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Li K, Yang Y, Zhao J, Zhou Q, Li Y, Yang M, Hu Y, Xu J, Zhao M, Xu Q. Associations of metals and metal mixtures with glucose homeostasis: A combined bibliometric and epidemiological study. JOURNAL OF HAZARDOUS MATERIALS 2024; 470:134224. [PMID: 38583198 DOI: 10.1016/j.jhazmat.2024.134224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
This study employs a combination of bibliometric and epidemiological methodologies to investigate the relationship between metal exposure and glucose homeostasis. The bibliometric analysis quantitatively assessed this field, focusing on study design, predominant metals, analytical techniques, and citation trends. Furthermore, we analyzed cross-sectional data from Beijing, examining the associations between 14 blood metals and 6 glucose homeostasis markers using generalized linear models (GLM). Key metals were identified using LASSO-PIPs criteria, and Bayesian kernel machine regression (BKMR) was applied to assess metal mixtures, introducing an "Overall Positive/Negative Effect" concept for deeper analysis. Our findings reveal an increasing research interest, particularly in selenium, zinc, cadmium, lead, and manganese. Urine (27.6%), serum (19.0%), and whole blood (19.0%) were the primary sample types, with cross-sectional studies (49.5%) as the dominant design. Epidemiologically, significant associations were found between 9 metals-cobalt, copper, lithium, manganese, nickel, lead, selenium, vanadium, zinc-and glucose homeostasis. Notably, positive-metal mixtures exhibited a significant overall positive effect on insulin levels, and notable interactions involving nickel were identified. These finding not only map the knowledge landscape of research in this domain but also introduces a novel perspective on the analysis strategies for metal mixtures.
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Affiliation(s)
- Kai Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Yisen Yang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Jiaxin Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Quan Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Yanbing Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Ming Yang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Yaoyu Hu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Jing Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Meiduo Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China.
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Yang J, Cheng Z, Zhang D, Zheng T, Yin C, Liu S, Zhang L, Wang Z, Wang Y, Chen R, Dou Q, Bai Y. A nested case-control study of serum zinc and incident diabetes among Chinese adults: Effect modifications and mediation analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 910:168678. [PMID: 37981151 DOI: 10.1016/j.scitotenv.2023.168678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/04/2023] [Accepted: 11/16/2023] [Indexed: 11/21/2023]
Abstract
Although numerous evidences suggest that zinc may have a beneficial impact on preventing and treating diabetes, findings from the population studies are inconclusive. To address this gap, we conducted a nested case-control study, employing restricted cubic splines and a conditional logistic regression model to explore the association between serum zinc levels and the risk of diabetes. We also assessed potential effect modifications through stratified analyses and examined the mediating effects of metabolic indicators using a multiclass mediation effect model. We measured baseline serum zinc concentrations using Inductively Coupled Plasma Mass Spectrometry in a cohort of 2156 participants, including 1078 individuals with diabetes and 1078 matched controls. Our findings revealed a 51 % increased risk of diabetes when comparing the highest quartile (Q4) to the lowest quartile (Q1) of serum zinc levels (Odds Ratio [95 % Confidence Interval]: 1.51 [1.09, 2.09]). There was a positive linear dose-response relationship between serum zinc and diabetes risk (P overall ≤0.01, P nonlinear = 0.20). Effect modifications were evident between serum zinc and factors such as educational attainment, body mass index, alcohol index, family history of diabetes, history of hypertension, coronary heart disease, and stroke, all of which influenced the risk of diabetes (all P-interaction <0.05). Moreover, our study identified significant indirect effects of triglycerides levels on diabetes risk for participants in the third (Q3) and fourth (Q4) quartiles of serum zinc, with mediation proportions of 19.23 % and 19.28 %, respectively. A significant indirect effect of alanine aminotransferase on diabetes risk was found for those in the Q4 of serum zinc, with a mediation proportion of 12.05 %. Considering these findings, it is advisable to conduct testing for serum zinc level and exercise caution when considering zinc supplementation. Furthermore, our results emphasized the necessity for additional validation through large-sample prospective population studies and experimental research.
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Affiliation(s)
- Jingli Yang
- School of Public Health, Lanzhou University, Lanzhou 730000, China; College of Earth and Environmental Sciences, Lanzhou University, Lanzhou 730000, China
| | - Zhiyuan Cheng
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Desheng Zhang
- Workers' Hospital of Jinchuan Corporation, Jinchuan Group CO., LTD, Jinchang, China
| | - Tongzhang Zheng
- School of Public Health, Brown University, Providence, RI 02901, USA
| | - Chun Yin
- Workers' Hospital of Jinchuan Corporation, Jinchuan Group CO., LTD, Jinchang, China
| | - Simin Liu
- School of Public Health, Brown University, Providence, RI 02901, USA
| | - Lizhen Zhang
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Zhongge Wang
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Yufeng Wang
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Ruirui Chen
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Qian Dou
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Yana Bai
- School of Public Health, Lanzhou University, Lanzhou 730000, China; College of Earth and Environmental Sciences, Lanzhou University, Lanzhou 730000, China.
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Kim MJ, Woo HW, Shin MH, Koh SB, Kim HC, Kim YM, Kim MK. Habitual intake of iron, copper, and zinc and the risk of type 2 diabetes in a prospective cohort: The CAVAS (Cardiovascular Disease Association Study). Nutr Metab Cardiovasc Dis 2024; 34:167-176. [PMID: 38000990 DOI: 10.1016/j.numecd.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 10/03/2023] [Accepted: 10/03/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND AND AIMS Unlike iron, evidence of the association between dietary copper and zinc intake and type 2 diabetes (T2D) risk is limited. This study aimed to examine the prospective associations of dietary intake of iron (total, plant-based, and animal-based), copper, and zinc with T2D risk among adults aged ≥40 years. METHODS AND RESULTS For 16,666 participants, dietary intakes (baseline, cumulative average, and most recent) of iron, copper, and zinc were calculated from repeated food frequency questionnaires; a modified Poisson regression model with a robust error estimator was conducted. In men, positive associations between T2D and baseline dietary intake of Cu and Zn, cumulative average dietary intake of Fe (total and animal-based), Cu and Zn, and most recent dietary intake of Fe (total, plant-based, and animal-based), Cu, and Zn [most recent diet: for total Fe, IRR(95%CI) = 1.93 (1.41-2.64); for plant-based Fe, 1.56 (1.15-2.11); for animal-based Fe, 1.44 (1.09-1.90); for Cu, 3.17 (2.33-4.30); for Zn, 2.18 (1.64-2.89)] were observed, where as in women, there were positive associations of only cumulative average dietary Zn intake and most recent dietary intake of plant-based Fe, Cu, and Zn [most recent diet: for plant-based Fe, 1.30 (1.01-1.68); for Cu, 1.62 (1.27-2.08); for Zn, 2.07 (1.61-2.66)]. CONCLUSION Dietary intakes of iron (total, plant-based, and animal-based), copper, and zinc may be positively associated with T2D risk. These positive associations are predominantly observed in most recent diet and appear to be stronger compared to baseline and cumulative average diet.
