{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:01:03Z","timestamp":1791489663059,"version":"4.3.4"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81570560"],"award-info":[{"award-number":["81570560"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Shanghai key project of Integrated Traditional Chinese and Western Medicine","award":["ZY (2018- 2020)-FWTX-3001"],"award-info":[{"award-number":["ZY (2018- 2020)-FWTX-3001"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hepatol Int"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This cross-sectional study aimed to investigate the impact of metabolic-associated diseases (MADs) on patients with autoimmune hepatitis (AIH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study analyzed the clinical characteristics of 283 AIH patients who underwent liver biopsy between January 2016 and February 2022 in Ruijin Hospital, Shanghai, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the identified AIH patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009283), 87.3%, 23.0%, or 43.1% had MADs, non-alcoholic fatty liver disease (NAFLD), or severe fibrosis, respectively. The proportion of diabetes mellitus (DM) was significantly higher in patients with severe liver fibrosis than in those with mild or moderate fibrosis in the AIH cohort (31.1% vs. 18.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Fibrosis was also more severe in patients with NAFLD than in those without (53.8% vs. 39.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Age, Plts, IgG and the presence with MADs were identified as independent predictors of the severity of inflammation in AIH patients. Moreover, severe liver fibrosis (stages 3 to 4) was independently associated with male (OR, 2.855;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025), \u03b3-GT (OR, 0.997;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), and combination with MADs (OR, 4.917;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). Furthermore, combination with DM was also an independent predictor of severe liver fibrosis in AIH patients (OR, 2.445,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Concurrent MADs, common in AIH patients, is an independent risk factor for severe fibrosis or inflammation; of note, combination with DM was also an independent predictor of severe liver fibrosis in AIH patients. While managing with AIH, routine assessment of co-existing MADs, especially DM, is also important.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12072-024-10727-w","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T11:03:19Z","timestamp":1725879799000},"page":"1528-1539","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Liver fibrosis is closely linked with metabolic-associated diseases in patients with autoimmune hepatitis"],"prefix":"10.1007","volume":"18","author":[{"given":"Kehui","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyang","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanqing","family":"Chi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhujun","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yezhou","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gangde","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziqiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lanyi","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shisan","family":"Bao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5285-7917","authenticated-orcid":false,"given":"Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,9]]},"reference":[{"key":"10727_CR1","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1002\/hep.31065","volume":"72","author":"CL Mack","year":"2020","unstructured":"Mack CL, Adams D, Assis DN, Kerkar N, Manns MP, Mayo MJ, et al. Diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American Association for the Study of Liver Diseases. Hepatology 2020;72:671\u2013722","journal-title":"Hepatology"},{"key":"10727_CR2","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.1111\/liv.14480","volume":"40","author":"L Gronbaek","year":"2020","unstructured":"Gronbaek L, Otete H, Ban L, Crooks C, Card T, Jepsen P, et al. Incidence, prevalence and mortality of autoimmune hepatitis in England 1997\u20132015. A population-based cohort study. Liver Int 2020;40:1634\u20131644","journal-title":"Liver Int"},{"key":"10727_CR3","doi-asserted-by":"publisher","first-page":"1592","DOI":"10.1111\/liv.14900","volume":"41","author":"GN Dalekos","year":"2021","unstructured":"Dalekos GN, Azariadis K, Lygoura V, Arvaniti P, Gampeta S, Gatselis NK. Autoimmune hepatitis in patients aged 70 years or older: disease characteristics, treatment response and outcome. Liver Int 