The Vicious Cycle of Type 2 Diabetes Mellitus and Skeletal Muscle Atrophy: Clinical, Biochemical, and Nutritional Bases

Today, type 2 diabetes mellitus (T2DM) and skeletal muscle atrophy (SMA) have become increasingly common occurrences. Whether the onset of T2DM increases the risk of SMA or vice versa has long been under investigation. Both conditions are associated with negative changes in skeletal muscle health, w...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Nutrients 2024-01, Vol.16 (1), p.172
Hauptverfasser: Lopez-Pedrosa, Jose M, Camprubi-Robles, Maria, Guzman-Rolo, German, Lopez-Gonzalez, Andres, Garcia-Almeida, Jose Manuel, Sanz-Paris, Alejandro, Rueda, Ricardo
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue 1
container_start_page 172
container_title Nutrients
container_volume 16
creator Lopez-Pedrosa, Jose M
Camprubi-Robles, Maria
Guzman-Rolo, German
Lopez-Gonzalez, Andres
Garcia-Almeida, Jose Manuel
Sanz-Paris, Alejandro
Rueda, Ricardo
description Today, type 2 diabetes mellitus (T2DM) and skeletal muscle atrophy (SMA) have become increasingly common occurrences. Whether the onset of T2DM increases the risk of SMA or vice versa has long been under investigation. Both conditions are associated with negative changes in skeletal muscle health, which can, in turn, lead to impaired physical function, a lowered quality of life, and an increased risk of mortality. Poor nutrition can exacerbate both T2DM and SMA. T2DM and SMA are linked by a vicious cycle of events that reinforce and worsen each other. Muscle insulin resistance appears to be the pathophysiological link between T2DM and SMA. To explore this association, our review (i) compiles evidence on the clinical association between T2DM and SMA, (ii) reviews mechanisms underlying biochemical changes in the muscles of people with or at risk of T2DM and SMA, and (iii) examines how nutritional therapy and increased physical activity as muscle-targeted treatments benefit this population. Based on the evidence, we conclude that effective treatment of patients with T2DM-SMA depends on the restoration and maintenance of muscle mass. We thus propose that regular intake of key functional nutrients, along with guidance for physical activity, can help maintain euglycemia and improve muscle status in all patients with T2DM and SMA.
doi_str_mv 10.3390/nu16010172
format Article
fullrecord <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10780454</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A779346826</galeid><sourcerecordid>A779346826</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-920d9382db84c4f2aa3b13b0c375c73ca8040a9f517ca4f838b851b41d53118b3</originalsourceid><addsrcrecordid>eNptkltvFCEYhonR2Kb2xh9gSLwxxq2cZmC8Mdu1tU1avXD1ljDMN10qCyvMaPbfy7i1ByNccHreF3jzIfSckiPOG_I2jLQmlFDJHqF9RiSb1bXgj-_N99BhztdkapLImj9Fe1wxwgih--jXcgX4m7MujhkvttYDjj1ebjeAGf7gTAsDZHwJ3ruhECZ0-Mt38DAYjy_HPPHzIcXNavsOL7wLzhr_Bh-7aFew3i0mzadxSG5wMRTZscmQn6EnvfEZDm_GA_T19GS5OJtdfP54vphfzKyQYpg1jHRNeW3XKmFFz4zhLeUtsVxWVnJrFBHENH1FpTWiV1y1qqKtoF3FKVUtP0Dvd76bsV1DZyEMyXi9SW5t0lZH4_TDk-BW-ir-1JTI4l2J4vDqxiHFHyPkQa9dtiUQE6CEpllDuRCNEk1BX_6DXscxlT__oVhdQqfVHXVlPGgX-lgutpOpnkvZcFErVhfq6D9U6d2UawzQu7L_QPB6J7Ap5pygv_0kJXoqFX1XKgV-cT-WW_RvYfDfFA-2hg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2912620215</pqid></control><display><type>article</type><title>The Vicious Cycle of Type 2 Diabetes Mellitus and Skeletal Muscle Atrophy: Clinical, Biochemical, and Nutritional Bases</title><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><creator>Lopez-Pedrosa, Jose M ; Camprubi-Robles, Maria ; Guzman-Rolo, German ; Lopez-Gonzalez, Andres ; Garcia-Almeida, Jose Manuel ; Sanz-Paris, Alejandro ; Rueda, Ricardo</creator><creatorcontrib>Lopez-Pedrosa, Jose M ; Camprubi-Robles, Maria ; Guzman-Rolo, German ; Lopez-Gonzalez, Andres ; Garcia-Almeida, Jose Manuel ; Sanz-Paris, Alejandro ; Rueda, Ricardo</creatorcontrib><description>Today, type 2 diabetes mellitus (T2DM) and skeletal muscle atrophy (SMA) have become increasingly common occurrences. Whether the onset of T2DM increases the risk of SMA or vice versa has long been under investigation. Both conditions are associated with negative changes in skeletal