{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T07:47:10Z","timestamp":1782200830418,"version":"3.54.5"},"reference-count":50,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The oncocytic variant of adrenocortical carcinoma (OACC) represents an exceptional type of adrenal malignancy, with heterogenous presentation. Currently, the genetic and molecular spectrum remains an open matter. A 20-year-old adult was accidentally found with a 7.2 cm adrenal tumor and underwent an open right adrenalectomy with OACC confirmation. Post-adrenalectomy positron emission tomography\/computed tomography was negative. Immunohistochemistry was positive for calretin, inhibin, steroidogenic factor 1; Ki67 of 20%. Microsatellite instability was 7.61. Lin\u2013Weiss\u2013Bisceglia score showed 2 major criteria [mitoses 6\/50 HPF + positive atypical mitoses], the reticuline algorithm (disrupted reticuline network + mitoses 6\/50 HPF) was consistent for a malignant behavior, the Helsinki score was of 48. Next generation sequencing identified a likely pathogenic variant of CEL gene (heterozygote, c.539-2A&gt;G) in peripheral blood and two pathogenic variants in the tumor: exon 48, NF1 gene [c.7159_7164del p.(N2387_F2388del)] and exon 6, TP53 gene [c.596delG p.(G199Efs*48)]. Polycystic ovary syndrome type A has been diagnosed as teenager with no phenotype change before the tumor detection. After surgery, oocyte retrieval and cryopreservation upon ovarian stimulation protocol (OSP) was performed before starting mitotane therapy. To the best of our knowledge, this is a novel genetic configuration in OACC with an impact on prognosis to be determined. Hyperandrogenemia stands on a dual source (potential CEL-driven insulin resistance for the ovary and OACC-originating for the adrenal glands). Also, this is the first case to receive OSP in OACC, noting that a tailored multidisciplinary management is mandatory.<\/jats:p>","DOI":"10.3390\/diagnostics16121935","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T06:13:37Z","timestamp":1782195217000},"page":"1935","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oncocytic Adrenocortical Carcinoma with Somatic Pathogenic Variants of NF1 and TP53 Genes in a Young Adult Harboring a Germline Likely Pathogenic Variant in CEL Gene: From Hyperandrogenemia of Dual (Adrenal\u2013Ovarian) Cause to Oocyte Preservation and Mitotane Initiation"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8585-3835","authenticated-orcid":false,"given":"Mara","family":"Carsote","sequence":"first","affiliation":[{"name":"Department of Endocrinology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Clinical Endocrinology V, \u201cC.I. Parhon\u201d National Institute of Endocrinology, 011863 Bucharest, Romania"},{"name":"PhD Doctoral School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustin","family":"Dima","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cDr. Carol Davila\u201d Central Military University Emergency Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana-Claudia","family":"Sima","sequence":"additional","affiliation":[{"name":"Department of Clinical Endocrinology V, \u201cC.I. Parhon\u201d National Institute of Endocrinology, 011863 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5970-3701","authenticated-orcid":false,"given":"Ana-Maria","family":"Gheorghe","sequence":"additional","affiliation":[{"name":"Department of Clinical Endocrinology V, \u201cC.I. Parhon\u201d National Institute of Endocrinology, 011863 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4748-6300","authenticated-orcid":false,"given":"Mihai","family":"Costachescu","sequence":"additional","affiliation":[{"name":"PhD Doctoral School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Radiology and Medical Imaging, \u201cDr. Carol Davila\u201d Central Military University Emergency Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3279-0492","authenticated-orcid":false,"given":"Elena-Emanuela","family":"Braha","sequence":"additional","affiliation":[{"name":"Research Department, \u201cC.I. Parhon\u201d National Institute of Endocrinology, 011863 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4886-2174","authenticated-orcid":false,"given":"Sorina Violeta","family":"Schipor","sequence":"additional","affiliation":[{"name":"Research Department, \u201cC.I. Parhon\u201d National Institute of Endocrinology, 011863 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9190-837X","authenticated-orcid":false,"given":"Dana","family":"Manda","sequence":"additional","affiliation":[{"name":"Research Department, \u201cC.I. Parhon\u201d National Institute of Endocrinology, 011863 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Muresan","sequence":"additional","affiliation":[{"name":"Research Department, \u201cC.I. Parhon\u201d National Institute of Endocrinology, 011863 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anda","family":"Dumitrascu","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, \u201cC.I. Parhon\u201d National Institute