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Affiliation(s)
- Min-Ji Kim
- Department of Epidemiology and Health Statistics, Graduate School of Public Health, Hanyang University, Seoul, South Korea; Institute for Health and Society, Hanyang University, Seoul, South Korea
| | - Hye Won Woo
- Institute for Health and Society, Hanyang University, Seoul, South Korea; Department of Preventive Medicine, Hanyang University, College of Medicine, Seoul, South Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University, Medical School, Gwangju, South Korea
| | - Sang Baek Koh
- Department of Preventive Medicine and Institute of Occupational Medicine, Yonsei Wonju College of Medicine, Wonju, South Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine and Public Health, Yonsei University, College of Medicine, Seoul, South Korea
| | - Yu-Mi Kim
- Department of Epidemiology and Health Statistics, Graduate School of Public Health, Hanyang University, Seoul, South Korea; Institute for Health and Society, Hanyang University, Seoul, South Korea; Department of Preventive Medicine, Hanyang University, College of Medicine, Seoul, South Korea
| | - Mi Kyung Kim
- Department of Epidemiology and Health Statistics, Graduate School of Public Health, Hanyang University, Seoul, South Korea; Institute for Health and Society, Hanyang University, Seoul, South Korea; Department of Preventive Medicine, Hanyang University, College of Medicine, Seoul, South Korea.
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Mba CM, Jones KS, Forouhi NG, Imamura F, Assah F, Mbanya JC, Wareham NJ. The association between plasma zinc concentrations and markers of glucose metabolism in adults in Cameroon. Br J Nutr 2023; 130:1220-1227. [PMID: 36693633 PMCID: PMC7615052 DOI: 10.1017/s0007114523000223] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
An abnormal Zn status has been suggested to play a role in the pathogenesis of type 2 diabetes. However, epidemiological studies of the relationship between plasma Zn concentrations and diabetes are sparse and inconclusive. We aimed to investigate the association between plasma Zn concentrations and glycaemic markers (fasting glucose, 2-h glucose and homeostatic model assessment of insulin resistance) in rural and urban Cameroon. We studied 596 healthy adults (63·3 % women) aged 25-55 years in a population-based cross-sectional study. The mean plasma Zn concentration was 13·7 ± 2·7 µmol/L overall, with higher levels in men (14·4 ± 2·9 µmol/l) than in women (13·2 ± 2·6 µmol/l), P-value < 0·0001. There was an inverse relationship between tertiles of plasma Zn and 2-h glucose concentrations (P-value for linear trend = 0·002). The difference in 2-h glucose between those in the highest tertile of plasma Zn compared to the lowest was -0·63 (95 % CI - 1·02, -0·23) mmol/l. This remained significant after adjusting for age, sex, smoking status, alcohol intake, education level, area of residence, adiposity and objectively measured physical activity -0·43(-0·82, -0·04). Similar inverse associations were observed between plasma Zn concentrations and fasting glucose and homeostatic model assessment of insulin resistance when adjusted for socio-demographic and health-related behavioural characteristics. The current findings of an inverse association between plasma Zn concentrations and several markers of glucose homeostasis, together with growing evidence from intervention studies, suggest a role for Zn in glucose metabolism. If supported by further evidence, strategies to improve Zn status in populations may provide a cheap public health prevention approach for diabetes.
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Affiliation(s)
- Camille M. Mba
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Kerry S. Jones
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- National Institute for Health Research Biomedical Research Centre Nutritional Biomarker Laboratory, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Nita G. Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Felix Assah
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Jean Claude Mbanya
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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Hara T, Yoshigai E, Ohashi T, Fukada T. Zinc in Cardiovascular Functions and Diseases: Epidemiology and Molecular Mechanisms for Therapeutic Development. Int J Mol Sci 2023; 24:ijms24087152. [PMID: 37108314 PMCID: PMC10139119 DOI: 10.3390/ijms24087152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/04/2023] [Accepted: 04/09/2023] [Indexed: 04/29/2023] Open
Abstract
Zinc is an essential trace element that plays an important physiological role in numerous cellular processes. Zinc deficiency can result in diverse symptoms, such as impairment of the immune response, skin disorders, and impairments in cardiovascular functions. Recent reports have demonstrated that zinc acts as a signaling molecule, and its signaling pathways, referred to as zinc signals, are related to the molecular mechanisms of cardiovascular functions. Therefore, comprehensive understanding of the significance of zinc-mediated signaling pathways is vital as a function of zinc as a nutritional component and of its molecular mechanisms and targets. Several basic and clinical studies have reported the relationship between zinc level and the onset and pathology of cardiovascular diseases, which has attracted much attention in recent years. In this review, we summarize the recent findings regarding the effects of zinc on cardiovascular function. We also discuss the importance of maintaining zinc homeostasis in the cardiovascular system and its therapeutic potential as a novel drug target.
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Affiliation(s)
- Takafumi Hara
- Molecular and Cellular Physiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan
| | - Emi Yoshigai
- Molecular and Cellular Physiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan
| | - Takuto Ohashi
- Molecular and Cellular Physiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan
| | - Toshiyuki Fukada
- Molecular and Cellular Physiology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima 770-8514, Japan
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Effect of Black Cumin Cake Addition on the Chemical Composition, Glycemic Index, Antioxidant Activity, and Cooking Quality of Durum Wheat Pasta. Molecules 2022; 27:molecules27196342. [PMID: 36234886 PMCID: PMC9573312 DOI: 10.3390/molecules27196342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/22/2022] Open
Abstract
Pasta is a good carrier for plant enrichment substances due to its popularity among consumers. The purpose of the study was to investigate the functional potential and optimize the recipe of pasta made from durum semolina with the addition of black cumin cake at the level of 5, 10, 15, 20, and 25%. The use of black cumin cake resulted in a statistically significant (p ≤ 0.05) increase in the content of protein, fat, ash, and fiber, including both the insoluble and soluble fractions. A reduction in the digestible carbohydrate content, in vitro starch hydrolysis index (HI), was observed. Pasta with a reduced glycemic index (GI) compared to the semolina control was obtained. The content of polyphenols, including flavonoids, in the cake-enriched pasta increased significantly (p ≤ 0.05), which resulted in higher antioxidant activity against DPPH. The increase in the iron content was over 2.5 times higher in the sample with the 25% addition of black cumin cake than in the control sample. The functional addition significantly (p ≤ 0.05) increased the loss of dry matter and influenced the cooking time of pasta.
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Triangulating evidence for the causal impact of single-intervention zinc supplement on glycaemic control for type 2 diabetes: systematic review and meta-analysis of randomised controlled trial and two-sample Mendelian randomisation. Br J Nutr 2022; 129:1929-1944. [PMID: 35946077 PMCID: PMC10167665 DOI: 10.1017/s0007114522002616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Although previous studies suggested the protective effect of Zn for type 2 diabetes (T2D), the unitary causal effect remains inconclusive. We investigated the causal effect of Zn as a single intervention on glycaemic control for T2D, using a systematic review of randomised controlled trials and two-sample Mendelian randomisation (MR). Four primary outcomes were identified: fasting blood glucose/fasting glucose, HbA1c, homeostatic model assessment for insulin resistance (HOMA-IR) and serum insulin/fasting insulin level. In the systematic review, four databases were searched until June 2021. Studies, in which participants had T2D and intervention did not comprise another co-supplement, were included. Results were synthesised through the random-effects meta-analysis. In the two-sample MR, we used single-nucleotide polymorphisms (SNP) from MR-base, strongly related to Zn supplements, to infer the relationship causally, but not specified T2D. In the systematic review and meta-analysis, fourteen trials were included with overall 897 participants initially. The Zn supplement led to a significant reduction in the post-trial mean of fasting blood glucose (mean difference (MD): −26·52 mg/dl, 95 % CI (−35·13, −17·91)), HbA1c (MD: −0·52 %, 95 % CI: (−0·90, −0·13)) and HOMA-IR (MD: −1·65, 95 % CI (−2·62, −0·68)), compared to the control group. In the two-sample MR, Zn supplement with two SNP reduced the fasting glucose (inverse-variance weighted coefficient: −2·04 mmol/l, 95 % CI (−3·26, −0·83)). From the two methods, Zn supplementation alone may causally improve glycaemic control among T2D patients. The findings are limited by power from the small number of studies and SNP included in the systematic review and two-sample MR analysis, respectively.
