{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:59:06Z","timestamp":1790787546961,"version":"4.1.0"},"reference-count":53,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:00:00Z","timestamp":1769299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Shanghai new three-year action plan for public health","award":["GWVl-11.1-23"],"award-info":[{"award-number":["GWVl-11.1-23"]}]},{"name":"Fudan School of Public Health-Jiading CDC key disciplines and key special projects for the high-quality development of public health","award":["GWGZLXK-2023-02"],"award-info":[{"award-number":["GWGZLXK-2023-02"]}]},{"name":"the local high-level discipline construction project of Shanghai and the National Key Research and Development Program of China","award":["2017YFC0907000"],"award-info":[{"award-number":["2017YFC0907000"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: The Prognostic Nutritional Index (PNI), which integrates serum albumin and lymphocyte count, reflects both nutritional and inflammatory status. However, its role in early renal function decline among patients with type 2 diabetes (T2D), particularly in relation to glycemic control, remains unclear. This study aimed to: (1) characterize the dose\u2013response relationship between PNI and early renal function decline in type 2 diabetes using restricted cubic splines; (2) identify whether glycemic control (HbA1c) modifies the PNI\u2013renal decline association; and (3) evaluate the clinical utility of combining PNI and HbA1c for risk stratification. Methods: We analyzed data from 1711 community-based participants with T2D who had preserved renal function at baseline. The PNI was calculated as serum albumin (g\/L) + 5 \u00d7 lymphocyte count (\u00d7109\/L). The primary outcome was a composite of rapid estimated glomerular filtration rate (eGFR) decline (&gt;3 mL\/min\/1.73 m2 per year) or incident chronic kidney disease (CKD) stage 3. Restricted cubic spline models, multivariable regression, and Johnson\u2013Neyman analyses were used to examine non-linearity and effect modification by glycated hemoglobin (HbA1c). Results: A consistent inverse linear association was observed between PNI and the rate of eGFR decline (P for non-linearity &gt; 0.05). Johnson\u2013Neyman analysis further demonstrated that the protective association of PNI was statistically significant within an HbA1c range of 7.24% to 8.71%. Stratification by clinical cut-offs revealed a significant effect modification by glycemic status. The inverse linear association between PNI and renal risk was most pronounced under hyperglycemic stress, as evidenced by the markedly elevated incidence (50.0%) among individuals with both poor glycemic control (HbA1c \u2265 8%) and low PNI (&lt;50). Conversely, under good glycemic control (HbA1c &lt; 8%), this inverse association was substantially attenuated, with a lower incidence observed in the low-PNI subgroup (6.7%) than in the high-PNI subgroup (15.9%). These findings indicate that the protective role of PNI is conditional upon the glycemic milieu. Conclusions: The PNI demonstrates a stable linear association with early renal function decline in T2D, with its protective effect most pronounced at suboptimal HbA1c levels. Combining PNI and HbA1c effectively identifies a high-risk subgroup characterized by synergistic risk, underscoring the need for integrated nutritional and glycemic management.<\/jats:p>","DOI":"10.3390\/nu18030395","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T11:14:07Z","timestamp":1769426047000},"page":"395","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Prognostic Nutritional Index and Glycemic Status Synergistically Predict Early Renal Function Decline in Type 2 Diabetes: A Community-Based Cohort Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8113-1851","authenticated-orcid":false,"given":"Yuting","family":"Yu","sequence":"first","affiliation":[{"name":"Songjiang District Center for Disease Control and Prevention and Health Inspection, Shanghai 201620, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianguo","family":"Yu","sequence":"additional","affiliation":[{"name":"Zhongshan Community Health Center, Shanghai 201620, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"Zhongshan Community Health Center, Shanghai 201620, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiedong","family":"Xu","sequence":"additional","affiliation":[{"name":"Maogang Community Health Center, Shanghai 201607, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunhui","family":"Wang","sequence":"additional","affiliation":[{"name":"Xinqiao Community Health Center, Shanghai 201612, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Jiang","sequence":"additional","affiliation":[{"name":"Sheshan Community Health Center, Shanghai 201602, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genming","family":"Zhao","sequence":"additional","affiliation":[{"name":"Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonggen","family":"Jiang","sequence":"additional","affiliation":[{"name":"Songjiang District Center for Disease Control and Prevention and Health Inspection, Shanghai 201620, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1002\/j.2040-4603.2011.tb00365.x","article-title":"Pathophysiology of the Diabetic Kidney","volume":"1","author":"Vallon","year":"2011","journal-title":"Compr. Physiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1053\/j.arrt.2003.08.008","article-title":"Inflammation and Nutrition in Renal Insufficiency","volume":"10","author":"Stenvinkel","year":"2003","journal-title":"Adv. Ren. Replace. Ther."