{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T17:26:29Z","timestamp":1793467589954,"version":"4.5.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100018217","name":"Universidade Federal De S\u00e3o Paulo","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100018217","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nutr"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      This randomized, double-blind, placebo-controlled trial investigated the effects of\n                      <jats:italic>Curcuma longa<\/jats:italic>\n                      extract (CLE) supplementation on vascular, redox-inflammatory biomarkers, and neuropathy symptoms in adults with type 2 diabetes mellitus (T2DM).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy-six adults with T2DM were randomized to receive CLE (1200\u00a0mg\/day) or placebo for three months. Plasma concentrations of hyaluronic acid (HA), syndecan-1 (SDC1), syndecan-4 (SDC4), matrix metalloproteinases (MMP-2 and MMP-9), thioredoxin-1 (Trx1), thioredoxin-binding protein-2 (TBP2), sirtuin-1 (SIRT1), nuclear factor erythroid 2\u2013related factor 2 (Nrf2), and the p65 subunit of nuclear factor kappa B (NF-\u03baB p65) were measured at baseline and post-intervention. Neuropathy symptoms were assessed using a validated questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable between groups. After 3\u00a0months, CLE supplementation resulted in a significant reduction in neuropathy symptom score compared with placebo (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.048). CLE significantly reduced markers of endothelial glycocalyx shedding, including SDC1 (66.5 vs. 113.0\u00a0ng\/mL;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), SDC4 (155.1 vs. 225.5\u00a0pg\/mL;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.040), and HA (259.8 vs. 371.7\u00a0ng\/mL;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002), as well as MMP-2 (198.4 vs. 233.3\u00a0ng\/mL;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and MMP-9 (1.2 vs. 2.0\u00a0ng\/mL;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). In parallel, CLE increased antioxidant\/redox markers Trx1, SIRT1, and Nrf2 (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) and reduced TBP2 and NF-\u03baB p65 levels (both\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), indicating coordinated modulation of vascular, redox, and inflammatory pathways.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Short-term supplementation with CLE was associated with favorable modulation of vascular and redox-inflammatory biomarkers and improvement in neuropathy symptoms in adults with T2DM. These findings support the role of CLE as a promising bioactive nutritional supplement for the prevention and management of vascular and neuropathic complications associated with diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00394-026-03963-3","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T12:44:29Z","timestamp":1776257069000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Curcuma longa improves endothelial glycocalyx integrity and redox-inflammatory pathways in type 2 diabetes mellitus: a randomized double-blind placebo-controlled study"],"prefix":"10.1007","volume":"65","author":[{"given":"Drielly Rodrigues","family":"Viudes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alanna Ramalho","family":"Mateus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Antoniali","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0604-7689","authenticated-orcid":false,"given":"Maria","family":"do Carmo Franco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"issue":"17","key":"3963_CR1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21176275","volume":"21","author":"U Galicia-Garcia","year":"2020","unstructured":"Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, Ostolaza