Diabetes, Obesity & Metabolism最新文献

{"title":"GLP-1 receptor agonists and the risk for cancer: A meta-analysis of randomized controlled trials.","authors":"Giovanni Antonio Silverii, Christian Marinelli, Costanza Bettarini, Gloria Giovanna Del Vescovo, Matteo Monami, Edoardo Mannucci","doi":"10.1111/dom.16489","DOIUrl":"https://doi.org/10.1111/dom.16489","url":null,"abstract":"<p><strong>Aims: </strong>To assess if there is a difference in the oncogenic risk between GLP-1 RA and comparators in randomized controlled trials.</p><p><strong>Materials and methods: </strong>A meta-analysis of randomized controlled trials comparing GLP-1RA to any comparators for diabetes and/or obesity, lasting at least 52 weeks. The endpoints included the incidence of overall cancers and single malignancies.</p><p><strong>Results: </strong>Fifty trials were included. GLP-1RA treatment was not associated with a significant difference in risk for overall cancer (MH-OR 1.05, 95% confidence interval [CI] [0.98, 1.13]). Uterine cancer was significantly reduced in the GLP-1RA arm in trials performed in subjects with obesity (MH-OR 0.24, 95% CI [0.06, 0.94]), but not in those aimed at diabetes treatment (MH-OR 0.92, [0.58, 1.47]). We detected an increase in the risk for thyroid cancer (MH-OR 1.55, [1.05, 2.27]), more evident in longer-term trials, and in the risk for colorectal cancer (MH-OR 1.27 [1.03, 1.57]), which, conversely, was significant only in shorter-term trials. No significant difference in the risk was detected for any other cancer.</p><p><strong>Conclusions: </strong>GLP-1 RA do not appear to produce an effect on most malignancies in clinical trials. A reduction of very close obesity-associated cancers seems possible, whereas a risk signal for thyroid cancer was observed, prompting the need for further specific studies. On the other hand, the small increase observed in colorectal cancer in shorter-term trials may be the effect of a disproportionate increase in diagnostic procedures in the GLP-1 RA arm, because of the suspicion raised by common side effects of GLP-1 RA.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172406","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":"Post-marketing safety of Lantus and its interchangeable biosimilar Semglee in the United States: A disproportionality analysis using the FDA Adverse Event Reporting System (FAERS) database.","authors":"Lotanna Ezeja, Jingjing Qian","doi":"10.1111/dom.16491","DOIUrl":"https://doi.org/10.1111/dom.16491","url":null,"abstract":"<p><strong>Aims: </strong>On 28 July 2021, Semglee (insulin glargine-yfgn) was approved by the U.S. Food and Drug Administration as the first interchangeable biosimilar to the reference product Lantus (insulin glargine) for treating diabetes mellitus. This study used the FDA Adverse Event Reporting System to identify reporting safety signals of Lantus and Semglee.</p><p><strong>Materials and methods: </strong>Adverse event (AE) reports were organized into high-level group terms (HLGTs) using the Medical Dictionary for Regulatory Activities (MedDRA). Disproportionality analysis, including reporting odds ratio (ROR) and empirical Bayesian geometric mean (EBGM), was performed to detect safety signals for serious AE, death, hospitalization, top 6 HLGTs, and specific AEs on products' FDA prescription labels.</p><p><strong>Results: </strong>Both products showed no significant safety signal of serious AE, death, or hospitalization. Lantus exhibited significant safety signals for device issues (ROR = 1.3, 95% confidence interval [CI] = 1.2-1.4; EBGM = 1.3, 90% CI = 1.2-1.3), medication errors and other product use errors and issues (ROR = 2.8, 95% CI = 2.7-2.9; EBGM = 2.1, 90% CI = 2.0-2.1), metabolic, nutritional, and blood gas investigations (ROR = 11.7, 95% CI = 11.2-12.2; EBGM = 9.6, 90% CI = 9.3-9.9), hyperglycaemia (ROR = 2.7, 95% CI = 2.1-3.5; EBGM = 2.3, 90% CI = 1.9-2.8) and hypoglycaemia (ROR = 4.6, 95% CI = 3.6-5.8; EBGM = 3.7, 90% CI = 3.0-4.5). Semglee had significant safety signals for device issues (ROR = 118.7, 95% CI = 103.9-135.7; EBGM = 22.8, 90% CI = 21.7-23.9), medication errors and other product use errors and issues (ROR = 3.4, 95% CI = 3.0-3.8; EBGM = 2.3, 90% CI = 2.1-2.4), metabolic, nutritional, and blood gas investigations (ROR = 3.0, 95% CI = 2.3-3.9; EBGM = 2.5, 90% CI = 2.0-3.1), product quality, supply, distribution, manufacturing, and quality system issues (ROR = 5.4, 95% CI = 4.6-6.3; EBGM = 4.4, 90% CI = 3.9-5.0), physical examination and organ system status topics (ROR = 2.6, 95% CI = 2.0-3.2; EBGM = 2.2, 90% CI = 1.9-2.7), weight gain (ROR = 3.6, 95% CI = 2.6-4.8; EBGM = 2.7, 90% CI = 2.1-3.5), weight loss (ROR = 2.0, 95% CI = 1.4-2.9; EBGM = 1.7, 90% CI = 1.2-2.2), and lipodystrophy (ROR = 146.0, 95% CI = 96.1-221.8; EBGM = 116.0, 90% CI = 81.7-160.8).