{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T05:22:31Z","timestamp":1794201751337,"version":"4.8.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T00:00:00Z","timestamp":1794182400000},"content-version":"vor","delay-in-days":149,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"the Hunan Provincial Natural Science Foundation","award":["2024JJ8121"],"award-info":[{"award-number":["2024JJ8121"]}]},{"name":"the Hunan Provincial Natural Science Foundation","award":["2024JJ5543"],"award-info":[{"award-number":["2024JJ5543"]}]},{"name":"the Open Research Fund of Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control","award":["HPKL2023020"],"award-info":[{"award-number":["HPKL2023020"]}]},{"name":"the Hunan Provincial Joint Project of Natural Science Foundation","award":["2026JJ81579"],"award-info":[{"award-number":["2026JJ81579"]}]},{"name":"the Changsha Natural Science Foundation","award":["kq2403048"],"award-info":[{"award-number":["kq2403048"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"DOI":"10.1186\/s12872-026-06111-1","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T07:35:12Z","timestamp":1781336112000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The triglyceride-glucose index and C-reactive protein-triglyceride-glucose index as surrogate markers of vascular stiffness in prediabetes: a cross-sectional study"],"prefix":"10.1186","volume":"26","author":[{"given":"Guoran","family":"Qiu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuhong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhua","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaojiao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0151-8285","authenticated-orcid":false,"given":"Xiaoling","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7373-3390","authenticated-orcid":false,"given":"Yaqin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,13]]},"reference":[{"key":"6111_CR1","doi-asserted-by":"publisher","first-page":"2498","DOI":"10.1001\/jama.2021.22208","volume":"326","author":"L Wang","year":"2021","unstructured":"Wang L, Peng W, Zhao Z, Zhang M, Shi Z, Song Z, et al. Prevalence and Treatment of Diabetes in China, 2013\u20132018. JAMA. 2021;326:2498\u2013506. https:\/\/doi.org\/10.1001\/jama.2021.22208.","journal-title":"JAMA"},{"key":"6111_CR2","doi-asserted-by":"publisher","first-page":"m2297","DOI":"10.1136\/bmj.m2297","volume":"370","author":"X Cai","year":"2020","unstructured":"Cai X, Zhang Y, Li M, Wu JH, Mai L, Li J, et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis. BMJ. Br Med J Publishing Group. 2020;370:m2297. https:\/\/doi.org\/10.1136\/bmj.m2297.","journal-title":"Br Med J Publishing Group"},{"key":"6111_CR3","doi-asserted-by":"publisher","first-page":"2279","DOI":"10.1016\/S0140-6736(12)60283-9","volume":"379","author":"AG Tab\u00e1k","year":"2012","unstructured":"Tab\u00e1k AG, Herder C, Rathmann W, Brunner EJ, Kivim\u00e4ki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012;379:2279\u201390. https:\/\/doi.org\/10.1016\/S0140-6736(12)60283-9.","journal-title":"Lancet"},{"key":"6111_CR4","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1093\/ajh\/hpw036","volume":"29","author":"LR Loehr","year":"2016","unstructured":"Loehr LR, Meyer ML, Poon AK, Selvin E, Palta P, Tanaka H, et al. Prediabetes and Diabetes Are Associated With Arterial Stiffness in Older Adults: The ARIC Study. Am J Hypertens. 