{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T13:12:48Z","timestamp":1788527568307,"version":"build-2803163510"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"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. Gastroenterol."],"abstract":"<jats:p>Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) has become the most common chronic liver disease worldwide, and its core pathophysiological mechanism is closely related to insulin resistance. This literature review aims to systematically summarize the application progress of insulin resistance-related indicators in the clinical assessment of MASLD, points out the limitations of existing indicators in clinical application, and looks forward to future research directions, including the development of more accurate and non-invasive biomarkers, exploration\u00a0of multi-omics integration models, and promotion of individualized diagnosis and treatment strategies, with the expectation of optimizing the clinical management of MASLD and improving patient prognosis.<\/jats:p>","DOI":"10.3389\/fgstr.2026.1859647","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T12:16:03Z","timestamp":1788524163000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Advances in the application of insulin resistance-related indicators in the clinical evaluation of metabolic dysfunction-associated steatotic liver disease"],"prefix":"10.3389","volume":"5","author":[{"given":"Yi","family":"Li","sequence":"first","affiliation":[{"name":"Institute of Digestive Diseases, Center of Clinical Medicine, Tianyou Hospital Affiliated to Wuhan University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Li","sequence":"additional","affiliation":[{"name":"Institute of Digestive Diseases, Center of Clinical Medicine, Tianyou Hospital Affiliated to Wuhan University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bolun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Institute of Digestive Diseases, Center of Clinical Medicine, Tianyou Hospital Affiliated to Wuhan University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingming","family":"Wu","sequence":"additional","affiliation":[{"name":"Institute of Digestive Diseases, Center of Clinical Medicine, Tianyou Hospital Affiliated to Wuhan University of Science and Technology","place":["Wuhan, China"]},{"name":"Hubei Provincial Key Laboratory of Occupational Hazard Identification and Control","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Long","sequence":"additional","affiliation":[{"name":"Institute of Digestive Diseases, Center of Clinical Medicine, Tianyou Hospital Affiliated to Wuhan University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1136\/gutjnl-2023-330595","article-title":"Masld: a systemic metabolic disorder with cardiovascular and Malignant complications","volume":"73","author":"Targher","year":"2024","journal-title":"Gut"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32511-3","article-title":"Non-alcoholic fatty liver disease","volume":"397","author":"Powell","year":"2021","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0431","article-title":"Epidemiology of metabolic dysfunction-associated steatotic liver disease","volume":"31","author":"Younossi","year":"2025","journal-title":"Clin Mol Hepatol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.70080","article-title":"Epidemiology of metabolic dysfunction-associated steatotic liver disease in South Asian ethnicities: a systematic review and meta-analysis","volume":"40","author":"James","year":"2025","journal-title":"J Gastroenterol Hepatol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000785","article-title":"Trends in the prevalence of steatotic liver disease among Chinese adults 2015-2023: a nationwide cross-sectional study","volume":"9","author":"Lin","year":"2025","journal-title":"Hepatol Commun"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1038\/s41573-024-01084-2","article-title":"Therapeutic landscape of metabolic dysfunction-associated steatohepatitis","volume":"24","author":"Do","year":"2025","journal-title":"Nat Rev Drug Discov"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms12977","article-title":"Differential hepatic distribution of insulin receptor substrates causes selective insulin resistance in diabetes and obesity","volume":"7","author":"Kubota","year":"2016","journal-title":"Nat Commun"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2024.04.006","article-title":"Hepatic selective insulin resistance at the intersection of insulin signaling and metabolic dysfunction-associated steatotic liver disease","volume":"36","author":"Bo","year":"2024","journal-title":"Cell Metab"},{"key":"B9","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/j.tem.2017.03.003","article-title":"Unraveling the regulation of hepatic metabolism by insulin","volume":"28","author":"Titchenell","year":"2017","journal-title":"Trends Endocrinol Metab"},{"key":"B10","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1038\/s41392-022-01073-0","article-title":"Trends in insulin resistance: insights into mechanisms and therapeutic strategy","volume":"7","author":"Li","year":"2022","journal-title":"Signal Transduct Target Ther"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2021.154868","article-title":"Diabetes and metabolic dysfunction-associated fatty liver