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Article History

Received: 21 August 2025

Accepted: 24 November 2025

First Online: 22 December 2025

Declarations

:

: Ethical approval was not applicable, as this study used publicly available and deidentified data from the GBD 2021 and GDD database. The NHANES protocol was reviewed and approved by the by the Institutional Review Board of the National Center for Health Statistics, with all participants providing written informed consent. As the current study utilized publicly available deidentified data, it was exempted from the requirement to obtain informed consent in accordance with the relevant regulations of the Zhejiang Chinese medical University Institutional Review Board.

: Not applicable. This study analyzed only publicly available, de-identified data and involved no direct interaction with human participants.

: The authors declare no competing interests.