{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T15:42:11Z","timestamp":1793720531074,"version":"4.6.1"},"reference-count":65,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"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. Med."],"abstract":"<jats:p>Obstructive sleep apnea syndrome (OSAS) is closely associated with obesity and metabolic dysfunction. Tirzepatide, a dual GLP-1 and GIP receptor agonist, has demonstrated superior efficacy for weight reduction and improved metabolic health compared with single GLP-1 agonists. Emerging evidence indicates that tirzepatide may alleviate OSAS through its multifaceted effects on adiposity, inflammation, and neuromuscular regulation. This review synthesizes the pharmacological mechanisms, clinical findings, and safety data of tirzepatide in OSAS management. Preliminary studies show promising reductions in body weight, apnea\u2013hypopnea index (AHI), and systemic inflammation, although long-term trials remain warranted. Further exploration into its integration with existing OSAS therapies could redefine the pharmacologic management of obesity-related OSAS.<\/jats:p>","DOI":"10.3389\/fmed.2026.1752341","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:09:46Z","timestamp":1777442986000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["GLP-1\/GIP dual agonist tirzepatide in obstructive sleep apnea syndrome: mechanisms, evidence, and clinical perspectives"],"prefix":"10.3389","volume":"13","author":[{"given":"Qiujie","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Ezhou Central Hospital","place":["Ezhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yipeng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Ezhou Central Hospital","place":["Ezhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture","place":["Enshi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peijun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture","place":["Enshi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1016\/S2213-2600(19)30198-5","article-title":"Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis","volume":"7","author":"Benjafield","year":"2019","journal-title":"Lancet Respir Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1111\/resp.13838","article-title":"Global burden of sleep\u2010disordered breathing and its implications","volume":"25","author":"Lyons","year":"2020","journal-title":"Respirology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/S2213-2600(15)00043-0","article-title":"Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study","volume":"3","author":"Heinzer","year":"2015","journal-title":"Lancet Respir Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s00408-020-00342-5","article-title":"Evaluation and management of children with obstructive sleep apnea syndrome","volume":"198","author":"Bitners","year":"2020","journal-title":"Lung"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1038\/s41392-023-01496-3","article-title":"Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome","volume":"8","author":"Lv","year":"2023","journal-title":"Signal Transduct Target Ther"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.3390\/medicina59081459","article-title":"An update on obstructive sleep apnea syndrome\u2014a literature review","volume":"59","author":"Platon","year":"2023","journal-title":"Medicina (Kaunas)"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1002\/ana.25515","article-title":"Sleep\u2010disordered breathing and poststroke outcomes","volume":"86","author":"Lisabeth","year":"2019","journal-title":"Ann Neurol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1007\/s11325-023-02899-w","article-title":"Sleep-disordered breathing and lung function abnormalities in adults with congenital heart disease","volume":"28","author":"Momcilovic","year":"2024","journal-title":"Sleep Breath"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1513\/pats.200708-137mg","article-title":"Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches","volume":"5","author":"Schwartz","year":"2008","journal-title":"Proc Am Thorac Soc"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"101996","DOI":"10.1016\/j.smrv.2024.101996","article-title":"Obstructive sleep apnea and obesity: a review of epidemiology, pathophysiology and the effect of weight-loss treatments","volume":"78","author":"Messineo","year":"2024","journal-title":"Sleep Med Rev"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e25946","DOI":"10.7759\/cureus.25946","article-title":"Adherence to positive airway pressure therapy in patients with obstructive sleep apnea","volume":"14","author":"Shaukat","year":"2022","journal-title":"Cureus"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"101836","DOI":"10.1016\/j.smrv.2023.101836","article-title":"Adherence to continuous positive airway pressure for the treatment of obstructive sleep apnea in neurodegenerative diseases: a systematic review","volume":"71","author":"Lajoie","year":"2023","journal-title":"Sleep Med Rev"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"4315","DOI":"10.3390\/molecules27134315","article-title":"Tirzepatide, a new era