</p><p><strong>Conclusions: </strong>Findings identified significant post-marketing safety signals of Lantus and Semglee. Longitudinal studies are warranted to verify these signals.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172361","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":"Fully automated insulin delivery systems in type 1 diabetes: A systematic review and meta-analysis.","authors":"Wenqi Fan, Chao Deng, Ruoyao Xu, Zhenqi Liu, Yuhu He, Zhiguang Zhou, Xia Li","doi":"10.1111/dom.16499","DOIUrl":"https://doi.org/10.1111/dom.16499","url":null,"abstract":"<p><strong>Aims: </strong>The landscape of insulin delivery is evolving, transitioning from hybrid automated insulin delivery (AID) to more sophisticated fully AID systems. We aimed to compare the efficacy of fully AID systems with any insulin delivery method in type 1 diabetes (T1D).</p><p><strong>Materials and methods: </strong>Following registration in PROSPERO, CRD42024528669, PubMed, Embase, Cochrane Library and Web of Science were searched up to 26 February 2025 for randomised clinical trials comparing fully AID systems to any insulin delivery method in T1D. The control treatments included conventional insulin therapy (multiple daily injections, continuous subcutaneous insulin infusion and sensor-augmented pumps) and hybrid AID systems. The primary outcome was the mean difference (MD) in the percentage of time blood glucose concentration remained in the target range (3.9-10.0 mmol/L or 4.0-10.0 mmol/L), assessed by random-effects models.</p><p><strong>Results: </strong>We identified 1308 reports; after exclusions, 16 trials (669 patients) were included. Time in range (TIR) was higher using fully AID systems than control treatments (MD 9.99% [95% confidence interval, 3.75% to 16.22%], p = 0.002). This improvement was accompanied by increased diabetes treatment satisfaction (MD 3.70 points [95% confidence interval, 0.22 points to 7.18 points], p = 0.04). Fully AID systems exhibited a favourable effect on TIR when compared with conventional insulin therapy, while exhibiting an opposite effect when compared with hybrid AID (17.44% vs. -3.05%, p < 0.001). Younger patients with T1D, as well as patients with a shorter diabetes duration, exhibited more significant glycaemic improvements with fully AID systems therapy.</p><p><strong>Conclusions: </strong>Fully AID systems improved glycaemic control and diabetes treatment satisfaction compared with other non-AID methods in patients with T1D, especially for younger patients. However, to achieve or exceed the desired benefits of hybrid AID, algorithm upgradation, along with the synergistic integration of multiple hormones, will be crucial for next-generation fully AID systems.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155422","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":"Real-world evaluation of automated insulin delivery therapy in type 1 diabetes: A multicentre study across regional and metropolitan Queensland, Australia.","authors":"Akash Konantambigi, Wenyong Wang, Dylan Boggild, Arushi Rana, Larisa Syphers, Catherine Presley, Candice Cummins, Usman Malabu, Kate Hawke, Vasant Shenoy, Gaurav Puri, Harshal Deshmukh","doi":"10.1111/dom.16485","DOIUrl":"https://doi.org/10.1111/dom.16485","url":null,"abstract":"<p><strong>Background: </strong>Automated insulin delivery (AID) systems, which integrate continuous glucose monitoring (CGM) with automated insulin dosing, have emerged as a transformative therapy. However, real-world data on AID effectiveness, particularly in regional Australia, remain limited.</p><p><strong>Methods: </strong>We conducted a retrospective audit across three Australian hospital sites-Logan (metropolitan), Mackay and Townsville (regional)-to evaluate the impact of AID therapy in adults with Type 1 Diabetes Mellitus (T1DM). Data on demographics, comorbidities, CGM metrics and clinical outcomes were extracted from medical records and device platforms. The primary outcome was change in HbA1c and CGM time-in-range (TIR; 3.9-10 mmol/L) at follow-up. Follow-up data were recorded up to 12 months following AID commencement. Secondary outcomes included changes in body weight, glycaemic variability and predictors of HbA1c reduction.</p><p><strong>Results: </strong>The study consisted of 158 people living with T1DM who were initiated on AID. Following AID initiation, mean TIR improved from 53.4% (SD 21.1%) to 70.0% (SD 14.6%) (p < 0.0001), and time in hyperglycaemia (>13.9 mmol/L) declined from 18.7% (SD 19.4%) to 8.4% (SD 9.31%) (p < 0.0001). The mean HbA1c significantly decreased from 8.62% (SD 1.70) at baseline to 7.34% (SD 1.31) at follow-up across the entire study cohort (p < 0.0001), with 42.7% achieving <7% and 64.1% achieving <7.5% at follow-up. Multivariable regression identified higher baseline HbA1c (p < 0.0001) as a significant predictor of HbA1c reduction. Improvements were consistent across AID system types and geographical settings.