Chenchen Qi , Xudong Liu , Jing Mao , Sen Zhang , Lan Ye , Xuan Wang , Jianan Peng , Xiaoling Zhou
{"title":"The time-averaged serum uric acid can better predict the prognosis of IgA nephropathy","authors":"Chenchen Qi , Xudong Liu , Jing Mao , Sen Zhang , Lan Ye , Xuan Wang , Jianan Peng , Xiaoling Zhou","doi":"10.1016/j.numecd.2024.103800","DOIUrl":"10.1016/j.numecd.2024.103800","url":null,"abstract":"<div><h3>Background and aim</h3><div>To understand the clinical and pathological characteristics of patients with IgA nephropathy (IgAN) complicated by hyperuricemia, and to analyze the time-averaged SUA (TA-SUA) on the prognosis of IgAN.</div></div><div><h3>Methods and results</h3><div>A retrospective analysis of 718 IgAN patients with diagnosis confirmed by renal biopsy and follow-up of more than 1 year was performed. At least two serum uric acid (SUA) levels were measured at intervals of 0.5–1 year during follow-up. The TA-SUA was calculated according to the area under the curve during the follow-up period. The primary endpoint of the study was the doubling of creatinine or end-stage renal disease. Four groups (Q1-Q4) were divided according to TA-SUA quartile spacing from low to high, and the association of the TA-SUA with prognosis in IgAN patients was assessed using Kaplan-Meier survival analysis and Cox proportional hazards models.</div><div>This study included 718 patients with IgAN, of whom 181 (25.21 %) had hyperuricemia.Compared with the other three groups, the clinical and pathological characteristics of patients in the fourth quarter were more severe in both baseline SUA and TA-SUA groups. Multivariate results suggested that baseline SUA was not an independent risk factor for renal prognosis in IgAN patients after adjustment for clinical variables such as eGFR. High TA-SUA is an independent risk factor for renal prognosis in IgAN patients.</div></div><div><h3>Conclusions</h3><div>Hyperuricemia is common in IgA nephropathy.High TA-SUA in IgAN patients show more severe clinical features and pathological damage. TA-SUA is an independent risk factor for renal prognosis in IgA nephropathy patients.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 3","pages":"Article 103800"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824796","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}
Anita Vergatti , Veronica Abate , Gabriella Iannuzzo , Antonio Barbato , Gianpaolo De Filippo , Domenico Rendina
{"title":"The bone-heart axis in the pathogenesis of cardiovascular diseases: A narrative review","authors":"Anita Vergatti , Veronica Abate , Gabriella Iannuzzo , Antonio Barbato , Gianpaolo De Filippo , Domenico Rendina","doi":"10.1016/j.numecd.2025.103872","DOIUrl":"10.1016/j.numecd.2025.103872","url":null,"abstract":"<div><div>Cardiovascular diseases (CVDs) cause about 30% of deaths worldwide, increasing social and economic burden in our societies. Although the treatment of the canonical cardiovascular risk factors has reduced the impact of CVDs on morbidity and mortality in the past few years, they continue to represent a major health problem. The definition of the biological properties of the bone-heart axis has led to new insights in the pathogenesis of CVDs; hence, the aim of this review is to try to elucidate the role of this axis on the susceptibility to CVDs. There is evidence that the bone interacts with extra-skeletal organs, including the cardiovascular system, through its endocrine functions. Clinical and experimental data strongly indicate that the interplay between the bone and the cardiovascular system represents a future tool for the prevention, diagnosis and treatment of CVDs. The identification of these non-canonical cardiovascular risk factors could prompt pharmacological research towards new target therapy aimed at precision medicine.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 3","pages":"Article 103872"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434297","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":"Abdominal obesity: A lethal factor in elderly male osteoporosis patients – insights from NHANES","authors":"Ziyao Ding , Xinzhe Qu , Qirui Zhu , Jinlong Tang , Zhengya Zhu , Changchang Chen , Fuchao Chu , Maji Sun , Feng Yuan","doi":"10.1016/j.numecd.2024.103788","DOIUrl":"10.1016/j.numecd.2024.103788","url":null,"abstract":"<div><h3>Background and aim</h3><div>This study aims to investigate the relationship between A Body Shape Index (ABSI) Z-score and all-cause mortality among osteoporotic patients using data from the National Health and Nutrition Examination Survey (NHANES).