Li, Keyi
Qu, Jianmin
Guo, Chunhong
Article History
Received: 11 September 2025
Revised: 23 January 2026
Accepted: 12 February 2026
First Online: 19 March 2026
Competing interests
: The authors declare no competing interests.
: This study utilized publicly available data from the NHANES, which is conducted by the CDC. NHANES received approval from the National Center for Health Statistics (NCHS) Research Ethics Review Board, and informed consent was obtained from all participants or their guardians. No additional ethical approval was required for this secondary analysis, as the data were fully anonymized and de-identified prior to access.