{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:06:06Z","timestamp":1790795166887,"version":"4.1.0"},"reference-count":50,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2023,5,7]],"date-time":"2023-05-07T00:00:00Z","timestamp":1683417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Metabolic dysfunction\u2013associated fatty liver disease (MAFLD) is highly prevalent among patients with type 2 diabetes mellitus (T2DM); however, there is still no approved pharmacological treatment. Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have been suggested to beneficially modify liver-related outcomes in patients with diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We aimed to investigate the effects of the SGLT-2 inhibitor canagliflozin on liver-related outcomes in patients with advanced T2DM and high cardiovascular risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a secondary post hoc analysis of 2 large double-blind randomized controlled trials, CANVAS (NCT01032629) and CANVAS-R (NCT01989754), which included patients with T2DM and high cardiovascular risk who were randomized to receive either canagliflozin or placebo once daily. The primary endpoint was a composite of improvement of alanine aminotransferase (ALT) levels &amp;gt;30% or normalization of ALT levels. Secondary endpoints included change in noninvasive tests of fibrosis and weight reduction of &amp;gt;10%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 10 131 patients were included, with a median follow-up of 2.4 years (mean age 62 years; mean duration of diabetes 13.5 years; 64.2% male). Of those patients, 8967 (88.5%) had MAFLD according to hepatic steatosis index and 2599 (25.7%) exhibited elevated liver biochemistry at baseline. The primary composite endpoint occurred in 35.2% of patients receiving canagliflozin and in 26.4% with placebo (adjusted odds ratio [aOR] 1.51; 95% CI, 1.38-1.64; P &amp;lt; .001). Canagliflozin led to improvements in some noninvasive tests of fibrosis (NFS, APRI, FNI). Significant weight reduction of &amp;gt;10% (within 6 years) was achieved in 12.7% with canagliflozin compared to 4.1% with placebo (aOR 3.45; 95% CI, 2.91-4.10; P &amp;lt; .001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In patients with T2DM, treatment with canagliflozin vs placebo resulted in improvements in liver biochemistry and metabolism and might beneficially affect liver fibrosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgad249","type":"journal-article","created":{"date-parts":[[2023,5,7]],"date-time":"2023-05-07T15:01:18Z","timestamp":1683471678000},"page":"2940-2949","source":"Crossref","is-referenced-by-count":35,"title":["Canagliflozin and Metabolic Associated Fatty Liver Disease in Patients With Diabetes Mellitus: New Insights From CANVAS"],"prefix":"10.1210","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7872-0118","authenticated-orcid":false,"given":"Angel N","family":"Borisov","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Center for Gastrointestinal and Liver Diseases , CH-4031 Basel , Switzerland"},{"name":"Division of Endocrinology, Diabetes, and Metabolism, University Hospital Basel , 4031 Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7549-5648","authenticated-orcid":false,"given":"Alexander","family":"Kutz","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, University Department of Medicine , Kantonsspital Aarau, 5001 Aarau , Switzerland"},{"name":"Division of General and Emergency Medicine, University Department of Medicine , Kantonsspital Aarau, 5001 Aarau , Switzerland"},{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5604-4606","authenticated-orcid":false,"given":"Emanuel R","family":"Christ","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, University Hospital Basel , 4031 Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7523-4894","authenticated-orcid":false,"given":"Markus H","family":"Heim","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Center for Gastrointestinal and Liver Diseases , CH-4031 Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5862-966X","authenticated-orcid":false,"given":"Fahim","family":"Ebrahimi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Center for Gastrointestinal and Liver Diseases , CH-4031 Basel , Switzerland"},{"name":"Division of Endocrinology, Diabetes, and Metabolism, University Hospital Basel , 4031 Basel , Switzerland"},{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , 17165 Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2023,5,7]]},"reference":[{"issue":"7","key":"2023101816070063200_dgad249-B1","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1053\/j.gastro.2019.11.312","article-title":"MAFLD: A consensus-driven proposed nomenclature for metabolic associated fatty liver disease","volume":"158","author":"Eslam","year":"2020","journal-title":"Gastroenterology"},{"issue":"4","key":"2023101816070063200_dgad249-B2","doi-asserted-by":"crossref","first-page":"632","DOI":"10.2337\/dc15-1876","article-title":"Metabolic impact of nonalcoholic steatohepatitis in obese patients with type 2 diabetes","volume":"39","author":"Lomonaco","year":"2016","journal-title":"Diabetes