{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:32:43Z","timestamp":1793424763759,"version":"4.5.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Seoul National University Hospital","id":[{"id":"https:\/\/ror.org\/01z4nnt86","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Evidence suggests that ambient air pollution contributes to metabolic dysregulation, including hyperuricemia. However, previous studies were limited to specific groups or regions with relatively high air pollutant concentrations. This study examined the association between long-term exposure to ambient air pollutants and hyperuricemia in a general population exposed to relatively low pollution concentrations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study analyzed 20,117 adults who underwent health screenings in the Republic of Korea (2015\u20132019). Annual mean concentrations of PM\n                      <jats:sub>2.5<\/jats:sub>\n                      , PM\n                      <jats:sub>10<\/jats:sub>\n                      , NO\n                      <jats:sub>2<\/jats:sub>\n                      , SO\n                      <jats:sub>2<\/jats:sub>\n                      , and CO were estimated at residential addresses using the Community Multiscale Air Quality model. Hyperuricemia was defined as serum uric acid level\u2009&gt;\u20097.0\u00a0mg\/dL (males) or\u2009&gt;\u20096.0\u00a0mg\/dL (females). Multivariable logistic regression estimated odds ratios (ORs) per interquartile range (IQR) increase in pollutant exposure, adjusting for confounders including estimated glomerular filtration rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 20,117 participants, 3,078 (15.3%) had hyperuricemia. All five pollutants were significantly associated with hyperuricemia. The ORs (95% CIs) per IQR increase were 1.06 (1.01\u20131.10) for PM\n                      <jats:sub>2.5<\/jats:sub>\n                      , 1.15 (1.08\u20131.21) for PM\n                      <jats:sub>10<\/jats:sub>\n                      , 1.07 (1.00\u20131.14) for NO\n                      <jats:sub>2<\/jats:sub>\n                      , 1.13 (1.07\u20131.19) for SO\n                      <jats:sub>2<\/jats:sub>\n                      , and 1.06 (1.01\u20131.11) for CO. Associations were stronger among current smokers, older adults, and individuals with dyslipidemia or central obesity (all\n                      <jats:italic>P<\/jats:italic>\n                      for interaction\u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Long-term exposure to air pollutants was significantly associated with hyperuricemia, independent of renal function and even at low concentrations. These findings suggest that air pollution is an important environmental risk factor for metabolic disease, emphasizing the need for stricter regulations to protect vulnerable populations.<\/jats:p>\n                    <jats:p>\n                      <jats:table-wrap>\n                        <jats:table>\n                          <jats:tbody>\n                            <jats:tr>\n                              <jats:td align=\"left\" colspan=\"2\">Key Points\u2022 Long-term exposure to major ambient air pollutants is significantly associated with an increased risk of hyperuricemia, even at relatively low concentrations.\u2022 The association between air pollution and hyperuricemia persists independent of renal function, suggesting a potential role in systemic metabolic dysregulation.\u2022 Vulnerable populations, including older adults, current smokers, and individuals with metabolic conditions, exhibit stronger associations between air pollution exposure and hyperuricemia.