Diabetes, Obesity & Metabolism最新文献

{"title":"Incretin-based therapies for individuals with obesity and heart failure with mildly reduced or preserved ejection fraction: A systematic review and meta-analysis of randomized controlled trials.","authors":"Thomaz Alexandre Costa, Nicole Felix, Gabriel Cavalcante Lima Chagas, Santiago Teran, Madelyn Boslough, Vrushali Shelar, Matthew M Y Lee, Ambarish Pandey, Marconi Abreu, Darren K McGuire, Josephine Harrington","doi":"10.1111/dom.16512","DOIUrl":"https://doi.org/10.1111/dom.16512","url":null,"abstract":"<p><strong>Aims: </strong>Obesity is a major risk factor for heart failure with mildly reduced or preserved ejection fraction (HFpEF). This meta-analysis of randomised clinical trials (RCTs) evaluated the effects of incretin-based therapies (IBTs), including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GIP/GLP-1 RAs, on clinical outcomes in individuals with the obesity-HFpEF phenotype.</p><p><strong>Materials and methods: </strong>A systematic search of PubMed, EMBASE and Web of Science through December 2024 identified RCTs comparing IBTs with placebo in patients with HFpEF and obesity. Hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were pooled for binary outcomes, and estimated differences (EDs) for continuous outcomes, using an inverse variance random-effects model.</p><p><strong>Results and conclusions: </strong>Six RCTs with 7282 participants (50.3% receiving IBTs) were included. IBTs reduced the risk of cardiovascular death or worsening HF (HR 0.74; 95% CI 0.63-0.88; I² = 0%), worsening HF events (HR 0.62; 95% CI 0.47-0.81; I² = 16%) and all-cause mortality (OR 0.81; 95% CI 0.67-0.99; I² = 0%) compared to placebo. No significant difference was found in cardiovascular mortality alone. IBTs also improved quality of life, functional status, systolic blood pressure and weight loss in patients with obesity-HFpEF.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264874","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":"A plasma metabolome-derived model predicts severe liver outcomes of nonalcoholic fatty liver disease in the UK Biobank.","authors":"Xiaoqin Xu, Jiang Li, Yanqi Fu, Jie Li, Wenqi Shen, Xiao Tan, Ningjian Wang, Bin Wang, Yingli Lu","doi":"10.1111/dom.16533","DOIUrl":"https://doi.org/10.1111/dom.16533","url":null,"abstract":"<p><strong>Aims: </strong>Severe liver disease (SLD) in nonalcoholic fatty liver disease (NAFLD) is often diagnosed late due to the long asymptomatic period of progressive fibrosis. We aimed to identify metabolomic profiles associated with SLD and develop a predictive model to improve risk stratification.</p><p><strong>Materials and methods: </strong>We enrolled 59 579 UK Biobank participants with a positive fatty liver index (≥60) and plasma metabolomic profiles, evaluating the incidence of cirrhosis, decompensated liver disease, hepatocellular carcinoma and/or liver transplantation. Cox regression models were applied to evaluate the associations between individual metabolites and SLD risk. Using an interpretable machine-learning framework, a metabolomics-integrated nomogram prediction model was developed and compared with conventional scoring systems.</p><p><strong>Results: </strong>After Bonferroni correction, 110 of 249 metabolites were significantly associated with the risk of incident SLD in the Cox regression model. Among them, 11 metabolites were ultimately prioritised as predictors to construct the metabolomic score based on the optimal machine learning algorithm. The nomogram integrating metabolomic score, gamma glutamyltransferase, platelet count, waist/hip ratio, diabetes and sex showed better predictive capacity of 10-year SLD risk (area under the receiver operating characteristic 0.841 [95% CI: 0.800-0.881]) than the fibrosis-4 index (0.712, 0.662-0.763), NAFLD fibrosis score (0.659, 0.609-0.709) and aspartate aminotransferase-to-platelet ratio index (0.705, 0.652-0.759) in the validation cohort. Categorisation of participants according to selected cutoffs revealed a distinct cumulative risk of SLD, with a hazard ratio of 25.71 (95% CI: 17.10-38.66) for the high-risk group compared with the low-risk group.</p><p><strong>Conclusions: </strong>Integrating plasma metabolomics with routine indicators enhanced the predictive capacity for severe liver outcomes of NAFLD, which shows the potential benefits in disease risk stratification and precise interventions.