disease","volume":"123","author":"Davis","year":"2021","journal-title":"Metabolism"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2017.56","article-title":"Hepatokines linking nonalcoholic fatty liver disease and insulin resistance","volume":"13","author":"Meex","year":"2017","journal-title":"Nat Rev Endocrinol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S468147","article-title":"Impact of lipids on insulin resistance: insights from human and animal studies","volume":"18","author":"Elkanawati","year":"2024","journal-title":"Drug Des Devel Ther"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-021-00502-9","article-title":"Metabolomics and lipidomics in NAFLD: biomarkers and non-invasive diagnostic tests","volume":"18","author":"Masoodi","year":"2021","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-005-1682-x","article-title":"Insulin resistance in non-diabetic patients with non-alcoholic fatty liver disease: sites and mechanisms","volume":"48","author":"Bugianesi","year":"2005","journal-title":"Diabetologia"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(22)00704-8","article-title":"The association between non-alcoholic fatty liver disease and insulin resistance within normal glucose level population","volume":"77","author":"Wang","year":"2022","journal-title":"J Hepatol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.ado3141","article-title":"Atf3-mediated metabolic reprogramming in hepatic macrophage orchestrates metabolic dysfunction-associated steatohepatitis","volume":"10","author":"Hu","year":"2024","journal-title":"Sci Adv"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.xcrm.2024.101564","article-title":"Monocyte bioenergetics: an immunometabolic perspective in metabolic dysfunction-associated steatohepatitis","volume":"5","author":"Sangineto","year":"2024","journal-title":"Cell Rep Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac660","article-title":"Adipose tissue insulin resistance predicts the severity of liver fibrosis in patients with type 2 diabetes and NAFLD","volume":"108","author":"Kalavalapalli","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000980","article-title":"Aramchol improves hepatic fibrosis in metabolic dysfunction-associated steatohepatitis: results of multimodality assessment using both conventional and digital pathology","volume":"81","author":"Ratziu","year":"2025","journal-title":"Hepatology"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1021\/acsnano.4c13404","article-title":"Prevent and reverse metabolic dysfunction-associated steatohepatitis and hepatic fibrosis via mRNA-mediated liver-specific antibody therapy","volume":"18","author":"Zhang","year":"2024","journal-title":"ACS Nano"},{"key":"B22","doi-asserted-by":"publisher","first-page":"4528","DOI":"10.1038\/s41467-024-48317-x","article-title":"Liver and pancreatic-targeted interleukin-22 as a therapeutic for metabolic dysfunction-associated steatohepatitis","volume":"15","author":"Sajiir","year":"2024","journal-title":"Nat Commun"},{"key":"B23","doi-asserted-by":"publisher","first-page":"31098","DOI":"10.1038\/s41598-025-15425-7","article-title":"HOMA-IR, an independent predictor of advanced liver fibrosis in metabolic-dysfunction associated fatty liver disease: a cross-sectional study in Egyptian patients","volume":"15","author":"Fouad","year":"2025","journal-title":"Sci Rep"},{"key":"B24","doi-asserted-by":"publisher","first-page":"57","DOI":"10.2337\/diacare.23.1.57","article-title":"Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity","volume":"23","author":"Bonora","year":"2000","journal-title":"Diabetes Care"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1590\/S0004-28032010000200009","article-title":"Insulin resistance index (HOMA-IR) in the differentiation of patients with non-alcoholic fatty liver disease and healthy individuals","volume":"47","author":"Farias de Azevedo Salgado","year":"2010","journal-title":"Arq Gastroenterol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-024-08309-9","article-title":"Insulin resistance\/sensitivity measures as screening indicators of metabolic-associated fatty liver disease and liver fibrosis","volume":"69","author":"Khamseh","year":"2024","journal-title":"Dig Dis Sci"},{"key":"B27","doi-asserted-by":"publisher","first-page":"47","DOI":"10.15403\/jgld-5901","article-title":"The mediation effects of type 2 diabetes mellitus and related biomarkers on the association of metabolic dysfunction-associated steatotic liver disease and fibrosis","volume":"34","author":"Cai","year":"2025","journal-title":"J Gastrointestin Liver Dis"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.metop.2025.100402","article-title":"Association between HOMA-IR and metabolic dysfunction-associated steatohepatitis in US adults with MASLD","volume":"28","author":"Tang","year":"2025","journal-title":"Metabol Open"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1007\/s40292-022-00542-5","article-title":"HOMA-IR as a predictor of health outcomes in patients with metabolic risk factors: a systematic review and meta-analysis","volume":"29","author":"Gonzalez-Gonzalez","year":"2022","journal-title":"High Blood Press Cardiovasc Prev"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.08.005","article-title":"Hs-CRP and HOMA-IR: include them in the MASLD definition or treat them as mediators between MASLD and atherosclerotic cardiovascular disease","volume":"82","author":"Wan","year":"2025","journal-title":"J