Zinc and cardiovascular disease

Zinc and aging: a narrative review of the effects on hematopoiesis and its link with diseases

There has been a global increase in the older population in recent decades and, as age advances, complex metabolic and epigenetic changes occur in the organism, and these may trigger some health complications commonly found among this population. Additionally, several changes occur in older people that can reduce the dietary intake or the process of nutrient absorption. In this way, tissues with high nutrient requirements are more affected. Hematopoiesis is the process of formation, development, and maturation of blood cells and is a process with a high turnover. This high demand makes the integrity of the hematopoietic process susceptible to various factors that impair physiological function, such as aging and micronutrient bioavailability. Among these micronutrients, Zinc is considered an important micronutrient, playing diverse roles across various tissues and cell types. Some of the alterations in hematopoiesis that appear as a consequence of aging and due to insufficient micronutrient intake are well described in the literature; however, not much is known about how zinc deficiency contributes towards the development of diseases seen in aging. Considering the importance of zinc to act on several biological processes, this narrative review discusses several studies related to the physiological requirements, deficiency, or excess of zinc, including studies in experimental models and humans, and aimed to shed light on the relationship between zinc and the regulation of hematopoietic tissue, exploring possible links between this mineral with common disorders that appear during aging.

Serum Zinc and Copper Concentrations and Dyslipidemia as Risk Factors of Cardiovascular Disease in Adults: Data Mining Techniques

This study aimed to examine the relationship between serum cholesterol levels and the ratio of zinc (Zn) and copper (Cu) in the blood serum and the incidence of cardiovascular disease (CVD). In Phase I of the study, 9704 individuals between the age of 35 and 65 years were recruited. Phase II of the cohort study comprised 7561 participants who completed the 10-year follow-up. The variables which were measured at the baseline of the study included gender, age, systolic blood pressure (SBP), diastolic blood pressure (DBP); biochemical parameters including serum Cu, Zn, copper-zinc ratio (Cu/Zn), zinc-copper ratio (Zn/Cu); fasted lipid profile consisting of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) as well as fasting serum glucose, and triglycerides-glucose (TyG) index. Decision tree (DT) and logical regression (LR) models were applied to examine the relationship between the aforementioned factors and CVD. CVD was diagnosed in 837 individuals (378 males and 459 females) out of 7561 participants. According to the LR models, SBP, TC, HDL, age, Zn/Cu, and TyG index for males and SBP, age, TyG index, HDL, TC, Cu/Zn, and Cu for females had the highest correlation with CVD (p-value ≤ 0.033). Based on the DT algorithm, 88% of males with SPB < 129.66 mmHg, younger age (age < 53 years), TyG index < 9.53, 173 ≤ TC < 187 mg/dL, and HDL ≥ 32 mg/dL had the lowest risk of CVD. Also, 98% of females with SBP < 128 mmHg, TyG index < 9.68, age < 44, TC < 222 mg/dL, and HDL ≥ 63.7 mg/dL had the lowest risk of CVD. It can be concluded that the Zn/Cu for men and Cu/Zn for women, along with dyslipidemia and SBP, could significantly predict the risk of CVD in this cohort from northeastern Iran.

Investigation of Zinc on hemorheological parameters in a rat model of diabetes

Diabetes mellitus (DM) is a complex, chronic metabolic disorder characterized by impaired regulation of blood glucose levels. Zinc (Zn) is an essential trace elements that plays a role in various physiological processes within the body, including those related to diabetes. The current study was investigated the effect of Zn supplementation on hemorheological parameters in a rat model of DM. After induction of DM, 32 male Wistar albino rats were divided into four groups: control, Zn, DM, and Zn+DM. Whole blood viscosity (WBV) was determined by using digital cone and plate viscometer and plasma viscosity (PV) was determined by a Coulter Harkness capillary viscometer. The rats in the DM Group showed a decrease in both Zn levels and body weight, as well as an increase in glucose levels when compared to the control group. Diabetic rats supplemented with Zn displayed lower blood glucose levels and higher concentrations of Zn compared to the DM Group. The higher PV and lower hematocrit level were measured in DM Group than control group and lower PV, higher hematocrit level were measured in Zn+DM group than DM Group. The WBV was measured at four different shear rates (57.6-115.2 - 172.8-230.4 s -1). A statistically significant increase was observed in the DM group compared to the control group. Additionally, a statistically significant decrease was observed in the Zn+DM Group compared to the DM Group at a shear rate of 230.4 s-1. Erythrocyte rigidity index (Tk) and oxygen delivery index (ODI) were computed under conditions of high shear rate. The rats in the DM group exhibited a reduction in ODI and an elevation in Tk in comparison to the control group. Conversely, the diabetic rats supplemented with Zn exhibited decreased Tk and increased ODI compared to the DM Group. Zn supplementation seems to have a potential beneficial effect for protecting adverse affect of diabetes on hemorheogical parameters and for maintaining vascular health.

Protective effects of polysaccharide extracted from green alga Chaetomorpha linum against zinc and copper-induced testicular toxicity in male mice

This study aimed to investigate the effects of copper (CuSO4) and zinc (ZnSO4) overload on male reproductive toxicity and the potential of a polysaccharide extracted from green alga Chaetomorpha linum (PS) in mitigating their toxicities. Adult male mice strain of 25 ± 2 g of weight was subdivided into eight groups. Group 1 served as control; group 2 received PS (200 mg/kg), and groups 3 and 4 received intraperitoneally zinc (60 mg/kg b.w) and copper (33 mg/kg b.w), respectively. Group 5 received both zinc (60 mg/kg b.w) and copper (33 mg/kg b.w), group 6 received zinc (60 mg/kg b.w) associated with PS (200 mg/kg), group 7 received copper (33 mg/kg b.w) associated with PS (200 mg/kg), and group 8 received zinc (60 mg/kg b.w) and copper (33 mg/kg b.w) associated with PS (200 mg/kg). Results suggested that ZnSO4 and CuSO4 significantly decreased the functional sperm parameters. Furthermore, extended exposure to these elements increased oxidative stress biomarkers, including malondialdehyde (MDA) as a measure of lipid peroxidation and advanced oxidation protein products (AOPP) indicating protein oxidative damage. This process also reduces the activity of antioxidant enzymes such as glutathione (GSH) and glutathione peroxidase (GPx), which neutralize and catalyze free radicals. Histopathological changes in mice testis were also studied. However, the co-treatments with PS significantly reduced these effects and promoted the reproductive parameters in male mice. In conclusion, PS exhibited protective effects against zinc and copper-induced reproductive toxicity, making it a potential adjuvant treatment for testicular toxicity.

The regulatory effect of zinc on the association between periodontitis and atherosclerotic cardiovascular disease: a cross-sectional study based on the National Health and Nutrition Examination Survey

BACKGROUND

Zinc has been proven to be effective against periodontitis, and also reported to reduce the risk of cardiovascular diseases (CVD). This study aims to explore the regulatory effect of zinc intake on the association between periodontitis and atherosclerotic cardiovascular disease (ASCVD).

METHODS

This was a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES). Logistic regression model was used to explore the association between zinc-RDA or periodontitis and 10-year ASCVD risk ≥ 20%, and results were shown as odds ratio (OR) and 95% confidence interval (95% CI). The regulatory effect of zinc intake on the association between periodontitis and 10-year ASCVD risk ≥ 20% was also assessed using logistic regression model. Subgroup analysis was performed based on age, gender, obesity, education level, lipid-lowering therapy, and dental floss.

RESULTS

6,075 patients were finally included for analysis. Zinc intake reaching the recommended level (OR = 0.82, 95%CI: 0.69-0.98) and periodontitis (OR = 2.47, 95%CI: 2.04-3.00) were found to be associated with 0.82-fold and 2.47-fold odds of 10-year ASCVD risk ≥ 20%, respectively. In addition, we found that the odds of 10-year ASCVD risk ≥ 20% was lower in patients with zinc intake reaching the recommended level than those without [OR (95%CI): 2.25 (1.81-2.80) vs. 2.72 (2.05-3.62)]. The similar regulatory effect was found in patients with age ≥ 60 years and < 60 years, in male and female, with or without obesity, in different education levels, with or without lipid lowering therapy, and with or without use of dental floss (all P < 0.05).

CONCLUSIONS

This study found the regulatory effect of adequate zinc intake on the association between periodontitis and ASCVD, providing guidance for periodontitis patients to decrease the risk of ASCVD.

Research progress and perspective of metallic implant biomaterials for craniomaxillofacial surgeries

Craniomaxillofacial bone serves a variety of functions. However, the increasing number of cases of craniomaxillofacial bone injury and the use of selective rare implants make the treatment difficult, and the cure rate is low. If such a bone injury is not properly treated, it can lead to a slew of complications that can seriously disrupt a patient's daily life. For example, premature closure of cranial sutures or skull fractures can lead to increased intracranial pressure, which can lead to headaches, vomiting, and even brain hernia. At present, implant placement is one of the most common approaches to repair craniomaxillofacial bone injury or abnormal closure, especially with biomedical metallic implants. This review analyzes the research progress in the design and development of degradable and non-degradable metallic implants in craniomaxillofacial surgery. The mechanical properties, corrosion behaviours, as well as in vitro and in vivo performances of these materials are summarized. The challenges and future research directions of metallic biomaterials used in craniomaxillofacial surgery are also identified.