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264942","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":"Current treatment guidelines and glycated haemoglobin goals for type 2 diabetes: Which patients are most likely to benefit from fixed-ratio basal insulin glucagon-like peptide-1 receptor agonist combinations?","authors":"Kevin Cowart, Nicholas W Carris","doi":"10.1111/dom.16502","DOIUrl":"https://doi.org/10.1111/dom.16502","url":null,"abstract":"<p><p>Basal insulin and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are available in two fixed-ratio combinations (FRCs) for the treatment of type 2 diabetes (T2D), insulin degludec with liraglutide and insulin glargine with lixisenatide. FRCs offer a convenient strategy to administer basal insulin and a GLP-1 RA, taking advantage of complementary mechanisms in a single injection to minimize treatment burden and improve glycemic control while mitigating weight gain. For most, a glycated haemoglobin (HbA1c) goal for patients with T2D using a FRC would be <7%, though it can be adjusted based on patient-specific factors. An HbA1c goal of <6.5% is less likely to be appropriate for patients requiring basal insulin, which is included in the FRCs. Ideal candidates for FRCs are those (1) taking oral antihyperglycemic medications only with an HbA1c <10% and <2% away from goal, (2) those on basal insulin and above HbA1c goal, (3) those unwilling or unable to initiate or manage multiple daily injections (i.e., basal-bolus insulin therapy) and (4) those tolerating a GLP-1 RA who require basal insulin to achieve glycemic goals.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264873","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 interaction of vitamin D supplementation with Omentin-1 gene polymorphism on metabolic biomarkers, omentin-1 levels and anthropometric measures in women with prediabetes: A double-blind randomized controlled trial.","authors":"Roghayeh Molani-Gol, Maryam Rafraf, Mohammad Asghari Jafarabadi, Sana Aftabi-Yousefabad, Dariush Shanehbandi","doi":"10.1111/dom.16497","DOIUrl":"https://doi.org/10.1111/dom.16497","url":null,"abstract":"<p><strong>Aims: </strong>Prediabetes is a public health problem, and its prevalence is increasing worldwide. Both genetic factors and lifestyle contribute to the development and progression of prediabetes. The Omentin-1 Val109Asp polymorphism is reported to be associated with insulin resistance and obesity. Moreover, research suggests that vitamin D may help decrease the risk of developing and progressing to type 2 diabetes mellitus. Therefore, this trial aimed to investigate the interaction between vitamin D supplementation and the Omentin-1 gene polymorphism on metabolic factors, omentin-1 levels and obesity values in women with prediabetes.</p><p><strong>Materials and methods: </strong>This double-blind randomized controlled trial was conducted on 204 women aged 18-65 with prediabetes. After obtaining informed consent, the blood samples of all participants were analysed to determine the Omentin-1 polymorphism (Val109Asp) genotypes. The women were then randomized into intervention (n = 24) and placebo (n = 24) groups (1:1) according to each genotype of the Omentin-1 polymorphism. In total, 96 women were allocated to receive vitamin D (50 000 IU) or a placebo every two weeks for 12 weeks. Anthropometric measures, dietary intake data and physical activity level information were collected at the beginning and after the intervention. Data analyses were performed using IBM SPSS Statistics software.</p><p><strong>Results: </strong>Vitamin D administration significantly increased serum levels of 25-hydroxyvitamin D (25(OH)D), insulin, HOMA-IR, HOMA-β and QUICKI in both AT and TT genotypes (all, p < 0.001). Moreover, the serum concentration of HDL-C decreased significantly after vitamin D intervention in the AT genotype, but not in the TT genotype (p < 0.001). A significant interaction was also observed between vitamin D intervention and Omentin-1 Val109Asp polymorphism on HDL-C (p = 0.003), waist circumference (WC) (p = 0.026) and waist-to-height ratio (WHthR) (p = 0.035). However, there was no significant interplay between vitamin D and Omentin-1 polymorphism on glycaemic factors, omentin-1 levels and other lipid profiles and anthropometric measures (p ≥ 0.05).</p><p><strong>Conclusions: </strong>The findings suggest that the Omentin-1 gene Val109Asp polymorphism may modify the effects of vitamin D intervention on serum HDL-C levels and abdominal obesity in women with prediabetes. Future clinical trials are necessary to clarify the influence of the Omentin-1 gene polymorphism genotype on the effects of vitamin D intervention.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264875","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 use of SGLT2 inhibitors in people with diabetes-related foot disease: A Delphi-based consensus study.","authors":"Patrick Highton, Ruksar Abdala, Rachel Evley, Victoria Balasubramanian, Melanie Davies, Ketan Dhatariya, Frances Game, Clare Hambling, John R Petrie, Sam Seidu, Solomon Tesfaye, Jonathan Valabhji, David Webb, Kamlesh Khunti","doi":"10.1111/dom.16498","DOIUrl":"https://doi.org/10.1111/dom.16498","url":null,"abstract":"<p><strong>Aims: </strong>To generate expert consensus-based clinical recommendations on the use of SGLT2 inhibitors in those with diabetes and diabetes-related foot disease (DFD).