{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:16:14Z","timestamp":1785413774736,"version":"3.56.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol Sci"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Idiopathic intracranial hypertension (IIH) in non-obese patients represents a notable subtype of the condition, and its underlying causes require further investigation. This study aimed to analyse the clinical features and risk factors associated with non-obese IIH patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 252 adult patients with clinically confirmed IIH between January 2015 and December 2023. Data on epidemiological characteristics, clinical manifestations, and imaging findings were reviewed. The cases were classified into two groups: obese group (body mass index, BMI\u226528\u00a0kg\/m\u00b2) and non-obese group(BMI&lt;28\u00a0kg\/m\u00b2). A comparative assessment of clinical data was performed between the groups, including demographic information, clinical findings, medical history, laboratory results, radiological indices, diagnosis, treatment, and prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 96 obese IIH and 82 non-obese IIH cases were included in this observation. Compared to the obese IIH group, non-obese cases were much older (37.94\u2009\u00b1\u200917.05vs.34.15\u2009\u00b1\u20098.74 year-old,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.044), exhibited a lower frequency of abnormal radiological signs indicating intracranial hypertension (58.54%vs72.92%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.043), more severe visual impairment, and a reduced remission rate (60.98% vs. 81.25%%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003). Additionally, 71 patients (86.59%) in the non-obese group had identifiable risk factors for IIH, including over-weight (63cases), obstructive sleep apnoea syndrome (OSAS) (36 cases), and weight gain (12cases). The mean duration of final follow-up was 15.02\u2009\u00b1\u20092.82 months. Univariate analysis showed that BMI, disease duration before treatment, visual field grading, and non-obese were significantly associated with poor best corrected visual acuity(BCVA) outcome (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.05). BCVA before treatment and imaging findings showed marginally significant associations (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.1). Multivariate logistic regression revealed that non-obese group (OR\u2009=\u20099.16, 95%CI: 1.09\u201377.18,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.041) and longer disease duration (OR\u2009=\u20091.14, 95%CI: 1.05\u20131.24,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002) were independent risk factors for poor BCVA outcome. Poor BCVA before treatment showed a marginally significant trend toward poor prognosis (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.089).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Non-obese patients with IIH tend to exhibit more severe visual impairment and longer disease duration. Close monitoring and early intervention are recommended for non-obese patients with a long disease course.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10072-026-09182-2","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T02:21:59Z","timestamp":1781835719000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical characteristics and outcomes of non-obese patients with idiopathic intracranial hypertension: a retrospective cohort study"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8209-4175","authenticated-orcid":false,"given":"Zhonghua","family":"Ma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanqiu","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilei","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingting","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"9182_CR1","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/S1474-4422(15)00298-7","volume":"15","author":"KA Markey","year":"2016","unstructured":"Markey KA, Mollan SP, Jensen RH, Sinclair AJ (2016) Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions. Lancet Neurol 15:78\u201391","journal-title":"Lancet Neurol"},{"key":"9182_CR2","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1177\/0333102421997093","volume":"41","author":"N Raoof","year":"2021","unstructured":"Raoof N, Hoffmann J (2021) Diagnosis and treatment of idiopathic intracranial hypertension. Cephalalgia 41:472\u2013478","journal-title":"Cephalalgia"},{"key":"9182_CR3","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1136\/jnnp-2017-317440","volume":"89","author":"SP Mollan","year":"2018","unstructured":"Mollan SP, Davies B, Silver NC, Shaw S, Mallucci CL, Wakerley BR et al (2018) Idiopathic intracranial hypertension: consensus guidelines on management. J Neurol Neurosurg Psychiatry 89:1088\u20131100","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"9182_CR4","doi-asserted-by":"publisher","first-page":"120271","DOI":"10.1016\/j.jns.2022.120271","volume":"437","author":"L Donaldson","year":"2022","unstructured":"Donaldson L, Jhaveri A, Micieli J, Margolin E (2022) Idiopathic intracranial hypertension in atypical demographics. J Neurol Sci 437:120271","journal-title":"J Neurol Sci"},{"key":"9182_CR5","unstructured":"DI F. DI. Novel.utah.edu Walsh and Hoyt Text, Chap. 5. In: Miller N, Newman NJ, Walsh and Hoyt\u2019s Clinical Neuro- Ophthalmology. 