of Endocrinology, 011863 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Ciuche","sequence":"additional","affiliation":[{"name":"Department 4\u2014Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Thoracic Surgery Department, \u201cDr. Carol Davila\u201d Central Military University Emergency Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Dracea","sequence":"additional","affiliation":[{"name":"Gynera Fertility Center, 020308 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodor Ionut","family":"Constantin","sequence":"additional","affiliation":[{"name":"Oncology Outpatient Compartment, \u201cC.I. Parhon\u201d National Institute of Endocrinology, 011863 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Terzea","sequence":"additional","affiliation":[{"name":"Department of Pathology, \u201cC.I. Parhon\u201d National Institute of Endocrinology, 011863 Bucharest, Romania"},{"name":"Oncoteam Diagnostics, 012244 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Coppola Bottazzi, E., Gambardella, C., Mongardini, F.M., Vanella, S., Noviello, A., Palma, T., Murano, R., De Chiara, G., Conzo, G., and Docimo, L. (2023). Prognosis of Adrenal Oncocytic Neoplasms (AONs): Literature Review of 287 Cases and Presentation of the Oldest Patient. J. Clin. Med., 12.","DOI":"10.3390\/jcm12216925"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/his.70045","article-title":"Pathology of adrenal tumours: Recent advances","volume":"88","author":"Erickson","year":"2026","journal-title":"Histopathology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1709401","DOI":"10.3389\/fmed.2025.1709401","article-title":"Adrenocortical oncocytic neoplasms: A case report","volume":"12","author":"Cao","year":"2025","journal-title":"Front. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"luaf227","DOI":"10.1210\/jcemcr\/luaf227","article-title":"Genomic Sequencing in Oncocytic Adrenal Carcinoma May Provide Insights into Disease Progression and Treatment Options","volume":"3","author":"Han","year":"2025","journal-title":"JCEM Case Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"106092","DOI":"10.1016\/j.esmoop.2026.106092","article-title":"Current clinical management and outcome of patients with adrenal cortical carcinoma (ACC) with rare histological subtypes-an ENSAT cohort study","volume":"11","author":"Kimpel","year":"2026","journal-title":"ESMO Open"},{"key":"ref_6","first-page":"e91554","article-title":"Rapidly Progressive Metastatic Adrenocortical Carcinoma With Oncocytic Features in a Young Male: A Case Report","volume":"17","author":"Nahar","year":"2025","journal-title":"Cureus"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.humpath.2014.11.015","article-title":"Helsinki score-a novel model for prediction of metastases in adrenocortical carcinomas","volume":"46","author":"Pennanen","year":"2015","journal-title":"Hum. Pathol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s12022-022-09710-8","article-title":"Overview of the 2022 WHO Classification of Adrenal Cortical Tumors","volume":"33","author":"Mete","year":"2022","journal-title":"Endocr. Pathol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1159\/000545715","article-title":"Oncocytic Adrenal Tumors: A Tri-Focal Review with Integrated Cytopathological, Pathological, and Molecular Perspectives","volume":"69","author":"Condello","year":"2025","journal-title":"Acta Cytol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"54","DOI":"10.4103\/ijpm.ijpm_921_25","article-title":"Oncocytic adrenocortical carcinomas: A clinicopathological and immunohistochemical review of 14 cases of a rare entity","volume":"69","author":"Kumari","year":"2026","journal-title":"Indian. J. Pathol. Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s12022-025-09857-0","article-title":"Multicentric Retrospective Analysis of Oncocytic Adrenocortical Carcinoma: Insights into Clinical and Management Strategies","volume":"36","author":"Prinzi","year":"2025","journal-title":"Endocr. Pathol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Huang, C.P., Dai, M.S., Kao, C.C., Tsai, W.C., and Yu, C.P. (2022). A Case of Oncocytic Adrenal Cortical Neoplasm with Uncertain Malignant Potential Turned Out to Be Oncocytic Adrenal Cortical Carcinoma with Distant Metastasis: Could Pathology Do Better Initially?. Medicina, 58.","DOI":"10.3390\/medicina58070900"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1038\/gim.2015.30","article-title":"Standards and guidelines for the interpretation of sequence variants: A joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology","volume":"17","author":"Richards","year":"2015","journal-title":"Genet. Med."},{"key":"ref_14","first-page":"178","article-title":"Integrative Genomics Viewer (IGV): High-performance genomics data visualization and exploration","volume":"14","author":"Helga","year":"2012","journal-title":"Brief. Bioinform."