Thyroid function and risk of all-cause and cardiovascular mortality: a prospective population-based cohort study
Purpose Although thyroid hormones are irrefutably implicated in cardiovascular physiology, the impact of within-reference range variations of thyroid function on cardiovascular disease (CVD) remains unclear. Elucidating this is important, since it could foster preventive treatment and reduce global...
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| Veröffentlicht in: | Endocrine 2021-02, Vol.71 (2), p.385-396 |
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| creator | Groothof, Dion Flores-Guerrero, Jose L. Nolte, Ilja M. Bouma, Hjalmar R. Gruppen, Eke G. Bano, Arjola Post, Adrian Kootstra-Ros, Jenny E. Hak, Eelko Bos, Jens H. J. de Borst, Martin H. Gans, Reinold O. B. Links, Thera P. Dullaart, Robin P. F. Bakker, Stephan J. L. |
| description | Purpose
Although thyroid hormones are irrefutably implicated in cardiovascular physiology, the impact of within-reference range variations of thyroid function on cardiovascular disease (CVD) remains unclear. Elucidating this is important, since it could foster preventive treatment and reduce global CVD burden. We therefore investigated the impact of within-reference range variations of thyroid function on all-cause and cardiovascular mortality.
Methods
We included community-dwelling individuals aged 28–75 years from a prospective cohort study, without known use of thyroid-affecting therapy and with thyrotropin within reference range. Associations of thyroid function with mortality were quantified using Cox models and adjusted for sociodemographic and cardiovascular risk factors.
Results
Mean (SD) age of the 6,054 participants (52.0% male) was 53.3 (12.0) years. During 47,594 person-years of follow-up, we observed 380 deaths from all causes and 103 from CVDs. Although higher thyrotropin was not associated with all-cause mortality (adjusted HR 1.02, 95% CI 0.92–1.14), point estimates for cardiovascular mortality diverged toward increased risk in younger ( |
| doi_str_mv | 10.1007/s12020-020-02397-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7881952</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2489110508</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-dc1aa03d377f642678ed91cde2473638e77e78542f12eac521f50980ea8226833</originalsourceid><addsrcrecordid>eNp9kctu1TAQhi0EoqXwAiyQJTZsDL7Exw4LJFRxkyqxKRI7a-pMelxy4mAnRzp9eqaklMuCxciW55t_Zvwz9lTJl0pK96oqLbUUa5jWiet77FhZ2wpJ-ft0N9YKKf3XI_ao1isptdYb95AdGb0x2mlzzKbz7aHk1PF-GeOc8shh7HhJ9RvPPYdhEBGWij9fI5Qu5T3UuAxQ-C6XGYY0H15z4FPJdUJS2COf8kTAjZi4gIpUmLfE8jov3eExe9DDUPHJ7XnCvrx_d376UZx9_vDp9O2ZiI1rZtFFBSBNZ5zrNw1N7bFrVexQN85sjEfn0Hnb6F5phGi16q1svUTwtKM35oS9WXWn5WKHXcRxLjCEqaQdlEPIkMLfmTFtw2XeB-e9aq0mgRe3AiV_X7DOYZdqxGGAEfNSg260UtIZ1xD6_B_0Ki9lpPWI8i1hVnqi9EpF-qtasL8bRslwY2hYDQ1rkKHhmoqe_bnGXckvBwkwK1ApNV5i-d37P7I_APH7rjg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2489110508</pqid></control><display><type>article</type><title>Thyroid function and risk of all-cause and cardiovascular mortality: a prospective population-based cohort study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Groothof, Dion ; Flores-Guerrero, Jose L. ; Nolte, Ilja M. ; Bouma, Hjalmar R. ; Gruppen, Eke G. ; Bano, Arjola ; Post, Adrian ; Kootstra-Ros, Jenny E. ; Hak, Eelko ; Bos, Jens H. J. ; de Borst, Martin H. ; Gans, Reinold O. B. ; Links, Thera P. ; Dullaart, Robin P. F. ; Bakker, Stephan J. L.</creator><creatorcontrib>Groothof, Dion ; Flores-Guerrero, Jose L. ; Nolte, Ilja M. ; Bouma, Hjalmar R. ; Gruppen, Eke G. ; Bano, Arjola ; Post, Adrian ; Kootstra-Ros, Jenny E. ; Hak, Eelko ; Bos, Jens H. J. ; de Borst, Martin H. ; Gans, Reinold O. B. ; Links, Thera P. ; Dullaart, Robin P. F. ; Bakker, Stephan J. L.</creatorcontrib><description>Purpose
Although thyroid hormones are irrefutably implicated in cardiovascular physiology, the impact of within-reference range variations of thyroid function on cardiovascular disease (CVD) remains unclear. Elucidating this is important, since it could foster preventive treatment and reduce global CVD burden. We therefore investigated the impact of within-reference range variations of thyroid function on all-cause and cardiovascular mortality.