2021;41:1592\u20131599","journal-title":"Liver Int"},{"key":"10727_CR4","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/S0140-6736(09)61794-3","volume":"375","author":"RH Eckel","year":"2010","unstructured":"Eckel RH, Alberti KG, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2010;375:181\u2013183","journal-title":"Lancet"},{"key":"10727_CR5","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","volume":"120","author":"KG Alberti","year":"2009","unstructured":"Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009;120:1640\u20131645","journal-title":"Circulation"},{"key":"10727_CR6","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1038\/nrgastro.2013.171","volume":"10","author":"R Loomba","year":"2013","unstructured":"Loomba R, Sanyal AJ. The global NAFLD epidemic. Nat Rev Gastroenterol Hepatol 2013;10:686\u2013690","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"10727_CR7","doi-asserted-by":"publisher","first-page":"2212","DOI":"10.1016\/S0140-6736(20)32511-3","volume":"397","author":"EE Powell","year":"2021","unstructured":"Powell EE, Wong VW, Rinella M. Non-alcoholic fatty liver disease. Lancet 2021;397:2212\u20132224","journal-title":"Lancet"},{"key":"10727_CR8","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1111\/jvh.13147","volume":"26","author":"WT Clarke","year":"2019","unstructured":"Clarke WT, Miranda J, Neidich E, Hudock R, Peters MG, Kelly EM. Metabolic syndrome and liver steatosis occur at lower body mass index in US Asian patients with chronic hepatitis B. J Viral Hepat 2019;26:1164\u20131169","journal-title":"J Viral Hepat"},{"key":"10727_CR9","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1159\/000521768","volume":"40","author":"KN Thin","year":"2022","unstructured":"Thin KN, Tran A, Li J, Lee EY, Yang H, Rui F, et al. Increased risk of liver-related outcomes in chronic hepatitis B patients with metabolic syndrome: a systematic review and meta-analysis. Dig Dis 2022;40:745\u2013753","journal-title":"Dig Dis"},{"key":"10727_CR10","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1111\/apt.12658","volume":"39","author":"GL Wong","year":"2014","unstructured":"Wong GL, Chan HL, Yu Z, Chan AW, Choi PC, Chim AM, et al. Coincidental metabolic syndrome increases the risk of liver fibrosis progression in patients with chronic hepatitis B\u2014a prospective cohort study with paired transient elastography examinations. Aliment Pharmacol Ther 2014;39:883\u2013893","journal-title":"Aliment Pharmacol Ther"},{"key":"10727_CR11","doi-asserted-by":"publisher","first-page":"6150861","DOI":"10.1155\/2018\/6150861","volume":"2018","author":"S Drazilova","year":"2018","unstructured":"Drazilova S, Gazda J, Janicko M, Jarcuska P. Chronic hepatitis C association with diabetes mellitus and cardiovascular risk in the era of DAA therapy. Can J Gastroenterol Hepatol 2018;2018:6150861","journal-title":"Can J Gastroenterol Hepatol"},{"key":"10727_CR12","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1111\/jvh.13167","volume":"26","author":"N Peleg","year":"2019","unstructured":"Peleg N, Issachar A, Sneh Arbib O, Cohen-Naftaly M, Harif Y, Oxtrud E, et al. Liver steatosis is a major predictor of poor outcomes in chronic hepatitis C patients with sustained virological response. J Viral Hepat 2019;26:1257\u20131265","journal-title":"J Viral Hepat"},{"key":"10727_CR13","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/j.jhep.2019.06.021","volume":"71","author":"ZM Younossi","year":"2019","unstructured":"Younossi ZM, Golabi P, de Avila L, Paik JM, Srishord M, Fukui N, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: a systematic review and meta-analysis. J Hepatol 2019;71:793\u2013801","journal-title":"J Hepatol"},{"key":"10727_CR14","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.1016\/j.cgh.2009.06.007","volume":"7","author":"N Hossain","year":"2009","unstructured":"Hossain N, Afendy A, Stepanova M, Nader F, Srishord M, Rafiq N, et al. Independent predictors of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 2009;7:1224\u20131229 (1229 e1221-1222)","journal-title":"Clin Gastroenterol Hepatol"},{"key":"10727_CR15","doi-asserted-by":"publisher","first-page":"2710","DOI":"10.1007\/s10620-016-4213-3","volume":"61","author":"J De Luca-Johnson","year":"2016","unstructured":"De Luca-Johnson J, Wangensteen KJ, Hanson J, Krawitt E, Wilcox R. Natural history of patients presenting with autoimmune hepatitis and coincident nonalcoholic fatty liver disease. Dig Dis Sci 2016;61:2710\u20132720","journal-title":"Dig Dis Sci"},{"key":"10727_CR16","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1002\/jgh3.12046","volume":"2","author":"A Takahashi","year":"2018","unstructured":"Takahashi A, Arinaga-Hino