of dual-targeted treatment for diabetes and obesity: a mini-review","volume":"27","author":"Chavda","year":"2022","journal-title":"Molecules"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1007\/s40265-023-01992-4","article-title":"Tirzepatide: a review in type 2 diabetes","volume":"84","author":"France","year":"2024","journal-title":"Drugs"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1056\/NEJMc2211120","article-title":"Tirzepatide once weekly for the treatment of obesity","volume":"387","author":"Venniyoor","year":"2022","journal-title":"N Engl J Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1016\/j.adaj.2025.05.007","article-title":"Tirzepatide gains US Food and Drug Administration approval for the management of obstructive sleep apnea: implications for oral health care providers","volume":"156","author":"Hassan","year":"2025","journal-title":"J Am Dent Assoc"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.5664\/jcsm.11798","article-title":"Pharmacological management of sleep apnea and obesity, a new frontier","volume":"21","author":"Taweesedt","year":"2025","journal-title":"J Clin Sleep Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.sleep.2024.01.030","article-title":"Pharmacological interventions for pediatric obstructive sleep apnea (OSA): network meta-analysis","volume":"116","author":"Zhang","year":"2024","journal-title":"Sleep Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1056\/nejmoa2107519","article-title":"Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes","volume":"385","author":"FR\u00edAS","year":"2021","journal-title":"N Engl J Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1431292","DOI":"10.3389\/fendo.2024.1431292","article-title":"Mechanisms of action and therapeutic applications of GLP-1 and dual GIP\/GLP-1 receptor agonists","volume":"15","author":"Liu","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"bvaf022","DOI":"10.1210\/jendso\/bvaf022","article-title":"Secretagogin is highly expressed in enteroendocrine K cells and plays a critical role in nutrient-induced GIP secretion","volume":"9","author":"Liu","year":"2025","journal-title":"J Endocr Soc"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1080\/13543784.2024.2377319","article-title":"Investigational and emerging gastric inhibitory polypeptide (GIP) receptor-based therapies for the treatment of obesity","volume":"33","author":"Gaffey","year":"2024","journal-title":"Expert Opin Investig Drugs"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e70392","DOI":"10.1002\/jbt.70392","article-title":"Tirzepatide induces ferroptosis in glioblastoma cell lines via the SOX2\/SLC7A11 axis: a potential therapeutic strategy for glioma treatment","volume":"39","author":"Wang","year":"2025","journal-title":"J Biochem Mol Toxicol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2000","DOI":"10.1001\/jama.2023.19897","article-title":"Obesity management in adults: a review","volume":"330","author":"Elmaleh-Sachs","year":"2023","journal-title":"JAMA"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1056\/nejmoa2410819","article-title":"Tirzepatide for obesity treatment and diabetes prevention","volume":"392","author":"Jastreboff","year":"2025","journal-title":"N Engl J Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1186\/s13098-025-01903-5","article-title":"Narrative review of metabolic syndrome and its relationships with non-alcoholic fatty liver disease, gonadal dysfunction and obstructive sleep apnea","volume":"17","author":"Reda","year":"2025","journal-title":"Diabetol Metab Syndr"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1007\/s13679-024-00592-x","article-title":"Estimating cardiovascular benefits of tirzepatide in sleep apnea and obesity: insight from the SURMOUNT-OSA trials","volume":"13","author":"Beccuti","year":"2024","journal-title":"Curr Obes Rep"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/j.arbres.2025.02.014","article-title":"Is obstructive sleep apnea in people without obesity a unique disease?","volume":"61","author":"Malhotra","year":"2025","journal-title":"Arch Bronconeumol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"209ra151","DOI":"10.1126\/scitranslmed.3007218","article-title":"Unimolecular dual incretins maximize metabolic benefits in rodents, monkeys, and humans","volume":"5","author":"Finan","year":"2013","journal-title":"Sci Transl Med"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1111\/dom.13129","article-title":"Incretin hormones: their role in health and disease","volume":"20","author":"Nauck","year":"2018","journal-title":"Diabetes Obes Metab"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1001\/jama.2023.24945","article-title":"Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity: the surmount-4 randomized clinical trial","volume":"331","author":"Aronne","year":"2024","journal-title":"JAMA"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1016\/s0140-6736(21)01443-4","article-title":"Once-weekly tirzepatide versus once-daily insulin degludec as add-on to metformin with or without SGLT2 inhibitors in patients with type 2 diabetes (SURPASS-3): a