2016;29:1038\u201345. https:\/\/doi.org\/10.1093\/ajh\/hpw036.","journal-title":"Am J Hypertens"},{"key":"6111_CR5","doi-asserted-by":"publisher","first-page":"603","DOI":"10.3390\/jcm8050603","volume":"8","author":"C-H Li","year":"2019","unstructured":"Li C-H, Lu F-H, Yang Y-C, Wu J-S, Chang C-J. Increased Arterial Stiffness in Prediabetic Subjects Recognized by Hemoglobin A1c with Postprandial Glucose but Not Fasting Glucose Levels. J Clin Med. 2019;8:603. https:\/\/doi.org\/10.3390\/jcm8050603.","journal-title":"J Clin Med"},{"key":"6111_CR6","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.atherosclerosis.2006.05.025","volume":"192","author":"J-S Kim","year":"2007","unstructured":"Kim J-S, Kang TS, Kim J-B, Seo H-S, Park S, Kim C, et al. Significant association of C-reactive protein with arterial stiffness in treated non-diabetic hypertensive patients. Atherosclerosis Elsevier. 2007;192:401\u20136. https:\/\/doi.org\/10.1016\/j.atherosclerosis.2006.05.025.","journal-title":"Atherosclerosis Elsevier"},{"key":"6111_CR7","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1186\/s12944-024-02183-0","volume":"23","author":"J Li","year":"2024","unstructured":"Li J, Ye P, Peng X, Xiang G. The roles of lipids and inflammation in the association between the triglyceride-glucose index and arterial stiffness: evidence from two large population-based surveys. Lipids Health Dis. 2024;23:190. https:\/\/doi.org\/10.1186\/s12944-024-02183-0.","journal-title":"Lipids Health Dis"},{"key":"6111_CR8","doi-asserted-by":"publisher","first-page":"3347","DOI":"10.1210\/jc.2010-0288","volume":"95","author":"F Guerrero-Romero","year":"2010","unstructured":"Guerrero-Romero F, Simental-Mend\u00eda LE, Gonz\u00e1lez-Ortiz M, Mart\u00ednez-Abundis E, Ramos-Zavala MG, Hern\u00e1ndez-Gonz\u00e1lez SO, et al. The Product of Triglycerides and Glucose, a Simple Measure of Insulin Sensitivity. Comparison with the Euglycemic-Hyperinsulinemic Clamp. J Clin Endocrinol Metab. 2010;95:3347\u201351. https:\/\/doi.org\/10.1210\/jc.2010-0288.","journal-title":"J Clin Endocrinol Metab"},{"key":"6111_CR9","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s12933-018-0692-1","volume":"17","author":"SB Lee","year":"2018","unstructured":"Lee SB, Ahn CW, Lee BK, Kang S, Nam JS, You JH, et al. Association between triglyceride glucose index and arterial stiffness in Korean adults. Cardiovasc Diabetol. 2018;17:41. https:\/\/doi.org\/10.1186\/s12933-018-0692-1.","journal-title":"Cardiovasc Diabetol"},{"key":"6111_CR10","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.585776","author":"W Guo","year":"2021","unstructured":"Guo W, Zhu W, Wu J, Li X, Lu J, Qin P, et al. Triglyceride Glucose Index Is Associated With Arterial Stiffness and 10-Year Cardiovascular Disease Risk in a Chinese Population. Front Cardiovasc Med [Internet] Front. 2021. https:\/\/doi.org\/10.3389\/fcvm.2021.585776. [cited 2025 Dec 12];8.","journal-title":"Front Cardiovasc Med [Internet] Front"},{"key":"6111_CR11","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1186\/s12933-021-01342-2","volume":"20","author":"S Wu","year":"2021","unstructured":"Wu S, Xu L, Wu M, Chen S, Wang Y, Tian Y. Association between triglyceride-glucose index and risk of arterial stiffness: a cohort study. Cardiovasc Diabetol. 2021;20:146. https:\/\/doi.org\/10.1186\/s12933-021-01342-2.","journal-title":"Cardiovasc Diabetol"},{"key":"6111_CR12","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1186\/s12933-021-01274-x","volume":"20","author":"S Wang","year":"2021","unstructured":"Wang S, Shi J, Peng Y, Fang Q, Mu Q, Gu W, et al. Stronger association of triglyceride glucose index than the HOMA-IR with arterial stiffness in patients with type 2 diabetes: a real-world single-centre study. Cardiovasc Diabetol. 