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Urinary copper levels and genome-wide DNA methylation were measured in early pregnancy for 432 pregnant women, and 737 circulating proteins were measured in a subset of 150 pregnant women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Urinary copper levels were positively associated with risk of GDM (adjusted odds ratio\u2005=\u20051.48 for each 1-unit increase in the log-transformed levels of copper, 95% CI, 1.15-1.91). A total of 73 differential cytosine-phosphoguanine sites (CpGs) were identified as associated with copper. Of these CpGs, cg23773809 annotated to SNX10 mediated 24.7% and 22.4% of the copper-GDM and copper-1\u2005hour plasma glucose (1-h PG) association, respectively. cg04168577 annotated to PPFIBP2 and cg06105935 located in the intergenic region mediated 23.4% and 13.9% of the copper-1-h PG association, respectively. The protein CD2AP was found to be a reliable predictor for GDM. The 73 differential CpGs mediated 64.1% of the copper-CD2AP association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Copper exposure may induce alterations in DNA methylation patterns, which can subsequently lead to changes in the expression of proteins associated with GDM and elevate the risk of developing GDM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf555","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T18:33:44Z","timestamp":1759775624000},"page":"1136-1146","source":"Crossref","is-referenced-by-count":1,"title":["Association between Urinary Copper and Gestational Diabetes Mellitus: Role of Epigenome-Wide DNA Methylation and Proteomics"],"prefix":"10.1210","volume":"111","author":[{"given":"Yingru","family":"Li","sequence":"first","affiliation":[{"name":"Section of Epidemiology and Population Health & Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & Children\u2019s Medicine Key Laboratory of Sichuan Province, West China Second University Hospital, Sichuan University , Chengdu, Sichuan 610041 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanshan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Section of Epidemiology and Population Health & Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & Children\u2019s Medicine Key Laboratory of Sichuan Province, West China Second University Hospital, Sichuan University , Chengdu, Sichuan 610041 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuwei","family":"Lai","sequence":"additional","affiliation":[{"name":"Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, Hubei 430030 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Wu","sequence":"additional","affiliation":[{"name":"Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, Hubei 430030 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengjiang","family":"Sun","sequence":"additional","affiliation":[{"name":"School of Public Health, Anhui University of Science and Technology , Hefei, Anhui 230041 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anqi","family":"Jiao","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health, Joe C. 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