{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:10:32Z","timestamp":1788952232250,"version":"build-2803163510"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"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>Introduction<\/jats:title>\n                    <jats:p>The physiological burden of chronic stress, quantified as allostatic load (AL), is implicated in cancer development and outcomes. However, a synthesis of evidence regarding its role in female-specific cancers is lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review aimed to synthesize existing evidence on the application of AL in female cancer patients, covering both its predictive value for cancer risk in healthy populations and its prognostic significance for outcomes and quality of life in cancer patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, we systematically searched PubMed, Web of Science, Springer Link, and Wiley Online Library from inception to June 2025. Studies investigating AL in patients with common female cancers (e.g., breast, endometrial, ovarian) were included. Study quality was assessed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data on study characteristics, AL assessment methods, associated factors, and key findings were extracted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>17 studies (14 on breast cancer, 2 on endometrial cancer, and 1 on ovarian cancer) were included. AL levels were influenced by sociodemographic, lifestyle, and structural factors. Higher AL was associated with an increased risk of female cancers (particularly breast cancer) incidence, poorer health-related quality of life, a higher incidence of postoperative complications (e.g., lymphedema), and increased all-cause mortality. And existing studies exhibit heterogeneity in biomarker selection and scoring thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AL is a promising composite marker associated with the risk, prognosis, and quality of life in female cancer patients, primarily breast cancer. Current evidence is concentrated on breast cancer with limited evidence available for other types of female cancers. Future research requires standardized AL assessment and investigations across diverse female cancer populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n                      , identifier CRD420251080672.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1881050","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:16:48Z","timestamp":1788949008000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Allostatic load in female cancer patients: a systematic review"],"prefix":"10.3389","volume":"17","author":[{"given":"Sisi","family":"Bu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minglu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luxia","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA: A Cancer J For Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.43198","article-title":"Global disparities of cancer and its projected burden in 2050","volume":"7","author":"Bizuayehu","year":"2024","journal-title":"JAMA Netw Open"},{"key":"B3","doi-asserted-by":"publisher","first-page":"3523","DOI":"10.1186\/s12889-024-21063-x","article-title":"Impact of the input of women's working hours on household non-economic welfare","volume":"24","author":"Chu","year":"2024","journal-title":"BMC Public Health"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s40572-024-00443-w","article-title":"Reproductive and social policies, sociopolitical stress, and implications for maternal and child health equity","volume":"11","author":"Eick","year":"2024","journal-title":"Curr Environ Health Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.semcancer.2025.05.007","article-title":"Psychological stress on cancer progression and immunosenescence","volume":"113","author":"Huang","year":"2025","journal-title":"Semin Cancer Biol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"75","DOI":"10.3390\/cancers16010075","article-title":"Analysis of anxiety, depression and fear of progression at 12 months post-cytoreductive surgery in the SOCQER-2 (Surgery in Ovarian Cancer-Quality of Life Evaluation Research) prospective, international, multicentre study","volume":"16","author":"Lakhiani","year":"2023","journal-title":"Cancers"},{"key":"B7","doi-asserted-by":"publisher","first-page":"492","DOI":"10.21037\/gs-23-94","article-title":"Analysis of risk factors for negative emotions in perioperative period of ovarian cancer patients and their impact on prognosis","volume":"12","author":"He","year":"2023","journal-title":"Gland Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"411","DOI":"10.3390\/cancers17030411","article-title":"Chemotherapy-induced alopecia in ovarian cancer: incidence, mechanisms, and impact across treatment regimens","volume":"17","author":"Gaumond","year":"2025","journal-title":"Cancers"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1080\/0167482X.2024.2404010","article-title":"Impact of diagnosis and surgical treatment of early stage borderline ovarian tumours on distress, anxiety, and