2021;20:82. https:\/\/doi.org\/10.1186\/s12933-021-01274-x.","journal-title":"Cardiovasc Diabetol"},{"key":"6111_CR13","doi-asserted-by":"publisher","first-page":"2464","DOI":"10.1016\/j.numecd.2024.07.005","volume":"34","author":"L D\u2019Elia","year":"2024","unstructured":"D\u2019Elia L, Masulli M, Rendina D, Iacone R, Russo O, Zarrella AF, et al. Predictive role of triglyceride-glucose index and HOMA index on development of arterial stiffening in non-diabetic men. Nutrition, Metabolism and Cardiovascular Diseases. Elsevier. 2024;34:2464\u201371. https:\/\/doi.org\/10.1016\/j.numecd.2024.07.005.","journal-title":"Elsevier"},{"key":"6111_CR14","doi-asserted-by":"publisher","unstructured":"Xu M, Zhang L, Xu D, Shi W, Zhang W. Usefulness of C-reactive protein-triglyceride glucose index in detecting prevalent coronary heart disease: findings from the National Health and Nutrition Examination Survey 1999\u20132018. Front Cardiovasc Med. Frontiers; 2024;11. https:\/\/doi.org\/10.3389\/fcvm.2024.1485538.\u00a0[cited 2026 Mar 21].","DOI":"10.3389\/fcvm.2024.1485538"},{"key":"6111_CR15","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1097\/JS9.0000000000003560","volume":"112","author":"G Song","year":"2026","unstructured":"Song G. The C-reactive protein-triglyceride glucose index (CTI) predicts mortality in cardiovascular-kidney-metabolic syndrome: a dual-cohort study with machine learning validation. Int J Surg. 2026;112:1340. https:\/\/doi.org\/10.1097\/JS9.0000000000003560.","journal-title":"Int J Surg"},{"key":"6111_CR16","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1186\/s12911-025-03265-4","volume":"25","author":"R Zheng","year":"2025","unstructured":"Zheng R, Wang T, Liu M, Cao X. Relationship between C-reactive protein triglyceride glucose index and cardiovascular disease risk: a cross-sectional analysis with machine learning. BMC Med Inf Decis Mak. 2025;25:424. https:\/\/doi.org\/10.1186\/s12911-025-03265-4.","journal-title":"BMC Med Inf Decis Mak"},{"key":"6111_CR17","doi-asserted-by":"publisher","unstructured":"Wang Y, Liu L, Yang P, Li Y, Zhou Y, Yang S et al. Associations of triglyceride\u2013glucose index cumulative exposure and variability with the transitions from normoglycaemia to prediabetes and prediabetes to diabetes: Insights from a cohort study. Diabetes Research and Clinical Practice. Elsevier; 2024;217. https:\/\/doi.org\/10.1016\/j.diabres.2024.111867.\u00a0[cited 2026 Mar 21].","DOI":"10.1016\/j.diabres.2024.111867"},{"key":"6111_CR18","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.905266","author":"G-T Ruan","year":"2022","unstructured":"Ruan G-T, Xie H-L, Zhang H-Y, Liu C-A, Ge Y-Z, Zhang Q, et al. A Novel Inflammation and Insulin Resistance Related Indicator to Predict the Survival of Patients With Cancer. Front Endocrinol [Internet] Front. 2022. https:\/\/doi.org\/10.3389\/fendo.2022.905266. [cited 2026 Jan 5];13.","journal-title":"Front Endocrinol [Internet] Front"},{"key":"6111_CR19","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1053\/j.ackd.2017.10.005","volume":"25","author":"BW Teo","year":"2018","unstructured":"Teo BW, Zhang L, Guh J-Y, Tang SCW, Jha V, Kang D-H, et al. Glomerular Filtration Rates in Asians. Advances in Chronic Kidney Disease. Elsevier. 