Methods
We included community-dwelling individuals aged 28–75 years from a prospective cohort study, without known use of thyroid-affecting therapy and with thyrotropin within reference range. Associations of thyroid function with mortality were quantified using Cox models and adjusted for sociodemographic and cardiovascular risk factors.
Results
Mean (SD) age of the 6,054 participants (52.0% male) was 53.3 (12.0) years. During 47,594 person-years of follow-up, we observed 380 deaths from all causes and 103 from CVDs. Although higher thyrotropin was not associated with all-cause mortality (adjusted HR 1.02, 95% CI 0.92–1.14), point estimates for cardiovascular mortality diverged toward increased risk in younger (<72 years) participants (1.31, 1.00–1.72) and decreased risk in elderly (≥72 years) (0.77, 0.56–1.06). Higher free thyroxine (FT
4
) was associated with all-cause mortality (1.18, 1.07–1.30) and with cardiovascular mortality only in elderly (1.61, 1.19–2.18), but not in younger participants (1.03, 0.78–1.34). Higher free triiodothyronine (FT
3
) was associated with all-cause mortality in females only (1.18, 1.02–1.35). FT
3
was not associated with cardiovascular mortality (0.91, 0.70–1.18).
Conclusions
Community-dwelling elderly individuals with high-normal thyroid function are at increased risk of all-cause and cardiovascular mortality, reinforcing the need of redefining the current reference ranges of thyroid function.</description><identifier>ISSN: 1355-008X</identifier><identifier>EISSN: 1559-0100</identifier><identifier>DOI: 10.1007/s12020-020-02397-z</identifier><identifier>PMID: 32632723</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Aged ; Cardiovascular Diseases ; Cohort analysis ; Cohort Studies ; Diabetes ; Endocrinology ; Female ; Humanities and Social Sciences ; Humans ; Internal Medicine ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; multidisciplinary ; Original ; Original Article ; Population studies ; Population-based studies ; Prospective Studies ; Risk factors ; Science ; Thyroid Function Tests ; Thyroid Gland ; Thyroid hormones ; Thyroid-stimulating hormone ; Thyrotropin ; Thyroxine ; Triiodothyronine</subject><ispartof>Endocrine, 2021-02, Vol.71 (2), p.385-396</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-dc1aa03d377f642678ed91cde2473638e77e78542f12eac521f50980ea8226833</citedby><cites>FETCH-LOGICAL-c474t-dc1aa03d377f642678ed91cde2473638e77e78542f12eac521f50980ea8226833</cites><orcidid>0000-0002-1886-4451</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12020-020-02397-z$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12020-020-02397-z$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32632723$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Groothof, Dion</creatorcontrib><creatorcontrib>Flores-Guerrero, Jose L.</creatorcontrib><creatorcontrib>Nolte, Ilja M.</creatorcontrib><creatorcontrib>Bouma, Hjalmar R.</creatorcontrib><creatorcontrib>Gruppen, Eke G.</creatorcontrib><creatorcontrib>Bano, Arjola</creatorcontrib><creatorcontrib>Post, Adrian</creatorcontrib><creatorcontrib>Kootstra-Ros, Jenny E.</creatorcontrib><creatorcontrib>Hak, Eelko</creatorcontrib><creatorcontrib>Bos, Jens H. J.</creatorcontrib><creatorcontrib>de Borst, Martin H.</creatorcontrib><creatorcontrib>Gans, Reinold O. B.</creatorcontrib><creatorcontrib>Links, Thera P.</creatorcontrib><creatorcontrib>Dullaart, Robin P. F.</creatorcontrib><creatorcontrib>Bakker, Stephan J. L.</creatorcontrib><title>Thyroid function and risk of all-cause and cardiovascular mortality: a prospective population-based cohort study</title><title>Endocrine</title><addtitle>Endocrine</addtitle><addtitle>Endocrine</addtitle><description>Purpose
Although thyroid hormones are irrefutably implicated in cardiovascular physiology, the impact of within-reference range variations of thyroid function on cardiovascular disease (CVD) remains unclear. Elucidating this is important, since it could foster preventive treatment and reduce global CVD burden. We therefore investigated the impact of within-reference range variations of thyroid function on all-cause and cardiovascular mortality.
Methods
We included community-dwelling individuals aged 28–75 years from a prospective cohort study, without known use of thyroid-affecting therapy and with thyrotropin within reference range. Associations of thyroid function with mortality were quantified using Cox models and adjusted for sociodemographic and cardiovascular risk factors.
