{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:06:41Z","timestamp":1784696801429,"version":"3.55.0"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"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>Phthalates (PAEs) are ubiquitous endocrine-disrupting chemicals (EDCs) with well-documented prenatal effects, while their impact during early postnatal life remains less understood. Minipuberty, a transient activation of the hypothalamic-pituitary-gonadal (HPG) axis in early infancy, represents a critical window of endocrine programming. This study aimed to investigate the association between early-life exposure to PAEs and urinary reproductive hormone levels during minipuberty in healthy term-born infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This longitudinal study included infants from the Modena birth cohort with repeated urine sampling at birth (T0), 3 (T3), and 6 months (T6). Urinary concentrations of PAE metabolites (MMP, MEP, MnBP, MBzP, \u03a3DEHPm) and urine reproductive hormones (uLH, uFSH, uT and uE) were measured. Associations were assessed using sex-stratified Spearman correlations, single-pollutant linear regression models, and mixture approaches, including Weighted Quantile Sum (WQS) regression and quantile g-computation (qgcomp).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PAE metabolites were evaluated in 162 infants and detected in nearly all samples, confirming widespread exposure. Consistent positive associations emerged between PAE exposure and urinary hormone levels. In males, increasing levels of metabolites were significantly associated particularly with increased uFSH and uT, at all timepoints. In females, associations were more evident at T3 and T6, mainly involving uFSH and uE. Mixture analyses confirmed these findings and identified MnBP, MBzP, and \u03a3DEHPm as the main contributors. Results were consistent across methods, highlighting a mixture association beside an isolated compound-specific findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early-life exposure to PAE mixtures is associated with sex-specific alterations in reproductive hormone levels during minipuberty. These findings highlight minipuberty as a sensitive window for endocrine disruption and underscore the importance of considering chemical mixtures in environmental health research. However, further studies are needed to determine whether these early hormonal perturbations may have implications for long-term reproductive development and health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1866609","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:48:35Z","timestamp":1784695715000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early-life phthalate mixture exposure and reproductive hormone levels during minipuberty"],"prefix":"10.3389","volume":"17","author":[{"given":"Viola","family":"Trevisani","sequence":"first","affiliation":[{"name":"PhD program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia","place":["Modena, Italy"]},{"name":"Pediatric Unit, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lucaccioni","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Starace","sequence":"additional","affiliation":[{"name":"Public Health Unit, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Passini","sequence":"additional","affiliation":[{"name":"Post-Graduate School of Pediatrics, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Public Health Unit, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Palandri","sequence":"additional","affiliation":[{"name":"Public Health Unit, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Lugli","sequence":"additional","affiliation":[{"name":"PhD program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia","place":["Modena, Italy"]},{"name":"Public Health Unit, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Pinetti","sequence":"additional","affiliation":[{"name":"Interdepartmental Centre for Large Instruments (CIGS), University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Tagliafico","sequence":"additional","affiliation":[{"name":"Diagnostic Hematology and Clinical Genomics Unit, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Licia","family":"Lugli","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Predieri","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Iughetti","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Righi","sequence":"additional","affiliation":[{"name":"Public Health Unit, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia","place":["Modena, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envpol.2021.118106","article-title":"Phthalate metabolites: Characterization, toxicities, global distribution, and exposure assessment","volume":"291","author":"Zhang","year":"2021","journal-title":"Environ pollut"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhazmat.2017.06.036","article-title":"Phthalates impact human health: Epidemiological evidences and plausible mechanism