randomised, open-label, parallel-group, phase 3 trial","volume":"398","author":"Ludvik","year":"2021","journal-title":"Lancet"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1056\/NEJMoa2404881","article-title":"Tirzepatide for the treatment of obstructive sleep apnea and obesity","volume":"391","author":"Malhotra","year":"2024","journal-title":"N Engl J Med"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"2105","DOI":"10.1007\/s40200-024-01472-w","article-title":"Effects of the switch from dulaglutide to tirzepatide on glycemic control, body weight, and fatty liver: a retrospective study","volume":"23","author":"Sawamura","year":"2024","journal-title":"J Diabetes Metab Disord"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e0305230","DOI":"10.1371\/journal.pone.0305230","article-title":"Intermittent hypoxia induces Th17\/Treg imbalance in a murine model of obstructive sleep apnea","volume":"19","author":"Park","year":"2024","journal-title":"PLoS One"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"3094642","DOI":"10.1155\/2016\/3094642","article-title":"Anti-inflammatory effects of GLP-1-based therapies beyond glucose control","volume":"2016","author":"Lee","year":"2016","journal-title":"Mediat Inflamm"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"20420188231222367","DOI":"10.1177\/20420188231222367","article-title":"Anti-inflammatory role of glucagon-like peptide 1 receptor agonists and its clinical implications","volume":"15","author":"Alharbi","year":"2024","journal-title":"Ther Adv Endocrinol Metab"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1515\/jbcpp-2024-0193","article-title":"Exploring the therapeutic potential of GLP-1 receptor agonists in the management of obstructive sleep apnea: a comprehensive review","volume":"36","author":"Alluri","year":"2025","journal-title":"J Basic Clin Physiol Pharmacol"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.2174\/0115734021398680251001102514","article-title":"Tirzepatide: a breakthrough therapy for obstructive sleep apnea and metabolic dysfunction","author":"Singh","year":"2025","journal-title":"Curr Hypertens Rev"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s13395-025-00387-1","article-title":"Abnormalities in the genioglossus muscle and its neuromuscular synapse in leptin-deficient male mice","volume":"15","author":"Medharametla","year":"2025","journal-title":"Skelet Muscle"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.cmet.2021.01.015","article-title":"The glucose-dependent insulinotropic polypeptide (GIP) regulates body weight and food intake via CNS-GIPR signaling","volume":"33","author":"Zhang","year":"2021","journal-title":"Cell Metab"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/s41574-024-01047-y","article-title":"Inflammation and resolution in obesity","volume":"21","author":"Sot\u00e1k","year":"2025","journal-title":"Nat Rev Endocrinol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1631","DOI":"10.1001\/jama.2023.20294","article-title":"Tirzepatide vs insulin lispro added to basal insulin in type 2 diabetes: the SURPASS-6 randomized clinical trial","volume":"330","author":"Rosenstock","year":"2023","journal-title":"JAMA"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"2492","DOI":"10.1056\/NEJMc2504728","article-title":"Tirzepatide for obesity treatment and diabetes prevention","volume":"392","author":"Shukla","year":"2025","journal-title":"N Engl J Med"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"e70196","DOI":"10.1111\/jsr.70196","article-title":"Evaluating the efficacy of sodium glucose cotransporter-2 inhibitors in management of obstructive sleep apnea; a systematic review and meta-analysis","author":"Murtaza","year":"2025","journal-title":"J Sleep Res"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1007\/s10787-023-01239-4","article-title":"Potential role of tirzepatide towards Covid-19 infection in diabetic patients: a perspective approach","volume":"31","author":"Batiha","year":"2023","journal-title":"Inflammopharmacology"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"113499","DOI":"10.1016\/j.intimp.2024.113499","article-title":"Tirzepatide's role in targeting adipose tissue macrophages to reduce obesity-related inflammation and improve insulin resistance","volume":"143","author":"Xia","year":"2024","journal-title":"Int Immunopharmacol"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"2484048","DOI":"10.1080\/20018525.2025.2484048","article-title":"Safety and efficacy of glucagon-like peptide-1 receptor agonists in patients with obstructive sleep apnea: a systematic review and meta-analysis of randomized controlled trials","volume":"12","author":"Altobaishat","year":"2025","journal-title":"Eur Clin Respir J"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"e0252353","DOI":"10.1371\/journal.pone.0252353","article-title":"Metabolic alterations and systemic inflammation in overweight\/obese children with obstructive sleep apnea","volume":"16","author":"Bhatt","year":"2021","journal-title":"PLoS One"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.5664\/jcsm.7890","article-title":"The impact of obstructive sleep