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Attia JR, Holliday E, Weaver N, Peel R, Fleming KC, Hure A, Wiggers J, McEvoy M, Searles A, Reeves P, Ranasinghe P, Jayawardena R, Samman S, Luu J, Rissel C, Acharya S. The effect of zinc supplementation on glucose homeostasis: a randomised double-blind placebo-controlled trial. Acta Diabetol 2022; 59:965-975. [PMID: 35451678 PMCID: PMC9026040 DOI: 10.1007/s00592-022-01888-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022]
Abstract
AIMS The burden and health costs of Type 2 Diabetes Mellitus continue to increase globally and prevention strategies in at-risk people need to be explored. Previous work, in both animal models and humans, supports the role of zinc in improving glucose homeostasis. We, therefore, aimed to test the effectiveness of zinc supplementation on glycaemic control in pre-diabetic adults. METHODS We conducted a randomized, double-blind, placebo-controlled trial across 10 General Practitioner (GP) practices in NSW, Australia. The trial is known as Zinc in Preventing the Progression of pre-Diabetes (ZIPPeD)Study. Pre-diabetic (haemoglobin A1c [HbA1c] 5.7-6.4%, 39-46 mmol/mol) men and women (N = 98) were all assigned to a free state government telephone health coaching service (New South Wales Get Healthy Information and Coaching Service) and then randomised to either daily 30 mg zinc gluconate or placebo. Blood tests were collected at baseline, 1, 6 and 12 months for the primary outcomes (HbA1c, fasting blood glucose (FBG)); secondary outcomes included Homeostasis Model Assessment 2 (HOMA 2) parameters, lipids, body weight, height, waist circumference, blood pressure and pulse. RESULTS The baseline-adjusted mean group difference at 6 months, expressed as treatment-placebo, (95% CI) was -0.02 (-0.14, 0.11, p = 0.78) for HbA1c and 0.17 (-0.07, 0.42; p = 0.17) for FBG, neither of which were statistically significant. There were also no significant differences between groups in any of the secondary outcomes. Zinc was well tolerated, and compliance was high (88%). CONCLUSION We believe our results are consistent with other Western clinical trial studies and do not support the use of supplemental zinc in populations with a Western diet. There may still be a role for supplemental zinc in the developing world where diets may be zinc deficient. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry, ACTRN12618001120268. Registered on 6 July 2018.
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Affiliation(s)
- John R Attia
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia.
- Division of Medicine, Hunter New England Local Health District, New Lambton Heights, Australia.
| | - Elizabeth Holliday
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
| | - Natasha Weaver
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
| | - Roseanne Peel
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
| | - Kerry C Fleming
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
| | - Alexis Hure
- Diabetes Service and Diabetes Alliance Hunter New England Local Health District, New Lambton Heights, Australia
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
- Hunter New England Local Health District, New Lambton Heights, Australia
| | - Mark McEvoy
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
- La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, VIC, Australia
| | - Andrew Searles
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Penny Reeves
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | | | | | - Samir Samman
- School of Life and Environmental Sciences, University of Sydney, New Lambton Heights, Australia
| | - Judy Luu
- Diabetes Stream, Diabetes Alliance HNELHD, New Lambton Heights, Australia
| | - Chris Rissel
- The University of Sydney, Camperdown, 2050, Australia
| | - Shamasunder Acharya
- Endocrinology and Diabetes Service and Diabetes Alliance Hunter New England Local Health District, New Lambton Heights, Australia
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Abstract
Zinc is an essential trace element due to its role as a key part of human enzymatic activity. As a cofactor in metalloenzymes and metalloproteins, zinc participates in diverse biological functions, including gene transcription, translation, and replication, phagocytosis, and immunoglobulin and cytokine production. In this review, we will focus on the role of zinc in the cardiovascular system, including heart failure, vascular calcification, and myocardial infarction. We will further highlight the role of zinc in cardiovascular pathology in individuals with chronic kidney disease, and type II diabetes mellitus, groups uniquely at risk for cardiovascular morbidity and mortality.
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He P, Li H, Liu M, Zhang Z, Zhang Y, Zhou C, Li Q, Liu C, Qin X. U-shaped Association Between Dietary Zinc Intake and New-onset Diabetes: A Nationwide Cohort Study in China. J Clin Endocrinol Metab 2022; 107:e815-e824. [PMID: 34448874 PMCID: PMC8902942 DOI: 10.1210/clinem/dgab636] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Indexed: 01/07/2023]
Abstract
AIMS We aimed to investigate the relationship of dietary zinc intake with new-onset diabetes among Chinese adults. MATERIALS AND METHODS A total of 16 257 participants who were free of diabetes at baseline from the China Health and Nutrition Survey were included. Dietary intake was measured by 3 consecutive 24-hour dietary recalls combined with a household food inventory. Participants with self-reported physician-diagnosed diabetes, or fasting glucose ≥ 7.0 mmol/L, or glycated hemoglobin ≥ 6.5% during the follow-up were defined as having new-onset diabetes. RESULTS A total of 1097 participants developed new-onset diabetes during a median follow-up duration of 9.0 years. Overall, the association between dietary zinc intake and new-onset diabetes followed a U-shape (P for nonlinearity < 0.001). The risk of new-onset diabetes was significantly lower in participants with zinc intake < 9.1 mg/day (per mg/day: hazard ratio [HR], 0.73; 95% CI, 0.60-0.88), and higher in those with zinc intake ≥ 9.1 mg/day (per mg/day: HR, 1.10; 95% CI, 1.07-1.13). Consistently, when dietary zinc intake was assessed as deciles, compared with those in deciles 2-8 (8.9 -<12.2 mg/day), the risk of new-onset diabetes was higher for decile 1 (<8.9 mg/day: HR, 1.29; 95% CI, 1.04-1.62), and deciles 9 to 10 (≥12.2 mg/day: HR, 1.62; 95% CI, 1.38-1.90). Similar U-shaped relations were found for plant-derived or animal-derived zinc intake with new-onset diabetes (all P for nonlinearity < 0.001). CONCLUSIONS There was a U-shaped association between dietary zinc intake and new-onset diabetes in general Chinese adults, with an inflection point at about 9.1 mg/day.