</p><p><strong>Materials and methods: </strong>This study employed a two-round online Delphi technique. Participants were healthcare practitioners from a range of relevant clinical backgrounds, recruited using convenience sampling. The statements for consideration were iteratively developed by study team members with expertise in managing diabetes and prescribing SGLT2 inhibitors, supported by key professional organisations and people with lived experience of DFD. Statements were ranked using a 6-point Likert Scale from Strongly Agree to Strongly Disagree. Consensus status for each statement was based on the Average Percent of Majority Opinions for each statement.</p><p><strong>Results: </strong>Twenty-one participants completed round 1 of the survey, with 19 completing round 2. Participants represented a diverse range of healthcare professions, including Diabetologists, General Practitioners, Nurses and Pharmacists. Of the 25 total statements, 16 reached consensus (13 in round 1 and 3 in round 2), including: agreement on prescribing SGLT2 inhibitors to people with type 2 diabetes (regardless of ulceration status) with concurrent heart failure and/or chronic kidney disease; agreement that those with a previous healed ulcer or amputation should be prescribed SGLT2 inhibitors; disagreement that SGLT2 inhibitors per se increase amputation risk; agreement that canagliflozin should be avoided in this group.</p><p><strong>Conclusions: </strong>These findings evidence the relative confidence of experienced clinicians in prescribing SGLT2 inhibitors to those with DFD, provided that they do not have a current ulcer and that canagliflozin is not prescribed.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264876","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":"A simplified protocol based on a standardized meal-stimulated beta-cell response to stratify people living with non-insulin-treated type 2 diabetes.","authors":"Cathy J Sun, Heather Lochnan, Alexander Sorisky, Julie Shaw, Timothy Ramsay, Christopher J Nolan, Marc Prentki, Rémi Rabasa-Lhoret","doi":"10.1111/dom.16528","DOIUrl":"https://doi.org/10.1111/dom.16528","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264943","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":"Diabetes, Obesity and Metabolism","authors":"","doi":"10.1111/dom.16517","DOIUrl":"https://doi.org/10.1111/dom.16517","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 S4","pages":"1-2"},"PeriodicalIF":5.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16517","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of once-weekly tirzepatide in Japanese participants with type 2 diabetes who have obesity or overweight: Subpopulation analysis of the SURMOUNT-2 trial.","authors":"Toshimasa Yamauchi, Taro Asakura, Tomotaka Shingaki, Tomonori Oura, Hideki Katagiri","doi":"10.1111/dom.16500","DOIUrl":"https://doi.org/10.1111/dom.16500","url":null,"abstract":"<p><strong>Aim: </strong>To assess the efficacy and safety of once-weekly tirzepatide in Japanese participants with obesity and type 2 diabetes (T2D).</p><p><strong>Materials and methods: </strong>This subpopulation analysis of 41 Japanese participants from three clinical trial sites in the SURMOUNT-2 trial evaluated the efficacy and safety of tirzepatide as an adjunct to lifestyle interventions in adults with body mass index ≥27 kg/m² and a diagnosis of T2D with glycated haemoglobin ≥7% to ≤10%. Coprimary endpoints were mean percent change in body weight and proportion of participants who achieved ≥5% body weight reduction at week 72. Percent change in body weight was compared between tirzepatide and placebo using a mixed model for repeated measures.</p><p><strong>Results: </strong>The mean percent change (standard error) in body weight from baseline to week 72 was statistically significantly greater for both tirzepatide 10 mg (p = 0.001) and 15 mg (p = 0.013) compared with placebo: -12.4% (1.8%) and -10.2% (1.8%), respectively, compared with -3.5% (1.8%). At week 72, 85.7% and 78.6% of participants in the tirzepatide 10 mg and 15 mg groups, respectively, had a body weight reduction of ≥5%, versus 46.2% of participants receiving placebo. Reductions in glycemic parameters, waist circumference and systolic blood pressure, as well as numerical improvements in the lipid profile, were also observed with tirzepatide. No new safety concerns were identified.