{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T08:00:54Z","timestamp":1793779254750,"version":"4.6.1"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"DOI":"10.1186\/s12902-025-02098-6","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:30:58Z","timestamp":1764333058000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of empagliflozin on liver fibrosis and steatosis in patients with type 2 diabetes and non-alcoholic fatty liver disease: a randomized clinical trial"],"prefix":"10.1186","volume":"25","author":[{"given":"Azam","family":"Erfanifar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahriar","family":"Nikpour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Davoudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pardis","family":"Jolfaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Toreyhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyedeh Naghmeh","family":"Mostafavi Nasab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"issue":"6","key":"2098_CR1","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":"7","key":"2098_CR2","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.2337\/dc14-1239","volume":"38","author":"J Bazick","year":"2015","unstructured":"Bazick J, Donithan M, Neuschwander-Tetri BA, Kleiner D, Brunt EM, Wilson L, et al. Clinical model for NASH and advanced fibrosis in adult patients with diabetes and NAFLD: guidelines for referral in NAFLD. Diabetes Care. 2015;38(7):1347\u201355.","journal-title":"Diabetes Care"},{"issue":"Suppl 1","key":"2098_CR3","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1111\/jgh.12212","volume":"28","author":"D Schuppan","year":"2013","unstructured":"Schuppan D, Schattenberg JM. Non-alcoholic steatohepatitis: pathogenesis and novel therapeutic approaches. J Gastroenterol Hepatol. 2013;28(Suppl 1):68\u201376.","journal-title":"J Gastroenterol Hepatol"},{"key":"2098_CR4","doi-asserted-by":"publisher","first-page":"637027","DOI":"10.1155\/2014\/637027","volume":"2014","author":"AM Gusdon","year":"2014","unstructured":"Gusdon AM, Song KX, Qu S. Nonalcoholic fatty liver disease: pathogenesis and therapeutics from a mitochondria-centric perspective. Oxid Med Cell Longev. 2014;2014:637027.","journal-title":"Oxid Med Cell Longev"},{"issue":"5","key":"2098_CR5","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1016\/S0002-9343(99)00271-5","volume":"107","author":"G Marchesini","year":"1999","unstructured":"Marchesini G, Brizi M, Morselli-Labate AM, Bianchi G, Bugianesi E, McCullough AJ, et al. Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med. 1999;107(5):450\u20135.","journal-title":"Am J Med"},{"issue":"5","key":"2098_CR6","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1111\/j.1572-0241.2005.41334.x","volume":"100","author":"MA Huang","year":"2005","unstructured":"Huang MA, Greenson JK, Chao C, Anderson L, Peterman D, Jacobson J, et al. One-year intense nutritional counseling results in histological improvement in patients with non-alcoholic steatohepatitis: a pilot study. Am J Gastroenterol. 2005;100(5):1072\u201381.","journal-title":"Am J Gastroenterol"},{"issue":"1","key":"2098_CR7","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1002\/hep.23276","volume":"51","author":"K Promrat","year":"2010","unstructured":"Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR, et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology. 