H, Mart\u00edn C (2020) Pathophysiology of type 2 diabetes mellitus. Int J Mol Sci 21(17):6275. https:\/\/doi.org\/10.3390\/ijms21176275","journal-title":"Int J Mol Sci"},{"key":"3963_CR2","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.freeradbiomed.2022.03.019","volume":"184","author":"JS Bhatti","year":"2022","unstructured":"Bhatti JS, Sehrawat A, Mishra J, Sidhu IS, Navik U, Khullar N, Kumar S, Bhatti GK, Reddy PH (2022) Oxidative stress in the pathophysiology of type 2 diabetes and related complications: current therapeutics strategies and future perspectives. Free Radic Biol Med 184:114\u2013134. https:\/\/doi.org\/10.1016\/j.freeradbiomed.2022.03.019","journal-title":"Free Radic Biol Med"},{"issue":"40","key":"3963_CR3","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000035285","volume":"102","author":"Y Lu","year":"2023","unstructured":"Lu Y, Wang W, Liu J, Xie M, Liu Q, Li S (2023) Vascular complications of diabetes: a narrative review. Medicine Baltimore 102(40):e35285. https:\/\/doi.org\/10.1097\/MD.0000000000035285","journal-title":"Medicine Baltimore"},{"issue":"7","key":"3963_CR4","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1111\/anae.12661","volume":"69","author":"CS Alphonsus","year":"2014","unstructured":"Alphonsus CS, Rodseth RN (2014) The endothelial glycocalyx: a review of the vascular barrier. Anaesthesia 69(7):777\u2013784. https:\/\/doi.org\/10.1111\/anae.12661","journal-title":"Anaesthesia"},{"issue":"7","key":"3963_CR5","doi-asserted-by":"publisher","first-page":"1427","DOI":"10.1161\/ATVBAHA.118.310839","volume":"38","author":"S Dogn\u00e9","year":"2018","unstructured":"Dogn\u00e9 S, Flamion B, Caron N (2018) Endothelial glycocalyx as a shield against diabetic vascular complications: Involvement of hyaluronan and hyaluronidases. Arterioscler Thromb Vasc Biol 38(7):1427\u20131439. https:\/\/doi.org\/10.1161\/ATVBAHA.118.310839","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"3963_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2021.111888","volume":"141","author":"YS Fu","year":"2021","unstructured":"Fu YS, Chen TH, Weng L, Huang L, Lai D, Weng CF (2021) Pharmacological properties and underlying mechanisms of curcumin and prospects in medicinal potential. Biomed Pharmacother 141:111888. https:\/\/doi.org\/10.1016\/j.biopha.2021.111888","journal-title":"Biomed Pharmacother"},{"key":"3963_CR7","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.01021","volume":"11","author":"J Sharifi-Rad","year":"2020","unstructured":"Sharifi-Rad J, Rayess YE, Rizk AA, Sadaka C, Zgheib R, Zam W et al (2020) Turmeric and its major compound curcumin on health: bioactive effects and safety profiles for food, pharmaceutical, biotechnological and medicinal applications. Front Pharmacol 11:01021. https:\/\/doi.org\/10.3389\/fphar.2020.01021","journal-title":"Front Pharmacol"},{"key":"3963_CR8","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/978-3-030-56153-6_8","volume":"1291","author":"A Mahdavi","year":"2021","unstructured":"Mahdavi A, Moradi S, Askari G, Iraj B, Sathyapalan T, Guest PC, Bagherniya M, Sahebkar A (2021) Effect of curcumin on glycemic control in patients with type 2 diabetes: a systematic review of randomized clinical trials. Adv Exp Med Biol 1291:139\u2013149. https:\/\/doi.org\/10.1007\/978-3-030-56153-6_8","journal-title":"Adv Exp Med Biol"},{"issue":"42","key":"3963_CR9","doi-asserted-by":"publisher","first-page":"6957","DOI":"10.2174\/0929867331666230707094644","volume":"31","author":"H Yaribeygi","year":"2024","unstructured":"Yaribeygi H, Maleki M, Butler AE, Jamialahmadi T, Gumpricht E, Sahebkar A (2024) The beneficial effects of curcumin on lipids: possible effects on dyslipidemia-induced cardiovascular complications. Curr Med Chem 31(42):6957\u20136970. https:\/\/doi.org\/10.2174\/0929867331666230707094644","journal-title":"Curr Med