Journal of diabetes and its complications最新文献

{"title":"Incidence of early-onset type 2 diabetes and sociodemographic predictors of complications: A nationwide registry study","authors":"Kristine Stoltenberg Addington ,&nbsp;Maria Kristiansen ,&nbsp;Nana F. Hempler ,&nbsp;Marie Frimodt-Møller ,&nbsp;Victor M. Montori ,&nbsp;Marleen Kunneman ,&nbsp;Stine H. Scheuer ,&nbsp;Lars J. Diaz ,&nbsp;Gregers S. Andersen","doi":"10.1016/j.jdiacomp.2024.108942","DOIUrl":"10.1016/j.jdiacomp.2024.108942","url":null,"abstract":"<div><h3>Aims</h3><div>Early-onset type 2 diabetes (T2DM) (18–45 years) is rising globally, yet complication incidence in this group remains unclear. We investigated the incidence of early-onset T2DM, the incidence of micro- and macrovascular complications, and how comorbidities (e.g., severe mental illness) and sociodemographic factors (e.g., education level) influence complication risk and timing in Denmark.</div></div><div><h3>Methods</h3><div>Using nationwide registers, we followed 8,129,005 individuals from 1996 to 2020 to estimate the incidence rate (IR) of early-onset T2DM. 49,850 individuals with early-onset T2DM were followed to calculate IRs for microvascular (nephropathy, retinopathy) and macrovascular (cardiovascular disease, amputation) complications. Incidence rate ratios (IRRs) assessed associations between comorbidities, sociodemographic factors, and complications. Poisson regression models calculated IRs and IRRs.</div></div><div><h3>Results</h3><div>From 1996 to 2020, the IR of early-onset T2DM more than doubled in men and tripled in women, with women dominating younger age groups. During follow-up (7.9–9.8 years), 37.6 % developed complications. Higher complication IRs were observed in men, those with sociodemographic disadvantages, and individuals with comorbidities. Early complications (≤5 years) were more common among the unemployed, single individuals, and those with comorbidities.</div></div><div><h3>Conclusions</h3><div>The rising IR of early-onset T2DM in younger women, and complications disproportionately affecting men and those with comorbidities or sociodemographic disadvantages, highlight the need for targeted interventions.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108942"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial sweeteners and Type 2 Diabetes Mellitus: A review of current developments and future research directions","authors":"Francisca Obianuju Okoro,&nbsp;Victor Markus","doi":"10.1016/j.jdiacomp.2025.108954","DOIUrl":"10.1016/j.jdiacomp.2025.108954","url":null,"abstract":"<div><div>While artificial sweeteners are Generally Regarded as Safe (GRAS), the scientific community remains divided on their safety status. The previous assumption that artificial sweeteners are inert within the body is no longer valid. Artificial sweeteners, known for their high intense sweetness and low or zero calories, are extensively used today in food and beverage products as sugar substitutes and are sometimes recommended for weight management and Type 2 Diabetes Mellitus (T2DM) patients. The general omission of information about the concentration of artificial sweeteners on market product labels makes it challenging to determine the amounts of artificial sweeteners consumed by people. Despite regulatory authorization for their usage, such as from the United States Food and Drug Administration (FDA), concerns remain about their potential association with metabolic diseases, such as T2DM, which the artificial sweeteners were supposed to reduce. This review discusses the relationship between artificial sweetener consumption and the risk of developing T2DM. With the increasing number of recent scientific studies adding to the debate on this subject matter, we assessed recent literature and up-to-date evidence. Importantly, we highlight future research directions toward furthering knowledge in this field of study.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108954"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039320","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":"Long-term mortality rates after lower extremity amputation in individuals with and without diabetes mellitus (DUDE-10): A retrospective matched cohort study","authors":"L. Rosien ,&nbsp;H.J.G. Bilo ,&nbsp;J. Oskam ,&nbsp;D. Ruwaard ,&nbsp;R.O.B. Gans ,&nbsp;M.A. Edens ,&nbsp;M.J. Molegraaf ,&nbsp;P.R. van Dijk","doi":"10.1016/j.jdiacomp.2025.108956","DOIUrl":"10.1016/j.jdiacomp.2025.108956","url":null,"abstract":"<div><h3>Background/objectives</h3><div>To determine mortality rates after lower extremity amputation (LEA) in individuals with and without diabetes mellitus (DM).