2010;51(1):121\u20139.","journal-title":"Hepatology"},{"issue":"2","key":"2098_CR8","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1111\/j.1365-2036.2008.03869.x","volume":"29","author":"R Loomba","year":"2009","unstructured":"Loomba R, Lutchman G, Kleiner DE, Ricks M, Feld JJ, Borg BB, et al. Clinical trial: pilot study of Metformin for the treatment of non-alcoholic steatohepatitis. Aliment Pharmacol Ther. 2009;29(2):172\u201382.","journal-title":"Aliment Pharmacol Ther"},{"issue":"22","key":"2098_CR9","doi-asserted-by":"publisher","first-page":"2297","DOI":"10.1056\/NEJMoa060326","volume":"355","author":"R Belfort","year":"2006","unstructured":"Belfort R, Harrison SA, Brown K, Darland C, Finch J, Hardies J, et al. A placebo-controlled trial of Pioglitazone in subjects with nonalcoholic steatohepatitis. N Engl J Med. 2006;355(22):2297\u2013307.","journal-title":"N Engl J Med"},{"issue":"18","key":"2098_CR10","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.1056\/NEJMoa0907929","volume":"362","author":"AJ Sanyal","year":"2010","unstructured":"Sanyal AJ, Chalasani N, Kowdley KV, McCullough A, Diehl AM, Bass NM, et al. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. N Engl J Med. 2010;362(18):1675\u201385.","journal-title":"N Engl J Med"},{"issue":"10019","key":"2098_CR11","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1016\/S0140-6736(15)00803-X","volume":"387","author":"MJ Armstrong","year":"2016","unstructured":"Armstrong MJ, Gaunt P, Aithal GP, Barton D, Hull D, Parker R, et al. Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN): a multicentre, double-blind, randomised, placebo-controlled phase 2 study. Lancet. 2016;387(10019):679\u201390.","journal-title":"Lancet"},{"issue":"2","key":"2098_CR12","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/S2213-8587(13)70050-0","volume":"1","author":"AA Tahrani","year":"2013","unstructured":"Tahrani AA, Barnett AH, Bailey CJ. SGLT inhibitors in management of diabetes. Lancet Diabetes Endocrinol. 2013;1(2):140\u201351.","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2098_CR13","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.ejphar.2014.01.040","volume":"727","author":"M Yokono","year":"2014","unstructured":"Yokono M, Takasu T, Hayashizaki Y, Mitsuoka K, Kihara R, Muramatsu Y, et al. SGLT2 selective inhibitor Ipragliflozin reduces body fat mass by increasing fatty acid oxidation in high-fat diet-induced obese rats. Eur J Pharmacol. 2014;727:66\u201374.","journal-title":"Eur J Pharmacol"},{"issue":"16","key":"2098_CR14","doi-asserted-by":"publisher","first-page":"9116","DOI":"10.1073\/pnas.161284298","volume":"98","author":"H Yamashita","year":"2001","unstructured":"Yamashita H, Takenoshita M, Sakurai M, Bruick RK, Henzel WJ, Shillinglaw W, et al. A glucose-responsive transcription factor that regulates carbohydrate metabolism in the liver. Proc Natl Acad Sci U S A. 2001;98(16):9116\u201321.","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"Suppl 2","key":"2098_CR15","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1111\/j.1463-1326.2010.01275.x","volume":"12","author":"P Ferr\u00e9","year":"2010","unstructured":"Ferr\u00e9 P, Foufelle F. Hepatic steatosis: a role for de Novo lipogenesis and the transcription factor SREBP-1c. Diabetes Obes Metab. 2010;12(Suppl 2):83\u201392.","journal-title":"Diabetes Obes Metab"},{"issue":"8","key":"2098_CR16","doi-asserted-by":"publisher","first-page":"1801","DOI":"10.2337\/dc18-0165","volume":"41","author":"MS Kuchay","year":"2018","unstructured":"Kuchay MS, Krishan S, Mishra SK, Farooqui KJ, Singh MK, Wasir JS, et al. Effect of empagliflozin on liver fat in patients with type 2 diabetes and nonalcoholic fatty liver disease: A randomized controlled trial (E-LIFT trial). Diabetes Care. 2018;41(8):1801\u20138.","journal-title":"Diabetes Care"},{"key":"2098_CR17","doi-asserted-by":"publisher","first-page":"101167","DOI":"10.1016\/j.molmet.2021.101167","volume":"50","author":"V Ajmera","year":"2021","unstructured":"Ajmera V, Loomba R. Imaging biomarkers of NAFLD, NASH, and fibrosis. Mol Metabolism. 2021;50:101167.","journal-title":"Mol Metabolism"},{"key":"2098_CR18","doi-asserted-by":"crossref","unstructured":"Blanco-Grau A, Gabriel-Medina P, Rodriguez-Algarra F, Villena Y, Lopez-Mart\u00ednez R, August\u00edn S, et al. Assessing liver fibrosis using the FIB4 index in the community setting. Diagnostics (Basel). 