apnea and positive airway pressure therapy on metabolic peptides regulating appetite, food intake, energy homeostasis, and systemic inflammation: a literature review","volume":"15","author":"Mashaqi","year":"2019","journal-title":"J Clin Sleep Med"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1016\/j.chest.2025.03.030","article-title":"Clinical impact of Tirzepatide on patients with OSA and obesity","volume":"168","author":"Wu","year":"2025","journal-title":"Chest"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"4870","DOI":"10.1093\/eurheartj\/ehae568","article-title":"Weekly journal scan: tirzepatide SURMOUNTs obesity-related obstructive sleep apnoea","volume":"45","author":"Liuzzo","year":"2024","journal-title":"Eur Heart J"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"e13717","DOI":"10.1111\/obr.13717","article-title":"Potent incretin-based therapy for obesity: a systematic review and meta-analysis of the efficacy of semaglutide and tirzepatide on body weight and waist circumference, and safety","volume":"25","author":"M\u00fcllertz","year":"2024","journal-title":"Obes Rev"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1007\/s12020-024-03896-z","article-title":"Efficacy and safety of once-weekly tirzepatide for weight management compared to placebo: an updated systematic review and meta-analysis including the latest SURMOUNT-2 trial","volume":"86","author":"Qin","year":"2024","journal-title":"Endocrine"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.1056\/nejmoa2404881","article-title":"Tirzepatide for the treatment of obstructive sleep apnea and obesity","volume":"391","author":"Malhotra","year":"2024","journal-title":"N Engl J Med"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"e2427258","DOI":"10.1001\/jamanetworkopen.2024.27258","article-title":"Clinical outcomes of tirzepatide or GLP-1 receptor agonists in individuals with type 2 diabetes","volume":"7","author":"Chuang","year":"2024","journal-title":"JAMA Netw Open"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"102614","DOI":"10.1016\/j.psychsport.2024.102614","article-title":"Weight loss and lifestyle intervention for cardiorespiratory fitness in obstructive sleep apnea: the INTERAPNEA trial","volume":"72","author":"Carneiro-Barrera","year":"2024","journal-title":"Psychol Sport Exerc"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"143","DOI":"10.17849\/insm-51-3-1-20.2","article-title":"Assessing the pathophysiology, morbidity, and mortality of obstructive sleep apnea","volume":"51","author":"Richie","year":"2024","journal-title":"J Insur Med"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1397029","DOI":"10.3389\/fphar.2024.1397029","article-title":"A real-world data analysis of tirzepatide in the FDA adverse event reporting system (FAERS) database","volume":"15","author":"Liu","year":"2024","journal-title":"Front Pharmacol"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1111\/dom.15318","article-title":"Tirzepatide reduces the predicted risk of atherosclerotic cardiovascular disease and improves cardiometabolic risk factors in adults with obesity or overweight: SURMOUNT-1 post hoc analysis","volume":"26","author":"Hankosky","year":"2024","journal-title":"Diabetes Obes Metab"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"701","DOI":"10.2147\/DMSO.S443396","article-title":"The effect of tirzepatide on weight, lipid metabolism and blood pressure in overweight\/obese patients with type 2 diabetes mellitus: a systematic review and meta-analysis","volume":"17","author":"Lv","year":"2024","journal-title":"Diabetes Metab Syndr Obes"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"e076410","DOI":"10.1136\/bmj-2023-076410","article-title":"Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis","volume":"384","author":"Yao","year":"2024","journal-title":"BMJ"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"521","DOI":"10.5664\/jcsm.10930","article-title":"Identifying clusters of patient comorbidities associated with obstructive sleep apnea using electronic health records","volume":"20","author":"Te","year":"2024","journal-title":"J Clin Sleep Med"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"Jc116","DOI":"10.7326\/ANNALS-24-02174-JC","article-title":"In adults with moderate-to-severe OSA and obesity, tirzepatide reduced apnea-hypopnea events vs. placebo","volume":"177","author":"Cheskin","year":"2024","journal-title":"Ann Intern Med"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"14631","DOI":"10.3390\/ijms232314631","article-title":"Tirzepatide: a systematic update","volume":"23","author":"Forzano","year":"2022","journal-title":"Int J Mol Sci"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1752341\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:09:49Z","timestamp":1777442989000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1752341\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,29]]},"references-count":65,"alternative-id":["10.3389\/fmed.2026.1752341"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1752341","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,29]]},"article-number":"1752341"}}