<\/jats:td>\n                            <\/jats:tr>\n                          <\/jats:tbody>\n                        <\/jats:table>\n                      <\/jats:table-wrap>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10067-026-08398-z","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T12:57:22Z","timestamp":1789217842000},"page":"6927-6936","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term exposure to ambient air pollution and an increased risk of hyperuricemia"],"prefix":"10.1007","volume":"45","author":[{"given":"Su Hwan","family":"Cho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Jin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soontae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon-Hee","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Moon","family":"Yun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3942-6813","authenticated-orcid":false,"given":"Jin Ho","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,12]]},"reference":[{"key":"8398_CR1","doi-asserted-by":"publisher","first-page":"88","DOI":"10.4078\/jrd.2022.0001","volume":"30","author":"JK Ahn","year":"2023","unstructured":"Ahn JK (2023) Epidemiology and treatment-related concerns of gout and hyperuricemia in Korean. J Rheum Dis 30:88\u201398. https:\/\/doi.org\/10.4078\/jrd.2022.0001","journal-title":"J Rheum Dis"},{"key":"8398_CR2","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2024.1417663","volume":"15","author":"S Jin","year":"2024","unstructured":"Jin S, Geng H, Lu Y et al (2024) Association between gout and kidney stone: results from Mendelian randomization and the NHANES study. Front Genet 15:1417663. https:\/\/doi.org\/10.3389\/fgene.2024.1417663","journal-title":"Front Genet"},{"key":"8398_CR3","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1056\/NEJMra0800885","volume":"359","author":"DI Feig","year":"2008","unstructured":"Feig DI, Kang DH, Johnson RJ (2008) Uric acid and cardiovascular risk. N Engl J Med 359:1811\u20131821. https:\/\/doi.org\/10.1056\/NEJMra0800885","journal-title":"N Engl J Med"},{"key":"8398_CR4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2024.131779","volume":"399","author":"L Zheng","year":"2024","unstructured":"Zheng L, Zhu Y, Ma Y et al (2024) Relationship between hyperuricemia and the risk of cardiovascular events and chronic kidney disease in both the general population and hypertensive patients: a systematic review and meta-analysis. Int J Cardiol 399:131779. https:\/\/doi.org\/10.1016\/j.ijcard.2024.131779","journal-title":"Int J Cardiol"},{"key":"8398_CR5","first-page":"393","volume":"10","author":"J Foody","year":"2017","unstructured":"Foody J, Turpin RS, Tidwell BA, Lawrence D, Schulman KL (2017) Major cardiovascular events in patients with gout and associated cardiovascular disease or heart failure and chronic kidney disease initiating a xanthine oxidase inhibitor. Am Health Drug Benefits 10:393\u2013401","journal-title":"Am Health Drug Benefits"},{"key":"8398_CR6","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1007\/s10653-015-9720-1","volume":"37","author":"FJ Kelly","year":"2015","unstructured":"Kelly FJ, Fussell JC (2015) Air pollution and public health: emerging hazards and improved understanding of risk. Environ Geochem Health 37:631\u2013649. https:\/\/doi.org\/10.1007\/s10653-015-9720-1","journal-title":"Environ Geochem Health"},{"key":"8398_CR7","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.ijcard.2015.08.109","volume":"213","author":"J Maiuolo","year":"2016","unstructured":"Maiuolo J, Oppedisano F, Gratteri S, Muscoli C, Mollace V (2016) Regulation of uric acid metabolism and excretion. Int J Cardiol 213:8\u201314. https:\/\/doi.org\/10.1016\/j.ijcard.2015.08.109","journal-title":"Int J Cardiol"},{"key":"8398_CR8","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1096\/fj.02-0752rev","volume":"17","author":"MS Cooke","year":"2003","unstructured":"Cooke MS, Evans MD, Dizdaroglu M, Lunec J (2003) Oxidative DNA damage: mechanisms, mutation, and disease. FASEB J 17:1195\u20131214. https:\/\/doi.org\/10.1096\/fj.02-0752rev","journal-title":"FASEB J"},{"key":"8398_CR9","doi-asserted-by":"publisher","first-page":"4145","DOI":"10.2174\/138161205774913255","volume":"11","author":"GK Glantzounis","year":"2005","unstructured":"Glantzounis GK, Tsimoyiannis EC, Kappas AM, Galaris DA (2005) Uric acid and oxidative stress. Curr Pharm Des 11:4145\u20134151. https:\/\/doi.org\/10.2174\/138161205774913255","journal-title":"Curr Pharm Des"},{"key":"8398_CR10","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2023.116631","volume":"235","author":"L