A cross-sectional analysis of zinc and copper levels and their relationship to cardiovascular disease risk markers in Qatar biobank participants

Cardiovascular diseases (CVD) are the leading cause of mortality and morbidity worldwide. Dietary intake, particularly zinc (Zn) and copper (Cu) has been strongly associated with CVD. These trace elements play a crucial role in human enzyme activity, suppressing inflammation, catalyzing lipid metabolism enzymes, reducing oxidative stress, and regulating glucose metabolism. However, imbalances in these elements are linked to cardiovascular disturbances. Thus, this study aimed to investigate the association between circulating levels of Zn, Cu, and Zn/Cu ratio with CVD risk factors in the Qatari population. Bivariate logistic regression, adjusted for age, nationality, gender, and education was performed to examine the impact of Zn, Cu, and Zn/Cu ratio (as independent variables) on major CVD risk markers (as dependent variables). Participants in the highest Zn tertiles (T2 and T3) were at greater odds ratio (OR) of unfavorable metabolic functions such as elevated HbA1C [OR = 2.5, p = 0.015 (T2) and OR = 3.2, p = 0.002 (T3)], triglycerides [OR = 2.17, p = 0.015 (T2), and TyG index [OR = 2.21, p = 0.004 (T2), and OR = 2.67, p < 0.001 (T3)] compared to T1. Conversely, they had significantly lower ORs for prolonged prothrombin time [OR = 0.37, p = 0.001 (T3)]. Higher levels of Cu (T2 and T3) had higher OR for elevated HDL-C levels [OR = 1.69, p = 0.046 (T2), and OR = 2.27, p = 0.002 (T3)] and lower OR for elevated levels of triglycerides (OR = 0.4, p = 0.009, T3), diastolic blood pressure [OR = 0.41, p = 0.024 (T2), and OR = 0.47, p = 0.049 (T3)], and creatinine kinase (OR = 0.27, p = 0.014, T3) compared to T1. Higher levels of Cu (T2 and T3) were associated with a higher risk for elevated fibrinogen levels [OR = 3.1, p = 0.035 (T2), and OR = 5.04, p = 0.002 (T3)]. Additionally, higher Zn/Cu ratio (T2 and T3) were associated with lower ORs for elevated fibrinogen levels [OR = 0.3, p = 0.005 (T2), and OR = 0.27, p = 0.005 (T3)] compared to T1, indicating a lower risk of developing CVD. The study reveals a link between Zn, Cu, and the Zn/Cu ratio and cardiovascular disease risk. A higher Zn/Cu ratio may protect against CVD, while elevated Cu levels are linked to obesity, fibrinogen levels, and HbA1C. Maintaining optimal levels of these trace elements, either through diet or supplementation, may help reduce CVD risk.

Roles of zinc in cancers: From altered metabolism to therapeutic applications

Zinc (Zn) is a crucial trace element involved in various cellular processes, including oxidative stress, apoptosis and immune response, contributing to cellular homeostasis. Dysregulation of Zn homeostasis occurs in certain cancers. This review discusses the role of Zn in cancer and its associated components, such as Zn-related proteins, their potential as biomarkers and the use of Zn-based strategies for tumor treatment. ZIP and ZnT proteins regulate Zn metabolism under normal conditions, but their expression is aberrant in cancer. These Zn proteins can serve as prognostic or diagnostic biomarkers, aiding in early cancer detection and disease monitoring. Moreover, targeting Zn and its pathways offers potential therapeutic approaches for cancer treatment. Modulating Zn biodistribution within cells using metal-binding agents allows for the control of downstream signaling pathways. Direct utilization of zinc as a therapeutic agent, including Zn supplementation or Zn oxide nanoparticle administration, holds promise for improving the prognosis of cancer patients.

The Role of Zinc in Bone Tissue Health and Regeneration-a Review

Zinc is a micronutrient of key importance for human health. An increasing number of studies indicate that zinc plays a significant role in bone tissue's normal development and maintaining homeostasis. Zinc is not only a component of bone tissue but is also involved in the synthesis of the collagen matrix, mineralization, and bone turnover. It has been demonstrated that zinc can stimulate runt-related transcription factor 2 (Runx2) and promote the differentiation of osteoblasts. On the other hand, zinc has been found to inhibit osteoclast-like cell formation and to decrease bone resorption by stimulating osteoclasts' apoptosis. Moreover, zinc regulates the RANKL/RANK/OPG pathway, thereby facilitating bone remodeling. To date, not all mechanisms of Zn activity on bone tissue are well understood and documented. The review aimed to present the current state of research on the role of zinc in bone tissue, its beneficial properties, and its effects on bone regeneration. Since calcium phosphates as bone substitute materials are increasingly enriched in zinc ions, the paper included an overview of research on the potential role of such materials in bone filling and regeneration.

The Mediterranean Diet for Adolescents with Type 1 Diabetes: A Prospective Interventional Study

The Mediterranean diet (MED) is highly recommended. Medical nutrition therapy is the cornerstone of diabetes treatment. The primary outcome was to evaluate the change in micronutrient intake of youth with type 1 diabetes before and after a 6-month MED intervention; we also assessed adherence and glycemic control. Twenty adolescents, median age 18 years (interquartile range: 15.5-21), median diabetes duration 9 years (7-14), using continuous glucose monitoring devices, received personalized diet regimes based on MED. At 6 months post-intervention, the caloric intake remained unchanged; however, the carbohydrate proportion was lower (p = 0.058), and the intakes of some monounsaturated fats increased (p = 0.049). Sodium intake exceeded the recommended daily allowance by 250% (p = 0.653), before and after the intervention. For blood glucose, the percent TIR (time-in-range, 70-180 mg/dL) improved from 52% (38-60) to 63% (47-71) (p = 0.047). The total insulin dose decreased marginally, from 0.76 u/kg (0.64-0.97) to 0.72 u/kg (0.61-0.89) (p = 0.067). BMI z-score and waist circumference did not change (p = 0.316 and p = 0.161, respectively). Diastolic blood pressure percentile decreased from 73% (68-88) to 69% (50-79) (p = 0.028), and LDL cholesterol from 114 mg/dL (105-134) to 104 mg/dL (96-124) (p = 0.059). The Israeli Mediterranean diet screener score increased, from 8 (7-11) to 13 points (12-14) (p < 0.001). The MED-based intervention in youth with type 1 diabetes is feasible and leads to improvement in monounsaturated fat intake, TIR, and diastolic blood pressure. Other parameters show no change (caloric intake, BMI, and HbA1c).

Association between latent profile of dietary intake and cardiovascular diseases (CVDs): Results from Fasa Adults Cohort Study (FACS)

Cardiovascular diseases (CVDs) have been among the most significant non-communicable diseases. Dietary risks account for the most cause of CVDs mortalities. Evaluating overall dietary patterns (through the Latent profile of dietary intake) can provide a more accurate prediction regarding the prevalence of CVDs. The present cross-sectional study aimed to investigate the relationship between the latent profile of dietary intake and CVDs prevalence. The population of the Fasa Adults Cohort Study was employed to gather the data (n = 8319). A modified FFQ was employed to assess eating behaviors. Minerals, as well as the energy intake and total fiber, were measured using Nutritionist IV software (version 7.0). To estimate the prevalence of CVDs, accurate records of patients' histories were made. Individuals were clustered according to their dietary intake using latent profile analysis. The mean age was 48.75 ± 9.59 years, and 53.28% (4430) were women. 63.9% of participants with low Socioeconomic Status (SES) were in the low-intake profile (P < 0.001), and high SES increases the odds of being in the high-intake profile (ORhigh/low = 2.87, 95% CI 2.55-3.24). The low-intake group had the lowest amount of physical activity (Met) (P < 0.001). The result of multivariate logistic regression revealed that categorized in the low-intake group significantly increased the development of CVDs (OR = 1.32, 95% CI 1.07-1.63, P = 0.010). The mean micronutrients and total fiber, in individuals with a low intake profile, were significantly lower than other groups (P < 0.001). Overall, we estimated that a low intake of all food groups increases the odds of developing CVDs significantly.

