{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:13:52Z","timestamp":1791807232776,"version":"4.3.4"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T00:00:00Z","timestamp":1620604800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T00:00:00Z","timestamp":1620604800000},"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":["BMC Gastroenterol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Metabolic associated fatty liver disease (MAFLD) is a new definition for liver disease associated with known metabolic dysfunction. Based on new diagnostic criteria, we aimed to investigate its prevalence and risk factors in Chinese population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted this study in a health examination population who underwent abdominal ultrasonography in China. The diagnosis of MAFLD was based on the new diagnostic criteria. The characteristics of the MAFLD population, as well as the associations between MAFLD and metabolic abnormalities, were explored. Mann\u2013Whitney U test and chi-square test were performed to compare different variables. Binary logistic regression was used to determine the risk factors for MAFLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 139,170 subjects, the prevalence of MAFLD was 26.1% (males: 35.4%; females: 14.1%). The prevalence based on female menopausal status, that is, premenopausal, perimenopausal, and postmenopausal, was 6.1%, 16.8%, and 30.2%, respectively. In different BMI groups (underweight, normal, overweight and obese), the prevalence was 0.1%, 4.0%, 27.4% and 59.8%, respectively. The proportions of abnormal metabolic features in the MAFLD group were significantly higher than those in the non-MAFLD group, as was the proportion of elevated alanine aminotransferase (ALT) (42.5% vs. 11%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). In nonobese individuals with MAFLD, the proportions of abnormal metabolic features were also all significantly higher than those in nonobese individuals without MAFLD. The prevalence of metabolic syndrome (MS), dyslipidaemia, and hyperuricaemia, respectively, in the MAFLD group (53.2%, 80.0%, and 45.0%) was significantly higher than that in the non-MAFLD group (10.1%, 41.7%, and 16.8%). Logistic regression revealed that age, BMI, waist circumference, ALT, triglycerides, fasting glucose, uric acid and platelet count were associated with MAFLD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MAFLD is prevalent in China and varies considerably among different age, sex, BMI, and female menopausal status groups. MAFLD is related to metabolic disorders, especially obesity, while metabolic disorders also play important roles in the occurrence of MAFLD in nonobese individuals. MAFLD patients exhibit a high prevalence of MS, dyslipidaemia, hyperuricaemia, and elevated liver enzymes. MAFLD tends to coexist with systemic metabolic disorders, and a deep inner relationship may exist between MAFLD and MS. Metabolic disorders should be considered to improve the management of MAFLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-021-01782-w","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T08:03:21Z","timestamp":1620633801000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":89,"title":["Prevalence of and risk factors for metabolic associated fatty liver disease in an urban population in China: a cross-sectional comparative study"],"prefix":"10.1186","volume":"21","author":[{"given":"Yu-ling","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhou","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shen","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin-yu","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi-li","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-ying","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-yu","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-nan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Ran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5705-9001","authenticated-orcid":false,"given":"Ling-quan","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,10]]},"reference":[{"issue":"1","key":"1782_CR1","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1038\/nrgastro.2017.109","volume":"15","author":"Z Younossi","year":"2018","unstructured":"Younossi Z, Anstee QM, Marietti M, Hardy T, Henry L, Eslam M, George J, Bugianesi E. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018;15(1):11\u201320.