Care"},{"issue":"9","key":"2023101816070063200_dgad249-B3","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/S2468-1253(22)00165-0","article-title":"The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis","volume":"7","author":"Riazi","year":"2022","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"6","key":"2023101816070063200_dgad249-B4","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1007\/s12072-019-09995-8","article-title":"Hepatocellular carcinoma and non-alcoholic fatty liver disease","volume":"13","author":"Golabi","year":"2019","journal-title":"Hepatol Int"},{"issue":"17","key":"2023101816070063200_dgad249-B5","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1056\/NEJMoa2029349","article-title":"Prospective study of outcomes in adults with nonalcoholic fatty liver disease","volume":"385","author":"Sanyal","year":"2021","journal-title":"N Engl J Med"},{"issue":"7","key":"2023101816070063200_dgad249-B6","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1136\/gutjnl-2020-322786","article-title":"Mortality in biopsy-confirmed nonalcoholic fatty liver disease: results from a nationwide cohort","volume":"70","author":"Simon","year":"2021","journal-title":"Gut"},{"issue":"6","key":"2023101816070063200_dgad249-B7","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1111\/joim.12964","article-title":"Nonalcoholic fatty liver disease increases risk of incident advanced chronic kidney disease: a propensity-matched cohort study","volume":"286","author":"Park","year":"2019","journal-title":"J Intern Med"},{"issue":"6","key":"2023101816070063200_dgad249-B8","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1038\/s41575-020-00408-y","article-title":"Therapeutic pipeline in nonalcoholic steatohepatitis","volume":"18","author":"Vuppalanchi","year":"2021","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"3","key":"2023101816070063200_dgad249-B9","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1007\/s00535-017-1415-1","article-title":"Current and future pharmacological therapies for NAFLD\/NASH","volume":"53","author":"Sumida","year":"2018","journal-title":"J Gastroenterol"},{"key":"2023101816070063200_dgad249-B10","doi-asserted-by":"crossref","first-page":"m4747","DOI":"10.1136\/bmj.m4747","article-title":"Management of non-alcoholic fatty liver disease","volume":"372","author":"Petroni","year":"2021","journal-title":"BMJ"},{"issue":"7","key":"2023101816070063200_dgad249-B11","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1056\/NEJMoa1611925","article-title":"Canagliflozin and cardiovascular and renal events in type 2 diabetes","volume":"377","author":"Neal","year":"2017","journal-title":"N Engl J Med"},{"issue":"4","key":"2023101816070063200_dgad249-B12","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1056\/NEJMoa1812389","article-title":"Dapagliflozin and cardiovascular outcomes in type 2 diabetes","volume":"380","author":"Wiviott","year":"2019","journal-title":"N Engl J Med"},{"issue":"1","key":"2023101816070063200_dgad249-B13","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S2213-8587(20)30343-0","article-title":"Guideline recommendations and the positioning of newer drugs in type 2 diabetes care","volume":"9","author":"Marx","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"6","key":"2023101816070063200_dgad249-B14","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.diabet.2018.09.005","article-title":"Effects of SGLT2 inhibitors on systemic and tissue low-grade inflammation: the potential contribution to diabetes complications and cardiovascular disease","volume":"44","author":"Bonnet","year":"2018","journal-title":"Diabetes Metab"},{"issue":"5","key":"2023101816070063200_dgad249-B15","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1111\/hepr.13304","article-title":"Impact of sodium glucose cotransporter 2 inhibitor on histological features and glucose metabolism of non-alcoholic fatty liver disease complicated by diabetes mellitus","volume":"49","author":"Akuta","year":"2019","journal-title":"Hepatology Res"},{"issue":"2","key":"2023101816070063200_dgad249-B16","doi-asserted-by":"crossref","first-page":"114","DOI":"10.4239\/wjd.v10.i2.114","article-title":"SGLT-2 inhibitors in non-alcoholic fatty liver disease patients with type 2 diabetes mellitus: A systematic review","volume":"10","author":"Raj","year":"2019","journal-title":"World J Diabetes"},{"key":"2023101816070063200_dgad249-B17","author":"World Medical Association","year":"2009"},{"issue":"3","key":"2023101816070063200_dgad249-B18","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.jhep.2021.10.029","article-title":"Non-invasive evaluation of response to obeticholic acid in patients with NASH: results from the REGENERATE study","volume":"76","author":"Rinella","year":"2022","journal-title":"J Hepatol"},{"issue":"5","key":"2023101816070063200_dgad249-B19","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1136\/gutjnl-2021-324243","article-title":"Diagnostic accuracy of non-invasive tests for advanced fibrosis in patients with NAFLD: an individual patient data meta-analysis","volume":"71","author":"M\u00f3zes","year":"2021","journal-title":"Gut"},{"issue":"4","key":"2023101816070063200_dgad249-B20","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/hep.21496","article-title":"The NAFLD fibrosis score: A noninvasive system that identifies liver fibrosis in patients with NAFLD","volume":"45","author":"Angulo","year":"2007","journal-title":"Hepatology"},{"issue":"6","key":"2023101816070063200_dgad249-B21","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1002\/hep.21178","article-title":"Development