Vascular protection afforded by zinc supplementation in human coronary artery smooth muscle cells mediated by NRF2 signaling under hypoxia/reoxygenation

Zinc (Zn) has antioxidant, anti-inflammatory and anti-proliferative actions, with Zn dysregulation associated with coronary ischemia/reperfusion injury and smooth muscle cell dysfunction. As the majority of studies concerning Zn have been conducted under non-physiological hyperoxic conditions, we compare the effects of Zn chelation or supplementation on total intracellular Zn content, antioxidant NRF2 targeted gene transcription and hypoxia/reoxygenation-induced reactive oxygen species generation in human coronary artery smooth muscle cells (HCASMC) pre-adapted to hyperoxia (18 kPa O2) or normoxia (5 kPa O2). Expression of the smooth muscle marker SM22-α was unaffected by lowering pericellular O2, whereas calponin-1 was significantly upregulated in cells under 5 kPa O2, indicating a more physiological contractile phenotype under 5 kPa O2. Inductively coupled plasma mass spectrometry established that Zn supplementation (10 μM ZnCl2 + 0.5 μM pyrithione) significantly increased total Zn content in HCASMC under 18 but not 5 kPa O2. Zn supplementation increased metallothionein mRNA expression and NRF2 nuclear accumulation in cells under 18 or 5 kPa O2. Notably, NRF2 regulated HO-1 and NQO1 mRNA expression in response to Zn supplementation was only upregulated in cells under 18 but not 5 kPa. Furthermore, whilst hypoxia increased intracellular glutathione (GSH) in cells pre-adapted to 18 but not 5 kPa O2, reoxygenation had negligible effects on GSH or total Zn content. Reoxygenation-induced superoxide generation in cells under 18 kPa O2 was abrogated by PEG-superoxide dismutase but not by PEG-catalase, and Zn supplementation, but not Zn chelation, attenuated reoxygenation-induced superoxide generation in cells under 18 but not 5kPaO2, consistent with a lower redox stress under physiological normoxia. Our findings highlight that culture of HCASMC under physiological normoxia recapitulates an in vivo contractile phenotype and that effects of Zn on NRF2 signaling are altered by oxygen tension.

The role of Zn2+ in shaping intracellular Ca2+ dynamics in the heart

Increasing evidence suggests that Zn2+ acts as a second messenger capable of transducing extracellular stimuli into intracellular signaling events. The importance of Zn2+ as a signaling molecule in cardiovascular functioning is gaining traction. In the heart, Zn2+ plays important roles in excitation-contraction (EC) coupling, excitation-transcription coupling, and cardiac ventricular morphogenesis. Zn2+ homeostasis in cardiac tissue is tightly regulated through the action of a combination of transporters, buffers, and sensors. Zn2+ mishandling is a common feature of various cardiovascular diseases. However, the precise mechanisms controlling the intracellular distribution of Zn2+ and its variations during normal cardiac function and during pathological conditions are not fully understood. In this review, we consider the major pathways by which the concentration of intracellular Zn2+ is regulated in the heart, the role of Zn2+ in EC coupling, and discuss how Zn2+ dyshomeostasis resulting from altered expression levels and efficacy of Zn2+ regulatory proteins are key drivers in the progression of cardiac dysfunction.

Redox and metal profiles in human coronary endothelial and smooth muscle cells under hyperoxia, physiological normoxia and hypoxia: Effects of NRF2 signaling on intracellular zinc

Zinc is an important component of cellular antioxidant defenses and dysregulation of zinc homeostasis is a risk factor for coronary heart disease and ischemia/reperfusion injury. Intracellular homeostasis of metals, such as zinc, iron and calcium are interrelated with cellular responses to oxidative stress. Most cells experience significantly lower oxygen levels in vivo (2-10 kPa O₂) compared to standard in vitro cell culture (18kPa O₂). We report the first evidence that total intracellular zinc content decreases significantly in human coronary artery endothelial cells (HCAEC), but not in human coronary artery smooth muscle cells (HCASMC), after lowering of O₂ levels from hyperoxia (18 kPa O₂) to physiological normoxia (5 kPa O₂) and hypoxia (1 kPa O₂). This was paralleled by O₂-dependent differences in redox phenotype based on measurements of glutathione, ATP and NRF2-targeted protein expression in HCAEC and HCASMC. NRF2-induced NQO1 expression was attenuated in both HCAEC and HCASMC under 5 kPa O₂ compared to 18 kPa O₂. Expression of the zinc efflux transporter ZnT1 increased in HCAEC under 5 kPa O₂, whilst expression of the zinc-binding protein metallothionine (MT) decreased as O₂ levels were lowered from 18 to 1 kPa O₂. Negligible changes in ZnT1 and MT expression were observed in HCASMC. Silencing NRF2 transcription reduced total intracellular zinc under 18 kPa O₂ in HCAEC with negligible changes in HCASMC, whilst NRF2 activation or overexpression increased zinc content in HCAEC, but not HCASMC, under 5 kPa O₂. This study has identified cell type specific changes in the redox phenotype and metal profile in human coronary artery cells under physiological O₂ levels. Our findings provide novel insights into the effect of NRF2 signaling on Zn content and may inform targeted therapies for cardiovascular diseases.

Cardiovascular Diseases and Zinc

Zinc is structurally and functionally essential for more than 300 enzymes and 2000 transcription factors in human body. Intracellular labile zinc is the metabolically effective zinc and tiny changes in its concentrations significantly affect the intracellular signaling and enzymatic responses. Zinc is crucial for the embrionic and fetal development of heart. Therefore, it is shown to be related with a variety of congenital heart defects. It is involved in epithelial-to-mesenchymal transformation including endocardial cushion development, which is necessary for atrioventricular septation as well as the morphogenesis of heart valves. In atherosclerosis, monocyte endothelial adhesion, and diapedesis, activation and transformation into macrophages and forming foam cells by the ingestion of oxidized LDL are monocyte related steps which need zinc. Intracellular zinc increases intracellular calcium through a variety of pathways and furthermore, zinc itself can work as a second messenger as calcium. These demonstrate the significance of intracellular zinc in heart failure and arterial hypertension. However, extracellular zinc has an opposite effect by blocking calcium channels, explaining decreased serum zinc levels, contrary to the increased cardiomyocyte and erythrocyte zinc levels in hypertensive subjects. These and other data in the literature demonstrate that zinc has important roles in healthy and diseased cardiovascular system but zinc-cardiovascular system relationship is so complex that, it has not been explained in all means. In this article, we try to review some of the available knowledge about this complex relationship.

Zinc status in public health: exploring emerging research trends through bibliometric analysis of the historical context from 1978 to 2022

The current study aims to provide a roadmap for future research by analyzing the research structures and trends in scholarly publications related to the status of zinc in public health. Only journal articles published between 1978 and 2022 are included in the refined bibliographical outputs retrieved from the Web of Science (WoS) database. The first section announces findings based on WoS categories, such as discipline heterogeneity, times cited and publications over time, and citation reports. The second section then employs VoSViewer software for bibliometric analysis, which includes a thorough examination of co-authorship among researchers, organizations, and countries and a count of all bibliographic databases among documents. The final section discusses the research's weaknesses and strengths in zinc status, public health, and potential future directions; 7158 authors contributed to 1730 papers (including 339 with publications, more than three times). "Keen, C.L." is a researcher with the most publications and a better understanding of zinc status in public health. Meanwhile, the USA has been the epicenter of research on the status of zinc in public health due to the highest percentage of publications with the most citations and collaboration with the rest of the world, with the top institution being the University of California, Davis. Future research can be organized collaboratively based on hot topics from co-occurrence network mapping and bibliographic couplings to improve zinc status and protect public health.

Geographical pattern of minerals and its association with health disparities in the USA

This study aimed to determine the common latent patterns of geographical distribution of health-related minerals across the USA and to evaluate the real-world cumulative effects of these patterns on overall population health. It was an ecological study using county-level data (3080 contiguous counties) on the concentrations of 14 minerals (i.e., aluminum, arsenic, calcium, copper, iron, lead, magnesium, manganese, mercury, phosphorus, selenium, sodium, titanium, zinc) in stream sediments (or surface soils), and the measurements of overall health including life expectancy at birth, age-specific mortality risks and cause-specific (summarized by 21 mutually exclusive groups) mortality rates. Latent class analysis (LCA) was employed to identify the common clusters of life expectancy-related minerals based on their concentration characteristics. Multivariate linear regression analyses were then conducted to examine the relationship between the LCA-derived clusters and the health measurements, with adjustment for potential confounding factors. Five minerals (i.e., arsenic, calcium, selenium, sodium and zinc) were associated with life expectancy and were analyzed in LCA. Three clusters were determined across the USA, the 'common' (n = 2056, 66.8%), 'infertile' (n = 739, 24.0%) and 'plentiful' (n = 285, 9.3%) clusters. Residents in counties with the 'infertile' profile were associated with the shortest life expectancy, highest mortality risks at all ages, and highest mortality rates for many reasons including the top five leading causes of death: cardiovascular diseases, neoplasms, neurological disorders, chronic respiratory conditions, and diabetes, urogenital, blood and endocrine diseases. Results remained statistically significant after confounding adjustment. Our study brings novel perspectives regarding environmental geochemistry to explain health disparities in the USA.

