{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:13:50Z","timestamp":1793812430306,"version":"4.6.1"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Evidence from randomized controlled trials (RCTs) on pharmacological management of primary osteoporosis in men is fragmented, making direct comparisons across drug classes difficult, and head-to-head evidence remains limited. We performed a network meta-analysis (NMA) to compare the relative efficacy and safety of commonly used anti-osteoporotic agents in men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Web of Science, and the Cochrane Library from inception to December 2025 for RCTs enrolling men with primary osteoporosis. Eligible interventions included oral bisphosphonates (OBP), intravenous bisphosphonates (IBP), abaloparatide (ABA), denosumab (DEN), teriparatide (TER), and odanacatib (ODN), compared with placebo\/usual care (PLA\/CTRL) or active treatments. Primary efficacy outcomes were changes in bone mineral density (BMD) at the lumbar spine (LS), total hip (TH), and femoral neck (FN), preferentially extracted at the time point closest to 12 months (range: 6\u201324 months). Safety outcomes were any adverse events (AEs) and serious adverse events (SAEs). Pairwise meta-analyses were conducted in Stata 18.0, and NMA in R 4.3.1 under a consistency framework. Treatments were ranked using SUCRA. The protocol was registered in PROSPERO (CRD420261279572).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-one RCTs (n = 4,409) were included. Compared with PLA\/CTRL, TER and ABA significantly improved FN-BMD (TER: MD 2.97, 95% CI 0.74\u20135.20; ABA: MD 2.83, 95% CI 0.11\u20135.55), and OBP also showed benefit (MD 1.61, 95% CI 0.15\u20133.07). For TH-BMD, significant gains were observed for OBP (MD 2.25, 95% CI 1.70\u20132.81), ABA (MD 2.13, 95% CI 1.43\u20132.83), and TER (MD 1.12, 95% CI 0.35\u20131.89); OBP showed a greater increase than TER (MD 1.13, 95% CI 0.32\u20131.95). For LS-BMD, ABA (MD 7.31, 95% CI 4.25\u201310.37), TER (MD 6.97, 95% CI 4.53\u20139.42), and OBP (MD 3.43, 95% CI 1.84\u20135.02) were superior to PLA\/CTRL, and both ABA and TER outperformed OBP (ABA vs OBP: MD 3.88, 95% CI 0.44\u20137.33; TER vs OBP: MD 3.55, 95% CI 1.08\u20136.01). Most head-to-head comparisons across active agents were inconclusive with wide uncertainty. Node-splitting suggested no significant local inconsistency (P &amp;gt; 0.05). Safety comparisons for AEs and SAEs were largely imprecise; SUCRA rankings should therefore be interpreted cautiously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In men with primary osteoporosis, treatment effects on BMD differ by skeletal site: ABA and TER yield larger gains at the lumbar spine, whereas OBP demonstrates robust improvements at the total hip; evidence for femoral neck improvement is clearer for TER and ABA versus PLA\/CTRL. However, the extent to which these BMD improvements translate into fracture risk reduction remains uncertain because direct fracture endpoint data were limited in the included RCTs. Safety evidence also remains limited due to imprecision, and SUCRA rankings should therefore be interpreted alongside effect estimates and their uncertainty. Further high-quality, long-term RCTs focusing on fracture outcomes and drug-specific adverse events are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1836818","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T04:40:40Z","timestamp":1778215240000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative efficacy and safety of odanacatib, abaloparatide, denosumab, teriparatide, and bisphosphonates for male osteoporosis: a systematic review and network meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Chengwu","family":"Lu","sequence":"first","affiliation":[{"name":"The Affiliated Nanping First Hospital of Fujian Medical University","place":["Nanping, China"]},{"name":"Fujian Minbei Orthopedic Research Institute","place":["Nanping, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libao","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Affiliated Nanping First Hospital of Fujian Medical University","place":["Nanping, China"]},{"name":"Fujian Minbei Orthopedic Research Institute","place":["Nanping, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhui","family":"Xue","sequence":"additional","affiliation":[{"name":"The Affiliated Nanping First Hospital of Fujian Medical University","place":["Nanping, China"]},{"name":"Fujian Minbei Orthopedic Research Institute","place":["Nanping, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingxin","family":"Liao","sequence":"additional","affiliation":[{"name":"The Affiliated Nanping First Hospital of Fujian Medical University","place":["Nanping, China"]},{"name":"Fujian Minbei Orthopedic Research Institute","place":["Nanping, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jichang","family":"Fei","sequence":"additional","affiliation":[{"name":"The Affiliated Nanping First Hospital of Fujian Medical University","place":["Nanping, China"]},{"name":"Fujian Minbei Orthopedic Research Institute","place":["Nanping, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojun","family":"Chen","sequence":"additional","affiliation":[{"name":"Fujian Minbei Orthopedic Research Institute","place":["Nanping, China"]},{"name":"The 907th Hospital of Chinese PLA Joint Logistics Support