of a simple noninvasive index to predict significant fibrosis in patients with HIV\/HCV coinfection","volume":"43","author":"Sterling","year":"2006","journal-title":"Hepatology"},{"issue":"2","key":"2023101816070063200_dgad249-B22","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1053\/jhep.2003.50346","article-title":"A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C","volume":"38","author":"Wai","year":"2003","journal-title":"Hepatology"},{"key":"2023101816070063200_dgad249-B23","article-title":"Development and validation of a score for fibrotic nonalcoholic steatohepatitis","author":"Tavaglione","year":"2022","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"7","key":"2023101816070063200_dgad249-B24","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.dld.2009.08.002","article-title":"Hepatic steatosis index: a simple screening tool reflecting nonalcoholic fatty liver disease","volume":"42","author":"Lee","year":"2010","journal-title":"Dig Liver Dis"},{"key":"2023101816070063200_dgad249-B25","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1111\/jgh.13814","article-title":"Fatty liver index and hepatic steatosis index for prediction of non-alcoholic fatty liver disease in type 1 diabetes","volume":"33","author":"Svikl\u0101ne","year":"2018","journal-title":"J Gastroenterol Hepatol"},{"issue":"9","key":"2023101816070063200_dgad249-B26","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1007\/s40618-021-01501-y","article-title":"Prevalence of hepatic steatosis in patients with type 2 diabetes and response to glucose-lowering treatments. A multicenter retrospective study in Italian specialist care","volume":"44","author":"Morieri","year":"2021","journal-title":"J Endocrinol Invest"},{"key":"2023101816070063200_dgad249-B27","article-title":"Supplementary appendix: canagliflozin and metabolic associated fatty liver disease in patients with diabetes mellitus: new insights from CANVAS","author":"Borisov","year":"2023","journal-title":"Mendeley Data"},{"issue":"6","key":"2023101816070063200_dgad249-B28","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1038\/nrgastro.2013.41","article-title":"Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis","volume":"10","author":"Anstee","year":"2013","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"11","key":"2023101816070063200_dgad249-B29","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/S2213-8587(14)70032-4","article-title":"Non-alcoholic fatty liver disease as a cause and a consequence of metabolic syndrome","volume":"2","author":"Yki-J\u00e4rvinen","year":"2014","journal-title":"Lancet Diabet Endocrinol"},{"issue":"8","key":"2023101816070063200_dgad249-B30","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1136\/gutjnl-2015-309265","article-title":"Screening diabetic patients for non-alcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements: A prospective cohort study","volume":"65","author":"Kwok","year":"2016","journal-title":"Gut"},{"issue":"3","key":"2023101816070063200_dgad249-B31","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.metabol.2012.08.005","article-title":"In patients with non-alcoholic fatty liver disease, metabolically abnormal individuals are at a higher risk for mortality while metabolically normal individuals are not","volume":"62","author":"Younossi","year":"2013","journal-title":"Metab Clin Exp"},{"issue":"2","key":"2023101816070063200_dgad249-B32","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1053\/jhep.2002.30692","article-title":"NASH And insulin resistance: insulin hypersecretion and specific association with the insulin resistance syndrome","volume":"35","author":"Chitturi","year":"2002","journal-title":"Hepatology"},{"key":"2023101816070063200_dgad249-B33","doi-asserted-by":"crossref","DOI":"10.1155\/2016\/3805372","article-title":"Sex-specific association between serum uric acid and nonalcoholic fatty liver disease in type 2 diabetic patients","volume":"2016","author":"Fan","year":"2016","journal-title":"J Diabetes Res"},{"issue":"2","key":"2023101816070063200_dgad249-B34","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1053\/j.gastro.2015.04.014","article-title":"Bariatric surgery reduces features of nonalcoholic steatohepatitis in morbidly obese patients","volume":"149","author":"Lassailly","year":"2015","journal-title":"Gastroenterology"},{"issue":"1","key":"2023101816070063200_dgad249-B35","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1038\/ajg.2014.134","article-title":"Nonalcoholic fatty liver disease is underrecognized in the primary care setting","volume":"110","author":"Blais","year":"2015","journal-title":"Am J Gastroenterol"},{"issue":"5","key":"2023101816070063200_dgad249-B36","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.amjmed.2020.01.007","article-title":"Nonalcoholic fatty liver disease: what does the primary care physician need to know?","volume":"133","author":"Budd","year":"2020","journal-title":"Am J Med"},{"issue":"7","key":"2023101816070063200_dgad249-B37","doi-asserted-by":"crossref","DOI":"10.1016\/j.clinre.2022.101970","article-title":"Effect of novel glucose lowering agents on non-alcoholic fatty liver disease: a systematic review and meta-analysis","volume":"46","author":"Zafar","year":"2022","journal-title":"Clin