</div></div><div><h3>Methods</h3><div>Retrospective, observational study using data from a database covering &gt;99 % of the Dutch population. LEAs in 2016 were identified, and mortality data from 2016 to 2021 were analyzed. Study group 1 (SG1) included individuals with DM and LEA (DM+/LEA+) with two control groups (CG), DM+/LEA− (matched by age, sex, without (1a) and with (1b) socioeconomic status matching). Study group 2 (SG2) (DM+/LEA+) was composed after matching with non-DM individuals with LEA (DM−/LEA+ (2a)).</div></div><div><h3>Results</h3><div>Among 5145 individuals with LEA in 2016, 56 % had DM. Five-year mortality was 61.2 % in SG1 (DM+/LEA+) and 27.9 % in CG1a (DM+, LEA−) and 1b. Study group 2 (DM+/LEA+) had a 62.6 % five-year mortality rate, compared to 56.4 % in CG2a (DM−/LEA+).</div></div><div><h3>Conclusions</h3><div>Mortality after LEA is high, especially in DM; socioeconomic status (SES) does not significantly impact mortality.</div></div><div><h3>Level of evidence</h3><div>Level III retrospective cohort study.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 3","pages":"Article 108956"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098441","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 effect of semaglutide combined with metformin on liver inflammation and pancreatic beta-cell function in patients with type 2 diabetes and non-alcoholic fatty liver disease","authors":"Rong Ren ,&nbsp;Yanxia Pei ,&nbsp;Lufei Kong ,&nbsp;Yixin Shi","doi":"10.1016/j.jdiacomp.2024.108932","DOIUrl":"10.1016/j.jdiacomp.2024.108932","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) were often coexistent conditions driven by insulin resistance and systemic inflammation. Effective management strategies that address both metabolic disorders were urgently needed. This study investigates the effect of combining semaglutide, a glucagon-like peptide-1 receptor agonist, with metformin on liver inflammation and pancreatic beta-cell function in patients with T2DM and NAFLD.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 261 patients with T2DM and NAFLD treated at our institution from January 2021 to December 2023. Patients were divided into two groups: 127 received metformin alone (M group), and 134 received a combination of semaglutide and metformin (SAM group). Liver inflammation and fibrosis were assessed using alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (γ-GTP), and the FIB-4 index. Pancreatic beta-cell function and insulin sensitivity were evaluated using the Matsuda index, HbA1c, fasting glucose, and the oral disposition index (DIo).</div></div><div><h3>Results</h3><div>Post-treatment, the SAM group showed significantly greater improvements in liver inflammation markers (ALT: 23.59 ± 5.67 U/L in SAM vs. 25.56 ± 5.46 U/L in M; AST: 18.97 ± 3.94 U/L in SAM vs. 20.15 ± 3.95 U/L in M), reduced fibrosis (FIB-4 index: 1.05 ± 0.44 in SAM vs. 1.16 ± 0.51 in M), and enhanced beta-cell function (Matsuda index: 5.18 ± 1.09 in SAM vs. 4.84 ± 1.15 in M; DIo: 0.18 ± 0.06 in SAM vs. 0.16 ± 0.05 in M). Glycemic control, as indicated by reduced HbA1c, was also superior in the SAM group.</div></div><div><h3>Conclusion</h3><div>The combination of semaglutide and metformin significantly improves liver inflammation, fibrosis, and beta-cell function in patients with T2DM and NAFLD compared to metformin alone.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108932"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864355","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":"Comprehensive treatment with dapagliflozin in elderly chronic kidney disease patients: Clinical efficacy and impact on body composition","authors":"Kazuhiro Nomura ,&nbsp;Toshiyuki Takata ,&nbsp;Naokazu Muramae ,&nbsp;Hiroaki Takahashi ,&nbsp;Kozue Abe ,&nbsp;Tomokazu Matsuda","doi":"10.1016/j.jdiacomp.2025.108951","DOIUrl":"10.1016/j.jdiacomp.2025.108951","url":null,"abstract":"<div><h3>Background</h3><div>Dapagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, is widely used for treating heart failure and chronic kidney disease (CKD). While its renoprotective effects are well established, concerns remain regarding its impact on muscle mass and function, especially in elderly patients.</div></div><div><h3>Objective</h3><div>To assess the effects of dapagliflozin on renal function, body composition, and muscle strength in elderly CKD patients.</div></div><div><h3>Methods</h3><div>Twelve elderly CKD patients (75.6 ± 1.4 years) were treated with dapagliflozin for 12 months. Body composition, serum parameters, and muscle function were evaluated at baseline, 6 months, and 12 months. Measurements included changes in eGFR, liver function, HbA1c, and muscle strength.