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Affiliation(s)
- Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou 510515, China
| | - Huan Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou 510515, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou 510515, China
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou 510515, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou 510515, China
| | - Qinqin Li
- Institute of Biomedicine, Anhui Medical University, Hefei 230032, China
| | - Chengzhang Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou 510515, China
- Institute of Biomedicine, Anhui Medical University, Hefei 230032, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou 510515, China
- Institute of Biomedicine, Anhui Medical University, Hefei 230032, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
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Mohammadi H, Talebi S, Ghavami A, Rafiei M, Sharifi S, Faghihimani Z, Ranjbar G, Miraghajani M, Askari G. Effects of zinc supplementation on inflammatory biomarkers and oxidative stress in adults: A systematic review and meta-analysis of randomized controlled trials. J Trace Elem Med Biol 2021; 68:126857. [PMID: 34560424 DOI: 10.1016/j.jtemb.2021.126857] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 09/03/2021] [Accepted: 09/10/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND & OBJECTIVE Current evidence is debatable regarding the feasible effects of zinc supplementation on the inflammation and oxidative stress status of adults. This systematic review and meta-analysis aimed to clarify this inconclusiveness. MATERIALS AND METHODS Literature search was conducted via online databases such as PubMed, Scopus, ISI Web of Science, Cochrane Library, and Google Scholar until June 2020. The overall effect was presented as the weighted mean difference (WMD) at 95 % confidence interval (CI) in a random-effects meta-analysis model. Publication bias was also assessed using Egger's and Begg's statistics. RESULTS In total, 25 clinical trials (n = 1428) were reviewed, which indicated that zinc supplementation significantly affects the concentration of C- reactive protein (WMD: -0.03 mg/l; 95 % CI: -0.06, 0.0; P = 0.029), interlukin-6 (WMD: -3.81 pg/mL; 95 % CI: -6.87, -0.76; P = 0.014), malondialdehyde (WMD: -0.78 μmol/l; 95 % CI: -1.14, -0.42; P < 0.001), and total antioxidant capacity (WMD: 95.96 mmol/l; 95 % CI: 22.47, 169.44; P = 0.010). In addition, a significant between-study heterogeneity and a non-significant increment was reported in nitric oxide (WMD: 1.47 μmol/l; 95 % CI: -2.45, 5.40; P = 0.461) and glutathione (WMD: 34.84 μmol/l; 95 % CI: -5.12, 74.80; P = 0.087). CONCLUSION According to the results, zinc supplementation may have beneficial anti-inflammatory and anti-oxidative effects in adults.
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Affiliation(s)
- Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepide Talebi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Abed Ghavami
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Rafiei
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shima Sharifi
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Faghihimani
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Golnaz Ranjbar
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Miraghajani
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; The Early Life Research Unit, Division of Child Health, Obstetrics and Gynecology, and Nottingham Digestive Disease Centre and Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Sciences, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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12
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Knez M, Glibetic M. Zinc as a Biomarker of Cardiovascular Health. Front Nutr 2021; 8:686078. [PMID: 34395491 PMCID: PMC8360846 DOI: 10.3389/fnut.2021.686078] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/25/2021] [Indexed: 12/18/2022] Open
Abstract
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.
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Affiliation(s)
- Marija Knez
- Centre of Research Excellence in Nutrition and Metabolism, National Institute for Medical Research, University of Belgrade, Belgrade, Serbia
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13
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Laouali N, MacDonald CJ, Shah S, El Fatouhi D, Mancini FR, Fagherazzi G, Boutron-Ruault MC. Dietary Copper/Zinc Ratio and Type 2 Diabetes Risk in Women: The E3N Cohort Study. Nutrients 2021; 13:2502. [PMID: 34444662 PMCID: PMC8400926 DOI: 10.3390/nu13082502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/07/2021] [Accepted: 07/14/2021] [Indexed: 11/17/2022] Open
Abstract
The serum copper (Cu) to zinc (Zn) ratio could be an important determinant of Type 2 diabetes (T2D) risk, but prospective epidemiological data are scarce. We aimed to investigate the association between T2D incidence and the dietary Cu/Zn ratio. A total of 70,991 women from the E3N cohort study were followed for 20 years. The intakes of copper and zinc were estimated at baseline using a validated food frequency questionnaire. We identified and validated 3292 incident T2D cases. Spline analysis showed that a Cu/Zn ratio < 0.55 was associated with a lower risk of T2D. Subgroup analyses comparing women in the highest versus the lowest quintile of Cu/Zn ratio showed the same pattern of association for obese women and those with zinc intake ≥8 mg/day. However, for women with zinc intake <8 mg/day, higher Cu/Zn ratio appeared to be associated with higher T2D risk. Our findings suggest that a lower dietary Cu/Zn ratio is associated with a lower T2D risk, especially among obese women and women with zinc intake >8 mg/day. Further studies are warranted to validate our results.
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Affiliation(s)
- Nasser Laouali
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, CEDEX, 94800 Villejuif, France; (N.L.); (C.-J.M.); (S.S.); (D.E.F.); (F.R.M.)
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, MA 01002, USA
| | - Conor-James MacDonald
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, CEDEX, 94800 Villejuif, France; (N.L.); (C.-J.M.); (S.S.); (D.E.F.); (F.R.M.)
| | - Sanam Shah
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, CEDEX, 94800 Villejuif, France; (N.L.); (C.-J.M.); (S.S.); (D.E.F.); (F.R.M.)
| | - Douae El Fatouhi
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, CEDEX, 94800 Villejuif, France; (N.L.); (C.-J.M.); (S.S.); (D.E.F.); (F.R.M.)
| | - Francesca Romana Mancini
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, CEDEX, 94800 Villejuif, France; (N.L.); (C.-J.M.); (S.S.); (D.E.F.); (F.R.M.)
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), L-1445 Strassen, Luxembourg;
| | - Marie-Christine Boutron-Ruault
- Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, CEDEX, 94800 Villejuif, France; (N.L.); (C.-J.M.); (S.S.); (D.E.F.); (F.R.M.)
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Wang X, Mukherjee B, Karvonen-Gutierrez CA, Herman WH, Batterman S, Harlow SD, Park SK. Urinary metal mixtures and longitudinal changes in glucose homeostasis: The Study of Women's Health Across the Nation (SWAN). ENVIRONMENT INTERNATIONAL 2020; 145:106109. [PMID: 32927284 PMCID: PMC7577932 DOI: 10.1016/j.envint.2020.106109] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/19/2020] [Accepted: 08/30/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Epidemiologic studies on associations between metals and insulin resistance and β-cell dysfunction have been cross-sectional and focused on individual metals. OBJECTIVE We assessed the association of exposure to metal mixtures, based on assessment of 15 urinary metals, with both baseline levels and longitudinal changes in homeostatic model assessments for insulin resistance (HOMA-IR) and β-cell function (HOMA-β). METHODS We examined 1262 women, aged 45-56 years at baseline (1999-2000), who were followed through 2015-2016, from the Study of Women's Health Across the Nation. Urinary concentrations of 15 metals (arsenic, barium, cadmium, cobalt, cesium, copper, mercury, manganese, molybdenum, nickel, lead, antimony, tin, thallium, and zinc) were determined at baseline. HOMA-IR and HOMA-β were repeatedly measured over 16 years of follow-up. A two-stage modeling was used to account for correlations in dependent and independent variables: In stage-1, linear mixed effects models were used to estimate the participant-specific baseline HOMA levels from random intercepts and participant-specific rates of changes from random slopes. In stage-2, adaptive elastic-net (AENET) models were fit to identify components of metal mixtures associated with participant-specific baseline levels and rates of changes in HOMA-IR and HOMA-β, respectively. An environmental risk score (ERS) was used to integrate metal mixture effects from AENET results. RESULTS In multivariable adjusted AENET models, urinary zinc was associated with higher HOMA-IR at baseline, whereas molybdenum was associated with lower HOMA-IR at baseline. The estimated changes in baseline HOMA-IR for one standard deviation increase in log-transformed urinary metal concentrations were 5.76% (3.05%, 8.55%) for zinc and -3.25% (-5.45%, -1.00%) for molybdenum, respectively. Urinary zinc was also associated with lower HOMA- β at baseline. Arsenic was associated with a slightly faster rate of decline in HOMA-β in the AENET model evaluating associations between metals and rate of changes. Significant associations of ERS with both HOMA-IR and HOMA-β at baseline were observed. ERS for the rate of changes was not calculated and examined in relation to rates of changes in HOMA-IR and HOMA-β because only a single metal was selected by AENET. CONCLUSION Exposure to metal mixtures may be exerting effects on insulin resistance and β-cell dysfunction, which might be mechanisms by which metal exposures lead to elevated diabetes risks.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | | | - William H Herman
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Stuart Batterman
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Siobán D Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States.