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"6","key":"1782_CR2","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1016\/S0016-5085(99)70506-8","volume":"116","author":"CA Matteoni","year":"1999","unstructured":"Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ. Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology. 1999;116(6):1413\u20139.","journal-title":"Gastroenterology"},{"issue":"1","key":"1782_CR3","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1002\/hep.29367","volume":"67","author":"N Chalasani","year":"2018","unstructured":"Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, Harrison SA, Brunt EM, Sanyal AJ. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328\u201357.","journal-title":"Hepatology"},{"issue":"7","key":"1782_CR4","doi-asserted-by":"publisher","first-page":"1999e1991","DOI":"10.1053\/j.gastro.2019.11.312","volume":"158","author":"M Eslam","year":"2020","unstructured":"Eslam M, Sanyal AJ, George J. International consensus P: MAFLD: a consensus-driven proposed nomenclature for metabolic associated fatty liver disease. Gastroenterology. 2020;158(7):1999e1991-2014e1991.","journal-title":"Gastroenterology"},{"issue":"1","key":"1782_CR5","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, Zelber-Sagi S, Wai-Sun Wong V, Dufour JF, Schattenberg JM, et al. A new definition for metabolic dysfunction-associated fatty liver disease: an international expert consensus statement. J Hepatol. 2020;73(1):202\u20139.","journal-title":"J Hepatol"},{"issue":"5","key":"1782_CR6","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.2214\/ajr.146.5.1011","volume":"146","author":"L Needleman","year":"1986","unstructured":"Needleman L, Kurtz AB, Rifkin MD, Cooper HS, Pasto ME, Goldberg BB. Sonography of diffuse benign liver disease: accuracy of pattern recognition and grading. AJR Am J Roentgenol. 1986;146(5):1011\u20135.","journal-title":"AJR Am J Roentgenol"},{"issue":"10","key":"1782_CR7","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1007\/s00535-003-1178-8","volume":"38","author":"S Kojima","year":"2003","unstructured":"Kojima S, Watanabe N, Numata M, Ogawa T, Matsuzaki S. Increase in the prevalence of fatty liver in Japan over the past 12 years: analysis of clinical background. J Gastroenterol. 2003;38(10):954\u201361.","journal-title":"J Gastroenterol"},{"key":"1782_CR8","unstructured":"World Health Organization. Regional Office for the Western, Pacific. The Asia-Pacific perspective : redefining obesity and its treatment. https:\/\/apps.who.int\/iris\/handle\/10665\/206936. Accessed 20 May 2020. Sydney : Health Communications Australia; 2000."},{"issue":"16","key":"1782_CR9","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, Fruchart JC, James WP, Loria CM, Smith SC Jr, 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(16):1640\u20135.","journal-title":"Circulation"},{"key":"1782_CR10","unstructured":"The Joint Committee on The Revision of Guidelines for the Prevention and Treatment of Dyslipidemia in Chines Adults. The guidelines for the prevention and treatment of dyslipidemia in Chinese Adults (2016 Revision). http:\/\/www.chinacirculation.org\/Magazine\/Show\/76944. Chin Circ J. 2016;31(10):937\u201350; (in Chinese)."},{"issue":"18","key":"1782_CR11","doi-asserted-by":"publisher","first-page":"2404","DOI":"10.1001\/jama.283.18.2404","volume":"283","author":"J Fang","year":"2000","unstructured":"Fang J, Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971\u20131992. National Health and Nutrition Examination Survey. JAMA. 2000;283(18):2404\u201310.","journal-title":"JAMA"},{"key":"1782_CR12","doi-asserted-by":"crossref","unstructured":"Collaborative Group on Hormonal Factors in Breast C: Menarche, menopause, and breast cancer risk: individual participant meta-analysis, including 118964 women with breast cancer from 117 epidemiological studies. Lancet Oncol. 2012;13(11):1141\u201351.","DOI":"10.1016\/S1470-2045(12)70425-4"},{"issue":"2","key":"1782_CR13","first-page":"502","volume":"46","author":"L Yang","year":"2017","unstructured":"Yang L, Li L, Millwood IY, Lewington S, Guo Y, Sherliker P, Peters SA, Bian Z, Wu X, Yu M, et al. Adiposity in relation to age at menarche and other reproductive factors among 300 000 Chinese women: findings from China Kadoorie Biobank study. Int J Epidemiol. 2017;46(2):502\u201312.","journal-title":"Int J Epidemiol"},{"issue":"5","key":"1782_CR14","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1053\/j.gastro.2004.02.015","volume":"126","author":"N Chalasani","year":"2004","unstructured":"Chalasani N, Aljadhey H, Kesterson J, Murray MD, Hall SD. Patients with elevated liver enzymes are not at higher risk for statin hepatotoxicity. Gastroenterology. 