of action","volume":"340","author":"Benjamin","year":"2017","journal-title":"J Hazard Mater"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.6065\/apem.2014.19.2.69","article-title":"Phthalate exposure and childhood obesity","volume":"19","author":"Kim","year":"2014","journal-title":"Ann Pediatr Endocrinol Metab"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2019.105061","article-title":"Children\u2019s exposure to phthalates and non-phthalate plasticizers in the home: The TESIE study","volume":"132","author":"Hammel","year":"2019","journal-title":"Environ Int"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijheh.2025.114704","article-title":"Regulatory framework of phthalates and two common alternatives: a review of the European Union legislation","volume":"271","author":"Palandri","year":"2026","journal-title":"Int J Hyg Environ Health"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2019.105254","article-title":"Joint impact of phthalate exposure and stressful life events in pregnancy on preterm birth","volume":"133","author":"Ferguson","year":"2019","journal-title":"Environ Int"},{"key":"B7","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.cppeds.2007.11.001","article-title":"Phthalates and children\u2019s health","volume":"38","author":"Sathyanarayana","year":"2008","journal-title":"Curr Probl Pediatr Adolesc Health Care"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e32835e1eb6","article-title":"Phthalate exposure and children\u2019s health","volume":"25","author":"Braun","year":"2013","journal-title":"Curr Opin Pediatr"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17228582","article-title":"Phthalate plasticizers in children\u2019s products and estimation of exposure: Importance of migration rate","volume":"17","author":"Kim","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1021\/es0264596","article-title":"Phthalates, alkylphenols, pesticides, polybrominated diphenyl ethers, and other endocrine-disrupting compounds in indoor air and dust","volume":"37","author":"Rudel","year":"2003","journal-title":"Environ Sci Technol"},{"key":"B11","article-title":"Regulation (EC) No 1223\/2009 of the European Parliament and of the Council of 30 November 2009 on cosmetic products","year":"","journal-title":"Off J Eur Union"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpharm.2022.122472","article-title":"Neonatal exposure to phthalate and alternative plasticizers via parenteral nutrition","volume":"631","author":"Panneel","year":"2023","journal-title":"Int J Pharm"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2021.147371","article-title":"The effects of phthalate ester exposure on human health: A review","volume":"786","author":"Chang","year":"2021","journal-title":"Sci Total Environ"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/s0378-4274(02)00254-0","article-title":"Defining the cellular and molecular mechanisms of toxicant action in the testis","volume":"135","author":"Richburg","year":"2002","journal-title":"Toxicol Lett"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2008.0281","article-title":"Components of plastic: experimental studies in animals and relevance for human health","volume":"364","author":"Talsness","year":"2009","journal-title":"Philos Trans R Soc B Biol Sci"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE20140205","article-title":"Association between urinary phthalates and pubertal timing in Chinese adolescents","volume":"25","author":"Shi","year":"2015","journal-title":"J Epidemiol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1172743","article-title":"Perinatal and postnatal exposure to phthalates and early neurodevelopment at 6 months in healthy infants born at term","volume":"14","author":"Lucaccioni","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22084063","article-title":"Perinatal exposure to phthalates: from endocrine to neurodevelopment effects","volume":"22","author":"Lucaccioni","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1017\/S2040174417000733","article-title":"Epigenetics and DOHaD: from basics to birth and beyond","volume":"8","author":"Bianco-Miotto","year":"2017","journal-title":"J Dev Orig Health Dis"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.00108s3545","article-title":"Fetal, infant, and childhood growth are predictors of coronary heart disease, diabetes, and hypertension in adult men and women","volume":"108","author":"Osmond","year":"2000","journal-title":"Environ Health Perspect"},{"key":"B21","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1530\/JOE-14-0111","article-title":"Phthalate exposure in utero causes epigenetic changes and impairs insulin signalling","volume":"223","author":"Rajesh","year":"2014","journal-title":"J Endocrinol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0055387","article-title":"Plastics derived endocrine disruptors (BPA, DEHP and DBP) induce epigenetic transgenerational inheritance of obesity, reproductive disease and sperm