</p><p><strong>Conclusions: </strong>AID therapy significantly improves glycaemic control in adults with T1DM in both regional and metropolitan Australia. Our findings support the real-world effectiveness of AID systems and highlight their potential to bridge care gaps across diverse settings.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155424","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 the visceral obesity indices and the future diabetes mellitus risk: A prospective cohort study.","authors":"Yue Zhang, Wenxing Gao, Binqi Li, Yang Liu, Xulei Tang, Li Yan, Zuojie Luo, Guijun Qin, Lulu Chen, Qin Wan, Zhengnan Gao, Weiqing Wang, Guang Ning, Yiming Mu","doi":"10.1111/dom.16492","DOIUrl":"https://doi.org/10.1111/dom.16492","url":null,"abstract":"<p><strong>Aim: </strong>As abnormal visceral fat accumulation is the core pathophysiology of diabetes mellitus (DM), this study evaluated five novel visceral obesity indices to provide optimized clinical metabolic risk assessment tools.</p><p><strong>Materials and methods: </strong>This study included 6575 participants aged ≥40 years without baseline diabetes. Waist-to-height ratio (WHtR), body roundness index (BRI), visceral adipose index (VAI), lipid accumulation product (LAP) and abdominal body shape index (ABSI) were exposure variables. Multivariable-adjusted Cox proportional hazards models analysed associations with diabetes onset; restricted cubic splines (RCS) explored dose-response relationships, stratified analyses and receiver operating characteristic (ROC) curve assessed model stability and predictive efficacy.</p><p><strong>Results: </strong>During an average follow-up period of 3.19 years, 752 (11.4%) of participants developed diabetes. Multivariable Cox regression showed that each visceral obesity index independently predicted the risk of diabetes (all P for trend <0.05), with LAP showing the strongest association (HR = 2.93, 95% CI = 2.27-4.01). The RCS model revealed the characteristics of a nonlinear dose-response relationship. Stratified analysis and sensitivity analysis confirmed the high stability of the association between LAP and the risk of diabetes. ROC curve analysis indicated that LAP had the optimal predictive efficacy (AUC = 0.752).</p><p><strong>Conclusions: </strong>Visceral obesity indices are closely linked to the risk of diabetes onset, highlighting the potential benefits of reducing visceral fat accumulation. Among these indices, LAP emerges as the most robust clinical indicator for predicting DM risk.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155425","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":"Why, how and in whom should we measure levels of lipoprotein(a): A review of the latest evidence and clinical implications.","authors":"Alexander C Razavi, Harpreet S Bhatia, Roger S Blumenthal, Michael D Shapiro, Anurag Mehta","doi":"10.1111/dom.16469","DOIUrl":"https://doi.org/10.1111/dom.16469","url":null,"abstract":"<p><p>Lipoprotein(a) [Lp(a)] is a genetically determined, causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve disease (CAVD). Despite robust evidence from epidemiological and genetic studies, Lp(a) remains underrecognised in clinical practice due to challenges in measurement, lack of guideline familiarity and limited therapeutic options. In this narrative review, we summarise the pathophysiological mechanisms linking Lp(a) to atherogenesis, thrombosis and inflammation, emphasising its unique structural features and causal role in cardiovascular disease. We discuss assay methodologies and make the case for a single lifetime measurement given the genetic stability of Lp(a). We review guideline-based indications for testing, highlighting high-risk populations such as those with premature ASCVD, a family history of cardiovascular disease and individuals of African or South Asian ancestry. We additionally outline clinical strategies to reduce ASCVD risk in individuals with elevated Lp(a), including lifestyle optimisation, statin therapy, PCSK9 inhibitors, and aspirin in select populations. Emerging targeted therapies, including antisense oligonucleotides and siRNA-based agents, demonstrate up to 90% Lp(a) reduction and are currently being evaluated in large-scale cardiovascular outcomes trials. As precision medicine advances, Lp(a) represents both a critical risk factor and a promising therapeutic target. Broader implementation of Lp(a) testing, particularly in high-risk individuals, will help improve ASCVD prevention efforts.