muscle health, which can, in turn, lead to impaired physical function, a lowered quality of life, and an increased risk of mortality. Poor nutrition can exacerbate both T2DM and SMA. T2DM and SMA are linked by a vicious cycle of events that reinforce and worsen each other. Muscle insulin resistance appears to be the pathophysiological link between T2DM and SMA. To explore this association, our review (i) compiles evidence on the clinical association between T2DM and SMA, (ii) reviews mechanisms underlying biochemical changes in the muscles of people with or at risk of T2DM and SMA, and (iii) examines how nutritional therapy and increased physical activity as muscle-targeted treatments benefit this population. Based on the evidence, we conclude that effective treatment of patients with T2DM-SMA depends on the restoration and maintenance of muscle mass. We thus propose that regular intake of key functional nutrients, along with guidance for physical activity, can help maintain euglycemia and improve muscle status in all patients with T2DM and SMA.</description><identifier>ISSN: 2072-6643</identifier><identifier>EISSN: 2072-6643</identifier><identifier>DOI: 10.3390/nu16010172</identifier><identifier>PMID: 38202001</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Age ; Aging ; Amino acids ; Atrophy ; B cells ; Chronic illnesses ; Development and progression ; Diabetes ; Diabetes Mellitus, Type 2 ; Exercise ; Glucose ; Homeostasis ; Humans ; Hyperglycemia ; Inflammation ; Insulin ; Insulin resistance ; Malnutrition ; Metabolism ; Muscle function ; Muscle strength ; Muscle, Skeletal ; Muscles ; Muscular Atrophy - etiology ; Musculoskeletal system ; Nutrition ; Obesity ; Older people ; Overweight ; Oxidative stress ; Proteins ; Quality of Life ; Review ; Sarcopenia ; Type 2 diabetes</subject><ispartof>Nutrients, 2024-01, Vol.16 (1), p.172</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 by the authors. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-920d9382db84c4f2aa3b13b0c375c73ca8040a9f517ca4f838b851b41d53118b3</citedby><cites>FETCH-LOGICAL-c474t-920d9382db84c4f2aa3b13b0c375c73ca8040a9f517ca4f838b851b41d53118b3</cites><orcidid>0000-0003-2127-3190 ; 0000-0002-7758-3588 ; 0000-0001-6163-8532 ; 0000-0001-8570-184X ; 0000-0002-4339-3380</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10780454/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10780454/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38202001$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lopez-Pedrosa, Jose M</creatorcontrib><creatorcontrib>Camprubi-Robles, Maria</creatorcontrib><creatorcontrib>Guzman-Rolo, German</creatorcontrib><creatorcontrib>Lopez-Gonzalez, Andres</creatorcontrib><creatorcontrib>Garcia-Almeida, Jose Manuel</creatorcontrib><creatorcontrib>Sanz-Paris, Alejandro</creatorcontrib><creatorcontrib>Rueda, Ricardo</creatorcontrib><title>The Vicious Cycle of Type 2 Diabetes Mellitus and Skeletal Muscle Atrophy: Clinical, Biochemical, and Nutritional Bases</title><title>Nutrients</title><addtitle>Nutrients</addtitle><description>Today, type 2 diabetes mellitus (T2DM) and skeletal muscle atrophy (SMA) have become increasingly common occurrences. Whether the onset of T2DM increases the risk of SMA or vice versa has long been under investigation. Both conditions are associated with negative changes in skeletal muscle health, which can, in turn, lead to impaired physical function, a lowered quality of life, and an increased risk of mortality. Poor nutrition can exacerbate both T2DM and SMA. T2DM and SMA are linked by a vicious cycle of events that reinforce and worsen each other. Muscle insulin resistance appears to be the pathophysiological link between T2DM and SMA. To explore this association, our review (i) compiles evidence on the clinical association between T2DM and SMA, (ii) reviews mechanisms underlying biochemical changes in the muscles of people with or at risk of T2DM and SMA, and (iii) examines how nutritional therapy and increased physical activity as muscle-targeted treatments benefit this population. Based on the evidence, we conclude that effective treatment of patients with T2DM-SMA depends on the restoration and maintenance of muscle mass. We thus propose that regular intake of key functional nutrients, along with guidance for physical activity, can help maintain euglycemia and improve muscle status in all patients with T2DM and SMA.