2021;11(12).","DOI":"10.3390\/diagnostics11122236"},{"issue":"8","key":"2098_CR19","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.3748\/wjg.v19.i8.1219","volume":"19","author":"S Treeprasertsuk","year":"2013","unstructured":"Treeprasertsuk S, Bj\u00f6rnsson E, Enders F, Suwanwalaikorn S, Lindor KD. NAFLD fibrosis score: a prognostic predictor for mortality and liver complications among NAFLD patients. World J Gastroenterol. 2013;19(8):1219\u201329.","journal-title":"World J Gastroenterol"},{"key":"2098_CR20","doi-asserted-by":"crossref","unstructured":"Chow S-C, Shao J, Wang H, Lokhnygina Y. Sample size calculations in clinical research. chapman and hall\/CRC; 2017.","DOI":"10.1201\/9781315183084"},{"key":"2098_CR21","doi-asserted-by":"crossref","unstructured":"Burt AD, Lackner C, Tiniakos DG, editors. Diagnosis and assessment of NAFLD: definitions and histopathological classification. Seminars in liver disease. Thieme Medical; 2015.","DOI":"10.1055\/s-0035-1562942"},{"issue":"8","key":"2098_CR22","doi-asserted-by":"publisher","first-page":"219","DOI":"10.3390\/jcm7080219","volume":"7","author":"F Salomone","year":"2018","unstructured":"Salomone F, Micek A, Godos J. Simple scores of fibrosis and mortality in patients with NAFLD: a systematic review with meta-analysis. J Clin Med. 2018;7(8):219.","journal-title":"J Clin Med"},{"issue":"11","key":"2098_CR23","doi-asserted-by":"publisher","first-page":"2567","DOI":"10.1016\/j.cgh.2021.12.034","volume":"20","author":"I Graupera","year":"2022","unstructured":"Graupera I, Thiele M, Serra-Burriel M, Caballeria L, Roulot D, Wong GL-H, et al. Low accuracy of FIB-4 and NAFLD fibrosis scores for screening for liver fibrosis in the population. Clin Gastroenterol Hepatol. 2022;20(11):2567\u201376. e6.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2098_CR24","doi-asserted-by":"crossref","unstructured":"Turner L, Shamseer L, Altman DG, Weeks L, Peters J, Kober T, et al. Consolidated standards of reporting trials (CONSORT) and the completeness of reporting of randomised controlled trials (RCTs) published in medical journals. Cochrane Database Syst Reviews. 2012(11).","DOI":"10.1002\/14651858.MR000030.pub2"},{"issue":"3","key":"2098_CR25","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1016\/j.jhep.2022.10.035","volume":"78","author":"G Cholankeril","year":"2023","unstructured":"Cholankeril G, Kramer JR, Chu J, Yu X, Balakrishnan M, Li L, et al. Longitudinal changes in fibrosis markers are associated with risk of cirrhosis and hepatocellular carcinoma in non-alcoholic fatty liver disease. J Hepatol. 2023;78(3):493\u2013500.","journal-title":"J Hepatol"},{"key":"2098_CR26","doi-asserted-by":"crossref","unstructured":"Anstee QM, Berentzen TL, Nitze LM, Jara M, Jensen AB, Kj\u00e6r MS, et al. Prognostic utility of Fibrosis-4 index for risk of subsequent liver and cardiovascular events, and all-cause mortality in individuals with obesity and\/or type 2 diabetes: a longitudinal cohort study. Volume 36. The Lancet Regional Health \u2013 Europe; 2024.","DOI":"10.1016\/j.lanepe.2023.100780"},{"issue":"5","key":"2098_CR27","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.1097\/HEP.0000000000000323","volume":"77","author":"ME Rinella","year":"2023","unstructured":"Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, Abdelmalek MF, Caldwell S, Barb D, et al. AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797\u2013835.","journal-title":"Hepatology"},{"issue":"8","key":"2098_CR28","doi-asserted-by":"publisher","first-page":"e2329568","DOI":"10.1001\/jamanetworkopen.2023.29568","volume":"6","author":"H Park","year":"2023","unstructured":"Park H, Yoon EL, Ito T, Jo AJ, Kim M, Lee J, et al. Diagnostic performance of the fibrosis-4 index and nonalcoholic fatty liver disease fibrosis score in lean adults with nonalcoholic fatty liver disease. JAMA Netw Open. 2023;6(8):e2329568.","journal-title":"JAMA Netw Open"},{"key":"2098_CR29","doi-asserted-by":"crossref","unstructured":"Park H, Yoon EL, Kim M, Lee J, Cho S, Jun DW, et al. Reappraisal of fibrosis-4 index and non-alcoholic fatty liver disease fibrosis score for advanced fibrosis in average-risk population. Front Med. 2022;9.","DOI":"10.3389\/fmed.2022.1024836"},{"key":"2098_CR30","first-page":"43","volume":"103","author":"M Chen","year":"2024","unstructured":"Chen M, Guo C, Ouyang K, Liu N. Diagnostic role of the fibrosis-4 index and nonalcoholic fatty liver disease fibrosis score as a noninvasive tool for liver fibrosis scoring. Medicine. 