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Effects of chromium supplementation on glycemic control in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 2020; 161:105098. [PMID: 32730903 DOI: 10.1016/j.phrs.2020.105098] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND We aimed to investigate the effect of chromium supplementation on glycemic control indices in patients with type 2 diabetes (T2DM). METHODS Randomized controlled trials examining the effect of chromium supplementation on glycemic control indices and published before February 2020 were detected by searching online databases, including PubMed, Scopus, Embase, Web of sciences and The Cochrane Library, using a combination of suitable keywords. Mean change and standard deviation (SD) of the outcome measures were used to estimate the mean difference between the supplementation group and the control group at follow-up. RESULTS Twenty-eight studies reported fasting plasma glucose (FPG), insulin, hemoglobin A1C (HbA1C) and homeostatic model assessment for insulin resistance (HOMA-IR) as an outcome measure. Results revealed significant reduction in FPG (weighted mean difference (WMD): -19.00 mg/dl, 95% CI: -36.15, -1.85, P = 0.030; I2: 99.8%, p < 0.001), insulin level (WMD: -12.35 pmol/l, 95% CI: -17.86, -6.83, P < 0.001), HbA1C (WMD: -0.71 %, 95% CI: -1.19, -0.23, P = 0.004) and HOMA-IR (WMD: -1.53, 95% CI: -2.35, -0.72, P < 0.001; I2: 89.9%, p < 0.001) after chromium supplementation. CONCLUSION The results of the current meta-analysis study might support the use of chromium supplementation for the improvement of glycemic control indices in T2DM patients.
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Wang X, Karvonen-Gutierrez CA, Herman WH, Mukherjee B, Harlow SD, Park SK. Urinary metals and incident diabetes in midlife women: Study of Women's Health Across the Nation (SWAN). BMJ Open Diabetes Res Care 2020; 8:e001233. [PMID: 32747380 PMCID: PMC7398092 DOI: 10.1136/bmjdrc-2020-001233] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 06/12/2020] [Accepted: 06/27/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Environmental exposure to metals may play a role in the pathogenesis of diabetes; however, evidence from human studies is limited. We prospectively evaluated the associations of 20 urinary metal concentrations and their mixtures with incident diabetes in the Study of Women's Health Across the Nation, a multisite, multiethnic cohort study of midlife women. RESEARCH DESIGN AND METHODS The sample included 1237 white, black, Chinese and Japanese-American women, aged 45-56 years, free of diabetes at baseline (1999-2000) who were followed through 2016. Concentrations of 20 metals (arsenic, barium, beryllium, cadmium, cobalt, chromium, cesium, copper, mercury, manganese, molybdenum, nickel, lead, antimony, tin, thallium, uranium, vanadium, tungsten and zinc) were measured in urine specimens at baseline. Incident diabetes was identified annually by fasting glucose ≥126 mg/dL, self-reported doctor-diagnosed diabetes, or self-reported use of antidiabetic medications. A non-parametric clustering method, k-means clustering, was used to identify subgroups with different exposure patterns to metal mixtures. RESULTS After multivariable adjustment, the HR (95% CI) for diabetes associated with each doubling increase in urinary metal concentrations was 1.19 (1.10 to 1.30) for arsenic and 1.20 (1.05 to 1.37) for lead, in Cox proportional hazards models after controlling for multiple comparisons. A doubling in urinary excretion of zinc was associated with higher risk of diabetes (adjusted HR 1.31, 95% CI 1.11 to 1.53). Two distinct exposure patterns to metal mixtures-'high' versus 'low'-were identified. Participants assigned to the 'high' pattern had higher overall concentrations of all metals compared with those classified into the 'low' pattern. Adjusted HR for diabetes associated with 'high' pattern compared with 'low' was 1.42 (1.08 to 1.87). CONCLUSIONS Higher urinary concentrations of arsenic and lead, increased urinary excretion of zinc, as well as higher overall exposure to metal mixtures were associated with elevated risk of diabetes. Future studies should further investigate the underlying mechanisms.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | | | - William H Herman
- Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Siobán D Harlow
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Sung Kyun Park
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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17
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Association of dietary patterns with the newly diagnosed diabetes mellitus and central obesity: a community based cross-sectional study. Nutr Diabetes 2020; 10:16. [PMID: 32499520 PMCID: PMC7272454 DOI: 10.1038/s41387-020-0120-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/13/2020] [Accepted: 05/19/2020] [Indexed: 12/16/2022] Open
Abstract
Aim The purpose of this study was to investigate the association of dietary patterns with the risk of insulin resistance (IR), diabetes mellitus (DM), and central obesity in China. Methods We performed a cross-sectional study on 1432 participants, aged 40–65 years in Hangzhou, Zhejiang province, China. Dietary intake was assessed using a semi-quantitative food frequency questionnaire. Results Factor analysis extracted four major dietary patterns: vegetable-fruits, rice–meat, seafood–eggs, and sweet–fast. The vegetable-fruits pattern was inversely associated with HOMA-IR (p < 0.001 in both genders), while sweet–fast food pattern was significantly associated with higher HOMA-IR (p = 0.002 in male, and p < 0.001 in female). The vegetables–fruits pattern was inversely correlated with visceral fat area (VFA) (p = 0.029 in males, and p = 0.017 in females), while sweet–fast food pattern presented a significant direct association (p < 0.001 in male) with VFA in males. There was no association observed between the rice–meat pattern or the seafood–eggs pattern and HOMA-IR or VFA. After adjustment for potential confounding factors, participants in the highest tertile of vegetable-fruits pattern showed a significantly lower risk of DM in both males and females (OR: 0.30, 95% CI: 0.13–0.70 in male, and OR: 0.28, 95% CI: 0.11–0.72 in female), and lower risk of central obesity was observed in males (OR: 0.50, 95% CI: 0.29–0.86 in male). Conversely, participants in the highest tertile of sweet–fast food pattern had higher risk of DM (OR: 2.58, 95% CI: 1.23–5.88 in male), and central obesity (OR: 2.85, 95% CI: 1.67–4.86 in male) only in male. While neither the rice–meat pattern nor the seafood–eggs pattern showed significant association with DM or central obesity in both genders. Conclusions Our findings indicated low risk of IR, DM, and central obesity with vegetable-fruits pattern while inverse relation with sweet–fast food pattern.