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1706262","DOI":"10.3389\/fendo.2026.1706262","article-title":"Novel variation in the CEL gene causing impaired fasting glucose in a Chinese pediatric patient: Case report and literature review","volume":"17","author":"Su","year":"2026","journal-title":"Front. Endocrinol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"12513","DOI":"10.18632\/oncotarget.23619","article-title":"Pancreatic adenocarcinoma, chronic pancreatitis, and MODY-8 diabetes: Is bile salt-dependent lipase (or carboxyl ester lipase) at the crossroads of pancreatic pathologies?","volume":"9","author":"Lombardo","year":"2017","journal-title":"Oncotarget"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e003127","DOI":"10.1136\/bmjdrc-2022-003127","article-title":"Identification and characterization of novel carboxyl ester lipase gene variants in patients with different subtypes of diabetes","volume":"11","author":"Wu","year":"2023","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s12020-023-03512-6","article-title":"Clinical and genetic characteristics of CEL-MODY (MODY8): A literature review and screening in Chinese individuals diagnosed with early-onset type 2 diabetes","volume":"83","author":"Sun","year":"2024","journal-title":"Endocrine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e1455","DOI":"10.1210\/clinem\/dgab864","article-title":"Two New Mutations in the CEL Gene Causing Diabetes and Hereditary Pancreatitis: How to Correctly Identify MODY8 Cases","volume":"107","author":"Haldorsen","year":"2022","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1038\/s42255-021-00516-2","article-title":"Abnormal exocrine-endocrine cell cross-talk promotes \u03b2-cell dysfunction and loss in MODY8","volume":"4","author":"Kahraman","year":"2022","journal-title":"Nat. Metab."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Dalva, M., Lavik, I.K., El Jellas, K., Gravdal, A., Lugea, A., Pandol, S.J., Nj\u00f8lstad, P.R., Waldron, R.T., Fjeld, K., and Johansson, B.B. (2020). Pathogenic Carboxyl Ester Lipase (CEL) Variants Interact with the Normal CEL Protein in Pancreatic Cells. Cells, 9.","DOI":"10.3390\/cells9010244"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"bvae163.860","DOI":"10.1210\/jendso\/bvae163.860","article-title":"8182 New Mouse Model Mirrors Human MODY8: Opening Doors to Understanding Exocrine-Endocrine Crosstalk in the Diabetic Pancreas","volume":"8","author":"Jellas","year":"2024","journal-title":"J. Endocr. Soc."},{"key":"ref_23","first-page":"64","article-title":"Chronic autoimmune thyroiditis and obesity","volume":"53","author":"Valea","year":"2018","journal-title":"Arch. Balk. Med. Union"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.cancergen.2019.09.005","article-title":"A new prognostic factor of breast cancer: High carboxyl ester lipase expression related to poor survival","volume":"239","author":"Cui","year":"2019","journal-title":"Cancer Genet."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/S0005-2760(97)00048-9","article-title":"Immunological identification of cholesterol ester hydrolase in the steroidogenic tissues, adrenal glands and testis","volume":"1346","author":"Lee","year":"1997","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1369\/jhc.2010.956169","article-title":"Localization of carboxyl ester lipase in human pituitary gland and pituitary adenomas","volume":"58","author":"Vigetti","year":"2010","journal-title":"J. Histochem. Cytochem."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1507\/endocrj.40.453","article-title":"Regulation of cholesterol metabolism in adrenal cortex: Comparative studies on cholesterol esterase in human adrenal glands","volume":"40","author":"Nishikawa","year":"1993","journal-title":"Endocr. J."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Tamura, R. (2021). Current Understanding of Neurofibromatosis Type 1, 2, and Schwannomatosis. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22115850"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"101172","DOI":"10.1016\/j.spen.2024.101172","article-title":"Neurofibromatosis type 1\u2014An update","volume":"52","author":"Moodley","year":"2024","journal-title":"Semin. Pediatr. Neurol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"101818","DOI":"10.1016\/j.eclinm.2022.101818","article-title":"ERN GENTURIS tumour surveillance guidelines for individuals with neurofibromatosis type 1","volume":"56","author":"Carton","year":"2023","journal-title":"eClinicalMedicine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e72224","DOI":"10.1002\/ccr3.72224","article-title":"Rare Association Between Neurofibromatosis Type 1 and Adrenocortical Carcinoma","volume":"14","author":"Pluim","year":"2026","journal-title":"Clin. Case Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"155725","DOI":"10.1016\/j.prp.2024.155725","article-title":"Whole genome profiling of primary and metastatic adrenocortical carcinoma unravels significant molecular events","volume":"266","author":"Kalomeris","year":"2025","journal-title":"Pathol. Res. Pract."