</description><subject>Age</subject><subject>Aging</subject><subject>Amino acids</subject><subject>Atrophy</subject><subject>B cells</subject><subject>Chronic illnesses</subject><subject>Development and progression</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2</subject><subject>Exercise</subject><subject>Glucose</subject><subject>Homeostasis</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Inflammation</subject><subject>Insulin</subject><subject>Insulin resistance</subject><subject>Malnutrition</subject><subject>Metabolism</subject><subject>Muscle function</subject><subject>Muscle strength</subject><subject>Muscle, Skeletal</subject><subject>Muscles</subject><subject>Muscular Atrophy - etiology</subject><subject>Musculoskeletal system</subject><subject>Nutrition</subject><subject>Obesity</subject><subject>Older people</subject><subject>Overweight</subject><subject>Oxidative stress</subject><subject>Proteins</subject><subject>Quality of Life</subject><subject>Review</subject><subject>Sarcopenia</subject><subject>Type 2 diabetes</subject><issn>2072-6643</issn><issn>2072-6643</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNptkltvFCEYhonR2Kb2xh9gSLwxxq2cZmC8Mdu1tU1avXD1ljDMN10qCyvMaPbfy7i1ByNccHreF3jzIfSckiPOG_I2jLQmlFDJHqF9RiSb1bXgj-_N99BhztdkapLImj9Fe1wxwgih--jXcgX4m7MujhkvttYDjj1ebjeAGf7gTAsDZHwJ3ruhECZ0-Mt38DAYjy_HPPHzIcXNavsOL7wLzhr_Bh-7aFew3i0mzadxSG5wMRTZscmQn6EnvfEZDm_GA_T19GS5OJtdfP54vphfzKyQYpg1jHRNeW3XKmFFz4zhLeUtsVxWVnJrFBHENH1FpTWiV1y1qqKtoF3FKVUtP0Dvd76bsV1DZyEMyXi9SW5t0lZH4_TDk-BW-ir-1JTI4l2J4vDqxiHFHyPkQa9dtiUQE6CEpllDuRCNEk1BX_6DXscxlT__oVhdQqfVHXVlPGgX-lgutpOpnkvZcFErVhfq6D9U6d2UawzQu7L_QPB6J7Ap5pygv_0kJXoqFX1XKgV-cT-WW_RvYfDfFA-2hg</recordid><startdate>20240101</startdate><enddate>20240101</enddate><creator>Lopez-Pedrosa, Jose M</creator><creator>Camprubi-Robles, Maria</creator><creator>Guzman-Rolo, German</creator><creator>Lopez-Gonzalez, Andres</creator><creator>Garcia-Almeida, Jose Manuel</creator><creator>Sanz-Paris, Alejandro</creator><creator>Rueda, Ricardo</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2127-3190</orcidid><orcidid>https://orcid.org/0000-0002-7758-3588</orcidid><orcidid>https://orcid.org/0000-0001-6163-8532</orcidid><orcidid>https://orcid.org/0000-0001-8570-184X</orcidid><orcidid>https://orcid.org/0000-0002-4339-3380</orcidid></search><sort><creationdate>20240101</creationdate><title>The Vicious Cycle of Type 2 Diabetes Mellitus and Skeletal Muscle Atrophy: Clinical, Biochemical, and Nutritional Bases</title><author>Lopez-Pedrosa, Jose M ; Camprubi-Robles, Maria ; Guzman-Rolo, German ; Lopez-Gonzalez, Andres ; Garcia-Almeida, Jose Manuel ; Sanz-Paris, Alejandro ; Rueda, Ricardo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-920d9382db84c4f2aa3b13b0c375c73ca8040a9f517ca4f838b851b41d53118b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Age</topic><topic>Aging</topic><topic>Amino acids</topic><topic>Atrophy</topic><topic>B cells</topic><topic>Chronic illnesses</topic><topic>Development and progression</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2</topic><topic>Exercise</topic><topic>Glucose</topic><topic>Homeostasis</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Inflammation</topic><topic>Insulin</topic><topic>Insulin resistance</topic><topic>Malnutrition</topic><topic>Metabolism</topic><topic>Muscle function</topic><topic>Muscle strength</topic><topic>Muscle, Skeletal</topic><topic>Muscles</topic><topic>Muscular Atrophy - etiology</topic><topic>Musculoskeletal system</topic><topic>Nutrition</topic><topic>Obesity</topic><topic>Older people</topic><topic>Overweight</topic><topic>Oxidative stress</topic><topic>Proteins</topic><topic>Quality of Life</topic><topic>Review</topic><topic>Sarcopenia</topic><topic>Type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lopez-Pedrosa, Jose M</creatorcontrib><creatorcontrib>Camprubi-Robles, Maria</creatorcontrib><creatorcontrib>Guzman-Rolo, German</creatorcontrib><creatorcontrib>Lopez-Gonzalez, Andres</creatorcontrib><creatorcontrib>Garcia-Almeida, Jose