{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T10:40:26Z","timestamp":1774003226582,"version":"3.50.1"},"reference-count":33,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"publisher","award":["DMR-112-155"],"award-info":[{"award-number":["DMR-112-155"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"publisher","award":["DMR-114-042"],"award-info":[{"award-number":["DMR-114-042"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004391","name":"China Medical University Hospital","doi-asserted-by":"publisher","award":["DMR-114-189"],"award-info":[{"award-number":["DMR-114-189"]}],"id":[{"id":"10.13039\/501100004391","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 114-2320-B-039-017"],"award-info":[{"award-number":["NSTC 114-2320-B-039-017"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["canadianjournalofdiabetes.com","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Diabetes"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1016\/j.jcjd.2025.10.178","type":"journal-article","created":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T10:31:08Z","timestamp":1762597868000},"page":"65-71.e3","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Causal Relationship Between Multiple Modifiable Risk Factors and Gestational Diabetes Mellitus: A 2-Sample Mendelian Randomization Study"],"prefix":"10.1016","volume":"50","author":[{"given":"Chung-Chih","family":"Liao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-I","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung-Miao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.jcjd.2025.10.178_bib1","doi-asserted-by":"crossref","first-page":"109050","DOI":"10.1016\/j.diabres.2021.109050","article-title":"IDF Diabetes Atlas: Estimation of global and regional gestational diabetes mellitus prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group\u2019s Criteria","volume":"183","author":"Wang","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"10.1016\/j.jcjd.2025.10.178_bib2","first-page":"E885","article-title":"Prevalence of gestational diabetes and its association with stillbirth, preterm birth, macrosomia, abortion and cesarean delivery: A national prevalence study of 11 provinces in Iran","volume":"62","author":"Darbandi","year":"2021","journal-title":"J Prev Med Hyg"},{"key":"10.1016\/j.jcjd.2025.10.178_bib3","doi-asserted-by":"crossref","first-page":"1012244","DOI":"10.3389\/fendo.2022.1012244","article-title":"Progression to type 2 diabetes mellitus after gestational diabetes mellitus diagnosed by IADPSG criteria: Systematic review and meta-analysis","volume":"13","author":"Juan","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"10.1016\/j.jcjd.2025.10.178_bib4","doi-asserted-by":"crossref","first-page":"5003","DOI":"10.3390\/ijms21145003","article-title":"Gestational diabetes mellitus: A harbinger of the vicious cycle of diabetes","volume":"21","author":"Alejandro","year":"2020","journal-title":"Int J Mol Sci"},{"key":"10.1016\/j.jcjd.2025.10.178_bib5","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1038\/s41572-019-0098-8","article-title":"Gestational diabetes mellitus","volume":"5","author":"McIntyre","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"10.1016\/j.jcjd.2025.10.178_bib6","doi-asserted-by":"crossref","first-page":"3342","DOI":"10.3390\/ijms19113342","article-title":"The pathophysiology of gestational diabetes mellitus","volume":"19","author":"Plows","year":"2018","journal-title":"Int J Mol Sci"},{"key":"10.1016\/j.jcjd.2025.10.178_bib7","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s12884-019-2185-y","article-title":"How diet, physical activity and psychosocial well-being interact in women with gestational diabetes mellitus: An integrative review","volume":"19","author":"Gilbert","year":"2019","journal-title":"BMC Pregnancy Childbirth"},{"key":"10.1016\/j.jcjd.2025.10.178_bib8","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1001\/jama.2017.17219","article-title":"Mendelian randomization","volume":"318","author":"Emdin","year":"2017","journal-title":"JAMA"},{"key":"10.1016\/j.jcjd.2025.10.178_bib9","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2022-070312","article-title":"Modifiable risk factors and long term risk of type 2 diabetes among individuals with a history of gestational diabetes mellitus: Prospective cohort