Endocrinology and metabolism (Seoul, Korea)最新文献

{"title":"Dietary Index for Gut Microbiota, Plasma Metabolic Signature, and Risk of All-Cause and Cardiovascular Disease Mortality.","authors":"Yingxin Liao, Yuqing Deng, Chao Yu, Yuxiang Huang, Beixuan Sun, Qiaoqiao Yang, Shijia Wang, Peiting Zhang, Mengyu Zhou, Ailan Chen, Wenhua Ling, Xu Chen, Hongliang Xue","doi":"10.3803/EnM.2025.2787","DOIUrl":"https://doi.org/10.3803/EnM.2025.2787","url":null,"abstract":"<p><strong>Background: </strong>The dietary index for gut microbiota (DI-GM) and its associations with mortality risk, as well as the underlying mechanisms, remain underexplored. We aimed to investigate the associations among DI-GM, a corresponding metabolic signature, and all-cause and cardiovascular disease (CVD) mortality.</p><p><strong>Methods: </strong>We analysed two cohort studies including 170,575 participants from the United Kingdom (UK) Biobank and 26,651 participants from the United States (US) National Health and Nutrition Examination Survey. We calculated DI-GM using 24-hour dietary recall questionnaire data and derived a corresponding metabolic signature using an elastic net regression model. Associations were assessed using Cox proportional hazards regression.</p><p><strong>Results: </strong>Participants in the highest DI-GM group had a lower risk of all-cause mortality (hazard ratio [HR], 0.86, P<0.001 in the UK cohort; HR, 0.79, P<0.001 in the US cohort) and CVD mortality (HR, 0.79, P=0.013 in the UK cohort; HR, 0.68, P=0.007 in the US cohort) than those in the lowest group. Both overall DI-GM and foods beneficial for gut microbiota were inversely associated with mortality risk in a dose-response manner. We identified a DI-GM metabolic signature comprising 124 metabolites in the UK cohort (r=0.25, P<2.2×10-16); this signature was associated with the risk of all-cause mortality (HR, 0.68, P<0.001) and CVD mortality (HR, 0.65, P=0.003) and explained 52.60% of the association between DI-GM and all-cause mortality.</p><p><strong>Conclusion: </strong>We identified a close connection between DI-GM, its metabolic signature, and mortality outcomes, highlighting the potential benefits of dietary patterns that support gut microbiota health for longevity.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THESIS (Treatment of Hypothyroidism in Europe by Specialists: An International Survey) Questionnaire Survey of Medical Thyroid Specialists in Korea on the Use of Thyroid Hormones in Hypothyroid and Euthyroid Patients.","authors":"Jee Hee Yoon, Dong Yeob Shin, Hee Kyung Kim, Roberto Attanasio, Enrico Papini, Petros Perros, Endre V Nagy, Laszlo Hegedüs, Sun Wook Kim, Ho-Cheol Kang","doi":"10.3803/EnM.2025.2868","DOIUrl":"https://doi.org/10.3803/EnM.2025.2868","url":null,"abstract":"<p><strong>Background: </strong>Recent surveys have highlighted substantial variability in the management of hypothyroidism that is associated with physician demographic and geo-economic characteristics. This study aimed to assess preferences for thyroid hormone therapy among medical thyroid specialists in Korea.</p><p><strong>Methods: </strong>An online survey was conducted using the Treatment of Hypothyroidism in Europe by Specialists: An International Survey (THESIS) questionnaire. Participants were medical thyroid specialists who were members of the Korean Thyroid Association (KTA).</p><p><strong>Results: </strong>Among the 349 regular members of the KTA who were physicians, 53 (15.2%) completed the survey. All respondents reported prescribing levothyroxine (LT4) as the initial treatment of choice for hypothyroidism. For patients with biochemical euthyroidism, 64.2% of respondents indicated that treatment was unnecessary; however, several conditions were cited as potential indications for thyroid hormone use (multiple responses were allowed), including female infertility with elevated thyroid antibody levels (30.2%), enlarging simple goiter (17.0%), and severe hypercholesterolemia as adjunctive therapy (9.4%). Although 24.5% of respondents reported avoiding LT4+liothyronine (LT3) therapy because of low-quality evidence, 62.3% indicated that they would consider it for symptomatic patients receiving LT4 monotherapy with normal thyroid-stimulating hormone levels.</p><p><strong>Conclusion: </strong>Korean thyroid specialists generally adhere to current clinical guidelines, favoring LT4 as the standard treatment for hypothyroidism. However, there is considerable willingness to use LT4+LT3 combination therapy and to prescribe thyroid hormones for certain non-thyroid conditions. Ongoing educational efforts are needed to improve understanding that many persistent symptoms despite biochemical euthyroidism are influenced by psychosocial factors and to facilitate consistent implementation of evidencebased, guideline-aligned clinical practice.