},{"key":"ref_3","first-page":"402","article-title":"Assessing the (Anti)-Inflammatory Potential of Diets","volume":"24","author":"Bahr","year":"2021","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_4","first-page":"839","article-title":"Type 2 diabetes complications","volume":"42","author":"Schlienger","year":"2013","journal-title":"Presse Medicale Paris Fr. 1983"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S75","DOI":"10.1016\/j.diabres.2008.09.042","article-title":"Diabetic Nephropathy: Important Pathophysiologic Mechanisms","volume":"82","author":"Soldatos","year":"2008","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/j.ajkd.2003.07.016","article-title":"Malnutrition-Inflammation Complex Syndrome in Dialysis Patients: Causes and Consequences","volume":"42","author":"Ikizler","year":"2003","journal-title":"Am. J. Kidney Dis."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Zhang, J., Xiao, X., Wu, Y., Yang, J., Zou, Y., Zhao, Y., Yang, Q., and Liu, F. (2022). Prognostic Nutritional Index as a Predictor of Diabetic Nephropathy Progression. Nutrients, 14.","DOI":"10.3390\/nu14173634"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1186\/s13741-025-00582-0","article-title":"Geriatric Nutritional Risk Index and Prognostic Nutritional Index Improves Predictive Value of Postoperative Mortality: A Large-Scale Retrospective Cohort Study","volume":"14","author":"Liu","year":"2025","journal-title":"Perioper. Med."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Tang, J., Yang, L., Yang, G.-Y., Li, Y.-H., Zhu, Y.-S., Li, H., and Gao, X.-M. (2025). Prognostic Nutritional Index as a Predictor of Cardiovascular and All-Cause Mortality in American Adults with Hypertension: Results from the NHANES Database. Front. Cardiovasc. Med., 11.","DOI":"10.3389\/fcvm.2024.1465379"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"111017","DOI":"10.1016\/j.diabres.2023.111017","article-title":"Circulating Tumor Necrosis Factor-Related Biomarkers Predict Kidney Function Decline in Japanese Patients with Diabetes: An Observational Cohort Study","volume":"206","author":"Murakoshi","year":"2023","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Wang, H., Chen, G., Sun, D., and Ma, Y. (2024). The Threshold Effect of Triglyceride Glucose Index on Diabetic Kidney Disease Risk in Patients with Type 2 Diabetes: Unveiling a Non-Linear Association. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1411486"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"113770","DOI":"10.1016\/j.isci.2025.113770","article-title":"Glucose Tasting Depletes Intracellular Calcium Stores and Impairs Macrophage Functionality","volume":"28","author":"Schlautmann","year":"2025","journal-title":"iScience"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Kang, D., Youn, S., Min, J.W., and Ko, E.J. (2025). Nutritional Status Evaluation and Intervention in Chronic Kidney Disease Patients: Practical Approach. Nutrients, 17.","DOI":"10.3390\/nu17203264"},{"key":"ref_14","first-page":"418","article-title":"Clinical Impact of Malnutrition According to the Global Leadership Initiative on Malnutrition Criteria Combined With Kidney Dysfunction to Determine Mortality in Inpatients","volume":"34","author":"Yamaguchi","year":"2024","journal-title":"J. Ren. Nutr. Off. J. Counc. Ren. Nutr. Natl. Kidney Found."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e035430","DOI":"10.1136\/bmjopen-2019-035430","article-title":"Cohort Profile: Protocol and Baseline Survey for the Shanghai Suburban Adult Cohort and Biobank (SSACB) Study","volume":"10","author":"Zhao","year":"2020","journal-title":"BMJ Open"},{"key":"ref_16","first-page":"641","article-title":"The Prognostic Value of Prognostic Nutritional Index in Patients with Lymphoma\u2014Review","volume":"30","author":"He","year":"2022","journal-title":"Zhongguo Shi Yan Xue Ye Xue Za Zhi"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1038\/s41598-023-28150-w","article-title":"Rapid Decline in Kidney Function Is Associated with Rapid Deterioration of Health-Related Quality of Life in Chronic Kidney Disease","volume":"13","author":"Kim","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Aminnejad, N., Greiver, M., and Huang, H. (2025). Predicting the Onset of Chronic Kidney Disease (CKD) for Diabetic Patients with Aggregated Longitudinal EMR Data. PLoS Digit. Health, 4.","DOI":"10.1371\/journal.pdig.0000700"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A New Equation to Estimate Glomerular