Results
Mean (SD) age of the 6,054 participants (52.0% male) was 53.3 (12.0) years. During 47,594 person-years of follow-up, we observed 380 deaths from all causes and 103 from CVDs. Although higher thyrotropin was not associated with all-cause mortality (adjusted HR 1.02, 95% CI 0.92–1.14), point estimates for cardiovascular mortality diverged toward increased risk in younger (<72 years) participants (1.31, 1.00–1.72) and decreased risk in elderly (≥72 years) (0.77, 0.56–1.06). Higher free thyroxine (FT
4
) was associated with all-cause mortality (1.18, 1.07–1.30) and with cardiovascular mortality only in elderly (1.61, 1.19–2.18), but not in younger participants (1.03, 0.78–1.34). Higher free triiodothyronine (FT
3
) was associated with all-cause mortality in females only (1.18, 1.02–1.35). FT
3
was not associated with cardiovascular mortality (0.91, 0.70–1.18).
Conclusions
Community-dwelling elderly individuals with high-normal thyroid function are at increased risk of all-cause and cardiovascular mortality, reinforcing the need of redefining the current reference ranges of thyroid function.</description><subject>Adult</subject><subject>Aged</subject><subject>Cardiovascular Diseases</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Diabetes</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>multidisciplinary</subject><subject>Original</subject><subject>Original Article</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Prospective Studies</subject><subject>Risk factors</subject><subject>Science</subject><subject>Thyroid Function Tests</subject><subject>Thyroid Gland</subject><subject>Thyroid hormones</subject><subject>Thyroid-stimulating hormone</subject><subject>Thyrotropin</subject><subject>Thyroxine</subject><subject>Triiodothyronine</subject><issn>1355-008X</issn><issn>1559-0100</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kctu1TAQhi0EoqXwAiyQJTZsDL7Exw4LJFRxkyqxKRI7a-pMelxy4mAnRzp9eqaklMuCxciW55t_Zvwz9lTJl0pK96oqLbUUa5jWiet77FhZ2wpJ-ft0N9YKKf3XI_ao1isptdYb95AdGb0x2mlzzKbz7aHk1PF-GeOc8shh7HhJ9RvPPYdhEBGWij9fI5Qu5T3UuAxQ-C6XGYY0H15z4FPJdUJS2COf8kTAjZi4gIpUmLfE8jov3eExe9DDUPHJ7XnCvrx_d376UZx9_vDp9O2ZiI1rZtFFBSBNZ5zrNw1N7bFrVexQN85sjEfn0Hnb6F5phGi16q1svUTwtKM35oS9WXWn5WKHXcRxLjCEqaQdlEPIkMLfmTFtw2XeB-e9aq0mgRe3AiV_X7DOYZdqxGGAEfNSg260UtIZ1xD6_B_0Ki9lpPWI8i1hVnqi9EpF-qtasL8bRslwY2hYDQ1rkKHhmoqe_bnGXckvBwkwK1ApNV5i-d37P7I_APH7rjg</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Groothof, Dion</creator><creator>Flores-Guerrero, Jose L.</creator><creator>Nolte, Ilja M.</creator><creator>Bouma, Hjalmar R.</creator><creator>Gruppen, Eke G.</creator><creator>Bano, Arjola</creator><creator>Post, Adrian</creator><creator>Kootstra-Ros, Jenny E.</creator><creator>Hak, Eelko</creator><creator>Bos, Jens H. J.</creator><creator>de Borst, Martin H.</creator><creator>Gans, Reinold O. B.</creator><creator>Links, Thera P.</creator><creator>Dullaart, Robin P. F.</creator><creator>Bakker, Stephan J. L.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><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>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1886-4451</orcidid></search><sort><creationdate>20210201</creationdate><title>Thyroid function and risk of all-cause and cardiovascular mortality: a prospective population-based cohort study</title><author>Groothof, Dion ; Flores-Guerrero, Jose L. ; Nolte, Ilja M. ; Bouma, Hjalmar R. ; Gruppen, Eke G. ; Bano, Arjola ; Post, Adrian ; Kootstra-Ros, Jenny E. ; Hak, Eelko ; Bos, Jens H. J. ; de Borst, Martin H. ; Gans, Reinold O. B. ; Links, Thera P. ; Dullaart, Robin P. F. ; Bakker, Stephan J. L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-dc1aa03d377f642678ed91cde2473638e77e78542f12eac521f50980ea8226833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Cardiovascular Diseases</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Diabetes</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>multidisciplinary</topic><topic>Original</topic><topic>Original Article</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Prospective Studies</topic><topic>Risk factors</topic><topic>Science</topic><topic>Thyroid Function Tests</topic><topic>Thyroid Gland</topic><topic>Thyroid hormones</topic><topic>Thyroid-stimulating hormone</topic><topic>Thyrotropin</topic><topic>Thyroxine</topic><topic>Triiodothyronine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Groothof, Dion</creatorcontrib><creatorcontrib>Flores-Guerrero, Jose L.</creatorcontrib><creatorcontrib>Nolte, Ilja M.