</div></div><div><h3>Results</h3><div>Dapagliflozin treatment stabilized eGFR without significant improvement, but proteinuria was notably reduced in most patients, indicating a positive renal effect. AST and ALT levels showed significant reduction after 12 months, suggesting improved liver function. No significant changes were observed in body weight, BMI, or muscle mass. Muscle function, as measured by the 5-sit-to-stand test, improved significantly, while grip strength remained stable. No serious adverse events were reported.</div></div><div><h3>Conclusion</h3><div>Dapagliflozin is a safe and effective treatment for CKD in elderly patients, demonstrating renal protection and improved liver function without adversely affecting muscle mass or strength. The study supports the use of dapagliflozin as part of a comprehensive approach, combining pharmacotherapy, lifestyle modification, and exercise to optimize patient outcomes in CKD management.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108951"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006492","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 muscle fatigability and diabetic kidney disease complications in patients with type 2 diabetes","authors":"Yuma Hirano ,&nbsp;Daisuke Tsuriya ,&nbsp;Kenichi Kono ,&nbsp;Tomoyuki Fujikura ,&nbsp;Tomoya Yamaguchi ,&nbsp;Kento Matsushita ,&nbsp;Yurina Yokoyama ,&nbsp;Katsuya Yamauchi ,&nbsp;Yusuke Nishida","doi":"10.1016/j.jdiacomp.2025.108955","DOIUrl":"10.1016/j.jdiacomp.2025.108955","url":null,"abstract":"<div><h3>Aims</h3><div>Type 2 diabetes mellitus (T2DM) requires the maintenance of high physical activity levels and specific interventions tailored to the characteristics of each patient. We hypothesized that T2DM combined with diabetic kidney disease (DKD) could increase muscle fatigability, becoming a specific contributor to physical inactivity. This study aimed to determine the association between muscle fatigability and DKD complications and investigate the relationship between muscle fatigability and physical activity in patients with T2DM.</div></div><div><h3>Methods</h3><div>Overall, 50 patients with T2DM aged 40–65 years and with an estimated glomerular filtration rate of 30 mL/min/1.73 m² or higher were included. Muscle function was assessed using an isokinetic dynamometer. Muscle fatigability (maximal voluntary concentric contraction [ΔMVCC] velocity, maximal voluntary isometric contraction [ΔMVIC] torque), which indicated the decrease in angular velocity and muscle strength associated with the exercise task, was calculated. The patient characteristics, physical activity (IPAQ-SV), knee extensor strength, and skeletal muscle index were evaluated. Participants were divided into two groups (DKD and non-DKD) according to the presence of DKD, and ΔMVCC velocity and ΔMVIC torque were compared.</div></div><div><h3>Results</h3><div>ΔMVCC velocity was significantly higher in the DKD group than in the non-DKD group (<em>p</em> &lt; 0.05). Similarly, ΔMVIC torque was significantly higher in the DKD group than in the non-DKD group (<em>p</em> &lt; 0.05). Subgroup analyses showed that ΔMVCC velocity was independently associated with physical activity in the DKD group (odds ratio: 0.93, 95 % confidence interval: 0.88–0.99).</div></div><div><h3>Conclusions</h3><div>Muscle fatigability increased with DKD in patients with T2DM and might be related to physical activity.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108955"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129414","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 association between age at diagnosis of diabetes and development of diabetic retinopathy and assessment of healthcare access as an effect modifier","authors":"Bria L. George ,&nbsp;Alejandro M. Perez ,&nbsp;Pura Rodriguez ,&nbsp;Prashant Parekh ,&nbsp;Noël C. Barengo","doi":"10.1016/j.jdiacomp.2024.108931","DOIUrl":"10.1016/j.jdiacomp.2024.108931","url":null,"abstract":"<div><h3>Aims</h3><div>To examine if healthcare access modifies the association between age at diagnosis of diabetes and the prevalence of retinopathy.</div></div><div><h3>Methods</h3><div>BRFSS 2020 survey data was obtained from 12,198 adults. Participants with missing information in the variables “retinopathy” (<em>N</em> = 569) and “insurance-cost barrier” (<em>N</em> = 75) were excluded. The final sample included 11,556 participants. Age at diagnosis of diabetes was the main exposure and retinopathy was the main outcome. We tested if the main association was different among the insurance-cost barrier variable. Binary logistic regression models were used to calculate odds ratios (OR) and 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>The odds of retinopathy decreased by 22 % in patients 46–64 years-of-age (OR 0.78; 95 CI 0.6–1.0) and 57 % in those 65+ (OR 0.43; 95 CI 0.28–0.65). The odds decreased by 39 % if female (OR 0.61; 95 CI 0.48–0.77). An increase in odds by 86 % (OR 1.86; 95 CI 1.07–3.21) occurred in other non-Hispanics, 50 % (OR 1.50; 95 CI 1.13–1.99) in black non-Hispanics and 70 % (OR 1.70; 95 CI 1.17–2.46) in Hispanics. There was no evidence that age at diagnosis of diabetes and presence of retinopathy varied by insurance cost (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Health professionals may utilize these results to advocate for early disease intervention.