psychosexual health","volume":"45","author":"Cosyns","year":"2024","journal-title":"J Psychosomatic Obstetrics Gynecology"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/ecc.13645","article-title":"'Sometimes I can't look in the mirror': recognising the importance of the sociocultural context in patient experiences of sexuality, relationships and body image after ovarian cancer","volume":"31","author":"Boding","year":"2022","journal-title":"Eur J Cancer Care"},{"key":"B11","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1186\/s12978-022-01369-y","article-title":"What factors shape quality of life for women affected by gynaecological cancer in South, South East and East Asian countries? A critical review [Journal Article; Review","volume":"19","author":"Spagnoletti","year":"2022","journal-title":"Reprod Health"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35776","article-title":"Cervical cancer stigma - a silent barrier to the elimination of cervical cancer","volume":"131","author":"Bae","year":"2025","journal-title":"Cancer"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2020.12.031","article-title":"Perceived social support in patients with endometrial or ovarian cancer: a secondary analysis from the ROGY care study","volume":"160","author":"Scheepers","year":"2021","journal-title":"Gynecologic Oncol"},{"key":"B14","article-title":"Stress and the individual. Mechanisms leading to disease","volume-title":"Arch Intern Med","author":"McEwen","year":"1993"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2022.111050","article-title":"Measuring allostatic load: approaches and limitations to algorithm creation","volume":"163","author":"Carbone","year":"2022","journal-title":"J Psychosomatic Res"},{"key":"B16","doi-asserted-by":"publisher","first-page":"89755495","DOI":"10.1177\/1177271920914585","article-title":"Allostatic load indices with cholesterol and triglycerides predict disease and mortality risk in zoo-housed western lowland gorillas (Gorilla gorilla gorilla)","volume":"15","author":"Edes","year":"2020","journal-title":"biomark Insights"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2023.106322","article-title":"Cellular allostatic load is linked to increased energy expenditure and accelerated biological aging","volume":"155","author":"Bobba-Alves","year":"2023","journal-title":"Psychoneuroendocrinology"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1186\/s12885-025-14980-6","article-title":"Allostatic load and kidney cancer incidence and mortality: a genetic susceptibility and proteomic mediation analysis","volume":"25","author":"Xu","year":"2025","journal-title":"BMC Cancer"},{"key":"B19","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1111\/j.1749-6632.1998.tb09546.x","article-title":"Stress, adaptation, and disease. Allostasis and allostatic load","volume":"840","author":"McEwen","year":"1998","journal-title":"Ann N Y Acad Sci"},{"key":"B20","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1159\/000510696","article-title":"Allostatic load and its impact on health: a systematic review","volume":"90","author":"Guidi","year":"2021","journal-title":"Psychother Psychosomatics"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2023.107817","article-title":"Allostatic load and risk of invasive breast cancer among postmenopausal women in the U.S [Journal Article","volume":"178","author":"Wang","year":"2024","journal-title":"Prev Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.033295","article-title":"Allostatic load\/chronic stress and cardiovascular outcomes in patients diagnosed with breast, lung, or colorectal cancer [Journal Article","volume":"13","author":"Stabellini","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djae223","article-title":"Allostatic load, genetic susceptibility, incidence risk, and all-cause mortality of colorectal cancer [Journal Article","volume":"117","author":"Zhao","year":"2025","journal-title":"Jnci-Journal Natl Cancer Institute"},{"key":"B24","doi-asserted-by":"publisher","first-page":"pkad005","DOI":"10.1093\/jncics\/pkad005","article-title":"Allostatic load and cardiovascular outcomes in males with prostate cancer [Journal Article; Research Support, N.I.H. Extramural; Research Support, Non-U.S. Gov't","volume":"7","author":"Stabellini","year":"2023","journal-title":"Jnci Cancer Spectr"},{"key":"B25","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1186\/s12905-023-02529-3","article-title":"Investigating the association between educational attainment and allostatic load with risk of cancer mortality among African American women","volume":"23","author":"Li","year":"2023","journal-title":"BMC Womens Health"},{"key":"B26","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1007\/s00520-025-09362-4","article-title":"The association between allostatic load and lymphedema in breast cancer survivors","volume":"33","author":"Obeng-Gyasi","year":"2025","journal-title":"Supportive Care Cancer"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.13989","article-title":"Association of allostatic load with