Force","place":["Nanping, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linfeng","family":"Wang","sequence":"additional","affiliation":[{"name":"The Affiliated Nanping First Hospital of Fujian Medical University","place":["Nanping, China"]},{"name":"Fujian Minbei Orthopedic Research Institute","place":["Nanping, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/j.ecl.2024.08.008","article-title":"Postmenopausal osteoporosis: a review of latest guidelines","volume":"53","author":"Subarajan","year":"2024","journal-title":"Endocrinol Metab Clinics North America"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2021.03.009","article-title":"Postmenopausal osteoporosis: latest guidelines","volume":"50","author":"Arceo-Mendoza","year":"2021","journal-title":"Endocrinol Metab Clinics North America"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2020.06.004","article-title":"Osteoporosis in older adults","volume":"104","author":"Johnston","year":"2020","journal-title":"Med Clinics North America"},{"key":"B4","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.semcdb.2021.05.014","article-title":"Interaction between bone and immune cells: implications for postmenopausal osteoporosis","volume":"123","author":"Fischer","year":"2022","journal-title":"Semin Cell Dev Biol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.20945\/2359-3997000000563","article-title":"Male osteoporosis","volume":"66","author":"Bandeira","year":"2022","journal-title":"Arch Endocrinol Metab"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000572","article-title":"Bone health and osteoporosis prevention and treatment","volume":"63","author":"Mu\u00f1oz","year":"2020","journal-title":"Clin Obstetrics Gynecology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1007\/s11657-024-01441-z","article-title":"Similarities and differences between European guidelines for the management of postmenopausal osteoporosis","volume":"19","author":"Cortet","year":"2024","journal-title":"Arch Osteoporosis"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-022-03281-1","article-title":"Quality of life in postmenopausal women with osteoporosis: a systematic review and meta-analysis","volume":"32","author":"Gao","year":"2023","journal-title":"Qual Life Research: Int J Qual Life Aspects Treatment Care Rehabil"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.3390\/nu13051609","article-title":"Botanicals in postmenopausal osteoporosis","volume":"13","author":"S\u0142upski","year":"2021","journal-title":"Nutrients"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s10354-004-0100-1","article-title":"Osteoporosis: gender-specific aspects","volume":"154","author":"Pietschmann","year":"2004","journal-title":"Wiener Medizinische Wochenschrift (1946)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/jbm4.10800","article-title":"Anabolic and antiresorptive osteoporosis treatment: trends, costs, and sequence in a commercially insured population, 2003-2021","volume":"7","author":"Wadhwa","year":"2023","journal-title":"JBMR Plus"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.4158\/ep-2019-0596","article-title":"Anabolic therapy and optimal treatment sequences for patients with osteoporosis at high risk for fracture","volume":"26","author":"Cosman","year":"2020","journal-title":"Endocrine Practice: Off J Am Coll Endocrinol Am Assoc Clin Endocrinologists"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1210\/js.2018-00118","article-title":"Osteoanabolic agents for osteoporosis","volume":"2","author":"Haas","year":"2018","journal-title":"J Endocr Soc"},{"key":"B14","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1002\/jbmr.3051","article-title":"Treatment sequence matters: anabolic and antiresorptive therapy for osteoporosis","volume":"32","author":"Cosman","year":"2017","journal-title":"J Bone Mineral Research: Off J Am Soc For Bone Mineral Res"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s11914-014-0237-9","article-title":"Anabolic and antiresorptive therapy for osteoporosis: combination and sequential approaches","volume":"12","author":"Cosman","year":"2014","journal-title":"Curr Osteoporosis Rep"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/jbm4.10838","article-title":"Antiresorptive versus anabolic therapy in managing osteoporosis in people with type 1 and type 2 diabetes","volume":"7","author":"Vilaca","year":"2023","journal-title":"JBMR Plus"},{"key":"B17","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.jclinepi.2024.111422","article-title":"Guideline for reporting systematic reviews of outcome measurement instruments (OMIs): PRISMA-COSMIN for OMIs 2024","volume":"8","author":"Elsman","year":"2024","journal-title":"J Patient-Reported Outcomes"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1055\/a-1984-0466","article-title":"Correlation between forearm bone mineral density measured by dual energy X-ray absorptiometry and Hounsfield units value measured by CT in lumbar spine","volume":"162","author":"Pu","year":"2024","journal-title":"Z Fur Orthopadie und Unfallchirurgie"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/s43390-023-00646-5","article-title":"Discrepancy between DXA and CT-based assessment of spine bone mineral density","volume":"11","author":"Davidson","year":"2023","journal-title":"Spine Deformity"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1177\/08968608221146867","article-title":"Differences