Hepatol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3390\/nu12072141","article-title":"Baseline HOMA IR and circulating FGF21 levels predict NAFLD improvement in patients undergoing a low carbohydrate dietary intervention for weight loss: a prospective observational pilot study","volume":"12","author":"Watanabe","year":"2020","journal-title":"Nutrients"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2024.01.032","article-title":"The emerging role of glucagon-like peptide-1 receptor agonists for the treatment of metabolic dysfunction-associated steatohepatitis","volume":"22","author":"Abushamat","year":"2024","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"3962","DOI":"10.1038\/s41467-024-47919-9","article-title":"The pan-PPAR agonist lanifibranor improves cardiometabolic health in patients with metabolic dysfunction-associated steatohepatitis","volume":"15","author":"Cooreman","year":"2024","journal-title":"Nat Commun"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000001475","article-title":"Chiglitazar in MASLD with hypertriglyceridemia and insulin resistance: a phase II, randomized, double-blind, placebo-controlled study","volume":"83","author":"Sun","year":"2026","journal-title":"Hepatology"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2015.11.019","article-title":"Optimal cutoff points for HOMA-IR and QUICKI in the diagnosis of metabolic syndrome and non-alcoholic fatty liver disease: a population based study","volume":"30","author":"Motamed","year":"2016","journal-title":"J Diabetes Complications"},{"key":"B36","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1186\/s12933-024-02263-6","article-title":"Lipid-based insulin-resistance markers predict cardiovascular events in metabolic dysfunction associated steatotic liver disease","volume":"23","author":"Colantoni","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1038\/s41598-024-84809-y","article-title":"Correlation analysis of the triglyceride-glucose index and related parameters in metabolic dysfunction-associated fatty liver disease","volume":"15","author":"Yang","year":"2025","journal-title":"Sci Rep"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3390\/metabo14070358","article-title":"Comparison of ten surrogate insulin resistance and obesity markers to identify metabolic syndrome in Mexican adults","volume":"14","author":"Contreras-Hernandez","year":"2024","journal-title":"Metabolites"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1373039","article-title":"Triglyceride glucose-related indexes and lipid accumulation products: reliable markers of insulin resistance in the Chinese population","volume":"11","author":"Liu","year":"2024","journal-title":"Front Nutr"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13237423","article-title":"Predictive value of TyG and TyG-BMI indices for non-alcoholic fatty liver disease in high-altitude regions of China: a cross-sectional study","volume":"13","author":"Wang","year":"2024","journal-title":"J Clin Med"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.951689","article-title":"Potential screening indicators for early diagnosis of NAFLD\/MAFLD and liver fibrosis: triglyceride glucose index-related parameters","volume":"13","author":"Xue","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B42","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/s12876-023-03095-6","article-title":"Association of insulin resistance indicators with hepatic steatosis and fibrosis in patients with metabolic syndrome","volume":"24","author":"Kuo","year":"2024","journal-title":"BMC Gastroenterol"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-024-02572-w","article-title":"Association between triglyceride-glucose related indices and cardiovascular diseases and mortality among individuals with metabolic dysfunction-associated steatotic liver disease: a cohort study of UK Biobank","volume":"24","author":"Qiao","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2025.102122","article-title":"Diagnosis of metabolic dysfunction-associated steatotic liver disease by triglyceride glucose-body mass index: a systematic review and meta-analysis","volume":"31","author":"Du","year":"2025","journal-title":"Ann Hepatol"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0324483","article-title":"Association of triglyceride glucose-body mass index with metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis","volume":"20","author":"Boushehri","year":"2025","journal-title":"PloS One"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.clnu.2025.04.006","article-title":"Association between triglyceride-glucose related indices and severe infection requiring hospital admission or resulting in mortality among individuals with metabolic dysfunction-associated steatotic liver disease","volume":"49","author":"Zhao","year":"2025","journal-title":"Clin Nutr"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-023-01625-2","article-title":"Comprehensive genetic study of the insulin resistance marker TG:HDL-C in the UK Biobank","volume":"56","author":"Oliveri","year":"2024","journal-title":"Nat Genet"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1161\/CIRC.150.suppl_1.4140042","article-title":"Impact of inflammatory and insulin resistance biomarkers on long-term risks in coronary heart disease patients with cardiovascular-kidney-metabolic