T, Ohira H, Abe K, Torimura T, Zeniya M, et al. Non-alcoholic fatty liver disease in patients with autoimmune hepatitis. JGH Open 2018;2:54\u201358","journal-title":"JGH Open"},{"key":"10727_CR17","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1111\/apt.17191","volume":"56","author":"MI Jalal","year":"2022","unstructured":"Jalal MI, Brahmbhatt M, Green K, Weinberg EM, Lammert C, Bittermann T. Autoimmune hepatitis and metabolic syndrome-associated disease development: a U.S. cohort study. Aliment Pharmacol Ther 2022;56:1183\u20131193","journal-title":"Aliment Pharmacol Ther"},{"key":"10727_CR18","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/S0140-6736(03)15268-3","volume":"363","author":"WHOE Consultation","year":"2004","unstructured":"Consultation WHOE. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157\u2013163","journal-title":"Lancet"},{"key":"10727_CR19","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1053\/j.gastro.2023.05.053","volume":"165","author":"S Man","year":"2023","unstructured":"Man S, Deng Y, Ma Y, Fu J, Bao H, Yu C, et al. Prevalence of liver steatosis and fibrosis in the general population and various high-risk populations: a nationwide study with 5.7 million adults in China. Gastroenterology 2023;165:1025\u20131040","journal-title":"Gastroenterology"},{"key":"10727_CR20","unstructured":"European Association for the Study of the Liver . Electronic address eee, European Association for the Study of D, European Association for the Study of O, European Association for the Study of the L. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol 2024"},{"key":"10727_CR21","first-page":"221","volume":"51","author":"Joint Committee on the Chinese Guidelines for Lipid M","year":"2023","unstructured":"Joint Committee on the Chinese Guidelines for Lipid M. Chinese guidelines for lipid management (2023). Zhonghua Xin Xue Guan Bing Za Zhi 2023;51:221\u2013255","journal-title":"Zhonghua Xin Xue Guan Bing Za Zhi"},{"key":"10727_CR22","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1016\/j.jhep.2015.11.004","volume":"64","author":"European Association for the Study of the L, European Association for the Study of D, European Association for the Study of O","year":"2016","unstructured":"European Association for the Study of the L, European Association for the Study of D, European Association for the Study of O. EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol 2016;64:1388\u20131402","journal-title":"J Hepatol"},{"key":"10727_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2022.105315","volume":"202","author":"M Feng","year":"2022","unstructured":"Feng M, Liu K, Zhao G, Lou S, An B, Lin L, et al. A novel model based on qAnti-HBc and conventional biomarkers for identifying significant liver injury among CHB patients with ALT <\/= ULN. Antiviral Res 2022;202: 105315","journal-title":"Antiviral Res"},{"key":"10727_CR24","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1002\/hep.22322","volume":"48","author":"EM Hennes","year":"2008","unstructured":"Hennes EM, Zeniya M, Czaja AJ, Pares A, Dalekos GN, Krawitt EL, et al. Simplified criteria for the diagnosis of autoimmune hepatitis. Hepatology 2008;48:169\u2013176","journal-title":"Hepatology"},{"key":"10727_CR25","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1002\/hep.510240201","volume":"24","author":"P Bedossa","year":"1996","unstructured":"Bedossa P, Poynard T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group. Hepatology 1996;24:289\u2013293","journal-title":"Hepatology"},{"key":"10727_CR26","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1002\/hep.27173","volume":"60","author":"P Bedossa","year":"2014","unstructured":"Bedossa P, Consortium FP. Utility and appropriateness of the fatty liver inhibition of progression (FLIP) algorithm and steatosis, activity, and fibrosis (SAF) score in the evaluation of biopsies of nonalcoholic fatty liver disease. Hepatology 2014;60:565\u2013575","journal-title":"Hepatology"},{"key":"10727_CR27","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1016\/j.jhep.2019.12.008","volume":"72","author":"F Nascimbeni","year":"2020","unstructured":"Nascimbeni F, Bedossa P, Fedchuk L, Pais R, Charlotte F, Lebray P, et al. Clinical validation of the FLIP algorithm and the SAF score in patients with non-alcoholic fatty liver disease. J Hepatol 2020;72:828\u2013838","journal-title":"J Hepatol"},{"key":"10727_CR28","doi-asserted-by":"publisher","first-page":"430","DOI":"10.5009\/gnl19261","volume":"14","author":"A Tanaka","year":"2020","unstructured":"Tanaka A. Autoimmune hepatitis: 2019 update. Gut Liver 2020;14:430\u2013438","journal-title":"Gut