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibrate-Statin Combination Therapy and Change of Hepatic Steatosis-Related Indices in Patients with Dyslipidemia: A Retrospective Study Using Korean National Health Insurance Data.","authors":"Jong Han Choi, Bongseong Kim, Kyungdo Han, Dong-Lim Kim, Suk Kyeong Kim, Keeho Song","doi":"10.3803/EnM.2026.2891","DOIUrl":"https://doi.org/10.3803/EnM.2026.2891","url":null,"abstract":"<p><strong>Background: </strong>The role of fibrates in modifying hepatic steatosis-related outcomes remains uncertain, particularly in real-world populations receiving statin therapy for dyslipidemia. We investigated the association between fibrate use and longitudinal changes in hepatic steatosis-related indices in statin-treated patients with moderate hypertriglyceridemia using nationwide health screening data.</p><p><strong>Methods: </strong>We analyzed data from 307,992 adults with triglyceride level of 150-500 mg/dL receiving statin therapy, identified from the Korean National Health Insurance Service database. Participants were classified according to fibrate exposure (users vs. non-users). Hepatic steatosis was operationally assessed using two validated surrogate indices, the fatty liver index (FLI) and the hepatic steatosis index (HSI), measured at baseline and follow-up health checkups. Propensity score matching was performed to balance baseline characteristics. Subgroup analyses were conducted according to medication possession ratio (MPR <0.8 vs. ≥0.8).</p><p><strong>Results: </strong>In propensity score-matched analyses, fibrate use was associated with lower odds of hepatic steatosis as defined by FLI (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.84 to 0.95) and HSI (OR, 0.82; 95% CI, 0.78 to 0.87). Among participants with high medication adherence (MPR ≥0.8), stronger associations were observed (FLI OR, 0.30; HSI OR, 0.34).</p><p><strong>Conclusion: </strong>In this large nationwide cohort, fibrate use in statin-treated patients with moderate hypertriglyceridemia was associated with lower prevalence of hepatic steatosis-related indices, particularly among individuals with high medication adherence. These findings should be interpreted as associations based on surrogate markers rather than definitive evidence of histologic improvement. Further studies incorporating imaging or histological endpoints are warranted to clarify the role of fibrates in the management of metabolic dysfunction-associated steatotic liver disease.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Trends in Thyroid Cancer Incidence and Mortality in Korea: Analysis of Korean National Data.","authors":"Yu Jeong Yoon, Jeong Min Seo, Jin Seob Kim, Yun Mi Choi, Won Gu Kim","doi":"10.3803/EnM.2025.2807","DOIUrl":"10.3803/EnM.2025.2807","url":null,"abstract":"<p><strong>Background: </strong>The incidence of thyroid cancer in Korea increased rapidly for decades and started declining around the mid-2010s. However, the mortality rate is stable without significant changes. This study evaluated the long-term trends in the standardized incidence rate/standardized mortality rate (SIR/SMR) of thyroid cancer in Korea.</p><p><strong>Methods: </strong>Cancer-specific incidence data from 1999 to 2021 and mortality data from 1985 to 2023 were obtained from Statistics Korea. SIR and SMR were calculated using the 2000 and 2005 Korean mid-year resident registration populations, respectively, as the standard populations. Trends in incidence and mortality were further analyzed using joinpoint regression analysis.</p><p><strong>Results: </strong>The SIR was 7.41 per 100,000 in 1999, which peaked at 75.06 in 2012. It then decreased to 42.50 by 2015, but subsequently increased to 60.13 in 2021. SIR patterns tend to vary by age and sex. Stage-specific analyses revealed a renewed increase in both localized and distant stage cancers from 2015 onwards. Histologically, the incidence of papillary carcinoma decreased after 2010, whereas that of follicular carcinoma showed a recent upward trend. The SMR increased until the early 2000s but has since steadily declined, with the trend most evident among those aged ≥55 years.</p><p><strong>Conclusion: </strong>The incidence of thyroid cancer in Korea peaked in 2012, decreased until 2015, and has since modestly increased, particularly among men, younger adults, and patients with follicular, localized, or distant-stage disease. Thyroid cancer mortality has continually declined since the early 2000s. Continuous long-term monitoring is required to assess the effects of changes in clinical and diagnostic practices.