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Akdas S, Yazihan N. Serum zinc level and dietary zinc intake status in non-alcoholic fatty liver disease: A meta-analysis and systematic review. HEPATOLOGY FORUM 2020; 1:59-67. [PMID: 35949440 PMCID: PMC9349339 DOI: 10.14744/hf.2020.2020.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/04/2020] [Indexed: 11/20/2022]
Abstract
Background and Aim Non-alcoholic fatty liver disease (NAFLD) is a common health problem related to diet and a sedentary lifestyle. Zinc has essential roles in diabetes, insulin resistance and inflammation. This meta-analysis aims to evaluate the relationship between NAFLD and dietary zinc intake/serum zinc levels. Materials and Methods A systematic search was performed in PubMed, Web of Science, and Scopus databases for relevant English articles with mean/standard deviation values of serum zinc levels (µg/dL) and dietary zinc intake (mg/day) up to February 2020. We screened "fatty liver disease" and "zinc" keywords; totally 864 articles, eight of them were found to have suitable serum zinc level or daily zinc intake data for meta-analysis. Results Serum zinc level in NAFLD patients were lower than healthy controls (data from 984 individuals, FEM, p<0.00001). The meta-analysis results of the nutritional zinc intake of totally 19438 individuals were similar in NAFLD and control groups (FEM, p=0.36). Conclusion Serum zinc levels were lower in NAFLD patients, even though they have similar zinc intake in the diet, which suggests that there may be an absorption problem or increased need, with a distributional disorder which results in lower serum zinc levels. Further studies need to evaluate the role of zinc in NAFLD.
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Affiliation(s)
- Sevginur Akdas
- Department of Interdisciplinary Food, Metabolism and Clinical Nutrition, Ankara University, Institute of Health Sciences, Ankara, Turkey
| | - Nuray Yazihan
- Department of Interdisciplinary Food, Metabolism and Clinical Nutrition, Ankara University, Institute of Health Sciences, Ankara, Turkey
- Department of Internal Medicine, Division of Pathophysiology, Ankara University Faculty of Medicine, Ankara, Turkey
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Farooq DM, Alamri AF, Alwhahabi BK, Metwally AM, Kareem KA. The status of zinc in type 2 diabetic patients and its association with glycemic control. J Family Community Med 2020; 27:29-36. [PMID: 32030076 PMCID: PMC6984028 DOI: 10.4103/jfcm.jfcm_113_19] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 11/17/2019] [Accepted: 11/30/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Zinc (Zn) is a trace element that carries antioxidant properties. Deficiency of Zn increases oxidative stress, especially in diabetes. The objective of this study was to assess the relationship between the level of Zn and glycemic control in type 2 diabetes. MATERIALS AND METHODS A cross-sectional study was carried out in the Department of Medicine at King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia, from March 2018 to September 2018. A total of 440 participants were included in the study; 252 of these had type 2 diabetes and 188 were controls. All participants had laboratory investigations including fasting blood sugar (FBS), glycosylated hemoglobin, and lipid profile and Zn levels. These two groups (diabetics and controls) were further divided into Zn deficient group and normal Zn group according to their Zn levels. Data were analyzed by using SPSS software. RESULTS The mean Zn level was 11.7 + 1.5 in the control group, whereas it was significantly low (9.3 + 1.6) in the diabetic group (P < 0.001). Zn deficiency in the control group was only 6.4%, while in the diabetic group, it was 67.9%, (P ≤ 0.001). The mean ages for the low Zn group and normal Zn group were 40.9 + 12.5 and 37.5 + 10.1, respectively, and the Zn deficient group was higher in age (P = 0.003). There was no significant statistical difference between genders regarding Zn deficiency. Obesity was associated with significantly low Zn levels (P = 0.016). The serum Zn level was significantly negatively associated with FBS and glycated hemoglobin in diabetic participants (P < 0.001). CONCLUSION Diabetic patients have Zn deficiency compared to normal individuals and poor glycemic control is associated with low Zn levels.
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Affiliation(s)
- Dhedhi M. Farooq
- Department of Internal Medicine and Family Medicine, King Abdullah Bin Abdul-Aziz University Hospital, Riyadh, Saudi Arabia
| | - Ali F. Alamri
- Department of Internal Medicine and Family Medicine, King Abdullah Bin Abdul-Aziz University Hospital, Riyadh, Saudi Arabia
| | - Basmah K. Alwhahabi
- Department of Internal Medicine and Family Medicine, King Abdullah Bin Abdul-Aziz University Hospital, Riyadh, Saudi Arabia
| | - Ashraf M. Metwally
- Department of Epidemiology and Biostatistics, College of Public Health Informatics, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khalid A. Kareem
- Department of Internal Medicine and Family Medicine, King Abdullah Bin Abdul-Aziz University Hospital, Riyadh, Saudi Arabia
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Shah M, Garg A. The relationships between macronutrient and micronutrient intakes and type 2 diabetes mellitus in South Asians: A review. J Diabetes Complications 2019; 33:500-507. [PMID: 31126704 DOI: 10.1016/j.jdiacomp.2019.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND South Asians (SA) have increased prevalence of type 2 diabetes mellitus (T2DM). The role of nutrient intakes in T2DM in SA is not well understood, however. OBJECTIVE The paper reviewed the relationship between macronutrient and micronutrients intakes and T2DM in SA. METHODS The MEDLINE database was searched for relevant papers on this topic in SA. RESULTS There was some evidence that dietary fiber and linoleic acid intake may reduce but carbohydrates may increase the risk of T2DM. Some studies found higher energy from protein and fat in subjects with T2DM versus controls. Other studies, however, found lower carbohydrate intake among those with T2DM or no relationship between diet composition and T2DM. Several vitamins and minerals were also inversely related to T2DM. CONCLUSIONS The data were limited to a few epidemiological studies. Most studies did not distinguish between undiagnosed and known T2DM. Subjects with known T2DM are more likely to have changed their diet. Prospective cohort or randomized controlled studies examining the role of diet composition, using precise image-assisted dietary assessment method and blood biomarkers, in the development of T2DM among migrant and native SA are needed. Lastly, a more complete nutrient database for foods consumed by SA is needed.
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Affiliation(s)
- Meena Shah
- Division of Nutrition and Metabolic Diseases, UT Southwestern Medical Center, Dallas, TX, United States of America; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States of America; Center for Human Nutrition, UT Southwestern Medical Center, Dallas, TX, United States of America; Department of Kinesiology, Texas Christian University, Fort Worth, TX, United States of America.
| | - Abhimanyu Garg
- Division of Nutrition and Metabolic Diseases, UT Southwestern Medical Center, Dallas, TX, United States of America; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States of America; Center for Human Nutrition, UT Southwestern Medical Center, Dallas, TX, United States of America.
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Zinc Intake and Status and Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Nutrients 2019; 11:nu11051027. [PMID: 31071930 PMCID: PMC6567047 DOI: 10.3390/nu11051027] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 12/14/2022] Open
Abstract
Zinc could have a protective role against type 2 diabetes mellitus (T2DM). This systematic review and meta-analysis aimed to evaluate the association between dietary, supplementary, and total zinc intake, as well as serum/plasma and whole blood zinc concentration, and risk of T2DM. Observational studies, conducted on cases of incident diabetes or T2DM patients and healthy subjects that reported a measure of association between zinc exposure and T2DM, were selected. Random effects meta-analyses were applied to obtain combined results. Stratified meta-analyses and meta-regressions were executed to assess sources of heterogeneity, as well as the impact of covariates on the findings. From 12,136 publications, 16 studies were selected. The odds ratio (OR) for T2DM comparing the highest versus lowest zinc intake from diet was 0.87 (95% CI: 0.78–0.98). Nevertheless, no association between supplementary or total zinc intake from both diet and supplementation, and T2DM was observed. A direct relationship was found between serum/plasma zinc levels and T2DM (OR = 1.64, 95% CI: 1.25–2.14). A moderately high dietary zinc intake, in relation to the Dietary Reference Intake, could reduce by 13% the risk of T2DM, and up to 41% in rural areas. Conversely, elevated serum/plasma zinc concentration was associated with an increased risk of T2DM by 64%, suggesting disturbances in zinc homeostasis.