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172363","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":"Efficacy and tolerance of liraglutide for weight loss in obese, type 2 diabetes and haemodialysis patients.","authors":"Maxime Touzot, Adela Voican, Louis Potier, Hélène Beaussier, Marine Cachanado, Emmanuelle Sacco, Gilles Chatellier, Christophe Ridel, Pablo Ureña-Torres, Isabela Banu, Olivier Dupuy","doi":"10.1111/dom.16484","DOIUrl":"https://doi.org/10.1111/dom.16484","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155421","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":"Disparities in diabetes burden in China and globally, with projections to 2050: A systematic analysis for the Global Burden of Disease Study 2021.","authors":"Min Yin, Wenqi Fan, Yi Yu, Zizhu Liu, Danyi Zhang, Chao Deng, Xia Li","doi":"10.1111/dom.16482","DOIUrl":"https://doi.org/10.1111/dom.16482","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155420","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 of new-onset type 1 diabetes in individuals with celiac disease and thyroid disease-An observational study.","authors":"Steve V Edelman, Daniel Agardh, Nancy Cui, Lichen Hao, Mattias Wieloch, Luigi Meneghini","doi":"10.1111/dom.16454","DOIUrl":"https://doi.org/10.1111/dom.16454","url":null,"abstract":"<p><strong>Aims: </strong>The objective of this study was to compare the risk of developing type 1 diabetes in individuals with celiac disease, hyperthyroidism and hypothyroidism to that of individuals without those conditions.</p><p><strong>Materials and methods: </strong>In this retrospective, observational, matched-cohort study based on real-world claims data, individuals with at least one diagnosis of celiac disease, hyperthyroidism (e.g. Graves' disease) or hypothyroidism (e.g. Hashimoto's disease) and a control cohort of individuals without any of these three conditions were included. Individuals from the disease and control cohorts were propensity score matched 1:1 based on baseline demographics and clinical characteristics. A Cox proportional hazards model was used to compare the risk of type 1 diabetes between cohorts.</p><p><strong>Results: </strong>Type 1 diabetes developed in 0.14% (68/47 099) of individuals with celiac disease compared to 0.06% (27/47 099) of controls. Of those with hyperthyroidism, type 1 diabetes developed in 0.17% (281/164 830) compared to 0.06% (99/164 830) of controls. Of those with hypothyroidism, type 1 diabetes developed in 0.18% (1756/980 477) compared to 0.08% (764/980 477) of controls. The risk of developing type 1 diabetes was increased for each of the disease cohorts compared to their respective controls (celiac disease: HR = 2.54 [p < 0.0001]; hyperthyroidism: adjusted HR = 2.98 [p < 0.0001]; hypothyroidism: HR = 2.41 [p < 0.0001]); risk was highest among individuals aged <18 years.</p><p><strong>Conclusions: </strong>The risk of developing type 1 diabetes was significantly higher for individuals with celiac disease or thyroid disease compared to those without any of these conditions. These findings support the screening of individuals with these conditions for stage 2 type 1 diabetes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172362","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":"Partial remission of type 1 diabetes: Do immunometabolic events define the honeymoon period?","authors":"J Jason Collier, Clive H Wasserfall, Michael A Brehm, Michael D Karlstad","doi":"10.1111/dom.16480","DOIUrl":"https://doi.org/10.1111/dom.16480","url":null,"abstract":"<p><p>Partial clinical remission in Type 1 diabetes (T1D) refers to a transient phase of improved glucose control following diagnosis. During this period, endogenous islet β-cells continue to produce and secrete insulin, resulting in lower exogenous insulin requirements and improved glycaemic status. Partial remission is often described colloquially as the 'honeymoon phase', a period lasting from months to years which is heterogeneous across patient groups. In this review, we discuss the immunometabolic events that may control the duration of the partial remission period by highlighting how glucose metabolism supports immune cell-driven inflammatory and autoimmune events. We thus propose that precise control of blood glucose within a healthy range delays the deleterious consequences that arise from autoimmune mechanisms within pancreatic islets, ultimately leading to the extension of the honeymoon phase. We further discuss data supporting the notion that managing blood glucose effectively also improves islet β-cell mass, function and maturity markers. Collectively, these paradigms help explain the success of recent clinical trial outcomes and offer novel opportunities to intervene in future study designs.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155423","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}