</div></div><div><h3>Methods and results</h3><div>We analyzed NHANES data from 2005 to 2010, 2013 to 2014, and 2017 to 2018, focusing on individuals aged 50 and above with complete bone mineral density (BMD) data. The ABSI Z-score, calculated by adjusting waist circumference (WC) for height and weight, was used to independently assess abdominal fat beyond Body Mass Index (BMI). Mortality status was confirmed by linking NHANES data with the National Death Index (NDI), with follow-up until December 31, 2019. Weighted Cox proportional hazards models were employed for analysis, adjusting for age, gender, race, fracture history, anti-osteoporosis treatment history, diabetes, and cardiovascular disease (CVD). The study included 1596 participants. Higher ABSI Z-scores were significantly associated with increased all-cause mortality risk, especially among elderly male osteoporotic patients. This association remained robust after adjusting for multiple potential confounders.</div></div><div><h3>Conclusion</h3><div>The ABSI Z-score serves as a valuable non-invasive screening tool that effectively identifies osteoporotic patients at higher risk of mortality. These findings emphasize the importance of body management in health, supporting further research to explore the practical utility of ABSI Z-score in osteoporotic patients and how body management can enhance long-term survival rates.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 3","pages":"Article 103788"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824768","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":"Mediating effect of physical activity on the relationship between high dietary live microbe intake and obesity among U.S adolescents, finding from NHANES 1999–2018","authors":"Jing-hong Liang , Ying-qi Pu , Xiu-zhi Yang, Jia-qi Chen, Zhuo-wen Wu, Mei-ling Liu, Nan Jiang, Shan Huang, Yu-shan Zhang, Li-xin Hu, Zheng-ge Jin, Wen-xin Ge, Xue-ya Pu, Shao-yi Huang, Ya-jun Chen","doi":"10.1016/j.numecd.2024.103786","DOIUrl":"10.1016/j.numecd.2024.103786","url":null,"abstract":"<div><h3>Background and aims</h3><div>The impact of dietary live microbe intake on adolescent obesity is still not fully understood. This study aims to investigate the potential relationship between dietary live microbe intake and obesity among U.S adolescents, and to explore the mediating role of physical activity (PA).</div></div><div><h3>Methods and results</h3><div>Data from NHANES (1999–2018) were analyzed, and dietary live microbe intake was categorized into low, medium, and high groups using a developed framework. Survey-weighted logistic regression and mediation analysis models were used to examine the association between live microbe intake and adolescent obesity, as well as the potential mediating effect of PA. Our study included 8443 participants aged 6–18, representing the noninstitutionalized U.S population of 184.5 million. We found that participants with a high dietary intake of live microbes had lower odds of developing obesity compared to those with the lowest exposure to live microbes (AOR = 0.900, 95 % CI: 0.812, 0.997). Additionally, our mediation analysis revealed a significant indirect effect of live microbes on obesity risk through PA (<em>P</em>-value <0.001), with 39.4 % (95 % CI: 24.5 %, 86.5 %) of the effect mediated by PA.</div></div><div><h3>Conclusion</h3><div>Our study highlights the association between consuming a higher amount of live microbes in the diet and a decreased risk of obesity among U.S adolescents. It also suggests that PA may act as a mediator in this relationship. Therefore, it is crucial to emphasize the incorporation of both dietary interventions and PA in the development of prevention and therapy policies for managing adolescent obesity.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 3","pages":"Article 103786"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824791","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":"LP(a): The new marker of high cardiovascular risk","authors":"Maurizio Averna , Angelo B. Cefalù","doi":"10.1016/j.numecd.2024.103845","DOIUrl":"10.1016/j.numecd.2024.103845","url":null,"abstract":"<div><div>The biological functions and role in human diseases of lipoprotein (a) discovered more than 60 years ago are still not fully understood. The high homology of apo(a) with plasminogen initially leads us to think of Lp(a) as a player in the coagulation system as pro-thrombotic factor. Over the years, a solid body of evidence from biology, epidemiology and from genetics and mendelian randomization has contributed to identify Lp(a) as a causal factor of atherosclerotic coronary heart disease, aortic calcific valve stenosis and ischaemic stroke. The active involvement of Lp(a) in atherogenesis and aortic calcific valve stenosis has been demonstrated by experimental data regarding the role of oxidized phospholipids, which are the cargo of Lp(a) and the presence of a Lp(a) receptor in valve interstitial cells. In secondary prevention, patients optimally treated for low density lipoprotein cholesterol (LDL-C) but with high Lp(a) levels show a residual cardiovascular risk. To date the LDL-C affecting drugs have a marginal effect on Lp(a). Statins produce a modest increase, monoclonal PCSK9i and Inclisiran a modest decrease not sufficient to reduce significantly the risk associated to Lp(a). Only lipoprotein apheresis and obicetrapib, a CETP novel inhibitor, reduce respectively by 75% and 40% Lp(a) levels. To obtain a lifetime risk reduction of 50% similar to that achieved by reducing LDL-C of about 40 mg/dl, Lp(a) should be reduced of about 100 mg/dl. The ongoing trials on drugs such as ASO, SiRnas, assembly inhibitors and maybe in the future the gene editing could obtain these results.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 3","pages":"Article 103845"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434295","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}