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22
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Król E, Bogdański P, Suliburska J, Krejpcio Z. The Relationship between Dietary, Serum and Hair Levels of Minerals (Fe, Zn, Cu) and Glucose Metabolism Indices in Obese Type 2 Diabetic Patients. Biol Trace Elem Res 2019; 189:34-44. [PMID: 30091069 PMCID: PMC6443611 DOI: 10.1007/s12011-018-1470-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/01/2018] [Indexed: 12/11/2022]
Abstract
The aim of this study was to assess the levels of Zn, Fe and Cu in the serum and hair, and dietary intake of type 2 diabetic patients and their association with glucose and lipid indices. The study was conducted on 62 people aged 40-78 years (31 diabetic patients and 31 healthy subjects, who were the control group). The content of trace elements in the hair and serum was analysed with the AAS method. The serum insulin, HbA1c, glucose, total cholesterol and triacylglycerol concentrations were measured by means of RIA, HPLC and colorimetric methods, respectively. The diabetic patients were found to have significantly higher dietary iron intake, higher hair Fe and lower serum Zn concentrations than the non-diabetic subjects, while the hair Zn and Cu contents were comparable in both groups. The serum Zn and Cu levels of the diabetic subjects were negatively correlated with the serum glucose, the serum Zn and Cu/Zn ratio was inversely correlated with the serum total cholesterol and the serum insulin level was positively associated with the hair Cu/Zn ratio. The results of this study indicate that the trace element status (Zn, Fe, Cu), as reflected in the blood serum and hair, may be disturbed due to metabolic derangement occurring in diabetes.
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Affiliation(s)
- Ewelina Król
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, 31 Wojska Polskiego, 60-624, Poznan, Poland.
| | - Paweł Bogdański
- Department of Internal Medicine, Metabolic Disorders and Hypertension, Poznan University of Medical Sciences, 84 Szamarzewskiego, 60-569, Poznan, Poland
| | - Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, 31 Wojska Polskiego, 60-624, Poznan, Poland
| | - Zbigniew Krejpcio
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, 31 Wojska Polskiego, 60-624, Poznan, Poland
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23
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Peel R, Hure A, Wiggers J, McEvoy M, Holliday E, Searles A, Reeves P, Ranasinghe P, Jayawardena R, Samman S, Acharya S, Luu J, Rissel C, Attia J. Zinc in Preventing the Progression of pre-Diabetes (ZIPPeD Study) - study protocol for a randomised placebo-controlled trial in Australia. Trials 2019; 20:219. [PMID: 30992081 PMCID: PMC6466783 DOI: 10.1186/s13063-019-3317-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetes is increasing in incidence, morbidity and treatment costs globally, hence prevention strategies need to be explored. Animal studies and some human data have shown that zinc can improve glycaemic control, but the impact of this effect in a pre-diabetic population remains uncertain. This study is designed to investigate whether zinc gluconate and lifestyle coaching can improve glucose handling and ultimately reduce diabetes incidence in an at-risk pre-diabetic population in Australia. METHODS/DESIGN The study will be a randomised, placebo-controlled, double-blind clinical trial. The study will be conducted at the Hunter New England Local Health District New South Wales (NSW), Australia. Pre-diabetic (haemoglobin A1c [HbA1c] 5.7-6.4) male and female participants (n = 410) aged 40-70 years will be recruited through the Diabetes Alliance Network, a collaboration of diabetes specialists and general practitioner practices. All participants will be given routine care to encourage healthy lifestyle changes using a telephone coaching service (Get Healthy Information and Coaching Service, NSW Health) and then randomised to receive a supplement, either zinc gluconate (equivalent to 30 mg of elemental zinc) or placebo of identical appearance for 12 months. The identity of the supplements will be blinded to both research personnel and the participants. Participants will be asked to complete medical, lifestyle and dietary surveys and will have baseline and final visits at their general practitioner practice. Primary outcomes will be HbA1c and insulin sensitivity collected at baseline and at 1, 6 and 12 months; secondary outcomes will include fasting blood glucose, fasting cholesterol, blood pressure and body mass index. The primary efficacy endpoint will be judged at 6 months. DISCUSSION This study will generate new evidence about the potential for health coaching, with or without zinc supplementation, to improve glucose handling and ultimately to reduce progression from pre-diabetes to diabetes. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry, ACTRN12618001120268 . Registered on 6 July 2018.
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Affiliation(s)
- Roseanne Peel
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Alexis Hure
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - John Wiggers
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Health Research and Translation and Population Health, Hunter New England Local Health District, New Lambton, NSW, Australia
| | - Mark McEvoy
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Elizabeth Holliday
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Andrew Searles
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Penny Reeves
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Ranil Jayawardena
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Department of Physiology Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Samir Samman
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
| | - Shamasunder Acharya
- Division of Medicine, Hunter New England Local Health District, New Lambton, NSW, Australia.,Diabetes Alliance, Hunter New England Local Health District, New Lambton, NSW, Australia
| | - Judy Luu
- Division of Medicine, Hunter New England Local Health District, New Lambton, NSW, Australia.,Diabetes Alliance, Hunter New England Local Health District, New Lambton, NSW, Australia
| | - Chris Rissel
- The NSW Office of Preventive Health, South Western Sydney Local Health District, Liverpool Hospital, Liverpool, NSW, Australia
| | - John Attia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia. .,Division of Medicine, Hunter New England Local Health District, New Lambton, NSW, Australia.
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24
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Ruz M, Carrasco F, Rojas P, Basfi-Fer K, Hernández MC, Pérez A. Nutritional Effects of Zinc on Metabolic Syndrome and Type 2 Diabetes: Mechanisms and Main Findings in Human Studies. Biol Trace Elem Res 2019; 188:177-188. [PMID: 30600497 DOI: 10.1007/s12011-018-1611-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/06/2018] [Indexed: 12/13/2022]
Abstract
Zinc (Zn) plays crucial roles in mammalian metabolism. There is increasing interest about the potential beneficial effects of Zn on the prevention or treatment of non-communicable diseases. This review critically analyzes the information related to the role of Zn on the metabolic syndrome (MetS) as well as type 2 diabetes (T2D), and summarizes the biological basis of these potential effects of Zn. There are several mechanisms by which Zn may help to prevent the development or progression of MetS and T2D, respectively. Zn is involved in both insulin secretion and action in peripheral tissues. Specifically, Zn has insulin-mimetic properties that increase the activity of the insulin signaling pathway. Zn modulates long-chain polyunsaturated fatty acids levels through its action on the absorption of essential fatty acids in the intestine and its subsequent desaturation. Zn is also involved in both the assembly of chylomicrons and lipoproteins as well as their clearance, and thus, plays a role in lipolysis regulation. Finally, Zn has been found to play a role in redox metabolism, and in turn, on blood pressure. The evidence related to the association between Zn status and occurrence of MetS is inconsistent. Although there are several studies reporting an inverse relationship between Zn status or dietary Zn intake and MetS prevalence, others found a direct relationship between Zn status and MetS prevalence. Intervention studies also provide confusing information about this issue, making it hard to reach firm conclusions. Zn as part of the treatment for patients with T2D has been shown to have positive responses in terms of glucose control outcomes, but only among those with Zn deficiency.