Chem"},{"key":"3963_CR10","doi-asserted-by":"publisher","DOI":"10.1016\/j.prostaglandins.2024.106867","volume":"174","author":"Z Kavyani","year":"2024","unstructured":"Kavyani Z, Najafi K, Naghsh N, Karvane HB, Musazadeh V (2024) The effects of curcumin supplementation on biomarkers of inflammation, oxidative stress, and endothelial function: A meta-analysis of meta-analyses. Prostaglandins Other Lipid Mediat 174:106867. https:\/\/doi.org\/10.1016\/j.prostaglandins.2024.106867","journal-title":"Prostaglandins Other Lipid Mediat"},{"issue":"8","key":"3963_CR11","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1001\/jama.2021.12531","volume":"326","author":"KW Davidson","year":"2021","unstructured":"US Preventive Services Task Force, Davidson KW, Barry MJ, Mangione CM, Cabana M, Caughey AB et al (2021) Screening for prediabetes and type 2 diabetes: US preventive services task force recommendation statement. JAMA 326(8):736\u2013743. https:\/\/doi.org\/10.1001\/jama.2021.12531","journal-title":"JAMA"},{"key":"3963_CR12","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-019-0437-7","volume":"11","author":"H Hodaei","year":"2019","unstructured":"Hodaei H, Adibian M, Nikpayam O, Hedayati M, Sohrab G (2019) The effect of curcumin supplementation on anthropometric indices, insulin resistance and oxidative stress in patients with type 2 diabetes: a randomized, double-blind clinical trial. Diabetol Metab Syndr 11:41. https:\/\/doi.org\/10.1186\/s13098-019-0437-7","journal-title":"Diabetol Metab Syndr"},{"key":"3963_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ctim.2017.05.006","volume":"33","author":"Y Panahi","year":"2017","unstructured":"Panahi Y, Khalili N, Sahebi E, Namazi S, Reiner \u017d, Majeed M, Sahebkar A (2017) Curcuminoids modify lipid profile in type 2 diabetes mellitus: a randomized controlled trial. Complement Ther Med 33:1\u20135. https:\/\/doi.org\/10.1016\/j.ctim.2017.05.006","journal-title":"Complement Ther Med"},{"issue":"6","key":"3963_CR14","doi-asserted-by":"publisher","first-page":"944","DOI":"10.1590\/S0004-27302005000600014","volume":"49","author":"RO Moreira","year":"2005","unstructured":"Moreira RO, Castro AP, Papelbaum M, Appolin\u00e1rio JC, Ellinger VC, Coutinho WF, Zagury L (2005) Translation into Portuguese and assessment of the reliability of a scale for the diagnosis of diabetic distal polyneuropathy. Arq Bras Endocrinol Metabol 49(6):944\u2013950. https:\/\/doi.org\/10.1590\/S0004-27302005000600014","journal-title":"Arq Bras Endocrinol Metabol"},{"issue":"2","key":"3963_CR15","doi-asserted-by":"publisher","first-page":"5","DOI":"10.12820\/rbafs.v.6n2p5-18","volume":"6","author":"S Matsudo","year":"2012","unstructured":"Matsudo S, Ara\u00fajo T, Matsudo V, Andrade D, Andrade E, Oliveira LC, Braggion G (2012) Question\u00e1rio internacional de atividade f\u00edsica (ipaq): estudo de validade e reprodutibilidade no brasil. Rev Bras Ativ Fis Saude 6(2):5\u201318. https:\/\/doi.org\/10.12820\/rbafs.v.6n2p5-18","journal-title":"Rev Bras Ativ Fis Saude"},{"issue":"6","key":"3963_CR16","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.1002\/JLB.1MA0620-357R","volume":"108","author":"S Li","year":"2020","unstructured":"Li S, Fu H, Wang Y, Wang L, Jia B, Bian Y (2020) Curcumin inhibits CT26 cells metastasis by decreasing heparanase expression. J Leukoc Biol 108(6):1727\u20131733. https:\/\/doi.org\/10.1002\/JLB.1MA0620-357R","journal-title":"J Leukoc Biol"},{"key":"3963_CR17","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellsig.2025.111909","volume":"134","author":"W Xu","year":"2025","unstructured":"Xu W, Ou D, Zhao Y, Liu Y, Yan P, Li S, Sun Q, Zhang X, Liu H, Huang J, Fang Y (2025) Curcumin alleviates lipopolysaccharide-induced alveolar epithelial glycocalyx damage by modulating the Rac1\/NF-\u03baB\/HPSE pathway. Cell Signal 134:111909. https:\/\/doi.org\/10.1016\/j.cellsig.2025.111909","journal-title":"Cell