Duan","year":"2023","unstructured":"Duan L, Zhang M, Cao Y et al (2023) Exposure to ambient air pollutants is associated with an increased incidence of hyperuricemia: a longitudinal cohort study among Chinese government employees. Environ Res 235:116631. https:\/\/doi.org\/10.1016\/j.envres.2023.116631","journal-title":"Environ Res"},{"key":"8398_CR11","doi-asserted-by":"publisher","first-page":"40507","DOI":"10.1007\/s11356-023-25132-3","volume":"30","author":"LK Hu","year":"2023","unstructured":"Hu LK, Liu YH, Yang K, Chen N, Ma LL, Yan YX (2023) Associations between long-term exposure to ambient fine particulate pollution with the decline of kidney function and hyperuricemia: a longitudinal cohort study. Environ Sci Pollut Res Int 30:40507\u201340518. https:\/\/doi.org\/10.1007\/s11356-023-25132-3","journal-title":"Environ Sci Pollut Res Int"},{"key":"8398_CR12","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1080\/09603123.2019.1628926","volume":"31","author":"YX Tang","year":"2021","unstructured":"Tang YX, Bloom MS, Qian ZM et al (2021) Association between ambient air pollution and hyperuricemia in traffic police officers in China: a cohort study. Int J Environ Health Res 31:54\u201362. https:\/\/doi.org\/10.1080\/09603123.2019.1628926","journal-title":"Int J Environ Health Res"},{"key":"8398_CR13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecoenv.2022.114354","volume":"249","author":"YX Tang","year":"2023","unstructured":"Tang YX, Zhang YT, Xu YJ et al (2023) Exposure to ambient particulate matter and hyperuricemia: an eight-year prospective cohort study on male traffic officers in China. Ecotoxicol Environ Saf 249:114354. https:\/\/doi.org\/10.1016\/j.ecoenv.2022.114354","journal-title":"Ecotoxicol Environ Saf"},{"key":"8398_CR14","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","volume":"385","author":"LA Inker","year":"2021","unstructured":"Inker LA, Eneanya ND, Coresh J et al (2021) New creatinine- and cystatin C-based equations to estimate GFR without race. N Engl J Med 385:1737\u20131749. https:\/\/doi.org\/10.1056\/NEJMoa2102953","journal-title":"N Engl J Med"},{"key":"8398_CR15","doi-asserted-by":"publisher","first-page":"10315","DOI":"10.5194\/acp-17-10315-2017","volume":"17","author":"HC Kim","year":"2017","unstructured":"Kim HC, Kim E, Bae C, Cho JH, Kim B-U, Kim S (2017) Regional contributions to particulate matter concentration in the Seoul metropolitan area, South Korea: seasonal variation and sensitivity to meteorology and emissions inventory. Atmos Chem Phys 17:10315\u201310332. https:\/\/doi.org\/10.5194\/acp-17-10315-2017","journal-title":"Atmos Chem Phys"},{"key":"8398_CR16","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2018.33.e193","volume":"33","author":"C Han","year":"2018","unstructured":"Han C, Kim S, Lim YH, Bae HJ, Hong YC (2018) Spatial and temporal trends of number of deaths attributable to ambient PM2.5 in the Korea. J Korean Med Sci 33:e193. https:\/\/doi.org\/10.3346\/jkms.2018.33.e193","journal-title":"J Korean Med Sci"},{"key":"8398_CR17","doi-asserted-by":"publisher","DOI":"10.3390\/atmos11020141","volume":"11","author":"M Bae","year":"2020","unstructured":"Bae M, Kim B-U, Kim HC, Kim S (2020) A multiscale tiered approach to quantify contributions: a case study of PM2.5 in South Korea during 2010\u20132017. Atmosphere (Basel) 11:141. https:\/\/doi.org\/10.3390\/atmos11020141","journal-title":"Atmosphere (Basel)"},{"key":"8398_CR18","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/j.semnephrol.2011.08.004","volume":"31","author":"YH Rho","year":"2011","unstructured":"Rho YH, Zhu Y, Choi HK (2011) The epidemiology of uric acid and fructose. Semin Nephrol 31:410\u2013419. https:\/\/doi.org\/10.1016\/j.semnephrol.2011.08.004","journal-title":"Semin Nephrol"},{"key":"8398_CR19","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1056\/NEJMcp1204714","volume":"368","author":"PD Friedmann","year":"2013","unstructured":"Friedmann PD (2013) Clinical practice. Alcohol use in adults. N Engl J Med 368:365\u2013373. https:\/\/doi.org\/10.1056\/NEJMcp1204714","journal-title":"N Engl J