Res Hepatol Gastroenterol"},{"issue":"1","key":"2023101816070063200_dgad249-B38","doi-asserted-by":"crossref","DOI":"10.1136\/bmjdrc-2020-001990","article-title":"Comparing the effects of tofogliflozin and pioglitazone in non-alcoholic fatty liver disease patients with type 2 diabetes mellitus (ToPiND study): a randomized prospective open-label controlled trial","volume":"9","author":"Yoneda","year":"2021","journal-title":"BMJ Open Diabetes Res Care"},{"issue":"4","key":"2023101816070063200_dgad249-B39","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1111\/dom.13584","article-title":"Effect of canagliflozin treatment on hepatic triglyceride content and glucose metabolism in patients with type 2 diabetes","volume":"21","author":"Cusi","year":"2019","journal-title":"Diabetes Obes Metab"},{"issue":"2","key":"2023101816070063200_dgad249-B40","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.jhep.2017.12.001","article-title":"A critical review of endpoints for non-cirrhotic NASH therapeutic trials","volume":"68","author":"Ratziu","year":"2018","journal-title":"J Hepatol"},{"issue":"12","key":"2023101816070063200_dgad249-B41","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1111\/liv.13480","article-title":"Serum biomarkers can predict a change in liver fibrosis 1 year after lifestyle intervention for biopsy-proven NASH","volume":"37","author":"Vilar-Gomez","year":"2017","journal-title":"Liver Int"},{"issue":"1","key":"2023101816070063200_dgad249-B42","doi-asserted-by":"crossref","first-page":"18345","DOI":"10.1038\/s41598-020-75227-x","article-title":"Current NAFLD guidelines for risk stratification in diabetic patients have poor diagnostic discrimination","volume":"10","author":"Blank","year":"2020","journal-title":"Sci Rep"},{"issue":"16","key":"2023101816070063200_dgad249-B43","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.2169\/internalmedicine.4398-19","article-title":"SGLT2 Inhibitor treatment outcome in nonalcoholic fatty liver disease complicated with diabetes mellitus: the long-term effects on clinical features and liver histopathology","volume":"59","author":"Akuta","year":"2020","journal-title":"Internal Medicine"},{"issue":"9","key":"2023101816070063200_dgad249-B44","doi-asserted-by":"crossref","first-page":"2064","DOI":"10.2337\/dc21-2049","article-title":"Comparison of tofogliflozin and glimepiride effects on nonalcoholic fatty liver disease in participants with type 2 diabetes: a randomized, 48-week, open-label, active-controlled trial","volume":"45","author":"Takeshita","year":"2022","journal-title":"2064 Diabetes Care"},{"issue":"5","key":"2023101816070063200_dgad249-B45","doi-asserted-by":"crossref","DOI":"10.1172\/jci.insight.123130","article-title":"SGLT2 Inhibition reprograms systemic metabolism via FGF21-dependent and -independent mechanisms","volume":"4","author":"Osataphan","year":"2019","journal-title":"JCI Insight"},{"issue":"9","key":"2023101816070063200_dgad249-B46","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1136\/gutjnl-2021-325724","article-title":"Non-alcoholic fatty liver disease and incident major adverse cardiovascular events: results from a nationwide histology cohort","volume":"71","author":"Simon","year":"2022","journal-title":"Gut"},{"issue":"6","key":"2023101816070063200_dgad249-B47","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1002\/hep.30664","article-title":"The natural history of advanced fibrosis due to nonalcoholic steatohepatitis: data from the simtuzumab trials","volume":"70","author":"Sanyal","year":"2019","journal-title":"Hepatology"},{"issue":"6","key":"2023101816070063200_dgad249-B48","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1016\/j.jhep.2017.08.024","article-title":"Development of chronic kidney disease in patients with non-alcoholic fatty liver disease: a cohort study","volume":"67","author":"Sinn","year":"2017","journal-title":"J Hepatol"},{"issue":"6","key":"2023101816070063200_dgad249-B49","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1002\/hep.32244","article-title":"Effect of diabetes medications and glycemic control on risk of hepatocellular cancer in patients with nonalcoholic fatty liver disease","volume":"75","author":"Kramer","year":"2022","journal-title":"Hepatology"},{"issue":"8","key":"2023101816070063200_dgad249-B50","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0160526","article-title":"Influence of ethnicity on the accuracy of non-invasive scores predicting non-alcoholic fatty liver disease","volume":"11","author":"Xia","year":"2016","journal-title":"PLoS One"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgad249\/50399752\/dgad249.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/108\/11\/2940\/52218114\/dgad249.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/108\/11\/2940\/52218114\/dgad249.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T16:15:14Z","timestamp":1697645714000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/108\/11\/2940\/7156575"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,7]]},"references-count":50,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,5,7]]},"published-print":{"date-parts":[[2023,10,18]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgad249","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,11]]},"published":{"date-parts":[[2023,5,7]]}}}