Liver"},{"key":"10727_CR29","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1016\/j.eprac.2022.03.010","volume":"28","author":"K Cusi","year":"2022","unstructured":"Cusi K, Isaacs S, Barb D, Basu R, Caprio S, Garvey WT, et al. American Association of Clinical Endocrinology clinical practice guideline for the diagnosis and management of nonalcoholic fatty liver disease in primary care and endocrinology clinical settings: co-sponsored by the American Association for the Study of Liver Diseases (AASLD). Endocr Pract 2022;28:528\u2013562","journal-title":"Endocr Pract"},{"key":"10727_CR30","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1111\/j.1365-2036.2004.02012.x","volume":"20","author":"VW Wong","year":"2004","unstructured":"Wong VW, Chan HL, Hui AY, Chan KF, Liew CT, Chan FK, et al. Clinical and histological features of non-alcoholic fatty liver disease in Hong Kong Chinese. Aliment Pharmacol Ther 2004;20:45\u201349","journal-title":"Aliment Pharmacol Ther"},{"key":"10727_CR31","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1111\/jvh.13808","volume":"30","author":"J Wang","year":"2023","unstructured":"Wang J, Huang R, Liu J, Lai R, Liu Y, Zhu C, et al. A novel non-invasive model for the prediction of advanced liver fibrosis in chronic hepatitis B patients with NAFLD. J Viral Hepat 2023;30:287\u2013296","journal-title":"J Viral Hepat"},{"key":"10727_CR32","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000022805","volume":"99","author":"S Chalasani","year":"2020","unstructured":"Chalasani S, Mathur K, Shammas N, Orman E, Vuppalanchi R, Lammert C. Hepatic steatosis is highly prevalent but is not correlated with stiffness in autoimmune hepatitis. Medicine (Baltimore) 2020;99: e22805","journal-title":"Medicine (Baltimore)"},{"key":"10727_CR33","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1007\/s12072-021-10170-1","volume":"15","author":"G Wang","year":"2021","unstructured":"Wang G, Tanaka A, Zhao H, Jia J, Ma X, Harada K, et al. The Asian Pacific Association for the Study of the Liver clinical practice guidance: the diagnosis and management of patients with autoimmune hepatitis. Hepatol Int 2021;15:223\u2013257","journal-title":"Hepatol Int"},{"key":"10727_CR34","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.jaut.2018.10.004","volume":"95","author":"B Terziroli Beretta-Piccoli","year":"2018","unstructured":"Terziroli Beretta-Piccoli B, Mieli-Vergani G, Vergani D. The clinical usage and definition of autoantibodies in immune-mediated liver disease: a comprehensive overview. J Autoimmun 2018;95:144\u2013158","journal-title":"J Autoimmun"},{"key":"10727_CR35","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1002\/hep.24080","volume":"53","author":"RT Stravitz","year":"2011","unstructured":"Stravitz RT, Lefkowitch JH, Fontana RJ, Gershwin ME, Leung PS, Sterling RK, et al. Autoimmune acute liver failure: proposed clinical and histological criteria. Hepatology 2011;53:517\u2013526","journal-title":"Hepatology"},{"key":"10727_CR36","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/j.jhep.2020.03.039","volume":"73","author":"M Eslam","year":"2020","unstructured":"Eslam M, Newsome PN, Sarin SK, Anstee QM, Targher G, Romero-Gomez M, et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol 2020;73:202\u2013209","journal-title":"J Hepatol"}],"container-title":["Hepatology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12072-024-10727-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12072-024-10727-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12072-024-10727-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T15:08:57Z","timestamp":1728400137000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12072-024-10727-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,9]]},"references-count":36,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10727"],"URL":"https:\/\/doi.org\/10.1007\/s12072-024-10727-w","relation":{},"ISSN":["1936-0533","1936-0541"],"issn-type":[{"value":"1936-0533","type":"print"},{"value":"1936-0541","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,9]]},"assertion":[{"value":"11 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 September 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Kehui Liu, Mingyang Feng, Wanqing Chi, Zhujun Cao, Xiaoyin Wang, Yezhou Ding, Gangde Zhao, Ziqiang Li, Lanyi Lin, Shisan Bao and Hui Wang declare that there is no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures were approved by the Ethic Committee, Ruijin Hospital. As a retrospective cohort study with minimal risk to the individual, the Ethic Committee, Ruijin Hospital approved a waiver for informed consent applicable to all study patients.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}}]}}