Filtration Rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1681\/ASN.2022030323","article-title":"Sex Differences in Age-Related Loss of Kidney Function","volume":"33","author":"Melsom","year":"2022","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1177\/2047487317739986","article-title":"Body-Fat Indicators and Kidney Function Decline in Older Post-Myocardial Infarction Patients: The Alpha Omega Cohort Study","volume":"25","author":"Esmeijer","year":"2018","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_22","first-page":"900","article-title":"Smoking\u2014A Renal Risk Factor","volume":"51","author":"Sandhu","year":"2003","journal-title":"J. Assoc. Physicians India"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5387\/fms.2020-20","article-title":"Effects of Daily Alcohol Intake on Glomerular Filtration Rate over Three Years","volume":"67","author":"Sato","year":"2021","journal-title":"Fukushima J. Med. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"585","DOI":"10.14740\/jocmr2021w","article-title":"Impact of Physical Activity on the Self-Perceived Quality of Life in Non-Frail Older Adults","volume":"7","author":"Svantesson","year":"2015","journal-title":"J. Clin. Med. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S498","DOI":"10.1097\/00005768-200009001-00009","article-title":"Compendium of Physical Activities: An Update of Activity Codes and MET Intensities","volume":"32","author":"Ainsworth","year":"2000","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Khadembashiri, M.M., Mohseni, S., Harandi, H., Pejman Sani, M., Khadembashiri, M.A., Atlasi, R., SeyedAlinaghi, S., Mohajeri- Tehrani, M., and Larijani, B. (2024). Comparison of Adrenalectomy with Conservative Treatment on Mild Autonomous Cortisol Secretion: A Systematic Review and Meta-Analysis. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1374711"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Maffetone, P., and Laursen, P.B. (2025). Refined Carbohydrates and the Overfat Pandemic: Implications for Brain Health and Public Health Policy. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1585680"},{"key":"ref_28","unstructured":"American Diabetes Association Professional Practice Committee (2024). Introduction and Methodology: Standards of Care in Diabetes\u20142025. Diabetes Care, 48, S1\u2013S5."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/0301-0511(76)90006-5","article-title":"A Modification of the Johnson-Neyman Technique Comparing Two Regressions, Applied to Treatment Effects Dependent on Baseline Levels","volume":"4","author":"Pigache","year":"1976","journal-title":"Biol. Psychol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1016\/j.juro.2014.02.164","article-title":"MP2-06 Can Prognostic Nutritional Index (PNI) Predict Outcomes After Robot-Assisted Radical Cystectomy?","volume":"191","author":"Tawfeeq","year":"2014","journal-title":"J. Urol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"100681","DOI":"10.1016\/j.ajpc.2024.100681","article-title":"Haptoglobin Phenotype and Intensive Glycemic Control for Coronary Artery Disease Risk Reduction in People with Type Two Diabetes: The Veterans Affairs Diabetes Trial","volume":"18","author":"Cahill","year":"2024","journal-title":"Am. J. Prev. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/BF01972208","article-title":"The Role of the Acute Phase Reaction in Inflammation","volume":"6","author":"Billingham","year":"1976","journal-title":"Agents Actions"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.2147\/DMSO.S373160","article-title":"Association Between Serum Albumin Level and Microvascular Complications of Type 2 Diabetes Mellitus","volume":"15","author":"Zhang","year":"2022","journal-title":"Diabetes Metab. Syndr. Obes. Targets Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3803\/EnM.2013.28.1.17","article-title":"Serum Albumin Levels: A Simple Answer to a Complex Problem? Are We on the Right Track of Assessing Metabolic Syndrome?","volume":"28","author":"Kim","year":"2013","journal-title":"Endocrinol. Metab."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s13098-023-01019-8","article-title":"Association of Prognostic Nutritional Index Level and Diabetes Status with the Prognosis of Coronary Artery Disease: A Cohort Study","volume":"15","author":"Li","year":"2023","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Liu, X., Zhang, C., Fu, Y., Xie, L., Kong, Y., and Yang, X. (2025). Inflammation, Apoptosis, and Fibrosis in Diabetic Nephropathy: Molecular Crosstalk in Proximal Tubular Epithelial Cells and Therapeutic Implications. Curr. Issues Mol. Biol., 47.","DOI":"10.3390\/cimb47110885"},{"key":"ref_37","unstructured":"Gulhar, R., Ashraf, M.A., and Jialal, I. (2018). Physiology, Acute Phase Reactants. StatPearls, StatPearls Publishing."