study","volume":"378","author":"Yang","year":"2022","journal-title":"BMJ"},{"issue":"Suppl.","key":"10.1016\/j.jcjd.2025.10.178_bib10","doi-asserted-by":"crossref","first-page":"1975s","DOI":"10.3945\/ajcn.110.001032","article-title":"Effect of dietary and lifestyle factors on the risk of gestational diabetes: Review of epidemiologic evidence","volume":"94","author":"Zhang","year":"2011","journal-title":"Am J Clin Nutr"},{"key":"10.1016\/j.jcjd.2025.10.178_bib11","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1038\/s41588-023-01607-4","article-title":"Distinct and shared genetic architectures of gestational diabetes mellitus and type 2 diabetes","volume":"56","author":"Elliott","year":"2024","journal-title":"Nat Genet"},{"key":"10.1016\/j.jcjd.2025.10.178_bib12","doi-asserted-by":"crossref","first-page":"100124","DOI":"10.1016\/j.deman.2022.100124","article-title":"The risk of developing type 2 diabetes after gestational diabetes: A registry study from Finland","volume":"10","author":"Per\u00e4m\u00e4ki","year":"2023","journal-title":"Diabetes Epidemiol Manage"},{"key":"10.1016\/j.jcjd.2025.10.178_bib13","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2023.1281845","article-title":"Causal association of circulating cytokines with sepsis: A Mendelian randomization study","volume":"14","author":"Lin","year":"2023","journal-title":"Front Immunol"},{"key":"10.1016\/j.jcjd.2025.10.178_bib14","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1093\/ije\/dyy258","article-title":"Improving the accuracy of two-sample summary-data Mendelian randomization: Moving beyond the NOME assumption","volume":"48","author":"Bowden","year":"2019","journal-title":"Int J Epidemiol"},{"key":"10.1016\/j.jcjd.2025.10.178_bib15","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1093\/ije\/dyab084","article-title":"The use of two-sample methods for Mendelian randomization analyses on single large datasets","volume":"50","author":"Minelli","year":"2021","journal-title":"Int J Epidemiol"},{"key":"10.1016\/j.jcjd.2025.10.178_bib16","doi-asserted-by":"crossref","first-page":"922382","DOI":"10.3389\/fgene.2022.922382","article-title":"Educational attainment and offspring birth weight: A bidirectional Mendelian randomization study","volume":"13","author":"Liu","year":"2022","journal-title":"Front Genet"},{"issue":"Suppl.","key":"10.1016\/j.jcjd.2025.10.178_bib17","doi-asserted-by":"crossref","first-page":"1674s","DOI":"10.1093\/jn\/133.5.1674S","article-title":"Gestational diabetes and insulin resistance: Role in short- and long-term implications for mother and fetus","volume":"133","author":"Catalano","year":"2003","journal-title":"J Nutr"},{"key":"10.1016\/j.jcjd.2025.10.178_bib18","doi-asserted-by":"crossref","first-page":"3611","DOI":"10.2147\/DMSO.S275898","article-title":"Obesity, insulin resistance, and type 2 diabetes: Associations and therapeutic implications","volume":"13","author":"Wondmkun","year":"2020","journal-title":"Diabetes Metab Syndr Obes"},{"key":"10.1016\/j.jcjd.2025.10.178_bib19","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1111\/aogs.13929","article-title":"Pregnancy in metabolic healthy and unhealthy obese women","volume":"99","author":"P\u00e9tursd\u00f3ttir Maack","year":"2020","journal-title":"Acta Obstet Gynecol Scand"},{"key":"10.1016\/j.jcjd.2025.10.178_bib20","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.placenta.2020.08.020","article-title":"First trimester biomarkers for prediction of gestational diabetes mellitus","volume":"101","author":"Tenenbaum-Gavish","year":"2020","journal-title":"Placenta"},{"key":"10.1016\/j.jcjd.2025.10.178_bib21","first-page":"774","article-title":"Insulin resistance and the polycystic ovary syndrome: Mechanism and implications for pathogenesis","volume":"18","author":"Dunaif","year":"1997","journal-title":"Endocr Rev"},{"key":"10.1016\/j.jcjd.2025.10.178_bib22","doi-asserted-by":"crossref","first-page":"50","DOI":"10.15420\/ecr.2018.33.1","article-title":"The role of inflammation in diabetes: Current concepts and future perspectives","volume":"14","author":"Tsalamandris","year":"2019","journal-title":"Eur Cardiol"},{"key":"10.1016\/j.jcjd.2025.10.178_bib23","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s13098-015-0018-3","article-title":"The impact of sleep disorders on glucose metabolism: Endocrine and molecular mechanisms","volume":"7","author":"Brian\u00e7on-Marjollet","year":"2015","journal-title":"Diabetol