in prevalence of reduced and low bone mineral density between lumbar spine and femoral neck in peritoneal dialysis patients using dual-energy X-ray absorptiometry (DXA)","volume":"43","author":"Davenport","year":"2023","journal-title":"Peritoneal Dialysis International: J Int Soc For Peritoneal Dialysis"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-020-05441-w","article-title":"Effects of dynamic resistance exercise on bone mineral density in postmenopausal women: a systematic review and meta-analysis with special emphasis on exercise parameters","volume":"31","author":"Shojaa","year":"2020","journal-title":"Osteoporosis International: A J Established as Result Cooperation Between Eur Foundation For Osteoporosis Natl Osteoporosis Foundation USA"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s00223-020-00744-w","article-title":"Effects of different types of exercise on bone mineral density in postmenopausal women: a systematic review and meta-analysis","volume":"107","author":"Kemmler","year":"2020","journal-title":"Calcif Tissue Int"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.3641","article-title":"Change in bone density and reduction in fracture risk: a meta-regression of published trials","volume":"34","author":"Bouxsein","year":"2019","journal-title":"J Bone Mineral Research: Off J Am Soc For Bone Mineral Res"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-069722","article-title":"Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis","volume":"378","author":"Pereira","year":"2022","journal-title":"BMJ (Clinical Res Ed)"},{"key":"B25","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.crtox.2020.06.001","article-title":"Development of an adverse drug event network to predict drug toxicity","volume":"1","author":"Wu","year":"2020","journal-title":"Curr Res Toxicol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1446","article-title":"Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis","volume":"374","author":"Cashin","year":"2021","journal-title":"BMJ (Clinical Res Ed)"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm-2024-112974","article-title":"Analgesic effects of non-surgical and non-interventional treatments for low back pain: a systematic review and meta-analysis of placebo-controlled randomised trials","volume":"3","author":"Cashin","year":"2025","journal-title":"BMJ Evidence-Based Med"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000005343","article-title":"21st century evidence: randomized controlled trials versus systematic reviews and meta-analyses","volume":"49","author":"Agarwal","year":"2021","journal-title":"Crit Care Med"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.ed000145","article-title":"Prospective meta-analyses and Cochrane\u2019s role in embracing next-generation methodologies","volume":"10","author":"Seidler","year":"2020","journal-title":"Cochrane Database Systematic Rev"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.15.1987","article-title":"The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials","volume":"285","author":"Moher","year":"2001","journal-title":"JAMA"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.08.042","article-title":"Epidemiological, methodological, and statistical characteristics of network meta-analysis in anaesthesia: a systematic review","volume":"130","author":"Sehmbi","year":"2023","journal-title":"Br J Anaesthesia"},{"key":"B32","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1186\/s12874-019-0829-2","article-title":"BUGSnet: an R package to facilitate the conduct and reporting of Bayesian network meta-analyses","volume":"19","author":"B\u00e9liveau","year":"2019","journal-title":"BMC Med Res Methodol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000013052","article-title":"Assessing the methodological and reporting quality of network meta-analyses in Chinese medicine","volume":"97","author":"Yang","year":"2018","journal-title":"Medicine"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1093\/jbmr\/zjaf003","article-title":"Bone turnover markers predict changes in bone mineral density in men treated with abaloparatide: results from the abaloparatide for the treatment of men with osteoporosis (ATOM) study","volume":"40","author":"Eastell","year":"2025","journal-title":"J Bone Mineral Research: Off J Am Soc For Bone Mineral Res"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac486","article-title":"Abaloparatide increases lumbar spine and hip BMD in Japanese patients with osteoporosis: the phase 3 ACTIVE-J study","volume":"107","author":"Matsumoto","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4719","article-title":"The efficacy and safety of abaloparatide-SC in men with osteoporosis: a randomized clinical trial","volume":"37","author":"Czerwinski","year":"2022","journal-title":"J Bone Mineral Research: Off J Am Soc For Bone Mineral Res"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.4314\/tjpr.v20i10.26","article-title":"Comparative efficacy and safety of alendronate and teriparatide in bone loss reduction and prevention of vertebral fracture in osteoporotic Chinese patients","volume":"20","author":"Qi","year":"2021","journal-title":"Trop J Pharm Res"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-020-05701-9","article-title":"Randomized, controlled trial to assess the safety and efficacy of odanacatib in