5 th edn. Baltimore, MD, Williams (2018) & Wilkins Ed, 1998:237\u201391. utah.edu\/details?id= 190037#contents https:\/\/collections.lib"},{"key":"9182_CR6","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1212\/WNL.0000000000004247","volume":"89","author":"M Sodhi","year":"2017","unstructured":"Sodhi M, Sheldon CA, Carleton B, Etminan M (2017) Oral fluoroquinolones and risk of secondary pseudotumor cerebri syndrome: Nested case-control study. Neurology 89:792\u2013795","journal-title":"Neurology"},{"key":"9182_CR7","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1212\/WNL.0b013e3182a55f17","volume":"81","author":"DI Friedman","year":"2013","unstructured":"Friedman DI, Liu GT, Digre KB (2013) Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology 81:1159\u20131165","journal-title":"Neurology"},{"key":"9182_CR8","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1136\/jnnp.45.1.13","volume":"45","author":"L Fris\u00e9n","year":"1982","unstructured":"Fris\u00e9n L (1982) Swelling of the optic nerve head: a staging scheme. J Neurol Neurosurg Psychiatry 45:13\u201318","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"9182_CR9","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1001\/archophthalmol.2010.94","volume":"128","author":"CJ Scott","year":"2010","unstructured":"Scott CJ, Kardon RH, Lee AG, Fris\u00e9n L, Wall M (2010) Diagnosis and grading of papilledema in patients with raised intracranial pressure using optical coherence tomography vs clinical expert assessment using a clinical staging scale. Arch Ophthalmol 128:705\u2013711","journal-title":"Arch Ophthalmol"},{"key":"9182_CR10","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1212\/01.wnl.0000299893.43918.a8","volume":"70","author":"VA Shah","year":"2008","unstructured":"Shah VA, Kardon RH, Lee AG, Corbett JJ, Wall M (2008) Long-term follow-up of idiopathic intracranial hypertension: the Iowa experience. Neurology 70:634\u2013640. https:\/\/doi.org\/10.1212\/01.wnl.0000299893.43918.a8. PMID: 182855388. The International Classification of Headache Disorders, 3rd","journal-title":"Neurology"},{"key":"9182_CR11","doi-asserted-by":"publisher","first-page":"1827","DOI":"10.1212\/WNL.0b013e3181e0f838","volume":"74","author":"BB Bruce","year":"2010","unstructured":"Bruce BB, Kedar S, Van Stavern GP, Corbett JJ, Newman NJ, Biousse V (2010) Atypical idiopathic intracranial hypertension: normal BMI and older patients. Neurology 74:1827\u20131832","journal-title":"Neurology"},{"issue":"10","key":"9182_CR12","first-page":"882","volume":"55","author":"JF Acheson","year":"1992","unstructured":"Acheson JF, Ayliffe W, Bingham E et al (1992) Non-obese patients with idiopathic intracranial hypertension: a separate clinical entity? J Neurol Neurosurg Psychiatry 55(10):882\u2013884","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"12","key":"9182_CR13","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1016\/S0161-6420(96)30392-8","volume":"103","author":"JL Keltner","year":"1996","unstructured":"Keltner JL, Johnson CA, Spoor TC et al (1996) Visual field abnormalities in idiopathic intracranial hypertension: a long-term follow-up. Ophthalmology 103(12):2017\u20132023","journal-title":"Ophthalmology"},{"issue":"2","key":"9182_CR14","first-page":"92","volume":"27","author":"K Radhakrishnan","year":"2007","unstructured":"Radhakrishnan K, Ayyar DR, Nair S et al (2007) Idiopathic intracranial hypertension: long-term visual outcome. J Neuroophthalmol 27(2):92\u201396","journal-title":"J Neuroophthalmol"},{"issue":"11","key":"9182_CR15","first-page":"1187","volume":"93","author":"K Thambiratnam","year":"2022","unstructured":"Thambiratnam K, Jones H, Jones HM et al (2022) Visual outcomes in idiopathic intracranial hypertension: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 93(11):1187\u20131194","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"1\u20132","key":"9182_CR16","first-page":"1","volume":"286","author":"JJ Corbett","year":"2009","unstructured":"Corbett JJ, Mehta S (2009) The diagnosis and management of idiopathic intracranial hypertension. J Neurol Sci 286(1\u20132):1\u20137","journal-title":"J Neurol Sci"},{"issue":"6","key":"9182_CR17","first-page":"483","volume":"24","author":"BB