Curative effect of zinc-selenium tea on rat's cardiotoxicity induced by long-term exposure to nonylphenol

This study aimed to explore whether zinc-selenium tea has an curative effect on the cardiotoxicity induced by nonylphenol (NP), and to compare the effect of zinc-selenium tea and green tea. After drinking of zinc-selenium tea or green tea, compared with the control group, the left ventricular anterior wall became thinner, and the left ventricular end-diastolic diameter increased, the anterior wall of the left ventricle became thin at the end of diastole in the NP group. The serum myocardial enzymes aspartate aminotransferase, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase in the NP group were significantly increased, and the serum myocardial enzymes were significantly decreased after the intervention of zinc-selenium tea. Proteins and mRNA expressions of Collagen I and Collagen III in the tea groups were lower than those in the NP group. In the green tea and zinc-selenium tea intervention groups, the disorder and degree of myocardial fiber were alleviated to varying degrees. The disturbance, breakage, and inflammatory cell infiltration of myocardial fibers in zinc-selenium tea and green tea groups were less than that of NP group. After tea intervention, collagen I and collagen III in the myocardium decreased. The intervention effect of zinc-selenium tea was better than that of green tea. Zinc-selenium tea and green tea could interfere with the cardiotoxicity indued by NP, which would alleviate the myocardial fibrosis by reducing expressions of collagen I and collagen III. Moreover, the curative effect of zinc-selenium tea was better than that of green tea.

Maternal micronutrient disturbance as risks of offspring metabolic syndrome

Metabolic syndrome (MetS) is defined as a constellation of individual metabolic disturbances, including central obesity, hypertension, dyslipidemia, and insulin resistance. The established pathogenesis of MetS varies extensively with gender, age, ethnic background, and nutritional status. In terms of nutritional status, micronutrients are more likely to be discounted as essential components of required nutrition than macronutrients due to the small amount required. Numerous observational studies have shown that pregnant women frequently experience malnutrition, especially in developing and low-income countries, resulting in chronic MetS in the offspring due to the urgent and increasing demands for micronutrients during gestation and lactation. Over the past few decades, scientific developments have revolutionized our understanding of the association between balanced maternal micronutrients and MetS in the offspring. Examples of successful individual, dual, or multiple maternal micronutrient interventions on the offspring include iron for hypertension, selenium for type 2 diabetes, and a combination of folate and vitamin D for adiposity. In this review, we aim to elucidate the effects of maternal micronutrient intake on offspring metabolic homeostasis and discuss potential perspectives and challenges in the field of maternal micronutrient interventions.

Essential microelement (copper, selenium, zinc) status according to age and sex in healthy cats

Although domestic cats are one of the most popular companion animals, current knowledge on the fate of micronutrients in cats according to their age, sex, and health is very limited. In this study, 72 whole blood and 54 plasma samples from cats of different ages and sex were collected at three veterinary offices in the Czech Republic, and the copper (Cu), selenium (Se), and zinc (Zn) concentrations were determined using inductively coupled plasma mass spectrometry (ICP-MS). The results showed that Cu was significantly (P < 0.05) higher in both plasma and whole blood of males (980 and 958 μg L-1 in plasma and whole blood, respectively) than in females (741 and 766 μg L-1 in plasma and whole blood, respectively), whereas no significant differences between males and females were found for Se and Zn. Similarly, no significant differences were recorded for any of the three elements according to age, although animals older than 7 years tended to have lower plasma concentrations of all three elements. Hypertrophic cardiomyopathy (HCM) is one of the most prevalent diseases of domestic cats. The potential relationship between the essential microelement status in the blood of cats with HCM vs. cats with no clinical signs of HCM was taken into account, but the limited number of HCM-positive individuals did not allow any clear conclusion. Thus, the potential relationships between micronutrient status in cats and the incidence of HCM should be elucidated in further research.

Bioactive food components and their inhibitory actions in multiple platelet pathways

In addition to hemostasis and thrombosis, blood platelets are involved in various processes such as inflammation, infection, immunobiology, cancer metastasis, wound repair and angiogenesis. Platelets' hemostatic and non-hemostatic functions are mediated by the expression of various membrane receptors and the release of proteins, ions and other mediators. Therefore, specific activities of platelets responsible for the non-hemostatic disease are to be inhibited while leaving the platelet's hemostatic function unaffected. Platelets' anti-aggregatory property has been used as a primary criterion for antiplatelet drugs/bioactives; however, their non-hemostatic activities are not well known. This review describes the hemostatic and non-hemostatic function of human blood platelets and the modulatory effects of bioactive food components. PRACTICAL APPLICATIONS: In this review, we have discussed the antiplatelet effects of several food components. These bioactive compounds inhibit both hemostatic and non-hemostatic pathways involving blood platelet. Platelets have emerged as critical biological factors of normal and pathologic vascular healing and other diseases such as cancers and inflammatory and immune disorders. The challenge for therapeutic intervention in these disorders will be to find drugs and bioactive compounds that preferentially block specific sites implicated in emerging roles of platelets' complicated contribution to inflammation, tumour growth, or other disorders while leaving at least some of their hemostatic function intact.

Does one plus one always equal two? Structural differences between nesfatin-1, -2, and nesfatin-1/2

Nesfatin-1 and -2 are produced from a reaction in which the N-terminus of human Nucleobindin-2 undergoes proteolytical processing. To date, Nucleobindin-2 and/or nesfatin-1 have only been shown to act as peptide hormones. On the other hand, the purpose of nesfatin-2 remains unknown. Since Nucleobindin-2/nesfatin-1 is thought impact the control of a wide range of physiological processes, including energy homeostasis, neurodegenerative processes and carcinogenesis, its ligands/interactions deserve special studies and attention. However, there are no reports about the molecular properties of the proteolytical products of human Nucleobindin-2 in the literature. Hence, this study aimed to analyze the effect of Zn(II) and Ca(II) on human nesfatin-1, -2, and -1/2 structures. Herein, we report that human nesfatin-1 is a member of the intrinsically disordered protein family, as indicated by circular dichroism and analytical ultracentrifugation experiments. In contrast, we found that the human nesfatin-2 and nesfatin-1/2 structures were globular with intrinsically disordered regions. Under Zn(II) treatment, we observed concentration-dependent structurization and compaction of intrinsically disordered nesfatin-1 and its propensity for oligomerization, as well as destabilization of both nesfatin-2 and nesfatin-1/2. Furthermore, dissociation constants for Zn(II) binding by nesfatin-1, nesfatin-2, and nesfatin-1/2 were also reported. Moreover, structurally distinct nesfatin-1 and -2 seem to be interdependent when linked together, as indicated by the observed molecular properties of nesfatin-1/2, which in turn are not a simple sum of the properties exhibited by the former peptides. Thus, herein, we shed new light on the molecular behavior of human nesfatins, which might help to elucidate the complex function of those peptides. Video abstract.

Role of Scl39a13/ZIP13 in cardiovascular homeostasis

Zinc plays a critical role in many physiological processes, and disruption of zinc homeostasis induces various disorders, such as growth retardation, osteopenia, immune deficiency, and inflammation. However, how the imbalance in zinc homeostasis leads to heart disease is not yet fully understood. Cardiovascular diseases are a major cause of death worldwide, and the development of novel therapeutic targets to treat it is urgently needed. We report that a zinc transporter, ZIP13, regulates cardiovascular homeostasis. We found that the expression level of Zip13 mRNA was diminished in both primary neonatal cardiomyocytes and mouse heart tissues treated with the cardiotoxic agent doxycycline. Primary neonatal cardiomyocytes from Zip13 gene-knockout (KO) mice exhibited abnormal irregular arrhythmic beating. RNA-seq analysis identified 606 differentially expressed genes in Zip13-KO mouse-derived primary neonatal cardiomyocytes and Gene ontology (GO) analysis revealed that both inflammation- and cell adhesion-related genes were significantly enriched. In addition, telemetry echocardiography analysis suggested that arrhythmias were likely to occur in Zip13-KO mice, in which elevated levels of the cardiac fibrosis marker Col1a1, vascular inflammation-related gene eNOS, and Golgi-related molecule GM130 were observed. These results indicate the physiological importance of ZIP13-it maintains cardiovascular homeostasis by resolving inflammation and stress response. Our findings suggest that optimizing ZIP13 expression and/or function may improve cardiovascular disease management.

Crystal structures of sildenafil compounds with nitrate and di(citrato)zinc counterions

The crystal structures of sildenafil nitrate trihydrate, (HSild)NO3·3H2O (1), and of the complex salt [Zn(HCit)2]⋅(H2Sild)2·2EtOH·6H2O (2) (where Sild = sildenafil, (HSild) and (H2Sild) are the mono and doubly charged sildenafil captions, and HCit is the triply deprotonated citric acid) have been determined by single-crystal X-ray diffraction. The compounds have been characterized by FTIR spectroscopy and the cations studied by Hirshfeld surfaces calculations. In compound 2, the Zn atom is octahedrally coordinated by two tridentate citrate anions. Doubly charged (H2Sild)2+ cations, solvate EtOH and water molecules of crystallization fill the voids of the crystal structure.