the treatment of men with osteoporosis","volume":"32","author":"Binkley","year":"2021","journal-title":"Osteoporosis International: A J Established as Result Cooperation Between Eur Foundation For Osteoporosis Natl Osteoporosis Foundation USA"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-013-2398-2","article-title":"Effect of the cathepsin K inhibitor odanacatib administered once weekly on bone mineral density in Japanese patients with osteoporosis--a double-blind, randomized, dose-finding study","volume":"25","author":"Nakamura","year":"2014","journal-title":"Osteoporosis International: A J Established as Result Cooperation Between Eur Foundation For Osteoporosis Natl Osteoporosis Foundation USA"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-012-9819-4","article-title":"Combination therapy with risedronate and teriparatide in male osteoporosis","volume":"44","author":"Walker","year":"2013","journal-title":"Endocrine"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-1569","article-title":"A randomized, placebo-controlled study of the effects of denosumab for the treatment of men with low bone mineral density","volume":"97","author":"Orwoll","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1204061","article-title":"Fracture risk and zoledronic acid therapy in men with osteoporosis","volume":"367","author":"Boonen","year":"2012","journal-title":"N Engl J Med"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03666.x","article-title":"Once-yearly zoledronic acid in older men compared with women with recent hip fracture","volume":"59","author":"Boonen","year":"2011","journal-title":"J Am Geriatrics Soc"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.119","article-title":"Efficacy and safety of a once-yearly i.v. infusion of zoledronic acid 5\u2009mg versus a once-weekly 70-mg oral alendronate in the treatment of male osteoporosis: a randomized, multicenter, double-blind, active-controlled study","volume":"25","author":"Orwoll","year":"2010","journal-title":"J Bone Mineral Research: Off J Am Soc For Bone Mineral Res"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2009.12.034","article-title":"Efficacy and safety of monthly ibandronate in men with low bone density","volume":"46","author":"Orwoll","year":"2010","journal-title":"Bone"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1007\/s00774-009-0136-9","article-title":"The effects of weekly alendronate therapy in Taiwanese males with osteoporosis","volume":"28","author":"Hwang","year":"2010","journal-title":"J Bone Miner Metab"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-008-0689-2","article-title":"Sustained efficacy of risedronate in men with primary and secondary osteoporosis: results of a 2-year study","volume":"29","author":"Ringe","year":"2009","journal-title":"Rheumatol Int"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.081214","article-title":"Once-weekly risedronate in men with osteoporosis: results of a 2-year, placebo-controlled, double-blind, multicenter study","volume":"24","author":"Boonen","year":"2009","journal-title":"J Bone Mineral Research: Off J Am Soc For Bone Mineral Res"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-004-1713-3","article-title":"Teriparatide effects on vertebral fractures and bone mineral density in men with osteoporosis: treatment and discontinuation of therapy","volume":"16","author":"Kaufman","year":"2005","journal-title":"Osteoporosis International: A J Established as Result Cooperation Between Eur Foundation For Osteoporosis Natl Osteoporosis Foundation USA"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-003-0388-y","article-title":"Alendronate treatment of established primary osteoporosis in men: 3-year results of a prospective, comparative, two-arm study","volume":"24","author":"Ringe","year":"2004","journal-title":"Rheumatol Int"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.2165\/00044011-200424060-00003","article-title":"Weekly oral alendronic acid in male osteoporosis","volume":"24","author":"Miller","year":"2004","journal-title":"Clin Drug Invest"},{"key":"B52","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/b978-0-12-412650-3.50025-9","article-title":"The effect of teriparatide [human parathyroid hormone (1-34)] therapy on bone density in men with osteoporosis","volume":"18","author":"Orwoll","year":"2003","journal-title":"J Bone Mineral Research: Off J Am Soc For Bone Mineral Res"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1007\/s00223-002-1085-7","article-title":"Alendronate treatment in men with primary osteoporosis: a three-year longitudinal study","volume":"73","author":"Gonnelli","year":"2003","journal-title":"Calcif Tissue Int"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1056\/nejm200008313430902","article-title":"Alendronate for the treatment of osteoporosis in men","volume":"343","author":"Orwoll","year":"2000","journal-title":"N Engl J Med"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1836818\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T04:40:58Z","timestamp":1778215258000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1836818\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":54,"alternative-id":["10.3389\/fendo.2026.1836818"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1836818","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,8]]},"article-number":"1836818"}}