2024;103:43.","journal-title":"Medicine"},{"issue":"4","key":"2098_CR31","doi-asserted-by":"publisher","first-page":"668","DOI":"10.2337\/dc23-1646","volume":"47","author":"S Abdelgani","year":"2024","unstructured":"Abdelgani S, Khattab A, Adams J, Baskoy G, Brown M, Clarke G, et al. Empagliflozin reduces liver fat in individuals with and without diabetes. Diabetes Care. 2024;47(4):668\u201375.","journal-title":"Diabetes Care"},{"issue":"1","key":"2098_CR32","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s12902-025-01882-8","volume":"25","author":"F Shojaei","year":"2025","unstructured":"Shojaei F, Erfanifar A, Kalbasi S, Nikpour S, Gachkar L. The effect of empagliflozin on non-alcoholic fatty liver disease-related parameters in patients with type 2 diabetes mellitus: a randomized controlled trial. BMC Endocr Disorders. 2025;25(1):52.","journal-title":"BMC Endocr Disorders"},{"issue":"1","key":"2098_CR33","doi-asserted-by":"publisher","first-page":"62","DOI":"10.22543\/2392-7674.1439","volume":"11","author":"MS Popoviciu","year":"2024","unstructured":"Popoviciu MS, Paduraru L, Rahman MM, Supti FA, Stoica RA, Reurean-Pintilei D, et al. The effects of SGLT2 inhibitors in patients with metabolic Dysfunction-Associated fatty liver Disease; A narrative review. J Mind Med Sci. 2024;11(1):62\u201377.","journal-title":"J Mind Med Sci"},{"issue":"2","key":"2098_CR34","doi-asserted-by":"publisher","first-page":"298","DOI":"10.2337\/dc19-0641","volume":"43","author":"S Kahl","year":"2020","unstructured":"Kahl S, Gancheva S, Stra\u00dfburger K, Herder C, Machann J, Katsuyama H, et al. Empagliflozin effectively lowers liver fat content in Well-Controlled type 2 diabetes: A Randomized, Double-Blind, phase 4, Placebo-Controlled trial. Diabetes Care. 2020;43(2):298\u2013305.","journal-title":"Diabetes Care"},{"key":"2098_CR35","doi-asserted-by":"crossref","unstructured":"Zhang Y, Liu X, Zhang H, Wang X. Efficacy and safety of empagliflozin on nonalcoholic fatty liver disease: a systematic review and meta-analysis. Front Endocrinol. 2022;13.","DOI":"10.3389\/fendo.2022.836455"},{"issue":"2","key":"2098_CR36","doi-asserted-by":"publisher","first-page":"298","DOI":"10.2337\/dc19-0641","volume":"43","author":"S Kahl","year":"2019","unstructured":"Kahl S, Gancheva S, Stra\u00dfburger K, Herder C, Machann J, Katsuyama H, et al. Empagliflozin effectively lowers liver fat content in Well-Controlled type 2 diabetes: A Randomized, Double-Blind, phase 4, Placebo-Controlled trial. Diabetes Care. 2019;43(2):298\u2013305.","journal-title":"Diabetes Care"},{"issue":"3","key":"2098_CR37","doi-asserted-by":"publisher","first-page":"e0151511","DOI":"10.1371\/journal.pone.0151511","volume":"11","author":"C Komiya","year":"2016","unstructured":"Komiya C, Tsuchiya K, Shiba K, Miyachi Y, Furuke S, Shimazu N, et al. Ipragliflozin improves hepatic steatosis in obese mice and liver dysfunction in type 2 diabetic patients irrespective of body weight reduction. PLoS ONE. 2016;11(3):e0151511.","journal-title":"PLoS ONE"},{"issue":"1","key":"2098_CR38","doi-asserted-by":"publisher","first-page":"2122","DOI":"10.1038\/s41598-024-52603-5","volume":"14","author":"AMC Ong Lopez","year":"2024","unstructured":"Ong Lopez AMC, Pajimna JAT. Efficacy of sodium glucose cotransporter 2 inhibitors on hepatic fibrosis and steatosis in non-alcoholic fatty liver disease: an updated systematic review and meta-analysis. Sci Rep. 2024;14(1):2122.","journal-title":"Sci Rep"},{"key":"2098_CR39","doi-asserted-by":"publisher","first-page":"109080","DOI":"10.1016\/j.intimp.2022.109080","volume":"111","author":"P Theofilis","year":"2022","unstructured":"Theofilis P, Sagris M, Oikonomou E, Antonopoulos AS, Siasos G, Tsioufis K, et al. The impact of SGLT2 inhibitors on inflammation: A systematic review and meta-analysis of studies in rodents. Int Immunopharmacol. 