Bruce","year":"2013","unstructured":"Bruce BB, Newman NJ (2013) Update on idiopathic intracranial hypertension. Curr Opin Ophthalmol 24(6):483\u2013489","journal-title":"Curr Opin Ophthalmol"},{"issue":"8","key":"9182_CR18","first-page":"1239","volume":"104","author":"NR Miller","year":"1997","unstructured":"Miller NR (1997) Pseudotumor cerebri: controversies in management. Ophthalmology 104(8):1239\u20131242","journal-title":"Ophthalmology"},{"issue":"11","key":"9182_CR19","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1001\/archneur.59.11.1721","volume":"59","author":"M Wall","year":"2002","unstructured":"Wall M, George D (2002) The pseudotumor cerebri treatment trial. Arch Neurol 59(11):1721\u20131725","journal-title":"Arch Neurol"},{"issue":"2","key":"9182_CR20","first-page":"162","volume":"39","author":"GK Matta","year":"2019","unstructured":"Matta GK, Gordon-Owen M, McDonald M et al (2019) Baseline visual loss as a predictor of final visual outcome in idiopathic intracranial hypertension. J Neuroophthalmol 39(2):162\u2013166","journal-title":"J Neuroophthalmol"},{"issue":"10","key":"9182_CR21","first-page":"1130","volume":"86","author":"AP Ottemesser","year":"2002","unstructured":"Ottemesser AP, de Jong PT, Galbraith S et al (2002) Prognostic factors for visual outcome in idiopathic intracranial hypertension. Br J Ophthalmol 86(10):1130\u20131133","journal-title":"Br J Ophthalmol"},{"key":"9182_CR22","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1007\/s00234-006-0095-y","volume":"48","author":"R Agid","year":"2006","unstructured":"Agid R, Farb RI, Willinsky RA, Mikulis DJ, Tomlinson G (2006) Idiopathic intracranial hypertension: the validity of cross-sectional neuroimaging signs. Neuroradiology 48:521\u2013527","journal-title":"Neuroradiology"},{"key":"9182_CR23","doi-asserted-by":"publisher","first-page":"1686","DOI":"10.1016\/S0161-6420(98)99039-X","volume":"105","author":"MC Brodsky","year":"1998","unstructured":"Brodsky MC, Vaphiades M (1998) Magnetic resonance imaging in pseudotumor cerebri. Ophthalmology 105:1686\u20131693","journal-title":"Ophthalmology"},{"key":"9182_CR24","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1007\/BF00600093","volume":"37","author":"L Manfr\u00e9","year":"1995","unstructured":"Manfr\u00e9 L, Lagalla R, Mangiameli A, Lupo F, Giuffr\u00e9 G, Ponte F et al (1995) Idiopathic intracranial hypertension: orbital MRI. Neuroradiology 37:459\u2013461","journal-title":"Neuroradiology"},{"key":"9182_CR25","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1212\/01.wnl.0000333254.84120.f5","volume":"72","author":"BB Bruce","year":"2009","unstructured":"Bruce BB, Kedar S, Van Stavern GP, Monaghan D, Acierno MD, Braswell RA et al (2009) Idiopathic intracranial hypertension in men. Neurology 72:304\u2013309","journal-title":"Neurology"},{"issue":"6","key":"9182_CR26","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1001\/jamaneurol.2014.133","volume":"71","author":"M Wall","year":"2014","unstructured":"Wall M, Kupersmith MJ, Kieburtz KD, Corbett JJ, Feldon SE, Friedman DI et al (2014) The idiopathic intracranial hypertension treatment trial: clinical profile at baseline. JAMA Neurol 71(6):693\u2013701 PUBMED | CROSSREF","journal-title":"JAMA Neurol"},{"issue":"2","key":"9182_CR27","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1007\/s10384-010-0907-9","volume":"55","author":"IH Liu","year":"2011","unstructured":"Liu IH, Wang AG, Yen MY (2011) Idiopathic intracranial hypertension: clinical features in Chinese patients. Jpn J Ophthalmol 55(2):138\u2013142","journal-title":"Jpn J Ophthalmol"},{"issue":"1","key":"9182_CR28","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s10194-024-01794-3","volume":"25","author":"KH Cho","year":"2024","unstructured":"Cho KH, Baek SH, Kim SH, Kim BS, Sohn JH, Chu MK et al (2024) Clinical profile and treatment outcomes of idiopathic intracranial hypertension: a multicenter study from Korea. J Headache Pain 25(1):106 PUBMED | CROSSREF","journal-title":"J Headache Pain"},{"issue":"1","key":"9182_CR29","doi-asserted-by":"publisher","first-page":"47","DOI":"10.4103\/aian.AIAN_116_18","volume":"22","author":"A Pal","year":"2019","unstructured":"Pal A, Sengupta P, Biswas D, Sen C, Mukherjee A, Pal S (2019) Pattern of idiopathic intracranial hypertension in Indian population. Ann Indian Acad Neurol 22(1):47\u201351 PUBMED | CROSSRE","journal-title":"Ann Indian Acad Neurol"},{"key":"9182_CR30","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1016\/j.ophtha.2017.01.006","volume":"124","author":"KP Kilgore","year":"2017","unstructured":"Kilgore KP, Lee MS, Leavitt JA, Mokri B, Hodge DO, Frank RD et al (2017) Re-evaluating the Incidence of Idiopathic Intracranial Hypertension in an Era of Increasing Obesity. Ophthalmology 124:697\u2013700","journal-title":"Ophthalmology"},{"key":"9182_CR31","doi-asserted-by":"publisher","first-page":"1564","DOI":"10.1212\/WNL.0b013e3182190f51","volume":"76","author":"MW Ko","year":"2011","unstructured":"Ko MW, Chang SC, Ridha MA, Ney JJ, Ali TF, Friedman DI et al (2011) Weight gain and recurrence in idiopathic intracranial hypertension: a case-control study. Neurology 76:1564\u20131567","journal-title":"Neurology"},{"key":"9182_CR32","doi-asserted-by":"crossref","unstructured":"Farahvash A, Micieli JA (2020) Neuro-Ophthalmological Manifestations of Obstructive Sleep Apnea: Current Perspectives.Eye Brain. 