all-cause mortality in patients with breast cancer","volume":"6","author":"Obeng-Gyasi","year":"2023","journal-title":"JAMA Netw Open"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2023.10.008","article-title":"Sex hormone signaling and regulation of immune function","volume":"56","author":"Hoffmann","year":"2023","journal-title":"Immunity"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2023.105212","article-title":"Menstrual cycle-related changes in HPA axis reactivity to acute psychosocial and physiological stressors - a systematic review and meta-analysis of longitudinal studies","volume":"150","author":"Klusmann","year":"2023","journal-title":"Neurosci Biobehav Rev"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26209994","article-title":"Chronic stress and autoimmunity: the role of HPA axis and cortisol dysregulation","volume":"26","author":"Nunez","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.2174\/1570159X22666231005090134","article-title":"Sex differences in stress response: classical mechanisms and beyond","volume":"22","author":"Hodes","year":"2024","journal-title":"Curr Neuropharmacol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2023.103584","article-title":"Causal relationship between female reproductive factors, sex hormones and uterine leiomyoma: a Mendelian randomization study","volume":"48","author":"Wang","year":"2024","journal-title":"Reprod Biomedicine Online"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ (Clinical Res Ed)"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ (Clinical Res Ed)"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2024.05.031","article-title":"Association of allostatic load with overall survival in epithelial ovarian cancer","volume":"186","author":"Borho","year":"2024","journal-title":"Gynecologic Oncol"},{"key":"B36","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1038\/s41523-024-00654-2","article-title":"Allostatic load as a predictor of postoperative complications in patients with breast cancer","volume":"10","author":"Chen","year":"2024","journal-title":"NPJ Breast Cancer"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.00907","article-title":"Association between neighborhood opportunity, allostatic load, and all-cause mortality in patients with breast cancer","volume":"42","author":"Chen","year":"2024","journal-title":"J Clin Oncol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-023-14431-1","article-title":"The implications of racialized economic segregation and allostatic load on mortality in patients with breast cancer","volume":"31","author":"Chen","year":"2024","journal-title":"Ann Surg Oncol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.28019","article-title":"Allostatic load and racial and rural disparities in breast cancer survival","volume":"8","author":"Guan","year":"2025","journal-title":"JAMA Netw Open"},{"key":"B40","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1186\/s13058-023-01754-w","article-title":"Association between allostatic load and breast cancer risk: a cohort study","volume":"25","author":"Guan","year":"2023","journal-title":"Breast Cancer Research: Bcr"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3044","article-title":"Association between breast cancer and allostatic load by race: National Health and Nutrition Examination Survey 1999-2008","volume":"22","author":"Parente","year":"2013","journal-title":"Psycho-Oncology"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwae134","article-title":"Association between neighborhood stressors and allostatic load in breast cancer survivors: the Pathways Study","volume":"194","author":"Sangaramoorthy","year":"2025","journal-title":"Am J Epidemiol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-020-05901-1","article-title":"Pre-diagnostic allostatic load and health-related quality of life in a cohort of Black breast cancer survivors","volume":"184","author":"Xing","year":"2020","journal-title":"Breast Cancer Res Treat"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-19-0712","article-title":"Prediagnostic allostatic load as a predictor of poorly differentiated and larger sized breast cancers among Black women in the Women's Circle of Health Follow-Up Study","volume":"29","author":"Xing","year":"2020","journal-title":"Cancer Epidemiology Biomarkers Prevention: A Publ Am Assoc For Cancer Research Cosponsored by Am Soc Prev Oncol"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-021-06102-0","article-title":"Allostatic score and its associations with demographics, healthy behaviors, tumor characteristics, and mitochondrial DNA among breast cancer patients","volume":"187","author":"Zhao","year":"2021","journal-title":"Breast Cancer Res Treat"},{"key":"B46","doi-asserted-by":"publisher","first-page":"2026.06.06.26355062","DOI":"10.64898\/2026.06.06.26355062","article-title":"Allostatic load in endometrial cancer disparities","author":"Bey","year":"2026","journal-title":"medRxiv"},{"key":"B47","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1007\/s10552-026-02186-5","article-title":"Association