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108931"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824348","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":"Behavioral health comorbidities in hospital outcomes post-lower extremity amputation in patients with type 1 and type 2 diabetes","authors":"Kelsey A. Schmittling","doi":"10.1016/j.jdiacomp.2025.108949","DOIUrl":"10.1016/j.jdiacomp.2025.108949","url":null,"abstract":"<div><div>Peripheral artery disease leading to chronic limb threatening ischemia (CLTI) represents a significant concern for up to 11.0 % of patients with diabetes, often culminating in amputation of the affected limb. This retrospective cohort study explores frequency of comorbid behavioral health conditions (CBHCs) in patients with diabetes and hospital stay characteristics related to post-lower extremity amputation (LEA). Utilizing patient data from the Healthcare Cost and Utilization Project from 2020, patients were categorized into groups including having comorbid depression only, alcohol abuse only, drug abuse only, more than one CBHC, or no CBHC. On average, patients with at least one CBHC underwent LEA over three years earlier (59.3<span><math><mo>±</mo></math></span>12.0 years versus 62.6<span><math><mo>±</mo></math></span>12.1 years, respectively). A greater proportion of patients with at least one CBHC were non-Hispanic White people, reside in a county metro area &lt;250,000 people, and were insured by Medicaid. Despite generally low mortality rates, patients with depression only display significantly higher survival rates relative to those without a CBHC. These findings begin exploring the socioeconomic complexities and healthcare disparities faced by patients with diabetes and behavioral health diagnoses, emphasizing the need for targeted preventive mental health screening and intervention prior to development of CLTI.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108949"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970133","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":"Contents/Barcode","authors":"","doi":"10.1016/S1056-8727(25)00015-7","DOIUrl":"10.1016/S1056-8727(25)00015-7","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108962"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350751","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":"Dapagliflozin has protective effects on palmitate-induced renal tubular epithelial cells by enhancing mitochondrial function and reducing oxidative stress","authors":"Tingting Ding ,&nbsp;Mingzhu Song ,&nbsp;Sihong Wang ,&nbsp;Chongbing Huang ,&nbsp;Tianrong Pan","doi":"10.1016/j.jdiacomp.2024.108930","DOIUrl":"10.1016/j.jdiacomp.2024.108930","url":null,"abstract":"<div><div>Sodium-glucose co-transporter 2 (SGLT2) inhibitors, commonly utilized for diabetic nephropathy, have demonstrated benefits beyond glucose control, including organ protection. This study investigated the protective effects of the SGLT2 inhibitor, dapagliflozin (DAPA), on palmitate-induced renal tubular epithelial cell (HK−2) injury, particularly concentrating on mitochondrial function and oxidative stress. HK-2 cells were treated with 150 μmol/L palmitate to induce mitochondrial dysfunction and oxidative stress, and they were co-treated with 2 μmol/L DAPA for 24 h. DAPA significantly increased cell viability (<em>P</em> &lt; 0.05), reduced reactive oxygen species (ROS) levels (<em>P</em> &lt; 0.001), and restored mitochondrial membrane potential (<em>P</em> &lt; 0.05). It also lowered malondialdehyde (MDA) level (<em>P</em> &lt; 0.001) and increased superoxide dismutase (SOD) expression level (<em>P</em> &lt; 0.001). Western blot analysis revealed that DAPA reversed palmitate-induced upregulation of apoptosis-related proteins, including Bax and Cytochrome C. DAPA also mitigated the overactivation of autophagy-related proteins, such as LC3 and Beclin-1, indicating its role in modulating autophagy under diabetic nephropathy. Electron microscopy confirmed improvements in mitochondrial morphology, accompanying by reduced swelling and restored cristae structure. These findings highlight the potential of DAPA, as an SGLT2 inhibitor, to mitigate renal injury by enhancing mitochondrial function and reducing oxidative stress, providing novel insights into its therapeutic value for diabetic nephropathy management.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 2","pages":"Article 108930"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}