</p><p><strong>Conclusions: </strong>In Japanese adults with obesity and T2D, once-weekly treatment with tirzepatide (10 or 15 mg) demonstrated significant reductions in body weight compared with placebo, with the safety profile generally consistent with previous studies.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256972","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":"Association between estimated glucose disposal rate and lower extremity arterial disease in type 2 diabetes: A nationwide cross-sectional study from China.","authors":"Xiaowei Wei, Jie Zhao, Ping Zhu, Wenfang Niu, Zhangrong Xu, Xingwu Ran, Xiaomei Zhang, Aihong Wang, Linong Ji","doi":"10.1111/dom.16514","DOIUrl":"https://doi.org/10.1111/dom.16514","url":null,"abstract":"<p><strong>Aims: </strong>Lower extremity arterial disease (LEAD), a prevalent but under-recognised macrovascular complication of type 2 diabetes mellitus (T2DM), is closely linked to insulin resistance (IR). The estimated glucose disposal rate (eGDR), a surrogate marker of IR, may facilitate early LEAD risk stratification; however, its clinical utility remains underexplored.</p><p><strong>Materials and methods: </strong>This cross-sectional analysis of 7482 adults aged ≥50 years with T2DM, from the China DIA-LEAD study evaluated the association between eGDR (quartiles: Q1-Q4) and LEAD, defined by the ankle-brachial index (ABI <0.9 or >1.3). Multivariate logistic regression and restricted cubic spline (RCS) models were used to assess the nonlinear relationships, adjusted for demographics, metabolic factors and comorbidities.</p><p><strong>Results: </strong>Participants in the lower eGDR quartiles showed a progressively higher LEAD prevalence (Q1: 31.4% vs. Q4: 12.8%), worse glycaemic control (HbA1c Q1: 9.8% vs. Q4: 7.3%) and a greater comorbidity burden (all p < 0.001). In fully adjusted models, Q1 had a 2.23-fold higher LEAD risk versus Q4 (95% CI 1.47-3.37). Each 1-unit eGDR increase conferred a 24% lower LEAD risk (adjusted OR 0.76, 95% CI 0.70-0.84). RCS analysis revealed an L-shaped relationship, with sharp risk escalation at eGDR < 8 mg/kg/min (p for nonlinearity = 0.003). Subgroup analyses confirmed consistency across populations (all p for interaction >0.05).</p><p><strong>Conclusions: </strong>eGDR demonstrated a significant inverse L-shaped association with LEAD in patients with T2DM. These findings support the clinical utility of eGDR as a practical indicator of LEAD risk screening and management. Patients with lower eGDR may benefit from insulin-sensitising therapies, which could reduce both glucose levels and the risk of LEAD.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245444","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":"Association of time in tight range and 1,5-anhydroglucitol in type 2 diabetes.","authors":"Hang Su, Jiaying Ni, Danfeng Peng, Xingxing He, Wei Lu, Wei Zhu, Yufei Wang, Xiaojing Ma, Jingyi Lu, Jian Zhou","doi":"10.1111/dom.16515","DOIUrl":"https://doi.org/10.1111/dom.16515","url":null,"abstract":"<p><strong>Aims: </strong>Among the novel metrics derived from continuous glucose monitoring (CGM), time in tight range (TITR) has gained increasing attention. Our study aimed to investigate the relationship between 1,5-anhydroglucitol (1,5-AG) and TITR in patients with type 2 diabetes.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 1531 moderately controlled patients with type 2 diabetes on a stable treatment regimen. TITR and time in range (TIR) were measured with CGM. Spearman correlation analysis was used to assess the relationship between serum 1,5-AG and TITR, and the predictive efficacy of serum 1,5-AG for identifying TITR > 50% was evaluated by the receiver operating characteristic curves.</p><p><strong>Results: </strong>The median levels of serum 1,5-AG and glycated haemoglobin A1c (HbA1c) in the total population were 7.4 (4.4, 12.1) μg/mL and 7.0% (6.4%, 7.5%), respectively. The median TITR was 52.0% (32.0%, 69.0%). Spearman correlation analysis showed that serum 1,5-AG was positively correlated with TITR (p < 0.001). The optimal serum 1,5-AG cut-off for TITR >50% was 8.0 μg/mL, with an area under the curve (AUC) of 0.693 (0.667, 0.719). Serum 1,5-AG combined with fasting glucose or 2-hour postprandial glucose further improved the predictive power for identifying TITR > 50% (both p < 0.001). Across all subgroups, serum 1,5-AG showed acceptable predictive accuracy for TITR > 50% (AUCs around 0.700).</p><p><strong>Conclusions: </strong>Serum 1,5-AG was significantly correlated with TITR in patients with type 2 diabetes, with 8.0 μg/mL emerging as a potential cut-off for identifying TITR > 50%.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256971","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}