Jinlin Tong , Xu Han , Yuanyuan Li , Yuyao Wang , Meijie Liu , Hong Liu , Jinghua Pan , Lei Zhang , Ying Liu , Miao Jiang , Hongyan Zhao
{"title":"Distinct metabolites in atherosclerosis based on metabolomics: A systematic review and meta-analysis primarily in Chinese population","authors":"Jinlin Tong , Xu Han , Yuanyuan Li , Yuyao Wang , Meijie Liu , Hong Liu , Jinghua Pan , Lei Zhang , Ying Liu , Miao Jiang , Hongyan Zhao","doi":"10.1016/j.numecd.2024.103789","DOIUrl":"10.1016/j.numecd.2024.103789","url":null,"abstract":"<div><h3>Aims</h3><div>Atherosclerosis is a life-threatening disease that develops when a plaque builds up inside an artery and progresses silently. Identifying the early pathological changes and the biomarkers of atherosclerosis deserves attention. We aimed to systematically study and integrate the various metabolites of atherosclerosis in the level of disease to provide more evidences to support early prevention and treatment of atherosclerosis.</div></div><div><h3>Data synthesis</h3><div>The protocol was registered with PROPSERO (CRD42023441845). We searched 14,985 records via EMBASE, PubMed, Web of Science, WanFang data, VIP data, and CNKI databases. The collected metabolites were for qualitative and quantitative meta-analysis. The I<sup>2</sup> statistic estimated heterogeneity, with over 50 % considered to adopt the random-effects model. A total of 49 articles were included in the meta-analysis. We finally integrated 83 and 16 metabolites presented more than two times in inclusion studies, respectively in blood (plasma and serum) and urine. Among them, the level of citric acid (SMD = −10.35 [95%CI -15.03, −5.67], p < 0.001), lactic acid (SMD = 6.32 [95%CI 0.12, 12.52], p < 0.001) and TMAO (SMD = 1.40 [95%CI 0.27, 2.53], p < 0.001) had significant differences between atherosclerosis and controls. And we observed blood stasis syndrome of atherosclerosis patients present arterial ischemia and energy disorder obviously.</div></div><div><h3>Conclusions</h3><div>The study provides an in-depth understanding of the roles of metabolites on atherosclerosis progression and prediction primarily in Chinese population, which contributing to development of prevention and therapeutic potential in the future.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 3","pages":"Article 103789"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848262","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}
Jingjing Song , Yupeng Liu , Ye Liu , Ying Liu , Qing Zhou , Jing Chen , Xiangbin Meng , Wenyao Wang , Yi-Da Tang
{"title":"MAFLD as a predictor of adverse cardiovascular events among CHD patients with LDL-C<1.8 mmol/L","authors":"Jingjing Song , Yupeng Liu , Ye Liu , Ying Liu , Qing Zhou , Jing Chen , Xiangbin Meng , Wenyao Wang , Yi-Da Tang","doi":"10.1016/j.numecd.2024.103798","DOIUrl":"10.1016/j.numecd.2024.103798","url":null,"abstract":"<div><h3>Background and aims</h3><div>Patients receiving statin therapy still suffer from adverse cardiovascular events. Metabolic (dysfunction)-associated fatty liver disease (MAFLD) is a newly proposed concept that shares common metabolic risk factors with cardiovascular disease. This study aimed to investigate the association between MAFLD and adverse cardiovascular outcomes in coronary heart disease (CHD) patients with LDL-C<1.8 mmol/L.</div></div><div><h3>Methods and results</h3><div>CHD patients with LDL-C<1.8 mmol/L were divided into MAFLD and non-MAFLD groups. Propensity score matching (PSM) was used to control for baseline differences between the two groups. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCEs). All MAFLD patients were further stratified into two groups with and without advanced liver fibrosis, according to the Fibrosis-4 (FIB-4) index cutoffs, and the associations between advanced liver fibrosis status and cardiovascular outcomes were analyzed. After PSM, 800 MAFLD and 800 non-MAFLD patients with LDL-C<1.8 mmol/L were analyzed. MAFLD patients exhibited a significantly greater cumulative incidence and risk of MACCEs than non-MAFLD patients (9.6 % versus 6.6 %, <em>p</em> < 0.05; HR 1.48, 95 % CI 1.04–2.1, <em>p</em> < 0.05). Among MAFLD patients with LDL-C<1.8 mmol/L, advanced liver fibrosis staged by the FIB-4 index was associated with an elevated risk for MACCEs (HR 2.91, 95 % CI 1.17–7.19, <em>p</em> < 0.05), all-cause mortality, myocardial infarction (MI) and stent thrombosis.</div></div><div><h3>Conclusion</h3><div>MAFLD was an independent risk factor for adverse cardiovascular outcomes in CHD patients with LDL-C<1.8 mmol/L. Additionally, advanced liver fibrosis predicts increased risks for adverse cardiovascular events among MAFLD patients. These findings suggest that MAFLD and liver fibrosis screening and management contribute to the residual cardiovascular risk of CHD patients.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 3","pages":"Article 103798"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972928","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}