Med"},{"key":"8398_CR20","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1001\/jama.2018.14854","volume":"320","author":"KL Piercy","year":"2018","unstructured":"Piercy KL, Troiano RP, Ballard RM et al (2018) The physical activity guidelines for Americans. JAMA 320:2020\u20132028. https:\/\/doi.org\/10.1001\/jama.2018.14854","journal-title":"JAMA"},{"key":"8398_CR21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0184260","volume":"12","author":"RD Huff","year":"2017","unstructured":"Huff RD, Hsu AC, Nichol KS et al (2017) Regulation of xanthine dehydrogensase gene expression and uric acid production in human airway epithelial cells. PLoS ONE 12:e0184260. https:\/\/doi.org\/10.1371\/journal.pone.0184260","journal-title":"PLoS ONE"},{"key":"8398_CR22","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1038\/mi.2015.104","volume":"9","author":"MJ Gold","year":"2016","unstructured":"Gold MJ, Hiebert PR, Park HY et al (2016) Mucosal production of uric acid by airway epithelial cells contributes to particulate matter-induced allergic sensitization. Mucosal Immunol 9:809\u2013820. https:\/\/doi.org\/10.1038\/mi.2015.104","journal-title":"Mucosal Immunol"},{"key":"8398_CR23","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.773001","volume":"13","author":"H Wang","year":"2022","unstructured":"Wang H, Xie L, Song X et al (2022) Purine-induced IFN-\u03b3 promotes uric acid production by upregulating xanthine oxidoreductase expression. Front Immunol 13:773001. https:\/\/doi.org\/10.3389\/fimmu.2022.773001","journal-title":"Front Immunol"},{"key":"8398_CR24","doi-asserted-by":"publisher","first-page":"E827","DOI":"10.1152\/ajpendo.00378.2020","volume":"319","author":"M Furuhashi","year":"2020","unstructured":"Furuhashi M (2020) New insights into purine metabolism in metabolic diseases: role of xanthine oxidoreductase activity. Am J Physiol Endocrinol Metab 319:E827\u2013E834. https:\/\/doi.org\/10.1152\/ajpendo.00378.2020","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"8398_CR25","doi-asserted-by":"publisher","first-page":"9835","DOI":"10.1021\/acs.analchem.1c01384","volume":"93","author":"X Duan","year":"2021","unstructured":"Duan X, Zhang X, Chen J et al (2021) Association of PM2.5 with insulin resistance signaling pathways on a microfluidic Liver-Kidney Microphysiological System (LK-MPS) device. Anal Chem 93:9835\u20139844. https:\/\/doi.org\/10.1021\/acs.analchem.1c01384","journal-title":"Anal Chem"},{"key":"8398_CR26","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1002\/acr.70007","volume":"78","author":"P Hu","year":"2026","unstructured":"Hu P, Wei S, Ran S et al (2026) Characterizing metabolic signatures of air pollution and their association with the risk of gout: a population-based cohort study. Arthritis Care Res (Hoboken) 78:946\u2013955. https:\/\/doi.org\/10.1002\/acr.70007","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"8398_CR27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2020.105108","volume":"88","author":"HJ Ryu","year":"2021","unstructured":"Ryu HJ, Seo MR, Choi HJ, Cho J, Baek HJ (2021) Particulate matter (PM(10)) as a newly identified environmental risk factor for acute gout flares: a time-series study. Jt Bone Spine 88:105108. https:\/\/doi.org\/10.1016\/j.jbspin.2020.105108","journal-title":"Jt Bone Spine"},{"key":"8398_CR28","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1093\/qjmed\/hcaa286","volume":"114","author":"WS Hu","year":"2021","unstructured":"Hu WS, Lin CL (2021) Effect of air pollution on gout development: a nationwide population-based observational study. QJM 114:471\u2013475. https:\/\/doi.org\/10.1093\/qjmed\/hcaa286","journal-title":"QJM"},{"key":"8398_CR29","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1146\/annurev-pharmtox-031023-125300","volume":"64","author":"Q Ma","year":"2024","unstructured":"Ma Q, Lim CS (2024) Molecular activation of NLRP3 inflammasome by particles and crystals: a continuing challenge of immunology and toxicology. Annu Rev Pharmacol Toxicol 64:417\u2013433. https:\/\/doi.org\/10.1146\/annurev-pharmtox-031023-125300","journal-title":"Annu Rev Pharmacol