</creatorcontrib><creatorcontrib>Bouma, Hjalmar R.</creatorcontrib><creatorcontrib>Gruppen, Eke G.</creatorcontrib><creatorcontrib>Bano, Arjola</creatorcontrib><creatorcontrib>Post, Adrian</creatorcontrib><creatorcontrib>Kootstra-Ros, Jenny E.</creatorcontrib><creatorcontrib>Hak, Eelko</creatorcontrib><creatorcontrib>Bos, Jens H. J.</creatorcontrib><creatorcontrib>de Borst, Martin H.</creatorcontrib><creatorcontrib>Gans, Reinold O. B.</creatorcontrib><creatorcontrib>Links, Thera P.</creatorcontrib><creatorcontrib>Dullaart, Robin P. F.</creatorcontrib><creatorcontrib>Bakker, Stephan J. L.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Endocrine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Groothof, Dion</au><au>Flores-Guerrero, Jose L.</au><au>Nolte, Ilja M.</au><au>Bouma, Hjalmar R.</au><au>Gruppen, Eke G.</au><au>Bano, Arjola</au><au>Post, Adrian</au><au>Kootstra-Ros, Jenny E.</au><au>Hak, Eelko</au><au>Bos, Jens H. J.</au><au>de Borst, Martin H.</au><au>Gans, Reinold O. B.</au><au>Links, Thera P.</au><au>Dullaart, Robin P. F.</au><au>Bakker, Stephan J. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thyroid function and risk of all-cause and cardiovascular mortality: a prospective population-based cohort study</atitle><jtitle>Endocrine</jtitle><stitle>Endocrine</stitle><addtitle>Endocrine</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>71</volume><issue>2</issue><spage>385</spage><epage>396</epage><pages>385-396</pages><issn>1355-008X</issn><eissn>1559-0100</eissn><abstract>Purpose
Although thyroid hormones are irrefutably implicated in cardiovascular physiology, the impact of within-reference range variations of thyroid function on cardiovascular disease (CVD) remains unclear. Elucidating this is important, since it could foster preventive treatment and reduce global CVD burden. We therefore investigated the impact of within-reference range variations of thyroid function on all-cause and cardiovascular mortality.
Methods
We included community-dwelling individuals aged 28–75 years from a prospective cohort study, without known use of thyroid-affecting therapy and with thyrotropin within reference range. Associations of thyroid function with mortality were quantified using Cox models and adjusted for sociodemographic and cardiovascular risk factors.
Results
Mean (SD) age of the 6,054 participants (52.0% male) was 53.3 (12.0) years. During 47,594 person-years of follow-up, we observed 380 deaths from all causes and 103 from CVDs. Although higher thyrotropin was not associated with all-cause mortality (adjusted HR 1.02, 95% CI 0.92–1.14), point estimates for cardiovascular mortality diverged toward increased risk in younger (<72 years) participants (1.31, 1.00–1.72) and decreased risk in elderly (≥72 years) (0.77, 0.56–1.06). Higher free thyroxine (FT
4
) was associated with all-cause mortality (1.18, 1.07–1.30) and with cardiovascular mortality only in elderly (1.61, 1.19–2.18), but not in younger participants (1.03, 0.78–1.34). Higher free triiodothyronine (FT
3
) was associated with all-cause mortality in females only (1.18, 1.02–1.35). FT
3
was not associated with cardiovascular mortality (0.91, 0.70–1.18).
Conclusions
Community-dwelling elderly individuals with high-normal thyroid function are at increased risk of all-cause and cardiovascular mortality, reinforcing the need of redefining the current reference ranges of thyroid function.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32632723</pmid><doi>10.1007/s12020-020-02397-z</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-1886-4451</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1355-008X |
| ispartof | Endocrine, 2021-02, Vol.71 (2), p.385-396 |
| issn | 1355-008X 1559-0100 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7881952 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Cardiovascular Diseases Cohort analysis Cohort Studies Diabetes Endocrinology Female Humanities and Social Sciences Humans Internal Medicine Male Medicine Medicine & Public Health Middle Aged Mortality multidisciplinary Original Original Article Population studies Population-based studies Prospective Studies Risk factors Science Thyroid Function Tests Thyroid Gland Thyroid hormones Thyroid-stimulating hormone Thyrotropin Thyroxine Triiodothyronine |
| title | Thyroid function and risk of all-cause and cardiovascular mortality: a prospective population-based cohort study |
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