Zinc Ion-crosslinked polycarbonate/heparin composite coatings for biodegradable Zn-alloy stent applications

Zinc and its alloys are the best candidates for biodegradable cardiovascular stents due to their good corrosion rate and biocompatibility in vasculature. However, the cytotoxicity caused by the rapid release of zinc ions during the initial degradation stage and the lack of an anticoagulant function are huge challenges for their practical clinical applications. In this work, we developed a zinc ion-crosslinked polycarbonate/heparin composite coating via electrophoretic deposition (EPD) to improve the biocompatibility and provide anticoagulant functions for Zn-alloy stents. Both electrochemical tests and in vitro immersion tests demonstrated an enhanced corrosion resistance and lower Zn ion release rate of the coated Zn alloys. Enhanced adhesion and proliferation of endothelial cells on coated Zn alloys were also observed, indicating faster reendothelialization than that on bare Zn alloys. Moreover, the surface erosion of the composite coating led to the uniform and long-term release of heparin, which remarkably inhibited the adhesion and activation of platelets, and may have endowed the coated Zn-alloy stents with long-term anticoagulant functions.

Lipoic Acid Restores Binding of Zinc Ions to Human Serum Albumin

Human serum albumin (HSA) is the main zinc(II) carrier in blood plasma. The HSA site with the strongest affinity for zinc(II), multi-metal binding site A, is disrupted by the presence of fatty acids (FAs). Therefore, the FA concentration in the blood influences zinc distribution, which may affect both normal physiological processes and a range of diseases. Based on the current knowledge of HSA’s structure and its coordination chemistry with zinc(II), we investigated zinc interactions and the effect of various FAs, including lipoic acid (LA), on the protein structure, stability, and zinc(II) binding. We combined NMR experiments and isothermal titration calorimetry to examine zinc(II) binding to HSA at a sub-atomic level in a quantitative manner as well as the effect of FAs. Free HSA results indicate the existence of one high-affinity zinc(II) binding site and multiple low-affinity sites. Upon the binding of FAs to HSA, we observed a range of behaviors in terms of zinc(II) affinity, depending on the type of FA. With FAs that disrupt zinc binding, the addition of LA restores HSA’s affinity for zinc ions to the levels seen with free defatted HSA, indicating the possible mechanism of LA, which is effective in the treatment of diabetes and cardiovascular diseases.

No Association of Hair Zinc Concentration with Coronary Artery Disease Severity and No Relation with Acute Coronary Syndromes

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Although zinc (Zn) was reported to have antioxidant, anti-inflammatory and protective properties in CVDs, its association with coronary artery disease (CAD) is still unclear. As methods commonly used to assess Zn levels in blood and urine do not show the full picture of the microelement supply, in this study, the nutritional status of Zn in patients with angiographically confirmed CAD was assessed using inductively coupled plasma optical emission spectrometry. We found no association between Zn and the severity of CAD evaluated with the Coronary Artery Surgery Study Score (p = 0.67). There were no statistically significant differences in Zn levels between patients with acute coronary syndrome and those with stable CAD (p = 0.937). A statically significant negative correlation was observed between Zn content and serum triglyceride concentration (p < 0.05). Patients with type 2 diabetes mellitus were found to have a significantly lower hair Zn content compared to non-diabetic individuals (p < 0.01). The role of Zn in the pathogenesis of CAD and its complications need further well-designed research as the moderation and supplementation of Zn dietary intake could be a simple intervention to reduce the CVDs risk.

No evidence of a prospective relationship between serum zinc and venous thromboembolism in Caucasian men: a cohort study

Serum zinc has been implicated as an important mediator of haemostasis and thrombosis. However, the nature and magnitude of any potential relationship between serum zinc and venous thromboembolism (VTE) is unknown. We aimed to evaluate the prospective association between serum zinc and VTE risk. We analyzed data involving 2472 men aged 42-61 years without a history of VTE in the Kuopio Ischemic Heart Disease population-based cohort study, with the assessment of serum zinc concentrations using atomic absorption spectrometry. Hazard ratios (95% confidence intervals [CIs]) for incident VTE were estimated. A total of 166 VTE cases occurred during a median follow-up of 27.1 years. The risk of VTE per 1 standard deviation increase in serum zinc in analysis adjusted for systolic blood pressure, body mass index, total cholesterol, triglycerides, smoking status, histories of type 2 diabetes and coronary heart disease, medication for dyslipidaemia, alcohol consumption, physical activity, and socioeconomic status was (HR 1.03; 95% CI 0.86-1.22), which remained similar (HR 1.04; 95% CI 0.87-1.23) following further adjustment for inflammation and history of cancer. Comparing the extreme tertiles of serum zinc, the corresponding adjusted HRs (95% CIs) were 0.92 (0.63-1.36) and 0.94 (0.64-1.39), respectively. Imputed results based on 2682 participants and 176 VTE events were consistent with the observed results. In middle-aged and older Finnish men, serum zinc is not associated with future VTE risk. Other large-scale prospective studies conducted in other populations are needed to confirm or refute these findings.

Biodegradable Zn-Cu-Fe Alloy as a Promising Material for Craniomaxillofacial Implants: An in vitro Investigation into Degradation Behavior, Cytotoxicity, and Hemocompatibility

Zinc-based nanoparticles, nanoscale metal frameworks and metals have been considered as biocompatible materials for bone tissue engineering. Among them, zinc-based metals are recognized as promising biodegradable materials thanks to their moderate degradation rate ranging between magnesium and iron. Nonetheless, materials’ biodegradability and the related biological response depend on the specific implant site. The present study evaluated the biodegradability, cytocompatibility, and hemocompatibility of a hot-extruded zinc-copper-iron (Zn-Cu-Fe) alloy as a potential biomaterial for craniomaxillofacial implants. Firstly, the effect of fetal bovine serum (FBS) on in vitro degradation behavior was evaluated. Furthermore, an extract test was used to evaluate the cytotoxicity of the alloy. Also, the hemocompatibility evaluation was carried out by a modified Chandler-Loop model. The results showed decreased degradation rates of the Zn-Cu-Fe alloy after incorporating FBS into the medium. Also, the alloy exhibited acceptable toxicity towards RAW264.7, HUVEC, and MC3T3-E1 cells. Regarding hemocompatibility, the alloy did not significantly alter erythrocyte, platelet, and leukocyte counts, while the coagulation and complement systems were activated. This study demonstrated the predictable in vitro degradation behavior, acceptable cytotoxicity, and appropriate hemocompatibility of Zn-Cu-Fe alloy; therefore, it might be a candidate biomaterial for craniomaxillofacial implants.

Preliminary study of genome-wide association identifies novel susceptibility genes for serum mineral elements in the Chinese Han population

Mineral elements (copper (Cu), zinc (Zn), calcium (Ca), magnesium (Mg), iron (Fe)) play important biological roles in enzymes, hormones, vitamins, and normal metabolism. The deficiency of mineral elements can lead to abnormal physiological functions. And some elements (such as lead (Pb)) are harmful to the body. We aim to identify genetic loci which can influence the serum levels of mineral elements (Cu, Zn, Ca, Mg, Fe, and Pb). Genotyping was performed using Applied Biosystems Axiom™ PMDA in 587 individuals, and 6,423,076 single-nucleotide polymorphisms (SNPs) were available for the genome-wide association study (GWAS) analysis. The association between genotype and phenotype was analyzed using mixed linear regression (additive genetic model) adjusting by age and gender combined with identical by descent (IBD) matrix. Genetic loci in BCHE-LOC105374194, DTX2P1-UPK3BP1-PMS2P11, VAT1L, LINC00908-LINC00683, LINC01310-NONE, and rs6747410 in VWA3B were identified to be associated with serum Cu element concentration (p < 5 × 10^-6). ADAMTSL1 rs17229526 (p = 4.96 × 10^-6) was significantly associated with serum Zn element levels. Genetic loci in LRP1B, PIGZ-MELTF, LINC01365-LINC02502, and HAPLN3 were related to serum Ca element levels (p < 5 ×1 0^-6). Three SNPs in ALPK1, ASAP1-ADCY8 and IER3IP1-SKOR2 also achieved a significant association with Mg element levels (p < 5 × 10^-6). TACSTD2-MYSM1, LRP1B, and ASAP1-ADCY8 showed suggestive associations with serum Fe element levels (p < 5 × 10^-6). Moreover, the two most significant SNPs associated with Pb were rs304234 in CADPS-LINC00698 (p = 2.47 × 10^-6) and rs12666460 in LOC101928211-GPR37 (p = 1.81 × 10^-6). In summary, we reported 19 suggestive loci associated with serum mineral elements in the Chinese Han population. These findings provided new insights into the potential mechanisms regulating serum mineral elements levels.