epimutations","volume":"8","author":"Manikkam","year":"2013","journal-title":"PloS One"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-013-2967-7","article-title":"Exposure to diethylhexyl phthalate (DEHP) results in a heritable modification of imprint genes DNA methylation in mouse oocytes","volume":"41","author":"Li","year":"2014","journal-title":"Mol Biol Rep"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.2217\/epi-2017-0178","article-title":"DNA methylation of imprinted genes in Mexican\u2013American newborn children with prenatal phthalate exposure","volume":"10","author":"Tindula","year":"2018","journal-title":"Epigenomics"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2018.01.009","article-title":"Association between fetal exposure to phthalate endocrine disruptor and genome-wide DNA methylation at birth","volume":"162","author":"Chen","year":"2018","journal-title":"Environ Res"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2024.175080","article-title":"Effect of prenatal phthalate exposure on fetal development and maternal\/neonatal health consequences: A systematic review","volume":"950","author":"Almeida-Toledano","year":"2024","journal-title":"Sci Total Environ"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2023.115975","article-title":"Early pregnancy phthalates and replacements in relation to fetal growth: The human placenta and phthalates study","volume":"229","author":"Stevens","year":"2023","journal-title":"Environ Res"},{"key":"B28","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1159\/000362414","article-title":"Activation of the hypothalamic-pituitary-gonadal axis in infancy: Minipuberty","volume":"82","author":"Kuiri-H\u00e4nninen","year":"2014","journal-title":"Horm Res Paediatr"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00410","article-title":"Up-to-date review about minipuberty and overview on hypothalamic-pituitary-gonadal axis activation in fetal and neonatal life","volume":"9","author":"Lanciotti","year":"2018","journal-title":"Front Endocrinol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1159\/000508329","article-title":"Minipuberty: why does it happen","volume":"93","author":"Becker","year":"2020","journal-title":"Horm Res Paediatr"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnae003","article-title":"Mini-puberty, physiological and disordered: consequences, and potential for therapeutic replacement","volume":"45","author":"Rohayem","year":"2024","journal-title":"Endocr Rev"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2020.612235","article-title":"Minipuberty: looking back to understand moving forward","volume":"8","author":"Lucaccioni","year":"2021","journal-title":"Front Pediatr"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhazmat.2023.132182","article-title":"Phthalates (PAEs) and reproductive toxicity: hypothalamic-pituitary-gonadal (HPG) axis aspects","volume":"459","author":"Zhang","year":"2023","journal-title":"J Hazard Mater"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.cbpc.2022.109498","article-title":"Phthalate toxicity mechanisms: an update","volume":"263","author":"Sree","year":"2023","journal-title":"Comp Biochem Physiol C Toxicol Pharmacol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.8075","article-title":"Human breast milk contamination with phthalates and alterations of endogenous reproductive hormones in infants three months of age","volume":"114","author":"Main","year":"2006","journal-title":"Environ Health Perspect"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijheh.2023.114166","article-title":"Urinary concentration of phthalates and bisphenol A during minipuberty is associated with reproductive hormone concentrations in infant boys","volume":"250","author":"M\u00fcller","year":"2023","journal-title":"Int J Hyg Environ Health"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1080\/15298669391355134","article-title":"Interpretation of urine results used to assess chemical exposure with emphasis on creatinine adjustments: a review","volume":"54","author":"Boeniger","year":"1993","journal-title":"Am Ind Hyg Assoc J"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1177\/0004563215580385","article-title":"Requirement for specific gravity and creatinine adjustments for urinary steroids and luteinizing hormone concentrations in adolescents","volume":"52","author":"Singh","year":"2015","journal-title":"Ann Clin Biochem"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1038\/jes.2010.43","article-title":"A critical evaluation of the creatinine correction approach: can it underestimate intakes of phthalates? A case study with di-2-ethylhexyl phthalate","volume":"21","author":"Lorber","year":"2011","journal-title":"J Expo Sci Environ Epidemiol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijheh.2011.01.009","article-title":"Exposure to phthalates in 5-6 years old primary school starters in Germany--a human biomonitoring study and a cumulative risk