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The NHANES protocol was approved by the National Center for Health Statistics (NCHS) Research Ethics Review Board, and all participants provided written informed consent. The transcriptomic datasets analysed here (GSE157827, GSE138852, GSE161355, GSE33000, GSE5281, GSE122063, GSE132903, GSE48350) were obtained from the Gene Expression Omnibus (GEO), where data were deposited following approval by the respective institutional review boards. As this study involved only secondary analysis of existing, anonymized data, no additional ethical approval was required.","order":1,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All NHANES participants provided written informed consent as part of the original survey protocol. For the publicly available GEO datasets, informed consent was obtained from participants or their legal representatives as part of the original study protocols. No additional consent was required for this secondary analysis.","order":2,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. This study used only publicly available, de-identified data and does not contain any individual person\u2019s data in any form.","order":3,"name":"Ethics","label":"Consent to Publish","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"143"}}