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s40560-024-00729-z","article-title":"Prognostic Nutritional Index as a Predictive Marker for Acute Kidney Injury in Adult Critical Illness Population: A Systematic Review and Diagnostic Test Accuracy Meta-Analysis","volume":"12","author":"Chen","year":"2024","journal-title":"J. Intensive Care"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Yang, B., Yang, Y., Liu, B., and Yang, M. (2024). Role of Composite Objective Nutritional Indexes in Patients with Chronic Kidney Disease. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1349876"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"111280","DOI":"10.4239\/wjd.v16.i11.111280","article-title":"Comparison of Three Types of Drugs for Cardiovascular and Renal Benefits in Type 2 Diabetes Mellitus","volume":"16","author":"An","year":"2025","journal-title":"World J. Diabetes"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1038\/ki.2012.401","article-title":"Intensive Glucose Control Improves Kidney Outcomes in Patients with Type 2 Diabetes","volume":"83","author":"Perkovic","year":"2013","journal-title":"Kidney Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"100106","DOI":"10.1016\/j.arres.2024.100106","article-title":"Evaluation of Serum Oxidative Stress Levels and Antioxidant Capacity in Prediabetes","volume":"12","author":"Balci","year":"2024","journal-title":"Adv. Redox Res."},{"key":"ref_43","first-page":"e62504","article-title":"Oxidative Stress in Prediabetic Young Adults","volume":"16","author":"Mulla","year":"2024","journal-title":"Cureus"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Grivtsova, L., Glukhareva, A., Melnikova, A., Mushkarina, T., Afonin, G., Efremova, A., Ivanov, S., Goldshtein, D., and Kaprin, A. (2025). Characteristics of Peripheral Blood Lymphocyte Populations in Patients with Locally Advanced Unresectable Non-Small Cell Lung Cancer. Cancers, 17.","DOI":"10.3390\/cancers17213504"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"114841","DOI":"10.1016\/j.yexcr.2025.114841","article-title":"Sagittaria Sagittifolia Polysaccharide Regulates Nrf2-Mediated Antioxidant to Improve Apoptosis and Ferroptosis in High Glucose-Induced Lens Epithelial Cells","volume":"454","author":"Zhou","year":"2025","journal-title":"Exp. Cell Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s12933-023-02114-w","article-title":"Association between the Cumulative Average Triglyceride Glucose-Body Mass Index and Cardiovascular Disease Incidence among the Middle-Aged and Older Population: A Prospective Nationwide Cohort Study in China","volume":"23","author":"Li","year":"2024","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"115911","DOI":"10.1016\/j.intimp.2025.115911","article-title":"HPGDS Promotes Tubular Injury and Interstitial Inflammation in Diabetic Nephropathy by Activating Canonical Pyroptosis Pathway","volume":"168","author":"Huang","year":"2026","journal-title":"Int. Immunopharmacol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"JOE-25-0095","DOI":"10.1530\/JOE-25-0095","article-title":"Triptolide Impedes High Glucose-Induced Cell Function in HK2 Cells through PRKN-Mediated Ubiquitination of ACSL1","volume":"267","author":"Jia","year":"2025","journal-title":"J. Endocrinol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"220","DOI":"10.4158\/EP.2.3.220","article-title":"Role of Glycemic Control and Protein Restriction in Clinical Management of Diabetic Kidney Disease","volume":"2","author":"Mudaliar","year":"1996","journal-title":"Endocr. Pract."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.numecd.2007.05.006","article-title":"Importance of Glycemic Control on the Course of Glomerular Filtration Rate in Type 2 Diabetes with Hypertension and Microalbuminuria under Tight Blood Pressure Control","volume":"18","author":"Thomaseth","year":"2008","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1007\/s00592-022-01985-x","article-title":"Prognostic Nutritional Index as a Risk Factor for Diabetic Kidney Disease and Mortality in Patients with Type 2 Diabetes Mellitus","volume":"60","author":"Zhang","year":"2023","journal-title":"Acta Diabetol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e70136","DOI":"10.1002\/edm2.70136","article-title":"Safety and Efficacy of Semaglutide in Patients With Chronic Kidney Disease, With or Without Type 2 Diabetes: A Systematic Review and Meta-Analysis","volume":"8","author":"Abdullah","year":"2025","journal-title":"Endocrinol. Diabetes Metab."},{"key":"ref_53","first-page":"7380","article-title":"Modulation of Inflammation and Immunity by Omega-3 Fatty Acids: A Possible Role for Prevention and to Halt Disease Progression in Autoimmune, Viral, and Age-Related Disorders","volume":"27","author":"Poggioli","year":"2023","journal-title":"Eur. Rev. Med. Pharmacol. Sci."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/3\/395\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T11:23:29Z","timestamp":1769426609000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/3\/395"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,25]]},"references-count":53,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["nu18030395"],"URL":"https:\/\/doi.org\/10.3390\/nu18030395","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,25]]}}}