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"147432","DOI":"10.1016\/j.gene.2023.147432","article-title":"Domain landscapes of somatic NF1 mutations in pheochromocytoma and paraganglioma","volume":"872","author":"Tabebi","year":"2023","journal-title":"Gene"},{"key":"ref_34","first-page":"a035931","article-title":"A History of Cancer Research: The P53 Pathway","volume":"15","author":"Lipsick","year":"2025","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1186\/s13045-022-01332-1","article-title":"Genotype-phenotype associations within the Li-Fraumeni spectrum: A report from the German Registry","volume":"15","author":"Penkert","year":"2022","journal-title":"J. Hematol. Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"114088","DOI":"10.1016\/j.ejca.2024.114088","article-title":"Germline NGS targeted analysis in adult patients with sporadic adrenocortical carcinoma","volume":"205","author":"Scatolini","year":"2024","journal-title":"Eur. J. Cancer"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"101428","DOI":"10.1016\/j.beem.2020.101428","article-title":"Adrenocortical tumorigenesis: Lessons from genetics","volume":"34","author":"Kamilaris","year":"2020","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/ejendo\/lvae077","article-title":"Targeted Next Generation Sequencing molecular profiling and its clinical application in adrenocortical cancer","volume":"191","author":"Cioppi","year":"2024","journal-title":"Eur. J. Endocrinol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e70112","DOI":"10.1111\/pin.70112","article-title":"Cortisol-Producing Oncocytic Adrenocortical Carcinoma Harboring a GNAS Mutation: An Integrated Histologic, Ultrastructural, and Genomic Analysis","volume":"76","author":"Sato","year":"2026","journal-title":"Pathol. Int."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/s13353-024-00907-7","article-title":"Unraveling the genetic basis of MODY: Insights from next-generation sequencing","volume":"66","author":"Eser","year":"2025","journal-title":"J. Appl. Genet."},{"key":"ref_41","first-page":"e90450","article-title":"Oncocytic Carcinoma: A Rare Hormone-Producing Tumor","volume":"17","author":"Fontes","year":"2025","journal-title":"Cureus"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"K11","DOI":"10.1093\/ejendo\/lvad025","article-title":"Immunohistochemical characterization of a steroid-secreting oncocytic adrenal carcinoma responsible for paraneoplastic hyperparathyroidism","volume":"188","author":"Haissaguerre","year":"2023","journal-title":"Eur. J. Endocrinol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"bvab143","DOI":"10.1210\/jendso\/bvab143","article-title":"Oncocytic Adrenocortical Carcinoma With Low (18)F-FDG Uptake and the Absence of Glucose Transporter 1 Expression","volume":"5","author":"Babaya","year":"2021","journal-title":"J. Endocr. Soc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e493","DOI":"10.1097\/RLU.0000000000006208","article-title":"Oncocytic Adrenocortical Carcinoma in an Infant: Clinical Findings and Imaging Features","volume":"51","author":"Meet","year":"2025","journal-title":"Clin. Nucl. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1177\/0218492316686480","article-title":"Appearance of a thymic mass after treatment of Cushing\u2019s syndrome","volume":"25","author":"Delitala","year":"2017","journal-title":"Asian Cardiovasc. Thorac. Ann."},{"key":"ref_46","first-page":"129","article-title":"Hashimoto\u2019s thyroiditis and breast cancer: Coincidence or correlation?","volume":"51","author":"Valea","year":"2016","journal-title":"Arch. Balk. Med. Union"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e286","DOI":"10.1097\/RLU.0000000000005656","article-title":"CXCR4-A Potential Novel Theranostic Target in Adrenocortical Carcinoma","volume":"50","author":"Nazar","year":"2025","journal-title":"Clin. Nucl. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-18-0608","article-title":"European Society of Endocrinology Clinical Practice Guidelines on the management of adrenocortical carcinoma in adults, in collaboration with the European Network for the Study of Adrenal Tumors","volume":"179","author":"Fassnacht","year":"2018","journal-title":"Eur. J. Endocrinol."},{"key":"ref_49","first-page":"476","article-title":"Metastases in daily endocrine practice","volume":"51","author":"Carsote","year":"2016","journal-title":"Arch. Balk. Med. Union"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/S2213-8587(24)00378-4","article-title":"Adrenocortical carcinoma: A practical guide for clinicians","volume":"13","author":"Fassnacht","year":"2025","journal-title":"Lancet Diabetes Endocrinol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/12\/1935\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T06:59:43Z","timestamp":1782197983000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/12\/1935"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":50,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["diagnostics16121935"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16121935","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]}}}