Metab Syndr"},{"key":"10.1016\/j.jcjd.2025.10.178_bib24","doi-asserted-by":"crossref","first-page":"3347","DOI":"10.3390\/nu14163347","article-title":"Gestational diabetes mellitus and high triglyceride levels mediate the association between pre-pregnancy overweight\/obesity and macrosomia: A prospective cohort study in central China","volume":"14","author":"Song","year":"2022","journal-title":"Nutrients"},{"key":"10.1016\/j.jcjd.2025.10.178_bib25","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ejogrb.2020.01.007","article-title":"Maternal obesity and dyslipidemia associated with gestational diabetes mellitus (GDM)","volume":"246","author":"O'Malley","year":"2020","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"10.1016\/j.jcjd.2025.10.178_bib26","doi-asserted-by":"crossref","first-page":"100830","DOI":"10.1016\/j.eclinm.2021.100830","article-title":"Association of maternal lipid profile and gestational diabetes mellitus: A systematic review and meta-analysis of 292 studies and 97,880 women","volume":"34","author":"Hu","year":"2021","journal-title":"EClinicalMedicine"},{"key":"10.1016\/j.jcjd.2025.10.178_bib27","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1177\/1933719114557896","article-title":"Early pregnancy maternal lipid profiles and the risk of gestational diabetes mellitus stratified for body mass index","volume":"22","author":"Li","year":"2015","journal-title":"Reprod Sci"},{"key":"10.1016\/j.jcjd.2025.10.178_bib28","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/jhn.12547","article-title":"The effect of pre-pregnancy lifestyle counselling on food intakes and association between food intakes and gestational diabetes in high-risk women: Results from a randomised controlled trial","volume":"31","author":"Valkama","year":"2018","journal-title":"J Hum Nutr Diet"},{"key":"10.1016\/j.jcjd.2025.10.178_bib29","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1007\/s00394-017-1377-3","article-title":"Association between pre-pregnancy consumption of meat, iron intake, and the risk of gestational diabetes: The SUN project","volume":"57","author":"Mar\u00ed-Sanchis","year":"2018","journal-title":"Eur J Nutr"},{"key":"10.1016\/j.jcjd.2025.10.178_bib30","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0302208","article-title":"The association of red and processed meat with gestational diabetes mellitus: Results from 2 Canadian birth cohort studies","volume":"19","author":"Stennett","year":"2024","journal-title":"PLoS One"},{"key":"10.1016\/j.jcjd.2025.10.178_bib31","first-page":"57","article-title":"Health effects associated with foods characteristic of the Nordic diet: A systematic literature review","author":"Akesson","year":"2013","journal-title":"Food Nutr Res"},{"key":"10.1016\/j.jcjd.2025.10.178_bib32","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.cell.2019.02.048","article-title":"The missing diversity in human genetic studies","volume":"177","author":"Sirugo","year":"2019","journal-title":"Cell"},{"key":"10.1016\/j.jcjd.2025.10.178_bib33","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1038\/s41576-023-00637-2","article-title":"Principles and methods for transferring polygenic risk scores across global populations","volume":"25","author":"Kachuri","year":"2024","journal-title":"Nat Rev Genet"}],"container-title":["Canadian Journal of Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1499267125003946?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1499267125003946?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T08:17:50Z","timestamp":1773994670000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1499267125003946"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":33,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["S1499267125003946"],"URL":"https:\/\/doi.org\/10.1016\/j.jcjd.2025.10.178","relation":{},"ISSN":["1499-2671"],"issn-type":[{"value":"1499-2671","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Causal Relationship Between Multiple Modifiable Risk Factors and Gestational Diabetes Mellitus: A 2-Sample Mendelian Randomization Study","name":"articletitle","label":"Article Title"},{"value":"Canadian Journal of Diabetes","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jcjd.2025.10.178","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Canadian Diabetes Association.","name":"copyright","label":"Copyright"}]}}