Signal"},{"key":"3963_CR18","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/978-3-319-33943-6_17","volume":"920","author":"BJ Abreu","year":"2016","unstructured":"Abreu BJ, de Brito Vieira WH (2016) Metalloproteinase changes in diabetes. Adv Exp Med Biol 920:185\u2013190. https:\/\/doi.org\/10.1007\/978-3-319-33943-6_17","journal-title":"Adv Exp Med Biol"},{"issue":"1","key":"3963_CR19","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.biocel.2008.06.010","volume":"41","author":"BB Aggarwal","year":"2009","unstructured":"Aggarwal BB, Harikumar KB (2009) Potential therapeutic effects of curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases. Int J Biochem Cell Biol 41(1):40\u201359. https:\/\/doi.org\/10.1016\/j.biocel.2008.06.010","journal-title":"Int J Biochem Cell Biol"},{"key":"3963_CR20","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.freeradbiomed.2013.07.036","volume":"66","author":"J Lu","year":"2014","unstructured":"Lu J, Holmgren A (2014) The thioredoxin antioxidant system. Free Radic Biol Med 66:75\u201387. https:\/\/doi.org\/10.1016\/j.freeradbiomed.2013.07.036","journal-title":"Free Radic Biol Med"},{"issue":"24","key":"3963_CR21","doi-asserted-by":"publisher","DOI":"10.3390\/molecules26247658","volume":"26","author":"S Ghareghomi","year":"2021","unstructured":"Ghareghomi S, Rahban M, Moosavi-Movahedi Z, Habibi-Rezaei M, Saso L, Moosavi-Movahedi AA (2021) The potential role of curcumin in modulating the master antioxidant pathway in diabetic hypoxia-induced complications. Molecules 26(24):7658. https:\/\/doi.org\/10.3390\/molecules26247658","journal-title":"Molecules"},{"issue":"1","key":"3963_CR22","doi-asserted-by":"publisher","DOI":"10.3390\/biom12010082","volume":"12","author":"S Ghafouri-Fard","year":"2022","unstructured":"Ghafouri-Fard S, Shoorei H, Bahroudi Z, Hussen BM, Talebi SF, Taheri M, Ayatollahi SA (2022) Nrf2-related therapeutic effects of curcumin in different disorders. Biomolecules 12(1):82. https:\/\/doi.org\/10.3390\/biom12010082","journal-title":"Biomolecules"},{"issue":"2","key":"3963_CR23","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1038\/s41580-020-00313-x","volume":"22","author":"AJ Covarrubias","year":"2021","unstructured":"Covarrubias AJ, Perrone R, Grozio A, Verdin E (2021) NAD+ metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol 22(2):119\u2013141. https:\/\/doi.org\/10.1038\/s41580-020-00313-x","journal-title":"Nat Rev Mol Cell Biol"},{"issue":"9","key":"3963_CR24","doi-asserted-by":"publisher","first-page":"7629","DOI":"10.1074\/jbc.M110.208173","volume":"286","author":"Y Kawai","year":"2011","unstructured":"Kawai Y, Gardu\u00f1o L, Theodore M, Yang J, Arinze IJ (2011) Acetylation-deacetylation of the transcription factor Nrf2 (nuclear factor erythroid 2-related factor 2) regulates its transcriptional activity and nucleocytoplasmic localization. J Biol Chem 286(9):7629\u20137640. https:\/\/doi.org\/10.1074\/jbc.M110.208173","journal-title":"J Biol Chem"},{"issue":"10","key":"3963_CR25","doi-asserted-by":"publisher","first-page":"1939","DOI":"10.1016\/j.cellsig.2013.06.007","volume":"25","author":"A Kauppinen","year":"2013","unstructured":"Kauppinen A, Suuronen T, Ojala J, Kaarniranta K, Salminen A (2013) Antagonistic crosstalk between NF-\u03baB and SIRT1 in the regulation of inflammation and metabolic disorders. Cell Signal 25(10):1939\u20131948. https:\/\/doi.org\/10.1016\/j.cellsig.2013.06.007","journal-title":"Cell Signal"},{"issue":"1","key":"3963_CR26","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1136\/annrheumdis-2014-205740","volume":"75","author":"P Zerr","year":"2016","unstructured":"Zerr P, Palumbo-Zerr K, Huang J, Tomcik M, Sumova B, Distler O, Schett G, Distler JH (2016) Sirt1 regulates canonical TGF-\u03b2 signalling to control fibroblast activation and tissue fibrosis. Ann Rheum Dis 