{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T13:14:33Z","timestamp":1783257273751,"version":"3.54.6"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Charcot neuro-osteoarthropathy (CNO) is a limb-threatening diabetic foot complication involving neuropathy, repetitive trauma, inflammation, and bone remodeling. Obesity is common in CNO, but observational interpretation is limited by confounding and reverse causation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed two-sample MR using GWAS summary statistics. The primary outcome was FinnGen R12 Charcot foot. BMI was prespecified as primary; glycemic traits, lipids, metabolic traits, and heel bone mineral density (BMD), a systemic proxy for skeletal strength, were secondary or comparator exposures. Instruments were genome-wide significant and European LD-clumped.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Per standardized BMI increment, higher BMI was strongly associated with Charcot foot (odds ratio [OR], 3.36; 95% CI, 2.30-4.92; P\u2009=\u20094.01\u2009\u00d7\u200910\n                      <jats:sup>\u221210<\/jats:sup>\n                      ); 1 standardized BMI unit is approximately 4.7 to 4.8\u2005kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      in large European cohorts. BMI was nominally associated with diabetic neuropathy (OR, 1.21; 95% CI, 1.04-1.42; P\u2009=\u20090.016). Fasting glucose was suggestive (OR, 2.35; 95% CI, 1.14-4.81; P\u2009=\u20090.020). Higher heel BMD was associated with lower Charcot foot risk (OR, 0.75; 95% CI, 0.59-0.96; P\u2009=\u20090.021).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Genetically proxied higher BMI was strongly associated with Charcot foot risk; fasting glucose and heel BMD-proxied skeletal findings were suggestive. These findings support considering adiposity in long-term risk recognition alongside neuropathy surveillance, foot protection, and offloading.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15347346261464688","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T10:57:48Z","timestamp":1783076268000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Genetic Evidence for Adiposity-Related Susceptibility and Heel BMD-Proxied Skeletal Resilience in Charcot Foot: A Two-Sample Mendelian Randomization Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9714-7070","authenticated-orcid":false,"given":"Shaowen","family":"Zhong","sequence":"first","affiliation":[{"name":"Department of Endocrinology, The Second Affiliated Hospital of Shaoyang University, Shaoyang, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2931-5462","authenticated-orcid":false,"given":"Quan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, The Second Affiliated Hospital of Shaoyang University, Shaoyang, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0844"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3646"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67029-8"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-0992-1"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3647"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2008.06.038"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2005.01510.x"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.86B3.14593"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-1141"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.2337\/db10-1220"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyg070"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.18236"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/15347346241283260"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/gepi.21758"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-022-05473-8"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddy271"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-021-00852-9"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng.2797"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-018-0302-x"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyr036"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/gepi.21965"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv080"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddy163"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-018-0099-7"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.4.956"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-024-06271-9"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.4317"}],"container-title":["The International Journal of Lower Extremity Wounds"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15347346261464688","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15347346261464688","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15347346261464688","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T12:16:11Z","timestamp":1783253771000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15347346261464688"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":27,"alternative-id":["10.1177\/15347346261464688"],"URL":"https:\/\/doi.org\/10.1177\/15347346261464688","relation":{},"ISSN":["1534-7346","1552-6941"],"issn-type":[{"value":"1534-7346","type":"print"},{"value":"1552-6941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]},"article-number":"15347346261464688"}}