Manuel</creatorcontrib><creatorcontrib>Sanz-Paris, Alejandro</creatorcontrib><creatorcontrib>Rueda, Ricardo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Physical Education Index</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Nutrients</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lopez-Pedrosa, Jose M</au><au>Camprubi-Robles, Maria</au><au>Guzman-Rolo, German</au><au>Lopez-Gonzalez, Andres</au><au>Garcia-Almeida, Jose Manuel</au><au>Sanz-Paris, Alejandro</au><au>Rueda, Ricardo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Vicious Cycle of Type 2 Diabetes Mellitus and Skeletal Muscle Atrophy: Clinical, Biochemical, and Nutritional Bases</atitle><jtitle>Nutrients</jtitle><addtitle>Nutrients</addtitle><date>2024-01-01</date><risdate>2024</risdate><volume>16</volume><issue>1</issue><spage>172</spage><pages>172-</pages><issn>2072-6643</issn><eissn>2072-6643</eissn><abstract>Today, type 2 diabetes mellitus (T2DM) and skeletal muscle atrophy (SMA) have become increasingly common occurrences. Whether the onset of T2DM increases the risk of SMA or vice versa has long been under investigation. Both conditions are associated with negative changes in skeletal muscle health, which can, in turn, lead to impaired physical function, a lowered quality of life, and an increased risk of mortality. Poor nutrition can exacerbate both T2DM and SMA. T2DM and SMA are linked by a vicious cycle of events that reinforce and worsen each other. Muscle insulin resistance appears to be the pathophysiological link between T2DM and SMA. To explore this association, our review (i) compiles evidence on the clinical association between T2DM and SMA, (ii) reviews mechanisms underlying biochemical changes in the muscles of people with or at risk of T2DM and SMA, and (iii) examines how nutritional therapy and increased physical activity as muscle-targeted treatments benefit this population. Based on the evidence, we conclude that effective treatment of patients with T2DM-SMA depends on the restoration and maintenance of muscle mass. We thus propose that regular intake of key functional nutrients, along with guidance for physical activity, can help maintain euglycemia and improve muscle status in all patients with T2DM and SMA.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>38202001</pmid><doi>10.3390/nu16010172</doi><orcidid>https://orcid.org/0000-0003-2127-3190</orcidid><orcidid>https://orcid.org/0000-0002-7758-3588</orcidid><orcidid>https://orcid.org/0000-0001-6163-8532</orcidid><orcidid>https://orcid.org/0000-0001-8570-184X</orcidid><orcidid>https://orcid.org/0000-0002-4339-3380</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2072-6643
ispartof Nutrients, 2024-01, Vol.16 (1), p.172
issn 2072-6643
2072-6643
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10780454
source MDPI - Multidisciplinary Digital Publishing Institute; MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; PubMed Central Open Access
subjects Age
Aging
Amino acids
Atrophy
B cells
Chronic illnesses
Development and progression
Diabetes
Diabetes Mellitus, Type 2
Exercise
Glucose
Homeostasis
Humans
Hyperglycemia
Inflammation
Insulin
Insulin resistance
Malnutrition
Metabolism
Muscle function
Muscle strength
Muscle, Skeletal
Muscles
Muscular Atrophy - etiology
Musculoskeletal system
Nutrition
Obesity
Older people
Overweight
Oxidative stress
Proteins
Quality of Life
Review
Sarcopenia
Type 2 diabetes
title The Vicious Cycle of Type 2 Diabetes Mellitus and Skeletal Muscle Atrophy: Clinical, Biochemical, and Nutritional Bases
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-15T03%3A40%3A51IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Vicious%20Cycle%20of%20Type%202%20Diabetes%20Mellitus%20and%20Skeletal%20Muscle%20Atrophy:%20Clinical,%20Biochemical,%20and%20Nutritional%20Bases&rft.jtitle=Nutrients&rft.au=Lopez-Pedrosa,%20Jose%20M&rft.date=2024-01-01&rft.volume=16&rft.issue=1&rft.spage=172&rft.pages=172-&rft.issn=2072-6643&rft.eissn=2072-6643&rft_id=info:doi/10.3390/nu16010172&rft_dat=%3Cgale_pubme%3EA779346826%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2912620215&rft_id=info:pmid/38202001&rft_galeid=A779346826&rfr_iscdi=true