mg/week, subcutaneously) for 12 weeks. Body weight, body mass index (BMI), total (TC), low-density (LDL-C) and high-density lipoprotein cholesterol (HDL-C), triglycerides, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), and hepatic steatosis index (HSI) were measured at baseline and week 12.</div></div><div><h3>Results</h3><div>Seventy-five participants (mean age 46.9 ± 9.9 years) were included. After 12 weeks, body weight (−8.1 ± 4.3 %) and BMI significantly decreased. TC, LDL-C, triglycerides, FPG, HbA1c, and HSI were significantly reduced and inversely associated with their baseline levels. HbA1c and HSI changes correlated with weight loss. No effect was observed on HDL-C. Statin use had no impact on outcomes.</div></div><div><h3>Conclusion</h3><div>Short-term low-dose tirzepatide improves the lipid profile, HbA1c, and HSI in obese adults without DM, especially in those with abnormal baseline values. Lipid changes occurred independently of weight loss.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 12","pages":"Article 109181"},"PeriodicalIF":3.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145247846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of diabetic neuropathy in Greenland and its association with Inuit genetic ancestry – a cross-sectional study","authors":"Marie Mathilde Bjerg Christensen ,&nbsp;Christian Stevns Hansen ,&nbsp;Jesper Fleischer ,&nbsp;Ninna Senftleber ,&nbsp;Frederik Filip Stæger ,&nbsp;Torben Hansen ,&nbsp;Daniel R. Witte ,&nbsp;Marit Eika Jørgensen","doi":"10.1016/j.jdiacomp.2025.109179","DOIUrl":"10.1016/j.jdiacomp.2025.109179","url":null,"abstract":"<div><h3>Aims</h3><div>Data on diabetic neuropathies in Greenland remains limited. The aim was to estimate the prevalence of diabetic peripheral neuropathy (DPN) and cardiovascular autonomic neuropathy (CAN) among Greenlanders with diabetes and prediabetes and investigate whether Inuit ancestry contributes to higher susceptibility.</div></div><div><h3>Methods</h3><div>Individuals with diabetes and prediabetes from the Greenland Population Survey 2018 were examined for DPN (Vibration Perception Threshold (VPT) and light pressure) and CAN (Cardiovascular Reflex Tests and Heart Rate Variability). Inuit genetic admixture was included as a determinant in regression models adjusted for age, sex, genetics, diabetes status and residency.</div></div><div><h3>Results</h3><div>Among 447 participants (1/3 diabetes, median age 61, 57 % female) DPN prevalence was 28 % in diabetes and 25 % in prediabetes. CAN prevalence was 24 % and 15 %, respectively. A 20-percentage point change in Inuit ancestry was associated with a 4 % higher VPT (coefficient: 1.04, 95 % CI: 1.003–1.08) and 51 % higher odds of CAN (OR: 1.51, 95 % CI: 1.09–2.08).</div></div><div><h3>Conclusions</h3><div>DPN and CAN are common among Greenlanders with diabetes and prediabetes, highlighting the need for improved diagnostics and prevention. The association between Inuit genetic ancestry and neuropathy suggests a predisposition to neuropathy among Inuit, which may be explained by both genetic and lifestyle factors.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 11","pages":"Article 109179"},"PeriodicalIF":3.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}