The Oxidative Balance Orchestrates the Main Keystones of the Functional Activity of Cardiomyocytes

This review is aimed at providing an overview of the key hallmarks of cardiomyocytes in physiological and pathological conditions. The main feature of cardiac tissue is the force generation through contraction. This process requires a conspicuous energy demand and therefore an active metabolism. The cardiac tissue is rich of mitochondria, the powerhouses in cells. These organelles, producing ATP, are also the main sources of ROS whose altered handling can cause their accumulation and therefore triggers detrimental effects on mitochondria themselves and other cell components thus leading to apoptosis and cardiac diseases. This review highlights the metabolic aspects of cardiomyocytes and wanders through the main systems of these cells: (a) the unique structural organization (such as different protein complexes represented by contractile, regulatory, and structural proteins); (b) the homeostasis of intracellular Ca²⁺ that represents a crucial ion for cardiac functions and E-C coupling; and (c) the balance of Zn²⁺, an ion with a crucial impact on the cardiovascular system. Although each system seems to be independent and finely controlled, the contractile proteins, intracellular Ca²⁺ homeostasis, and intracellular Zn²⁺ signals are strongly linked to each other by the intracellular ROS management in a fascinating way to form a "functional tetrad" which ensures the proper functioning of the myocardium. Nevertheless, if ROS balance is not properly handled, one or more of these components could be altered resulting in deleterious effects leading to an unbalance of this "tetrad" and promoting cardiovascular diseases. In conclusion, this "functional tetrad" is proposed as a complex network that communicates continuously in the cardiomyocytes and can drive the switch from physiological to pathological conditions in the heart.

The Cardiac Ryanodine Receptor Provides a Suitable Pathway for the Rapid Transport of Zinc (Zn2+)

The sarcoplasmic reticulum (SR) in cardiac muscle is suggested to act as a dynamic storage for Zn²⁺ release and reuptake, albeit it is primarily implicated in the Ca²⁺ signaling required for the cardiac cycle. A large Ca²⁺ release from the SR is mediated by the cardiac ryanodine receptor (RYR2), and while this has a prominent conductance for Ca²⁺ in vivo, it also conducts other divalent cations in vitro. Since Zn²⁺ and permeant Mg²⁺ have similar physical properties, we tested if the RYR2 channel also conducts Zn²⁺. Using the method of planar lipid membranes, we evidenced that the RYR2 channel is permeable to Zn²⁺ with a considerable conductance of 81.1 ± 2.4 pS, which was significantly lower than the values for Ca²⁺ (127.5 ± 1.8 pS) and Mg²⁺ (95.3 ± 1.4 pS), obtained under the same asymmetric conditions. Despite similar physical properties, the intrinsic Zn²⁺ permeability (P_Ca/P_Zn = 2.65 ± 0.19) was found to be ~2.3-fold lower than that of Mg²⁺ (P_Ca/P_Mg = 1.146 ± 0.071). Further, we assessed whether the channel itself could be a direct target of the Zn²⁺ current, having the Zn²⁺ finger extended into the cytosolic vestibular portion of the permeation pathway. We attempted to displace Zn²⁺ from the RYR2 Zn²⁺ finger to induce its structural defects, which are associated with RYR2 dysfunction. Zn²⁺ chelators were added to the channel cytosolic side or strongly competing cadmium cations (Cd²⁺) were allowed to permeate the RYR2 channel. Only the Cd²⁺ current was able to cause the decay of channel activity, presumably as a result of Zn²⁺ to Cd²⁺ replacement. Our findings suggest that the RYR2 channel can provide a suitable pathway for rapid Zn²⁺ escape from the cardiac SR; thus, the channel may play a role in local and/or global Zn²⁺ signaling in cardiomyocytes.

Serum/Plasma Zinc Is Apparently Increased in Ischemic Stroke: a Meta-analysis

Zinc (Zn) is found in many neuronal pathways in the brain and has implications for neuromodulation and cerebrovascular disease. However, the association between Zn levels and stroke risk remains controversial. Therefore, we conducted a meta-analysis to explore these relationships. A systematic literature search using PubMed, EMBASE database, and Google Scholar was performed for relevant articles from inception to August 2020. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were considered the effect sizes and statistical analyses were performed using Stata 12.0. A total of 12 studies involving 1878 cases of stroke and 1754 controls were enrolled. Overall, the meta-analysis demonstrated no significant difference in Zn levels between the stroke group and control group (SMD =-0.18, 95% CI =-0.69 to 0.32, P = 0.480). Subgroup analysis showed that type of stroke had an influence on the Zn levels. A meta-analysis of nine ischemic stroke (IS) studies, which included 1645 cases and 1585 controls, revealed that the Zn levels were significantly higher in IS patients than in controls (SMD (95% CI): 0.61(0.04, 1.19), P = 0.036), but no significant association was found between Zn levels and risk of hemorrhagic stroke (P = 0.113). Egger's test indicated no significant publication bias. This meta-analysis indicates that higher Zn levels may be associated with increased risk of IS; however, these findings should be further confirmed.

Zinc deficiency as a possible risk factor for increased susceptibility and severe progression of Corona Virus Disease 19

The importance of Zn for human health becomes obvious during Zn deficiency. Even mild insufficiencies of Zn cause alterations in haematopoiesis and immune functions, resulting in a proinflammatory phenotype and a disturbed redox metabolism. Although immune system malfunction has the most obvious effect, the functions of several tissue cell types are disturbed if Zn supply is limiting. Adhesion molecules and tight junction proteins decrease, while cell death increases, generating barrier dysfunction and possibly organ failure. Taken together, Zn deficiency both weakens the resistance of the human body towards pathogens and at the same time increases the danger of an overactive immune response that may cause tissue damage. The case numbers of Corona Virus Disease 19 (COVID-19) are still increasing, which is causing enormous problems for health systems and economies. There is an urgent need to reduce both the number of severe cases and the resulting deaths. While therapeutic options are still under investigation, and first vaccines have been approved, cost-effective ways to reduce the likelihood of or even prevent infection, and the transition from mild symptoms to more serious detrimental disease, are highly desirable. Nutritional supplementation might be an effective option to achieve these aims. In this review, we discuss known Zn deficiency effects in the context of an infection with Severe Acute Respiratory Syndrome-Coronavirus-2 and its currently known pathogenic mechanisms and elaborate on how severe pre-existing Zn deficiency may pre-dispose patients to a severe progression of COVID-19. First published clinical data on the association of Zn homoeostasis with COVID-19 and registered studies in progress are listed.

A review on current research status of the surface modification of Zn-based biodegradable metals

Recently, zinc and its alloys have been proposed as promising candidates for biodegradable metals (BMs), owning to their preferable corrosion behavior and acceptable biocompatibility in cardiovascular, bone and gastrointestinal environments, together with Mg-based and Fe-based BMs. However, there is the desire for surface treatment for Zn-based BMs to better control their biodegradation behavior. Firstly, the implantation of some Zn-based BMs in cardiovascular environment exhibited intimal activation with mild inflammation. Secondly, for orthopedic applications, the biodegradation rates of Zn-based BMs are relatively slow, resulting in a long-term retention after fulfilling their mission. Meanwhile, excessive Zn2+ release during degradation will cause in vitro cytotoxicity and in vivo delayed osseointegration. In this review, we firstly summarized the current surface modification methods of Zn-based alloys for the industrial applications. Then we comprehensively summarized the recent progress of biomedical bulk Zn-based BMs as well as the corresponding surface modification strategies. Last but not least, the future perspectives towards the design of surface bio-functionalized coatings on Zn-based BMs for orthopedic and cardiovascular applications were also briefly proposed.

Advances on biodegradable zinc-silver-based alloys for biomedical applications

The biodegradable metals have great potential for the biomedical applications, which could be gradually degraded, absorbed, or excreted in the human body, avoiding the removal though secondary surgery. Zinc-based alloys are novel series of degradable metals for medical applications, and they are gaining lots of attention in the research field of absorbable metals. Zinc-silver (Zn-Ag) alloys show superior mechanical strength, good biodegradability, biocompatibility, and antibacterial properties, which render them to be potential candidates for biomedical applications. In this paper, we reviewed the development of Zn-Ag alloys in terms of mechanical properties, degradabilities, biocompatibilities, antibacterial properties, and potential applications in dentistry.