12:61\u201371","DOI":"10.2147\/EB.S247121"},{"issue":"4","key":"9182_CR33","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1097\/WNO","volume":"31","author":"MJ Thurtell","year":"2011","unstructured":"Thurtell MJ, Bruce BB, Rye DB, Newman NJ, Biousse V (2011) The Berlin questionnaire screens for obstructive sleep apnea in idiopathic intracranial hypertension. J Neuroophthalmol 31(4):316\u2013319. https:\/\/doi.org\/10.1097\/WNO0b013e 3 1821a4d54","journal-title":"J Neuroophthalmol"},{"issue":"2","key":"9182_CR34","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1378\/chest.95.2.279","volume":"95","author":"P Jennum","year":"1989","unstructured":"Jennum P, B\u00f8rgesen SE (1989) Intracranial pressure and obstructive sleep apnea. Chest 95(2):279\u2013283. https:\/\/doi.org\/10.1378\/chest.95.2.279","journal-title":"Chest"},{"issue":"3","key":"9182_CR35","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/0013-4694(85)90033-1","volume":"60","author":"Y Sugita","year":"1985","unstructured":"Sugita Y, Iijima S, Teshima Y et al (1985) Marked episodic elevation of cerebrospinal fluid pressure during nocturnal sleep in patients with sleep apnea hypersomnia syndrome. Electroencephalogr Clin Neurophysiol 60(3):214\u2013219. https:\/\/doi.org\/10.1016\/0013-4694(85)90033-1","journal-title":"Electroencephalogr Clin Neurophysiol"},{"key":"9182_CR36","doi-asserted-by":"publisher","first-page":"1945","DOI":"10.1007\/s00415-021-10700-9","volume":"269","author":"A Yiangou","year":"2022","unstructured":"Yiangou A, Mitchell JL, Nicholls M, Chong YJ, Vijay V, Wakerley BR et al (2022) Obstructive sleep apnoea in women with idiopathic intracranial hypertension: a sub-study of the idiopathic intracranial hypertension weight randomised controlled trial (IIH: WT). J Neurol 269:1945\u20131956","journal-title":"J Neurol"},{"issue":"12","key":"9182_CR37","doi-asserted-by":"publisher","first-page":"3776","DOI":"10.1007\/s00415-020-10090-4","volume":"267","author":"O Grech","year":"2020","unstructured":"Grech O et al (2020) Emerging themes in idiopathic intracranial hypertension. J Neurol 267(12):3776\u20133784","journal-title":"J Neurol"},{"key":"9182_CR38","doi-asserted-by":"publisher","first-page":"c2701","DOI":"10.1136\/bmj.c2701","volume":"341","author":"AJ Sinclair","year":"2010","unstructured":"Sinclair AJ et al (2010) Low energy diet and intracranial pressure in women with idiopathic intracranial hypertension: prospective cohort study. BMJ 341:c2701","journal-title":"BMJ"},{"issue":"9","key":"9182_CR39","doi-asserted-by":"publisher","first-page":"e54","DOI":"10.2105\/AJPH.2015.302773","volume":"105","author":"A Fildes","year":"2015","unstructured":"Fildes A, Charlton J, Rudisill C, Littlejohns P, Prevost AT, Gulliford MC (2015) Probability of an obese person attaining normal body weight: cohort study using electronic health records. Am J Public Health 105(9):e54\u2013e59","journal-title":"Am J Public Health"}],"container-title":["Neurological Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-026-09182-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10072-026-09182-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-026-09182-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T07:01:12Z","timestamp":1783407672000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10072-026-09182-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,19]]},"references-count":39,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["9182"],"URL":"https:\/\/doi.org\/10.1007\/s10072-026-09182-2","relation":{},"ISSN":["1590-1874","1590-3478"],"issn-type":[{"value":"1590-1874","type":"print"},{"value":"1590-3478","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,19]]},"assertion":[{"value":"4 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 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":"This study was approved by the Clinical Research Ethics Committee of Beijing Tongren Hospital, Capital Medical University (approval no. TRECKY2018-052). Written informed consent was obtained from all participants. The study was conducted in accordance with the principles of the 1964 Declaration of Helsinki and its later amendments, as well as relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"575"}}