2004;126(5):1287\u201392.","journal-title":"Gastroenterology"},{"key":"1782_CR15","first-page":"66","volume":"6","author":"TG Simon","year":"2020","unstructured":"Simon TG, Roelstraete B, Khalili H, Hagstrom H, Ludvigsson JF. Mortality in biopsy-confirmed nonalcoholic fatty liver disease: results from a nationwide cohort. Gut. 2020;6:66.","journal-title":"Gut"},{"issue":"2","key":"1782_CR16","first-page":"191","volume":"5","author":"A Suzuki","year":"2009","unstructured":"Suzuki A, Abdelmalek MF. Nonalcoholic fatty liver disease in women. Womens Health. 2009;5(2):191\u2013203.","journal-title":"Womens Health"},{"issue":"5","key":"1782_CR17","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.3748\/wjg.v9.i5.1106","volume":"9","author":"L Shen","year":"2003","unstructured":"Shen L, Fan JG, Shao Y, Zeng MD, Wang JR, Luo GH, Li JQ, Chen SY. Prevalence of nonalcoholic fatty liver among administrative officers in Shanghai: an epidemiological survey. World J Gastroenterol. 2003;9(5):1106\u201310.","journal-title":"World J Gastroenterol"},{"issue":"4","key":"1782_CR18","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1016\/S1665-2681(19)31616-3","volume":"9","author":"Y Gutierrez-Grobe","year":"2010","unstructured":"Gutierrez-Grobe Y, Ponciano-Rodriguez G, Ramos MH, Uribe M, Mendez-Sanchez N. Prevalence of non alcoholic fatty liver disease in premenopausal, posmenopausal and polycystic ovary syndrome women. The role of estrogens. Ann Hepatol. 2010;9(4):402\u20139.","journal-title":"Ann Hepatol"},{"issue":"4","key":"1782_CR19","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1097\/00132577-200512000-00018","volume":"4","author":"SM Grundy","year":"2005","unstructured":"Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association\/National Heart, Lung, and Blood Institute scientific statement: executive summary. Crit Pathw Cardiol. 2005;4(4):198\u2013203.","journal-title":"Crit Pathw Cardiol"},{"issue":"1","key":"1782_CR20","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/S0168-8278(97)80287-5","volume":"27","author":"T Ueno","year":"1997","unstructured":"Ueno T, Sugawara H, Sujaku K, Hashimoto O, Tsuji R, Tamaki S, Torimura T, Inuzuka S, Sata M, Tanikawa K. Therapeutic effects of restricted diet and exercise in obese patients with fatty liver. J Hepatol. 1997;27(1):103\u20137.","journal-title":"J Hepatol"},{"issue":"6","key":"1782_CR21","doi-asserted-by":"publisher","first-page":"1979","DOI":"10.1002\/hep.23593","volume":"51","author":"EK Speliotes","year":"2010","unstructured":"Speliotes EK, Massaro JM, Hoffmann U, Vasan RS, Meigs JB, Sahani DV, Hirschhorn JN, O\u2019Donnell CJ, Fox CS. Fatty liver is associated with dyslipidemia and dysglycemia independent of visceral fat: the Framingham Heart Study. Hepatology. 2010;51(6):1979\u201387.","journal-title":"Hepatology"},{"issue":"3","key":"1782_CR22","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.1002\/hep.23789","volume":"52","author":"N Ghouri","year":"2010","unstructured":"Ghouri N, Preiss D, Sattar N. Liver enzymes, nonalcoholic fatty liver disease, and incident cardiovascular disease: a narrative review and clinical perspective of prospective data. Hepatology. 2010;52(3):1156\u201361.","journal-title":"Hepatology"},{"issue":"9","key":"1782_CR23","doi-asserted-by":"publisher","first-page":"2082","DOI":"10.1111\/liv.14548","volume":"40","author":"S Lin","year":"2020","unstructured":"Lin S, Huang J, Wang M, Kumar R, Liu Y, Liu S, Wu Y, Wang X, Zhu Y. Comparison of MAFLD and NAFLD diagnostic criteria in real world. Liver Int. 2020;40(9):2082\u20139.","journal-title":"Liver Int"},{"issue":"3","key":"1782_CR24","doi-asserted-by":"publisher","first-page":"378","DOI":"10.5009\/gnl.2010.4.3.378","volume":"4","author":"JW Lee","year":"2010","unstructured":"Lee JW, Cho YK, Ryan M, Kim H, Lee SW, Chang E, Joo KJ, Kim JT, Kim BS, Sung KC. Serum uric Acid as a predictor for the development of nonalcoholic Fatty liver disease in apparently healthy subjects: a 5-year retrospective cohort study. Gut Liver. 