Association between serum zinc concentrations and metabolic risk factors among Chinese children and adolescents

The aim of the present study was to examine whether serum Zn concentrations were associated with metabolic risk factors in Chinese children and adolescents. This was a cross-sectional study including 3241 participants, aged 6 to 17 years, from Jiangsu, China. Metabolic risk factors included fasting glucose (FG), total cholesterol (TC), TAG, HDL-cholesterol, LDL-cholesterol, systolic blood pressure and diastolic blood pressure. Data were analysed using multi-variable linear regression and generalised additive models, which were adjusted for age, sex, high-sensitive C-reactive protein, estimated glomerular filtration rate, BMI and region of residence, to assess the associations of serum Zn concentrations with metabolic risk factors. We observed a negative association between serum Zn concentrations and FG (coefficient = -0·532; 95 % CI -0·569, -0·495; P < 0·001). Moreover, TC (coefficient = 0·175; 95 % CI 0·127, 0·222; P < 0·001), HDL-cholesterol (coefficient = 0·137; 95 % CI 0·082, 0·193; P < 0·001) and LDL-cholesterol (coefficient = 0·195; 95 % CI 0·128, 0·263; P < 0·001) were found to be positively associated with Zn levels. A generalised additive model showed that the negative association between serum Zn and FG was weak at lower serum Zn concentrations and was stronger with the increase in serum Zn concentrations. Additionally, a U-shaped association between serum Zn and TAG was observed. Serum Zn concentrations were associated with FG, TC, TAG, HDL-cholesterol and LDL-cholesterol levels in Chinese children and adolescents. Lower levels of serum Zn were more likely related to a poor metabolic status.

Slc39a2-Mediated Zinc Homeostasis Modulates Innate Immune Signaling in Phenylephrine-Induced Cardiomyocyte Hypertrophy

Zinc dyshomeostasis has been involved in the pathogenesis of cardiac hypertrophy; however, the dynamic regulation of intracellular zinc and its downstream signaling in cardiac hypertrophy remain largely unknown. Using Zincpyr1 staining, we found a significant decrease of intracellular Zinc concentration in phenylephrine (PE)-induced hypertrophy of neonatal rat ventricular myocytes (NRVMs). We then screened SLC39 family members responsible for zinc uptake and identified Slc39a2 as the only one altered by PE treatment. Slc39a2 knockdown in NRVMs reduced the intracellular Zinc level, and exacerbated the hypertrophic responses to PE treatment. In contrast, adenovirus-mediated Slc39a2 overexpression enhanced zinc uptake and suppressed PE-induced Nppb expression. RNA sequencing analysis showed a pro-hypertrophic transcriptome reprogramming after Slc39a2 knockdown. Interestingly, the innate immune signaling pathways, including NOD signaling, TOLL-like receptor, NFκB, and IRFs, were remarkably enriched in the Slc39a2-regulated genes. Slc39a2 deficiency enhanced the phosphorylation of P65 NFκB and STAT3, and reduced the expression of IκBα. Finally, the expression of IRF7 was significantly increased by Slc39a2 knockdown, which was in turn suppressed by IRF7 knockdown. Our data demonstrate that zinc homeostasis mediated by a Slc39a2/IRF7 regulatory circuit contributes to the alteration of innate immune signaling in cardiomyocyte hypertrophy.

Factors associated with inflamm-aging in institutionalized older people

The increase in inflammatory cytokines associated with a reduction in the bioavailability of zinc has been used as a marker for inflammation. Despite the high inflammatory state found in institutionalized older individuals, few studies have proposed verifying the factors associated with this condition in this population. To verify the factors associated with inflamm-aging in institutionalized older people. A total of 178 older people (≥ 60 years old) living in nursing homes in Natal/RN were included in the study. Cluster analysis was used to identify three groups according to their inflammatory state. Analysis anthropometric, biochemical, sociodemographic, and health-related variables was carried out. In sequence, an ordinal logistic regression was performed for a confidence level of 95% in those variables with p < 0.20 in the bivariate analysis. IL-6, TNF-α, zinc, low-density lipids (LDL), high-density lipids (HDL), and triglycerides were associated with inflamm-aging. The increase of 1 unit of measurement of LDL, HDL, and triglycerides increased the chance of inflammation-aging by 1.5%, 4.1%, and 0.9%, respectively, while the oldest old (≥ 80 years old) had an 84.9% chance of presenting inflamm-aging in relation to non-long-lived older people (< 80 years). The association between biochemical markers and inflamm-aging demonstrates a relationship between endothelial injury and the inflammatory state. In addition, the presence of a greater amount of fat in the blood may present a higher relative risk of death.

Workability, quality of life and cardiovascular risk markers in aging nightshift workers: a pilot study

Background

In aging healthcare professionals, multiple stressors such as night work may affect life and work satisfaction and risk for chronic diseases (e.g. cardiovascular disease [CVD]). In this pilot study we compared workability, quality of life (QoL), and CVD risk markers between night shift and day workers.

Methods

We included 70 hospital employees (mean age 52 ± 4 years, 91.4% female): 32 rotating night shift workers (> 3 nights/month) and 38 permanent day workers. In addition to sociodemographic, lifestyle, and sleep characteristics, we assessed i) workability index (WAI), ii) QoL (World Health Organization Quality of Life [WHOQOL-Bref]) and iii) CVD risk markers, i.e. carotid ultrasound measurements, and biomarkers (NTproBNP, CRP, IL‑6, LDL, ferritin, copper, zinc, and selenium). WAI, QoL, and CVD risk markers were compared between night and day workers. In a subgroup of participants (N = 38) with complete data, we used quantile regression analysis to estimate age and multivariate adjusted differences in biomarker levels.

Results

We found no differences in the domains of QoL (physical health, psychological, social relationships, and environment) and WAI scores between night and day workers. Night shift workers were less likely to report excellent workability than day workers, although differences were not statistically significant. Night shift workers reported more sleep problems (73.1% vs. 55.6%) and tended to have lower zinc levels and higher inflammatory markers (CRP, IL‑6, ferritin), but differences were not significant after adjusting for potential confounders.

Conclusions

Workability, QoL and CVD markers did not significantly differ between rotating night shift and day workers in this small pilot study. Sleep problems and inflammatory marker levels carry implications for occupational health.

Supplementary Information

The online version of this article (10.1007/s00508-021-01928-6) contains supplementary material, which is available to authorized users.

The Association between Zinc and Copper Circulating Levels and Cardiometabolic Risk Factors in Adults: A Study of Qatar Biobank Data

Cardiometabolic risk (CMR) factors increase the likelihood of developing cardiovascular diseases (CVD). In Qatar, 24% of the total deaths are attributed to CVDs. Several nutritional disturbances have been linked to high risk of CVD. Many studies have discussed the effects of zinc (Zn) and copper (Cu) on CMR factors; however, evidence has been controversial. This investigated the association between CMR factors and the status of Zn and Cu, in addition to Zn/Cu ratio. A total of 575 Qatari men and women aged 18 years and older were obtained from Qatar Biobank. Plasma levels of Zn and Cu were determined using inductively coupled plasma mass spectrometry (ICP-MS). Anthropometric data and CMR factors were determined using standard methods. Adjusted associations between trace minerals and CMR were estimated by logistic regression. Partial correlation was performed to test the strength of the associations. Zn was not strongly correlated (p-value ˃ 0.01) or significantly associated with CMR factors and metabolic syndrome (MetS). Cu levels correlated positively with body mass index (BMI) (0.23; p ˂ 0.001), pulse rate (PR) (0.18; p ˂ 0.001), total cholesterol (0.13; p = 0.01), and high-density lipoproteins (HDL) (0.27; p ˂ 0.001); and negatively with diastolic blood pressure (DBP) (−0.13; p = 0.01). High plasma Cu significantly decreased the risk of metabolic syndrome (MetS) (0.121; p ˂ 0.001). Furthermore, Zn/Cu ratio positively correlated with waist circumference (0.13; p = 0.01), systolic blood pressure (0.13; p ˂ 0.01), and DBP (0.14; p ˂ 0.01); and negatively with BMI (−0.19; p ˂ 0.001), PR (−0.17; p ˂ 0.001), and HDL (−0.27; p ˂ 0.001). High Zn/Cu ratio increased the prevalence of low HDL (4.508; p ˂ 0.001) and MetS (5.570; p ˂ 0.01). These findings suggest that high plasma Cu levels are associated with a protective effect on DBP, HDL and MetS and that high plasma Zn/Cu ratio is associated with the risk of having low HDL and MetS.

Zinc as a Biomarker of Cardiovascular Health

The importance of zinc (Zn) for cardiovascular health continuously gains recognition. As shown earlier, compromised Zn homeostasis and prolonged inflammation are common features in various cardiovascular diseases (CVDs). Similarly, Zn biochemistry alters several vascular processes, and Zn status is an important feature of cardiovascular health. Zn deficiency contributes to the development of CVDs; thus, Zn manipulations, including Zn supplementation, are beneficial for preventing and treating numerous cardiovascular (CV) disorders. Finally, additional long-term, well-designed studies, performed in various population groups, should be pursued to further clarify significant relationships between Zn and CVDs.

A Case of Spontaneous Coronary Artery Dissection in a Patient with Severe Anorexia Nervosa

There are a variety of cardiac complications of anorexia nervosa including arrythmias, valvopathies, and myopathies. Spontaneous coronary artery dissection (SCAD) has not been widely reported among this patient population. This case report describes a middle-aged female with severe anorexia nervosa, who presented after being found unconscious, and was later diagnosed with SCAD. A literature review revealed one previous case of SCAD in a patient with anorexia nervosa and prompted a discussion of a series of possible predisposing factors for SCAD in this patient population. Patients with anorexia nervosa may be at increased risk for SCAD due to their complex nutritional and endocrine imbalances. This case highlights a possible underdiagnosed cardiac complication of anorexia nervosa.