Toxicol"},{"key":"8398_CR30","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/j.freeradbiomed.2018.01.030","volume":"117","author":"HJ Forman","year":"2018","unstructured":"Forman HJ, Finch CE (2018) A critical review of assays for hazardous components of air pollution. Free Radic Biol Med 117:202\u2013217. https:\/\/doi.org\/10.1016\/j.freeradbiomed.2018.01.030","journal-title":"Free Radic Biol Med"},{"key":"8398_CR31","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2019.108890","volume":"180","author":"DW Riggs","year":"2020","unstructured":"Riggs DW, Zafar N, Krishnasamy S et al (2020) Exposure to airborne fine particulate matter is associated with impaired endothelial function and biomarkers of oxidative stress and inflammation. Environ Res 180:108890. https:\/\/doi.org\/10.1016\/j.envres.2019.108890","journal-title":"Environ Res"},{"key":"8398_CR32","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1708280","volume":"16","author":"L M\u00fcller","year":"2025","unstructured":"M\u00fcller L, Di Benedetto S (2025) Immunosenescence and inflammaging: mechanisms and modulation through diet and lifestyle. Front Immunol 16:1708280. https:\/\/doi.org\/10.3389\/fimmu.2025.1708280","journal-title":"Front Immunol"},{"key":"8398_CR33","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1462548","volume":"12","author":"J Zhang","year":"2024","unstructured":"Zhang J, Zhang J, Duan Z et al (2024) Association between long-term exposure to PM2.5 chemical components and metabolic syndrome in middle-aged and older adults. Front Public Health 12:1462548. https:\/\/doi.org\/10.3389\/fpubh.2024.1462548","journal-title":"Front Public Health"},{"key":"8398_CR34","doi-asserted-by":"publisher","first-page":"2513","DOI":"10.1056\/NEJMoa1702747","volume":"376","author":"Q Di","year":"2017","unstructured":"Di Q, Wang Y, Zanobetti A et al (2017) Air pollution and mortality in the medicare population. N Engl J Med 376:2513\u20132522. https:\/\/doi.org\/10.1056\/NEJMoa1702747","journal-title":"N Engl J Med"},{"key":"8398_CR35","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1681\/ASN.2017030253","volume":"29","author":"B Bowe","year":"2018","unstructured":"Bowe B, Xie Y, Li T, Yan Y, Xian H, Al-Aly Z (2018) Particulate matter air pollution and the risk of incident CKD and progression to ESRD. J Am Soc Nephrol 29:218\u2013230. https:\/\/doi.org\/10.1681\/ASN.2017030253","journal-title":"J Am Soc Nephrol"},{"key":"8398_CR36","doi-asserted-by":"publisher","DOI":"10.1002\/jbt.23610","volume":"38","author":"W Xu","year":"2024","unstructured":"Xu W, Jia L, Lin Y et al (2024) Association of air pollution and risk of chronic kidney disease: a systematic review and meta-analysis. J Biochem Mol Toxicol 38:e23610. https:\/\/doi.org\/10.1002\/jbt.23610","journal-title":"J Biochem Mol Toxicol"}],"container-title":["Clinical Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-026-08398-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10067-026-08398-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-026-08398-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:05:36Z","timestamp":1793423136000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10067-026-08398-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,12]]},"references-count":36,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["8398"],"URL":"https:\/\/doi.org\/10.1007\/s10067-026-08398-z","relation":{},"ISSN":["0770-3198","1434-9949"],"issn-type":[{"value":"0770-3198","type":"print"},{"value":"1434-9949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,12]]},"assertion":[{"value":"31 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 August 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study protocol was approved by the Institutional Review Board of Seoul National University Hospital (IRB No. H-2202\u2013073-1299). The requirement for informed consent was waived owing to the retrospective nature of the study. All procedures were performed in accordance with the Declaration of Helsinki and its amendments.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"None.","order":2,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}}]}}