2022;111:109080.","journal-title":"Int Immunopharmacol"},{"key":"2098_CR40","doi-asserted-by":"publisher","first-page":"609135","DOI":"10.3389\/fendo.2020.609135","volume":"11","author":"C Wong","year":"2020","unstructured":"Wong C, Yaow CYL, Ng CH, Chin YH, Low YF, Lim AYL, et al. Sodium-glucose co-transporter 2 inhibitors for non-alcoholic fatty liver disease in Asian patients with type 2 diabetes: a meta-analysis. Front Endocrinol (Lausanne). 2020;11:609135.","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2098_CR41","doi-asserted-by":"crossref","unstructured":"Gu Y, Sun L, Zhang W, Kong T, Zhou R, He Y, et al. Comparative efficacy of 5 sodium-glucose cotransporter protein-2 (SGLT-2) inhibitor and 4 glucagon-like peptide-1 (GLP-1) receptor agonist drugs in non-alcoholic fatty liver disease: a GRADE-assessed systematic review and network meta-analysis of randomized controlled trials. Front Pharmacol. 2023;14.","DOI":"10.3389\/fphar.2023.1102792"},{"issue":"3","key":"2098_CR42","doi-asserted-by":"publisher","first-page":"391","DOI":"10.4314\/ahs.v22i3.42","volume":"22","author":"X Tang","year":"2022","unstructured":"Tang X, Zhang H, Wang X, Yang D. Empagliflozin for the treatment of non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials. Afr Health Sci. 2022;22(3):391\u20138.","journal-title":"Afr Health Sci"},{"issue":"11","key":"2098_CR43","doi-asserted-by":"publisher","first-page":"4697","DOI":"10.1007\/s12325-020-01498-5","volume":"37","author":"H Taheri","year":"2020","unstructured":"Taheri H, Malek M, Ismail-Beigi F, Zamani F, Sohrabi M, Reza Babaei M, et al. Effect of empagliflozin on liver steatosis and fibrosis in patients with Non-Alcoholic fatty liver disease without diabetes: A Randomized, Double-Blind, Placebo-Controlled trial. Adv Ther. 2020;37(11):4697\u2013708.","journal-title":"Adv Ther"},{"issue":"3","key":"2098_CR44","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1007\/s13300-021-01011-3","volume":"12","author":"H Chehrehgosha","year":"2021","unstructured":"Chehrehgosha H, Sohrabi MR, Ismail-Beigi F, Malek M, Reza Babaei M, Zamani F, et al. Empagliflozin improves liver steatosis and fibrosis in patients with Non-Alcoholic fatty liver disease and type 2 diabetes: A Randomized, Double-Blind, Placebo-Controlled clinical trial. Diabetes Ther. 2021;12(3):843\u201361.","journal-title":"Diabetes Ther"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-025-02098-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-025-02098-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-025-02098-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:31:00Z","timestamp":1764333060000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcendocrdisord.biomedcentral.com\/articles\/10.1186\/s12902-025-02098-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["2098"],"URL":"https:\/\/doi.org\/10.1186\/s12902-025-02098-6","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,28]]},"assertion":[{"value":"6 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was approved by the Ethics Committee of Shahid Beheshti University of Medical Sciences (Internal Review Board - IRB) under approval code IR.SBMU.MSP.REC.1403.415. All participants received detailed information about the study objectives and procedures and provided written informed consent prior to enrollment.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors consent to the publication of this manuscript.","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":"277"}}