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Article History

Received: 10 July 2025

Accepted: 16 December 2025

First Online: 22 December 2025

Declarations

:

: This study used publicly available, aggregated, and anonymized data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (open data). As the data contained no personally identifiable information and did not involve direct interaction with human participants, ethical approval and informed consent were not required in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects in Japan.

: Consent for publication was not required because no individuals participated in this study.

: The authors declare no competing interests.