assessment","volume":"214","author":"Koch","year":"2011","journal-title":"Int J Hyg Environ Health"},{"key":"B41","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.ijheh.2013.03.014","article-title":"Phthalate metabolites in urine samples from Danish children and correlations with phthalates in dust samples from their homes and daycare centers","volume":"217","author":"Langer","year":"2014","journal-title":"Int J Hyg Environ Health"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-14-0010","article-title":"The diagnostic value of first-voided urinary LH compared with GNRH-stimulated gonadotropins in differentiating slowly progressive from rapidly progressive precocious puberty in girls","volume":"170","author":"Zung","year":"2014","journal-title":"Eur J Endocrinol"},{"key":"B43","doi-asserted-by":"publisher","first-page":"110","DOI":"10.4103\/ijem.IJEM_47_21","article-title":"The role of urinary LH and FSH in the diagnosis of pubertal disorders","volume":"25","author":"Tripathy","year":"2021","journal-title":"Indian J Endocrinol Metab"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.6065\/apem.2040208.104","article-title":"Single random measurement of urinary gonadotropin concentration for screening and monitoring girls with central precocious puberty","volume":"26","author":"Lee","year":"2021","journal-title":"Ann Pediatr Endocrinol Metab"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab806","article-title":"Reproducibility and refinement of urinary LH in the screening of progressive puberty in girls","volume":"107","author":"Zung","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"key":"B46","doi-asserted-by":"crossref","DOI":"10.20945\/2359-3997000000212","article-title":"Diagnostic value of urinary luteinizing hormone levels in the monitoring of precocious puberty treatment","volume-title":"Arch. Endocrinol. Metab","author":"Y\u00fcce","year":"2020"},{"key":"B47","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1186\/s12887-022-03481-1","article-title":"The value of urinary gonadotropins in the diagnosis of central precocious puberty: a meta-analysis","volume":"22","author":"Xu","year":"2022","journal-title":"BMC Pediatr"},{"key":"B48","article-title":"Laboratory Procedure Manual - Metabolites of phthalates and phthalate alternatives, Method n. 6306.07","volume-title":"CDC (Center for Disease Control and Prevention)","author":"Ye","year":"2015"},{"key":"B49","doi-asserted-by":"publisher","first-page":"26375","DOI":"10.1038\/s41598-024-76972-z","article-title":"Associations between exposure to mixed environmental endocrine disruptors and sex steroid hormones in men: a comparison of different statistical models","volume":"14","author":"Zhao","year":"2024","journal-title":"Sci Rep"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1007\/s13253-014-0180-3","article-title":"Characterization of weighted quantile sum regression for highly correlated data in a risk analysis setting","volume":"20","author":"Carrico","year":"2015","journal-title":"J Agric Biol Environ Stat"},{"key":"B51","doi-asserted-by":"publisher","first-page":"047004","DOI":"10.1289\/EHP5838","article-title":"A quantile-based g-computation approach to addressing the effects of exposure mixtures","volume":"128","author":"Keil","year":"2020","journal-title":"Environ Health Perspect"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-024-02493-1","article-title":"The assessment of urinary sexual hormones within minipuberty and correlations with anthropometrics in a cohort of healthy term children","volume":"48","author":"Trevisani","year":"2025","journal-title":"J Endocrinol Invest"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-022-03409-9","article-title":"Applying the adverse outcome pathway concept for assessing non-monotonic dose\u00a0responses: biphasic effect of DEHP on testosterone levels","volume":"97","author":"Astuto","year":"2023","journal-title":"Arch Toxicol"},{"key":"B54","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1210\/er.2011-1050","article-title":"Hormones and endocrine-disrupting chemicals: low-dose effects and nonmonotonic dose responses","volume":"33","author":"Vandenberg","year":"2012","journal-title":"Endocr Rev"},{"key":"B55","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.tox.2006.05.007","article-title":"A dose-response study following in utero and lactational exposure to DEHP: effects on androgenic status, developmental landmarks and testicular histology in male offspring rats","volume":"225","author":"Andrade","year":"2006","journal-title":"Toxicology"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1866609\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:48:41Z","timestamp":1784695721000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1866609\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":55,"alternative-id":["10.3389\/fendo.2026.1866609"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1866609","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"article-number":"1866609"}}