Article History
Received: 16 October 2024
Accepted: 26 February 2025
First Online: 5 March 2025
Declarations
:
: The authors declare no competing interests.
: During the execution of the study, we followed the Declaration of Helsinki, including its updates, or comparable international ethical guidelines to ensure that all research activities met ethical standards. The NHANES project, overseen by the NCHS, received thorough approval from the NCHS Ethics Review Board to guarantee that data collection and usage are legal and ethical. Given the secondary analytic nature of this study based on the NHANES database, and adhering to the STROBE guidelines to ensure the scientific validity and transparency of the data analyses, additional ethical approval was not required. Information on the status of ethical review approvals for the NHANES project can be obtained by visiting .