Selenium, Copper, Zinc Concentrations and Cu/Zn, Cu/Se Molar Ratios in the Serum of Patients with Acute Ischemic Stroke in Northeastern Poland-A New Insight into Stroke Pathophysiology

Background: In recent years, trace elements (TEs) have gained considerable attention in the course of treatment and diagnosis of ischemic stroke. The purpose of the conducted research was to determine the trace mineral status (Se, Cu, Zn, Cu/Zn ratio, and Cu/Se ratio) in patients with acute ischemic stroke compared to the population of healthy people in the northeastern region of Poland. Materials and methods: 141 patients with acute ischemic stroke (AIS) and 69 healthy control subjects were examined. The serum concentrations of mineral components were assessed by the atomic absorption spectrometry method. Clinical parameters were updated based on medical records. Results: The serum Se and Zn concentrations were significantly decreased (p < 0.0001; p < 0.0001) in patients with AIS compared with healthy control subjects. However, no significant differences were revealed in terms of the serum Cu concentration (p = 0.283). As expected, we found that the serum Cu/Zn and Cu/Se molar ratios were significantly higher (p = 0.001; p < 0.0001) in patients with AIS compared with healthy control subjects. Conclusions: Disturbed metal homeostasis is a significant contributor to AIS pathogenesis. Furthermore, marked disruption of the serum Cu/Zn and Cu/Se molar ratios could serve as a valuable indicator of AIS patients’ nutritional status and oxidative stress levels.

Association of Zinc and Copper Status with Cardiovascular Diseases and their Assessment Methods: A Review Study

Cardiovascular disease (CVD) is the leading cause of mortality, morbidity, and financial losses and has a high prevalence across the world. Several studies have investigated the association between various CVD types with zinc and copper status as the essential minerals for the human body, proposing contradictory and similar results. This narrative review aimed to survey the correlations between zinc and copper status in the human body and some risk factors of CVD, as well as the assessment methods of zinc and copper status in the human body. According to the reviewed articles, zinc and copper deficiency may increase the risk of coronary heart disease, valvular regurgitation, and myocardial lesions, cardiac hypertrophy. Furthermore, it could lead to the expanded mitochondrial compartments of the heart, acute and chronic heart failure, and elevation of inflammation markers, such as interleukin-1 (IL-1) and IL-6. Two methods are primarily used for the assessment of zinc and copper in the human body, including the direct method (measurement of their concentrations) and indirect method (determining the activity of zinc- and copper-containing enzymes). Both these methods are considered reliable for the assessment of the zinc and copper levels in healthy individuals. Serum or plasma levels of these elements are also commonly used for the assessment of the correlation between zinc and copper status and CVD. But, which one is a more accurate indicator in relation to CVD is not yet clear; therefore, further studies are required in this field.

New Zn3Mg-xY Alloys: Characteristics, Microstructural Evolution and Corrosion Behavior

Zinc biodegradable alloys attracted an increased interest in the last few years in the medical field among Mg and Fe-based materials. Knowing that the Mg element has a strengthening influence on Zn alloys, we analyze the effect of the third element, namely, Y with expected results in mechanical properties improvement. Ternary ZnMgY samples were obtained through induction melting in Argon atmosphere from high purity (Zn, Mg, and Y) materials and MgY (70/30 wt%) master alloys with different percentages of Y and keeping the same percentage of Mg (3 wt%). The corrosion resistance and microhardness of ZnMgY alloys were compared with those of pure Zn and ZnMg binary alloy. Materials were characterized using scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), X-ray diffraction (XRD), linear and cyclic potentiometry, and immersion tests. All samples present generalized corrosion after immersion and electro-corrosion experiments in Dulbecco solution. The experimental results show an increase in microhardness and indentation Young Modulus following the addition of Y. The formation of YZn12 intermetallic phase elements with a more noble potential than pure Zinc is established. A correlation is obtained between the appearance of new Y phases and aggressive galvanic corrosion.

Short-Term Inhalation of Ultrafine Zinc Particles Could Alleviate Cardiac Dysfunctions in Rats of Myocardial Infarction

It is not clear for inhalation of ultrafine metal particles in air pollution to impair human health. In the study, we aimed to investigate whether short-term (4 weeks) inhalation of ultrafine zinc particles could deteriorate the cardiac and hemodynamic functions in rats of myocardial infarction (MI). MI was induced in Wistar rats through coronary artery ligation surgery and given an inhalation of ultrafine zinc particles for 4 weeks (post-MI 4 weeks, 4 days per week, and 4 h per day). Cardiac strain and strain rate were quantified by the speckle tracking echocardiography. The pressure and flow wave were recorded in the carotid artery and analyzed by using the Womersley model. Myocardial infarction resulted in the LV wall thinning, LV cavity dilation, remarkable decrease of ejection fraction, dp/dt Max, −dp/dt Min, myocardial strain and strain rates, and increased LV end-diastolic pressure, as well as impaired hemodynamic environment. The short-term inhalation of ultrafine zinc particles significantly alleviated cardiac and hemodynamic dysfunctions, which could protect from the MI-induced myocardial and hemodynamic impairments albeit it is unknown for the long-term inhalation.

Trace element, immune and opioid biomarkers of unstable angina, increased atherogenicity and insulin resistance: Results of machine learning

BACKGROUND

Aberrations in endothelial cells, immune and oxidative pathways are associated with atherosclerosis (ATS) and unstable angina (UA). The role of trace elements, minerals, and the endogenous opioid system (EOS) in UA are less well established.

METHODS

We measured lipid, insulin resistance (IR), and immune, trace element (copper and zinc), mineral (magnesium, calcium), EOS (β-endorphin and mu-opioid receptor (MOR)) and antioxidant (vitamin D3) biomarkers in patients with ATS (n = 60) and UA (n = 60) and healthy controls (n = 58).

RESULTS

ATS patients showed increased atherogenic and IR indices, IL-6, IL-10, β-endorphin, copper and magnesium, and lower zinc than healthy controls. Logistic regression showed that UA was significantly discriminated from ATS without UA with an accuracy of 85.5 % using calcium, IL-10, β-endorphin, MOR, triglycerides, IR (all positively), and copper and vitamin D3 (inversely). Neural networks showed that UA was discriminated from ATS without UA with an area under the ROC curve of 0.942 using MOR, β-endorphin, calcium, insulin resistance, vitamin D3 and copper as input variables. We found that 50.0 % of the variance in IR was explained by the regression on copper, IL-10, IL-6 (all positively), and zinc (inversely), while 32.9 % of the variance in the atherogenic index of plasma was explained by copper, IL-10 (both positively), and magnesium (inversely).

CONCLUSION

UA is not only mediated by insulin resistance, atherogenicity, and immune disorders, but also by aberrations in the endogenous opioid system and trace elements as well as lowered antioxidant levels. Copper appears to play a key role in IR and atherogenicity.

Association of Circulating and Aortic Zinc and Copper Levels with Clinical Abdominal Aortic Aneurysm: a Meta-analysis

It remains obscure whether circulating aortic zinc (Zn) and copper (Cu) levels are associated with the progress of human abdominal aortic aneurysms (AAA). Therefore, we conducted a meta-analysis to explore this relationship. A literature search on circulating and aortic zinc and copper levels and AAA patients was conducted using online databases including PubMed, Embase, and Cochrane up to March 20, 2019. To compare Zn and Cu concentrations in AAA patients with those in aortic occlusive disease (AOD) patients or healthy aorta donors or healthy blood donors, pooled weighted mean difference (WMD) and its 95% confidence interval (CI) were calculated. Subgroup analysis, sensitivity analysis, and meta-regression analysis were applied to explain the heterogeneity and evaluate the robustness of combined results. A total of 10 cross-sectional studies, including 252 cases and 304 controls, were used for meta-analysis. We found that circulating zinc and Zn/Cu ratio in AAA patients were significantly lower [WMD (95%CI): - 2.23 (- 4.10, - 0.36); - 0.18 (- 0.31, - 0.05), respectively] than those in non-AAA patients. Similarly, aneurysmal aorta had significantly lower zinc levels and Zn/Cu ratio [WMD (95%CI): - 9.22 (- 15.37, - 3.07); - 6.46 (- 10.14, - 2.77), respectively] than those in control group. No difference in circulating or aortic copper levels was noted between AAA patients and control group [WMD (95%CI): - 0.24 (- 2.09, 1.61); 0.30 (- 0.01, 0.61) , respectively]. Our meta-analysis suggests that zinc levels and Zn-Cu ratio, but not copper levels, may influence aneurysmal progress of AAA.