2018;25:41\u20138. https:\/\/doi.org\/10.1053\/j.ackd.2017.10.005.","journal-title":"Elsevier"},{"key":"6111_CR20","doi-asserted-by":"publisher","first-page":"S19","DOI":"10.2337\/dc23-S002","volume":"46","author":"NA ElSayed","year":"2023","unstructured":"ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes\u20142023. Diabetes Care. 2023;46:S19\u201340. https:\/\/doi.org\/10.2337\/dc23-S002.","journal-title":"Diabetes Care"},{"key":"6111_CR21","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1001\/jama.2013.284427","volume":"311","author":"PA James","year":"2014","unstructured":"James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507. https:\/\/doi.org\/10.1001\/jama.2013.284427.","journal-title":"JAMA"},{"key":"6111_CR22","doi-asserted-by":"publisher","first-page":"2212","DOI":"10.1161\/CIRCULATIONAHA.111.065904","volume":"125","author":"W Yang","year":"2012","unstructured":"Yang W, Xiao J, Yang Z, Ji L, Jia W, Weng J, et al. Serum Lipids and Lipoproteins in Chinese Men and Women. Circulation. 2012;125:2212\u201321. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.111.065904.","journal-title":"Circulation"},{"key":"6111_CR23","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1016\/j.jacc.2019.12.039","volume":"75","author":"Y Lu","year":"2020","unstructured":"Lu Y, Pechlaner R, Cai J, Yuan H, Huang Z, Yang G, et al. Trajectories of Age-Related Arterial Stiffness in Chinese Men and Women. JACC Am Coll Cardiol Foundation. 2020;75:870\u201380. https:\/\/doi.org\/10.1016\/j.jacc.2019.12.039.","journal-title":"JACC Am Coll Cardiol Foundation"},{"key":"6111_CR24","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1159\/000443740","volume":"3","author":"M Munakata","year":"2016","unstructured":"Munakata M. Brachial-Ankle Pulse Wave Velocity: Background, Method, and Clinical Evidence. Pulse (Basel). 2016;3:195\u2013204. https:\/\/doi.org\/10.1159\/000443740.","journal-title":"Pulse (Basel)"},{"key":"6111_CR25","unstructured":"Physiological Diagnostic Criteria for Vascular Failure. | Hypertension. https:\/\/www.ahajournals.org\/doi\/10.1161\/HYPERTENSIONAHA.118.11554.\u00a0Accessed 21 Mar 2026. [cited 2026 Mar 21]."},{"key":"6111_CR26","doi-asserted-by":"publisher","first-page":"101390","DOI":"10.1016\/j.cpcardiol.2022.101390","volume":"47","author":"Triglyceride Glucose Index for the Prediction of Subclinical Atherosclerosis and Arterial Stiffness","year":"2022","unstructured":"Triglyceride Glucose Index for the Prediction of Subclinical Atherosclerosis and Arterial Stiffness. A Meta-analysis of 37,780 Individuals. Curr Probl Cardiol Mosby. 2022;47:101390. https:\/\/doi.org\/10.1016\/j.cpcardiol.2022.101390.","journal-title":"Curr Probl Cardiol Mosby"},{"key":"6111_CR27","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.ejim.2024.08.026","volume":"131","author":"Y Sun","year":"2025","unstructured":"Sun Y, Ji H, Sun W, An X, Lian F. Triglyceride glucose (TyG) index: A promising biomarker for diagnosis and treatment of different diseases. Eur J Intern Med. 2025;131:3\u201314. https:\/\/doi.org\/10.1016\/j.ejim.2024.08.026.","journal-title":"Eur J Intern Med"},{"key":"6111_CR28","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.2337\/diacare.25.7.1135","volume":"25","author":"E Bonora","year":"2002","unstructured":"Bonora E, Formentini G, Calcaterra F, Lombardi S, Marini F, Zenari L, et al. HOMA-Estimated Insulin Resistance Is an Independent Predictor of Cardiovascular Disease in Type 2 Diabetic SubjectsProspective data from the Verona Diabetes Complications Study. Diabetes Care Am Diabetes Association. 2002;25:1135\u201341. https:\/\/doi.org\/10.2337\/diacare.25.7.1135.","journal-title":"Diabetes Care Am Diabetes Association"},{"key":"6111_CR29","doi-asserted-by":"publisher","first-page":"e98","DOI":"10.1016\/j.diabres.2011.05.030","volume":"93","author":"ACJ Vasques","year":"2011","unstructured":"Vasques ACJ, Novaes FS, de Oliveira MdaS, Souza JRM, Yamanaka A, Pareja JC, et al. TyG index performs better than HOMA in a Brazilian population: A hyperglycemic clamp validated study. Diabetes Res Clin Pract Elsevier. 