syndrome","volume":"150","author":"Zhang","year":"2024","journal-title":"Circulation"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.12182\/20220960102","article-title":"Application of TG\/HDL-C combined with liver function indexes to predict metabolic-associated fatty liver disease","volume":"53","author":"Xia","year":"2022","journal-title":"Sichuan Da Xue Xue Bao Yi Xue Ban"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1362396","article-title":"Association between triglyceride to high-density lipoprotein cholesterol ratio and nonalcoholic fatty liver disease and liver fibrosis in American adults: an observational study from the National Health and Nutrition Examination Survey 2017-2020","volume":"15","author":"Wang","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.3390\/nu16091310","article-title":"Triglyceride to HDL cholesterol ratio for the identification of MASLD in obesity: a liver biopsy-based case-control study","volume":"16","author":"Martinez-Montoro","year":"2024","journal-title":"Nutrients"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1383489","article-title":"TG\/HDL-C ratio is positively associated with risk and severity of CHD among NAFLD patients: a case control study","volume":"15","author":"Cheng","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B53","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1186\/s12933-024-02334-8","article-title":"Metabolic score for insulin resistance (METS-IR) predicts all-cause and cardiovascular mortality in the general population: evidence from NHANES 2001-2018","volume":"23","author":"Duan","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-17-0883","article-title":"METS-IR, a novel score to evaluate insulin sensitivity, is predictive of visceral adiposity and incident type 2 diabetes","volume":"178","author":"Bello-Chavolla","year":"2018","journal-title":"Eur J Endocrinol"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2022.0099","article-title":"The usefulness of metabolic score for insulin resistance for the prediction of incident non-alcoholic fatty liver disease in Korean adults","volume":"28","author":"Lee","year":"2022","journal-title":"Clin Mol Hepatol"},{"key":"B56","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1186\/s12902-024-01646-w","article-title":"METS-IR\/HOMA-IR and MAFLD in US adults: dose-response correlation and the effect mediated by physical activity","volume":"24","author":"Peng","year":"2024","journal-title":"BMC Endocr Disord"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2025.101419","article-title":"Identification of pediatric MASLD using insulin resistance indices","volume":"7","author":"Song","year":"2025","journal-title":"JHEP Rep"},{"key":"B58","doi-asserted-by":"publisher","first-page":"24917","DOI":"10.1038\/s41598-025-10765-w","article-title":"Nonlinear relationship between body fat percentage and NAFLD mediated by METS-IR: threshold effects and subgroup differences","volume":"15","author":"Zhao","year":"2025","journal-title":"Sci Rep"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1224967","article-title":"Mets-IR as a predictor of cardiovascular events in the middle-aged and elderly population and mediator role of blood lipids","volume":"14","author":"Qian","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4930355","article-title":"Dose-response associations of metabolic score for insulin resistance index with nonalcoholic fatty liver disease among a nonobese Chinese population: retrospective evidence from a population-based cohort study","volume":"2022","author":"Cai","year":"2022","journal-title":"Dis Markers"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14092973","article-title":"Use of metabolic scores and lipid ratios to predict metabolic dysfunction-associated steatotic liver disease onset in patients with inflammatory bowel diseases","volume":"14","author":"Abenavoli","year":"2025","journal-title":"J Clin Med"},{"key":"B62","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1186\/s12902-025-01988-z","article-title":"Non-linear association between metabolic score for insulin resistance and nonalcoholic fatty liver disease: analysis of US National Health and Nutrition Examination Survey data, 2017-2020","volume":"25","author":"Wang","year":"2025","journal-title":"BMC Endocr Disord"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2023.0350","article-title":"Insulin resistance, non-alcoholic fatty liver disease and type 2 diabetes mellitus: clinical and experimental perspective","volume":"48","author":"Jung","year":"2024","journal-title":"Diabetes Metab J"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26062770","article-title":"Unraveling the mystery of insulin resistance: from principle mechanistic insights and consequences to therapeutic interventions","volume":"26","author":"Mir","year":"2025","journal-title":"Int J Mol Sci"}],"container-title":["Frontiers in Gastroenterology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgstr.2026.1859647\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T12:16:05Z","timestamp":1788524165000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgstr.2026.1859647\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":64,"alternative-id":["10.3389\/fgstr.2026.1859647"],"URL":"https:\/\/doi.org\/10.3389\/fgstr.2026.1859647","relation":{},"ISSN":["2813-1169"],"issn-type":[{"value":"2813-1169","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]},"article-number":"1859647"}}