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Health Behaviors on Cardiovascular Risk in Thyroid Cancer Survivors according to Metastasis: A Nationwide Cohort Study.","authors":"Jeongmin Lee, Jaekyung Lee, Joonseon Park, Kwangsoon Kim, Ja Seong Bae, Kyung-Do Han, Dong-Jun Lim","doi":"10.3803/EnM.2025.2767","DOIUrl":"https://doi.org/10.3803/EnM.2025.2767","url":null,"abstract":"<p><strong>Background: </strong>Patients with thyroid cancer receive thyroid-stimulating hormone suppressive therapy and radioactive iodine therapy, which can alter metabolism and affect the association between lifestyle factors and cardiovascular disease (CVD) outcomes. However, it remains unclear how changes in lifestyle relate to CVD risk, particularly according to metastatic status. We investigated the impact of baseline and changing lifestyle behaviors on CVD risk among thyroid cancer patients by metastasis status.</p><p><strong>Methods: </strong>This study was a nationwide cohort study using data from the Korean National Health Insurance Service claims database with the Cancer Clinical Library Database from the Korea Clinical Data Utilization Network for Research Excellence project. Over a mean follow-up of 5.7 years, 99,742 thyroid cancer patients were analyzed.</p><p><strong>Results: </strong>Current smoking increased CVD risk in both no metastasis (NM) group (hazard ratio [HR], 1.77; 95% confidence interval [CI], 1.33 to 2.35) and the local metastasis (LM) group (HR, 1.30; 95% CI, 1.00 to 1.68), but not in those with distant metastasis. Regular activity reduced the risk in the NM group (HR, 0.84; 95% CI, 0.79 to 0.96). Alcohol consumption was not significantly associated with the CVD risk. Sustained smoking showed an increased CVD risk in both NM (HR, 1.95; 95% CI, 1.31 to 2.90) and LM (HR, 1.88; 95% CI, 1.28 to 2.77). Sustained regular physical activity was associated with a lower risk of CVD only in NM (HR, 0.68; 95% CI, 0.53 to 0.87).</p><p><strong>Conclusion: </strong>Sustained smoking increased CVD risk, while regular physical activity was associated with a lower risk of CVD, particularly in those without distant metastasis.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Serum CXCL9 Levels Are Associated with Greater Frailty Risk in Older Women.","authors":"Da Hea Seo, Nancy E Lane, Seongbin Hong, Beom-Jun Kim","doi":"10.3803/EnM.2025.2783","DOIUrl":"https://doi.org/10.3803/EnM.2025.2783","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a clinical syndrome that increases the vulnerability to adverse outcomes in older adults. C-X-C motif ligand 9 (CXCL9), a marker of chronic inflammation, has been implicated in musculoskeletal decline and mortality. However, its relationship with frailty in older individuals has not been well studied.</p><p><strong>Methods: </strong>This study included 237 community-dwelling women, aged 65 years or older, who underwent a comprehensive geriatric assessment. Serum CXCL9 levels were measured by enzyme-linked immunosorbent assay. Frailty was defined using the Fried phenotype and the Rockwood deficit accumulation index. Associations between serum CXCL9 levels and frailty outcomes were examined using a multivariate regression analysis.</p><p><strong>Results: </strong>Serum CXCL9 increased progressively across the frailty categories (robust: 239.3±110.1 pg/mL; frail: 347.5±119.0 pg/mL; P<0.001). Higher levels of CXCL9 were independently associated with a greater frailty index (β=0.0001, P<0.001), lower skeletal muscle index (β=-0.001, P=0.004), weaker grip strength (β=-0.010, P<0.001), and slower gait speed (β=-0.0003, P=0.039). Women in the highest CXCL9 quartile had 3.20-fold greater odds of frailty (95% confidence interval [CI], 1.70 to 14.56), 3.41-fold greater odds of sarcopenia (95% CI, 1.25 to 9.30), and 6.71-fold greater odds of low muscle strength (95% CI, 1.75 to 25.78) compared with the lowest quartile.</p><p><strong>Conclusion: </strong>Elevated CXCL9 levels were independently associated with greater frailty burden and adverse musculoskeletal phenotypes in older women. These findings support CXCL9 as a promising biomarker of chronic inflammation and frailty, and warrant further investigation through longitudinal studies.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Cardiovascular Events in Patients with Osteoporosis on Romosozumab Treatment Compared with Denosumab: A Multicenter Observational Cohort Study.","authors":"Seong Hee Ahn, Dachung Boo, Kyoung Jin Kim, Jimi Choi, Hyemin Yoon, Chai Young Jung, Seng Chan You, Ji Seon Oh, Namki Hong","doi":"10.3803/EnM.2026.2883","DOIUrl":"10.3803/EnM.2026.2883","url":null,"abstract":"<p><strong>Backgruound: </strong>Romosozumab, a potent anabolic agent for osteoporosis, has been associated with an increased risk of adjudicated cardiovascular events compared with alendronate in postmenopausal women, although such an association was not observed in a placebo-controlled trial. Evidence from real-world clinical practice remains limited.