between allostatic load and risk of breast carcinoma in situ in the UK biobank","volume":"37","author":"Fengfu","year":"2026","journal-title":"Cancer causes control CCC"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.71993","article-title":"Impact of allostatic load on overall survival in patients with endometrial cancer","volume":"15","author":"Sinha","year":"2026","journal-title":"Cancer Med"},{"key":"B49","doi-asserted-by":"publisher","first-page":"2026.06.06.26355062","DOI":"10.64898\/2026.06.06.26355062","article-title":"Allostatic load in endometrial cancer disparities","author":"Bey","year":"2026","journal-title":"medRxiv preprint server Health Sci"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.49855","article-title":"Allostatic load, educational attainment, and risk of cancer mortality among US men","volume":"7","author":"Li","year":"2024","journal-title":"JAMA Netw Open"},{"key":"B51","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1002\/aac2.12064","article-title":"Allostatic load and risk of all-cause, cancer-specific, and cardiovascular mortality in older cancer survivors: an analysis of the National Health and Nutrition Examination Survey 1999-2010","volume":"4","author":"Yang","year":"2023","journal-title":"Aging Cancer"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1007\/s12529-023-10235-5","article-title":"Associations of socioeconomic factors and unhealthy lifestyles with allostatic load: a meta-analysis","volume":"31","author":"Yuan","year":"2024","journal-title":"Int J Behav Med"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.70979","article-title":"Understanding racial disparities in prostate cancer: a multifaceted approach","volume":"14","author":"Cobbs","year":"2025","journal-title":"Cancer Med"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1200\/OA-25-00177","article-title":"Impact of race, socioeconomic status, and clinicopathologic features on clinical outcomes in triple-negative breast cancer in the ECOG-ACRIN EA1131 trial","volume":"3","author":"Forster","year":"2026","journal-title":"JCO Oncol Adv"},{"key":"B55","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/s13058-024-01839-0","article-title":"Association of early menarche with breast tumor molecular features and recurrence","volume":"26","author":"Harris","year":"2024","journal-title":"Breast Cancer research: BCR"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34846","article-title":"Healthy lifestyle and cancer survival: a multinational cohort study","volume":"154","author":"Bian","year":"2024","journal-title":"Int J Cancer"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-025-02059-3","article-title":"Lifestyle factors affecting the prognosis of gynecological cancer: systematic review and meta-analysis","volume":"36","author":"Park","year":"2025","journal-title":"Cancer Causes Control: Ccc"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-025-17711-0","article-title":"The hidden burden: impact of allostatic load on colorectal cancer surgery outcomes","volume":"32","author":"Khalil","year":"2025","journal-title":"Ann Surg Oncol"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2022.09.006","article-title":"Bearing allostatic load: insights into a more equitable future within cardio-oncology","volume":"28","author":"Barrett","year":"2022","journal-title":"Trends Mol Med"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.3390\/ijms222011137","article-title":"Insulin resistance and cancer: in search for a causal link","volume":"22","author":"Chiefari","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1016\/j.jare.2025.11.001","article-title":"Depression remodels tumor microenvironment to drive tumor progression: bio-behavioural signalling pathways and clinical interventions","author":"Ge","year":"2025","journal-title":"J Adv Res"},{"key":"B62","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1038\/s41392-025-02241-8","article-title":"Neuro-immune crosstalk in cancer: mechanisms and therapeutic implications","volume":"10","author":"Pu","year":"2025","journal-title":"Signal Transduction Targeted Ther"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcp.2023.115545","article-title":"Triple-negative breast cancer: epidemiology, molecular mechanisms, and modern vaccine-based treatment strategies","volume":"212","author":"Karim","year":"2023","journal-title":"Biochem Pharmacol"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.3390\/molecules30071411","article-title":"Androgen receptors in human breast cancer and female canine mammary tumors","volume":"30","author":"Vidovi\u0107","year":"2025","journal-title":"Molecules"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1881050\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:16:50Z","timestamp":1788949010000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1881050\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":64,"alternative-id":["10.3389\/fendo.2026.1881050"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1881050","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"1881050"}}