2011;93:e98\u2013100. https:\/\/doi.org\/10.1016\/j.diabres.2011.05.030.","journal-title":"Diabetes Res Clin Pract Elsevier"},{"key":"6111_CR30","doi-asserted-by":"publisher","unstructured":"Simental-Mend\u00eda LE, Rodr\u00edguez-Mor\u00e1n M, Guerrero-Romero F. The Product of Fasting Glucose and Triglycerides As Surrogate for Identifying Insulin Resistance in Apparently Healthy Subjects. Metabolic Syndrome and Related Disorders. Volume 6. Mary Ann Liebert, Inc., publishers;; 2008. pp. 299\u2013304. https:\/\/doi.org\/10.1089\/met.2008.0034.","DOI":"10.1089\/met.2008.0034"},{"key":"6111_CR31","doi-asserted-by":"publisher","first-page":"4678526","DOI":"10.1155\/2020\/4678526","volume":"2020","author":"A S\u00e1nchez-Garc\u00eda","year":"2020","unstructured":"S\u00e1nchez-Garc\u00eda A, Rodr\u00edguez-Guti\u00e9rrez R, Mancillas-Adame L, Gonz\u00e1lez-Nava V, D\u00edaz Gonz\u00e1lez-Colmenero A, Solis RC, et al. Diagnostic Accuracy of the Triglyceride and Glucose Index for Insulin Resistance: A Systematic Review. Int J Endocrinol. 2020;2020:4678526. https:\/\/doi.org\/10.1155\/2020\/4678526.","journal-title":"Int J Endocrinol"},{"key":"6111_CR32","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s11154-012-9229-1","volume":"14","author":"R Muniyappa","year":"2013","unstructured":"Muniyappa R, Sowers JR. Role of insulin resistance in endothelial dysfunction. Rev Endocr Metab Disord. 2013;14:5\u201312. https:\/\/doi.org\/10.1007\/s11154-012-9229-1.","journal-title":"Rev Endocr Metab Disord"},{"key":"6111_CR33","doi-asserted-by":"publisher","DOI":"10.3389\/fmolb.2022.1002710","author":"MA Mengstie","year":"2022","unstructured":"Mengstie MA, Chekol Abebe E, Behaile Teklemariam A, Tilahun Mulu A, Agidew MM, Teshome Azezew M, et al. Endogenous advanced glycation end products in the pathogenesis of chronic diabetic complications. Front Mol Biosci [Internet] Front. 2022. https:\/\/doi.org\/10.3389\/fmolb.2022.1002710. [cited 2026 Apr 6];9.","journal-title":"Front Mol Biosci [Internet] Front"},{"key":"6111_CR34","doi-asserted-by":"publisher","first-page":"1039700","DOI":"10.3389\/fendo.2022.1039700","volume":"13","author":"P Ning","year":"2022","unstructured":"Ning P, Yang F, Kang J, Yang J, Zhang J, Tang Y, et al. Predictive value of novel inflammatory markers platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in arterial stiffness in patients with diabetes: A propensity score\u2013matched analysis. Front Endocrinol. 2022;13:1039700. https:\/\/doi.org\/10.3389\/fendo.2022.1039700.","journal-title":"Front Endocrinol"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-026-06111-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-026-06111-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-026-06111-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T04:57:04Z","timestamp":1794200224000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-026-06111-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,13]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6111"],"URL":"https:\/\/doi.org\/10.1186\/s12872-026-06111-1","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,13]]},"assertion":[{"value":"9 May 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":"13 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study protocol was reviewed and approved by the Institutional Review Board of the Third Xiangya Hospital, Central South University (Approval No. 2021YFC2500501). Written informed consent was obtained from all participants prior to enrolment. All procedures were performed in accordance with the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1048"}}