75(1):226\u2013233. https:\/\/doi.org\/10.1136\/annrheumdis-2014-205740","journal-title":"Ann Rheum Dis"},{"key":"3963_CR27","doi-asserted-by":"publisher","DOI":"10.1038\/sigtrans.2017.23","volume":"2","author":"T Liu","year":"2017","unstructured":"Liu T, Zhang L, Joo D, Sun SC (2017) NF-\u03baB signaling in inflammation. Signal Transduct Target Ther 2:17023. https:\/\/doi.org\/10.1038\/sigtrans.2017.23","journal-title":"Signal Transduct Target Ther"},{"key":"3963_CR28","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2017.00798","volume":"8","author":"SV Suryavanshi","year":"2017","unstructured":"Suryavanshi SV, Kulkarni YA (2017) NF-\u03ba\u03b2: a potential target in the management of vascular complications of diabetes. Front Pharmacol 8:798. https:\/\/doi.org\/10.3389\/fphar.2017.00798","journal-title":"Front Pharmacol"},{"issue":"42","key":"3963_CR29","doi-asserted-by":"publisher","first-page":"24995","DOI":"10.1074\/jbc.270.42.24995","volume":"270","author":"S Singh","year":"1995","unstructured":"Singh S, Aggarwal BB (1995) Activation of transcription factor NF-kappa B is suppressed by curcumin. J Biol Chem 270(42):24995\u201325000. https:\/\/doi.org\/10.1074\/jbc.270.42.24995","journal-title":"J Biol Chem"},{"issue":"14","key":"3963_CR30","doi-asserted-by":"publisher","first-page":"7645","DOI":"10.3390\/ijms22147645","volume":"22","author":"C Buhrmann","year":"2021","unstructured":"Buhrmann C, Brockmueller A, Mueller AL, Shayan P, Shakibaei M (2021) Curcumin attenuates environment-derived osteoarthritis by Sox9\/NF-kB signaling axis. Int J Mol Sci 22(14):7645. https:\/\/doi.org\/10.3390\/ijms22147645","journal-title":"Int J Mol Sci"},{"key":"3963_CR31","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.53627","volume":"9","author":"J Muri","year":"2020","unstructured":"Muri J, Thut H, Feng Q, Kopf M (2020) Thioredoxin-1 distinctly promotes NF-\u03baB target DNA binding and NLRP3 inflammasome activation independently of Txnip. Elife 9:e53627. https:\/\/doi.org\/10.7554\/eLife.53627","journal-title":"Elife"},{"issue":"12","key":"3963_CR32","doi-asserted-by":"publisher","first-page":"2369","DOI":"10.1038\/sj.emboj.7600244","volume":"23","author":"F Yeung","year":"2004","unstructured":"Yeung F, Hoberg JE, Ramsey CS, Keller MD, Jones DR, Frye RA, Mayo MW (2004) Modulation of NF-kappaB-dependent transcription and cell survival by the SIRT1 deacetylase. EMBO J 23(12):2369\u20132380. https:\/\/doi.org\/10.1038\/sj.emboj.7600244","journal-title":"EMBO J"},{"issue":"5","key":"3963_CR33","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1016\/j.bbamcr.2018.02.010","volume":"1865","author":"I Bellezza","year":"2018","unstructured":"Bellezza I, Giambanco I, Minelli A, Donato R (2018) Nrf2-Keap1 signaling in oxidative and reductive stress. Biochim et Biophys Acta (BBA) Mol Cell Res 1865(5):721\u2013733. https:\/\/doi.org\/10.1016\/j.bbamcr.2018.02.010","journal-title":"Biochim et Biophys Acta (BBA) Mol Cell Res"}],"container-title":["European Journal of Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00394-026-03963-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00394-026-03963-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00394-026-03963-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:06:45Z","timestamp":1781647605000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00394-026-03963-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":33,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["3963"],"URL":"https:\/\/doi.org\/10.1007\/s00394-026-03963-3","relation":{},"ISSN":["1436-6207","1436-6215"],"issn-type":[{"value":"1436-6207","type":"print"},{"value":"1436-6215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"23 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the local ethics committee (approval number: 5.554.571). Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"116"}}