Hoyoun Won , Yong-Hoon Kim , Jeongsook Kim , Yonghwan Kim , Hee-Taik Kang
{"title":"Long-term impact of socioeconomic status after acute myocardial infarction in Korea","authors":"Hoyoun Won , Yong-Hoon Kim , Jeongsook Kim , Yonghwan Kim , Hee-Taik Kang","doi":"10.1016/j.numecd.2024.08.022","DOIUrl":"10.1016/j.numecd.2024.08.022","url":null,"abstract":"<div><h3>Background and aims</h3><div>Socioeconomic status (SES) is known to impact the prognosis of acute myocardial infarction (AMI). However, due to the limited scope of previous studies, this study aimed to investigate the impact of SES on the prognosis of AMI patients within the Korean national healthcare insurance system.</div></div><div><h3>Methods and results</h3><div>A retrospective cohort study included patients who were diagnosed with AMI between 2007 and 2008 from the Korean National Health Insurance Service and underwent a national health check-up program. Primary endpoint was all-cause mortality. The median follow-up duration was 13.5 years. The SES was divided into tertile scale based on insurance premiums and economic status. Tertile 1 (T1) was the lowest SES, and tertile 3 (T3) was the highest SES. A total of 5971 patients were included, of whom 4329 were employed insured (EI), and 1642 were self-employed insured (SI). After adjusted confounding variables, the Cox-regression model showed SI was associated with worse outcome compared with EI (hazard ratio (HR) [95 % confidence intervals (CIs)], 1.11 [1.02−1.22]). Among individuals in EI, lower economic status showed a trend of worse outcome, but it was not significant (lower tertile vs. higher tertile group, HR [95 % CIs], 1.01 [0.88−1.14]). However, compared with T3 in SI, HRs (95 % CIs) for all-cause death in T2 and T1 were 1.33 (1.09−1.63) and 1.34 (1.10−1.64), respectively.</div></div><div><h3>Conclusion</h3><div>SES significantly affected the long-term outcome in patients with AMI. SI and lower economic status in SI were associated with a higher mortality rate than EI and higher economic status, respectively. Further investigation of the underlying role of SES in increased mortality after AMI is warranted.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 3","pages":"Article 103729"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511679","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":"Impact of dietary inflammatory index on cardiometabolic, endocrine, liver, renal, and bone biomarkers","authors":"Jiaxu Wang, Jigong Wu, Liqi Li","doi":"10.1016/j.numecd.2024.103793","DOIUrl":"10.1016/j.numecd.2024.103793","url":null,"abstract":"","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 3","pages":"Article 103793"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824725","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":"Is the triglyceride-glucose index ready for cardiovascular risk assessment?","authors":"Lanfranco D'Elia","doi":"10.1016/j.numecd.2024.103834","DOIUrl":"10.1016/j.numecd.2024.103834","url":null,"abstract":"<div><h3>Aims</h3><div>Insulin resistance is a major risk factor for cardiovascular disease. Thus, early identification of insulin resistance is important for classifying individuals at high cardiovascular risk. All the tools commonly used in epidemiological studies and clinical practice to assess insulin resistance require measuring insulin levels, which is a limitation. Hence, simpler methods have been proposed to overcome these limitations. One of the most promising is the triglyceride-glucose index.</div><div>Therefore, this narrative review focuses on the most significant epidemiological findings concerning the relationship between the triglyceride-glucose index and cardiovascular risk. Furthermore, it also highlights this new tool's strengths, limitations, and perspectives for assessing cardiovascular risk.</div></div><div><h3>Data synthesis</h3><div>Even though the assessment of this index is relatively recent, there are numerous papers on this topic, and their number is constantly increasing. Observational studies have shown a substantial positive association between the triglyceride-glucose index and cardiovascular risk, although some conflicting results have been observed.</div></div><div><h3>Conclusions</h3><div>The index is strongly associated with cardiovascular mortality and cardiovascular risk factors. However, some gaps need to be addressed.</div></div>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":"35 3","pages":"Article 103834"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411334","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}