</p><p><strong>Methods: </strong>In this multicenter observational study, we analyzed patients aged ≥50 years who were newly prescribed romosozumab 120 mg monthly or denosumab 60 mg every 6 months for osteoporosis at three tertiary hospitals in South Korea between January 1, 2020, and the end of each site's data collection period. The primary outcomes were major adverse cardiovascular events (MACE; acute myocardial infarction, ischemic stroke, or sudden cardiac death) and all cardiovascular adverse events (CVAEs; MACE, heart failure, peripheral artery disease, and non-coronary revascularization), assessed at 1- and 3-year follow-up. Large-scale 1:1 propensity score matching and Cox proportional hazards models were applied within a common data model framework with individual-level meta-analysis.</p><p><strong>Results: </strong>A total of 4,896 patients were included in the MACE analysis (4,758 in the CVAE analysis). At 1 year, the incidence rate of MACE did not differ significantly between the romosozumab and denosumab groups (9.20 per 1,000 person-years vs. 6.43 per 1,000 person-years; adjusted hazard ratio [aHR], 1.42; 95% confidence interval [CI], 0.64 to 3.19). The risk of CVAE was also similar between groups (16.23 per 1,000 person-years vs. 15.45 per 1,000 person-years; aHR, 1.05; 95% CI, 0.62 to 1.78). At 3 years, no significant differences were observed for MACE (aHR, 1.51; 95% CI, 0.79 to 2.88) or CVAE (aHR, 1.04; 95% CI, 0.69 to 1.58).</p><p><strong>Conclusion: </strong>In real-world clinical practice, romosozumab use was not associated with a statistically significant increase in cardiovascular risk compared with denosumab.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"442-451"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Romosozumab and Cardiovascular Safety: Bridging the Gap between Clinical Trials and Real-World Evidence.","authors":"Beom-Jun Kim","doi":"10.3803/EnM.2026.3119","DOIUrl":"10.3803/EnM.2026.3119","url":null,"abstract":"","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":"41 3","pages":"390-392"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrarenal Hemodynamic Mechanisms of Kidney Protection by Nonsteroidal Mineralocorticoid Receptor Antagonists.","authors":"Eun Sil Koh, So Young Lee, Doan Thi Thien Hao, Sungjin Chung","doi":"10.3803/EnM.2026.3093","DOIUrl":"10.3803/EnM.2026.3093","url":null,"abstract":"<p><p>Nonsteroidal mineralocorticoid receptor antagonists (nsMRAs), especially finerenone, have shown significant cardiorenal benefits in patients with chronic kidney disease (CKD). Clinical trials consistently report reductions in albuminuria and improved renal outcomes; however, the specific intrarenal hemodynamic mechanisms remain partially understood. nsMRAs lower albuminuria, a critical surrogate marker for CKD progression, with early reductions contributing significantly to renal benefits. These agents produce mild natriuretic effects by inhibiting aldosterone-mediated sodium reabsorption in the distal nephron, resulting in a slight reduction in extracellular volume. Additionally, nsMRAs may impact glomerular hemodynamics by mitigating aldosterone-induced constriction of the efferent arterioles and restoring tubuloglomerular feedback, while also modulating connecting tubule glomerular feedback. Collectively, these effects may contribute to lowering intraglomerular pressure and attenuating glomerular hyperfiltration. However, current evidence does not definitively show that nsMRAs are superior to steroidal mineralocorticoid receptor antagonists in correcting hyperfiltration. Their clinical benefits seem to arise from enhanced safety, tolerability, and sustained therapeutic use. This narrative review synthesizes existing clinical and experimental evidence on the intrarenal hemodynamic effects of nsMRAs, emphasizing their roles in sodium handling, natriuresis, and regulation of intraglomerular pressure.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"337-350"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levothyroxine Discontinuation: The Potential Role of Excess Iodine Exposure.","authors":"Sun Wook Cho","doi":"10.3803/EnM.2026.3155","DOIUrl":"10.3803/EnM.2026.3155","url":null,"abstract":"","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"470-471"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}