2010;4(3):378\u201383.","journal-title":"Gut Liver"},{"issue":"7","key":"1782_CR25","doi-asserted-by":"publisher","first-page":"e11578","DOI":"10.1371\/journal.pone.0011578","volume":"5","author":"C Xu","year":"2010","unstructured":"Xu C, Yu C, Xu L, Miao M, Li Y. High serum uric acid increases the risk for nonalcoholic Fatty liver disease: a prospective observational study. PLoS ONE. 2010;5(7):e11578.","journal-title":"PLoS ONE"},{"issue":"3","key":"1782_CR26","doi-asserted-by":"publisher","first-page":"386","DOI":"10.3346\/jkms.2011.26.3.386","volume":"26","author":"IC Hwang","year":"2011","unstructured":"Hwang IC, Suh SY, Suh AR, Ahn HY. The relationship between normal serum uric acid and nonalcoholic fatty liver disease. J Korean Med Sci. 2011;26(3):386\u201391.","journal-title":"J Korean Med Sci"},{"issue":"6","key":"1782_CR27","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1016\/S0016-5085(00)70364-7","volume":"118","author":"V Ratziu","year":"2000","unstructured":"Ratziu V, Giral P, Charlotte F, Bruckert E, Thibault V, Theodorou I, Khalil L, Turpin G, Opolon P, Poynard T. Liver fibrosis in overweight patients. Gastroenterology. 2000;118(6):1117\u201323.","journal-title":"Gastroenterology"},{"issue":"11","key":"1782_CR28","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1007\/s00535-011-0436-4","volume":"46","author":"M Yoneda","year":"2011","unstructured":"Yoneda M, Fujii H, Sumida Y, Hyogo H, Itoh Y, Ono M, Eguchi Y, Suzuki Y, Aoki N, Kanemasa K, et al. Platelet count for predicting fibrosis in nonalcoholic fatty liver disease. J Gastroenterol. 2011;46(11):1300\u20136.","journal-title":"J Gastroenterol"},{"issue":"5","key":"1782_CR29","doi-asserted-by":"publisher","first-page":"1486","DOI":"10.1002\/hep.29302","volume":"66","author":"G Xiao","year":"2017","unstructured":"Xiao G, Zhu S, Xiao X, Yan L, Yang J, Wu G. Comparison of laboratory tests, ultrasound, or magnetic resonance elastography to detect fibrosis in patients with nonalcoholic fatty liver disease: A meta-analysis. Hepatology. 2017;66(5):1486\u2013501.","journal-title":"Hepatology"},{"issue":"8","key":"1782_CR30","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1038\/ajg.2013.104","volume":"108","author":"C Xu","year":"2013","unstructured":"Xu C, Yu C, Ma H, Xu L, Miao M, Li Y. Prevalence and risk factors for the development of nonalcoholic fatty liver disease in a nonobese Chinese population: the Zhejiang Zhenhai Study. Am J Gastroenterol. 2013;108(8):1299\u2013304.","journal-title":"Am J Gastroenterol"},{"issue":"10","key":"1782_CR31","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1111\/j.1753-4887.2004.tb00010.x","volume":"62","author":"GM Lam","year":"2004","unstructured":"Lam GM, Mobarhan S. Central obesity and elevated liver enzymes. Nutr Rev. 2004;62(10):394\u20139.","journal-title":"Nutr Rev"},{"issue":"2","key":"1782_CR32","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1111\/j.1467-789X.2006.00226.x","volume":"7","author":"K Narkiewicz","year":"2006","unstructured":"Narkiewicz K. Diagnosis and management of hypertension in obesity. Obes Rev. 2006;7(2):155\u201362.","journal-title":"Obes Rev"},{"issue":"5","key":"1782_CR33","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.1053\/gast.2002.36572","volume":"123","author":"AJ Sanyal","year":"2002","unstructured":"Sanyal AJ, American Gastroenterological A. AGA technical review on nonalcoholic fatty liver disease. Gastroenterology. 2002;123(5):1705\u201325.","journal-title":"Gastroenterology"},{"key":"1782_CR34","first-page":"66","volume":"5","author":"M Eslam","year":"2020","unstructured":"Eslam M, Sarin SK, Wong VW, Fan JG, Kawaguchi T, Ahn SH, Zheng MH, Shiha G, Yilmaz Y, Gani R, et al. The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease. Hepatol Int. 2020;5:66.","journal-title":"Hepatol Int"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-021-01782-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-021-01782-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-021-01782-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T20:04:33Z","timestamp":1620677073000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-021-01782-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,10]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1782"],"URL":"https:\/\/doi.org\/10.1186\/s12876-021-01782-w","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,10]]},"assertion":[{"value":"17 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures in studies involving human participants were performed in accordance with the ethical standards of the institutional research committee (The Ethics Committee of the First Affiliated Hospital of Chongqing Medical University, approval number: 2019-141) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The informed consent was waived because the information of all the participants was anonymous and retrospective.","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 that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"212"}}