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Affiliation(s)
- Manuel Ruz
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Santiago, Chile.
| | - Fernando Carrasco
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Santiago, Chile
| | - Pamela Rojas
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Santiago, Chile
| | - Karen Basfi-Fer
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Santiago, Chile
| | - Maria Catalina Hernández
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Santiago, Chile
| | - Alvaro Pérez
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Santiago, Chile
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25
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Brandão-Lima PN, Carvalho GBD, Santos RKF, Santos BDC, Dias-Vasconcelos NL, Rocha VDS, Barbosa KBF, Pires LV. Intakes of Zinc, Potassium, Calcium, and Magnesium of Individuals with Type 2 Diabetes Mellitus and the Relationship with Glycemic Control. Nutrients 2018; 10:E1948. [PMID: 30544774 PMCID: PMC6316646 DOI: 10.3390/nu10121948] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 02/06/2023] Open
Abstract
The role of the concomitant intake of zinc, potassium, calcium, and magnesium in the glycemic control of individuals with type 2 diabetes mellitus (T2DM) has not been extensively discussed. We evaluated the relationship between the dietary intake of these micronutrients and glycemic markers in 95 individuals with T2DM (mean age 48.6 ± 8.4 years). Hierarchical grouping analysis was used to divide the individuals into two clusters according to their micronutrient intake, and differences between clusters were statistically assessed. Effects of individual and combination intake of micronutrients on glycated hemoglobin percentage (%HbA1c) were assessed using multiple linear regression and binary logistic regression analysis. We observed a high likelihood of inadequate intake of the four micronutrients. The group with lower micronutrient intake (cluster 1) displayed higher %HbA1c (p = 0.006) and triglyceride (p = 0.010) levels. High %HbA1c showed an association with cluster 1 (odds ratio (OR) = 3.041, 95% confidence interval (CI) = 1.131; 8.175) and time of T2DM diagnosis (OR = 1.155, 95% CI = 1.043; 1.278). Potassium (β = -0.001, p = 0.017) and magnesium (β = -0.007, p = 0.015) intakes were inversely associated with %HbA1c. Reduced concomitant intake of the four micronutrients studied proved to be associated with risk of increased %HbA1c in individuals with T2DM, which was particularly predicted by magnesium and potassium intakes.
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Affiliation(s)
- Paula Nascimento Brandão-Lima
- Health Sciences Postgraduate Program, Department of Medicine, Federal University of Sergipe, Rua Cláudio Batista, S/N, Cidade Nova, Aracaju, 49060-108 Sergipe, Brazil.
| | - Gabrielli Barbosa de Carvalho
- Nutrition Sciences Postgraduate Program, Department of Nutrition, Federal University of Sergipe, Avenida Marechal Rondon, S/N, Jardim Rosa Elze, São Cristovão, 49100-000 Sergipe, Brazil.
| | - Ramara Kadija Fonseca Santos
- Nutrition Sciences Postgraduate Program, Department of Nutrition, Federal University of Sergipe, Avenida Marechal Rondon, S/N, Jardim Rosa Elze, São Cristovão, 49100-000 Sergipe, Brazil.
| | - Beatriz da Cruz Santos
- Department of Nutrition, Federal University of Sergipe, Avenida Marechal Rondon, S/N, Jardim Rosa Elze, São Cristovão, 49100-000 Sergipe, Brazil.
| | - Natalia Lohayne Dias-Vasconcelos
- Department of Nutrition, Federal University of Sergipe, Avenida Marechal Rondon, S/N, Jardim Rosa Elze, São Cristovão, 49100-000 Sergipe, Brazil.
| | - Vivianne de Sousa Rocha
- Department of Nutrition, Federal University of Sergipe, Avenida Governador Marcelo Déda, 13, Centro, Lagarto, 49400-000 Sergipe, Brazil.
| | - Kiriaque Barra Ferreira Barbosa
- Health Sciences Postgraduate Program, Department of Medicine, Federal University of Sergipe, Rua Cláudio Batista, S/N, Cidade Nova, Aracaju, 49060-108 Sergipe, Brazil.
- Nutrition Sciences Postgraduate Program, Department of Nutrition, Federal University of Sergipe, Avenida Marechal Rondon, S/N, Jardim Rosa Elze, São Cristovão, 49100-000 Sergipe, Brazil.
- Department of Nutrition, Federal University of Sergipe, Avenida Marechal Rondon, S/N, Jardim Rosa Elze, São Cristovão, 49100-000 Sergipe, Brazil.
| | - Liliane Viana Pires
- Nutrition Sciences Postgraduate Program, Department of Nutrition, Federal University of Sergipe, Avenida Marechal Rondon, S/N, Jardim Rosa Elze, São Cristovão, 49100-000 Sergipe, Brazil.
- Department of Nutrition, Federal University of Sergipe, Avenida Marechal Rondon, S/N, Jardim Rosa Elze, São Cristovão, 49100-000 Sergipe, Brazil.
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26
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Ostadmohammadi V, Samimi M, Mobini M, Zarezade Mehrizi M, Aghadavod E, Chamani M, Dastorani M, Asemi Z. The effect of zinc and vitamin E cosupplementation on metabolic status and its related gene expression in patients with gestational diabetes. J Matern Fetal Neonatal Med 2018; 32:4120-4127. [PMID: 29804469 DOI: 10.1080/14767058.2018.1481952] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Objective: The aim of this study was to determine the effects of zinc and vitamin E cosupplementation on metabolic status and gene expression related to insulin and lipid metabolism in women with gestational diabetes mellitus (GDM).Methods: Fifty-four women, in the age range of 18-40 years, diagnosed with GDM were recruited for this randomized, double-blinded, placebo-controlled trial. Subjects were randomly allocated into two intervention groups to either taking 233 mg/day Zinc Gluconate plus 400-IU/day vitamin E supplements or placebo (n = 27 each group) for 6 weeks. Gene expression related to insulin and lipid metabolism was evaluated in peripheral blood mononuclear cells (PBMCs) of women with GDM using RT-PCR method.Results: Participants who received zinc plus vitamin E supplements had significantly lower serum insulin levels (β = -3.81; 95% CI, -5.90, -1.72; p = .001), homeostasis model of assessment-insulin resistance (β = -0.96; 95% CI, -1.54, -0.38; p = .002), serum total-cholesterol (β = -8.56; 95% CI, -16.69, -0.43; p = .03) and low density lipoprotein-cholesterol (LDL)-cholesterol (β = -8.72; 95% CI, -15.27, -2.16; p = .01), and higher quantitative insulin sensitivity check index (β = 0.01; 95% CI, 0.005, 0.02; p = .007) compared with the placebo. Moreover, zinc and vitamin E cosupplementation upregulated gene expression of peroxisome proliferator-activated receptor gamma (PPAR-γ; p = .03) and low-density lipoprotein receptor (LDLR; p = .04) compared with the placebo. Though, zinc and vitamin E combination did not affect other metabolic parameters.Conclusions: Overall, zinc and vitamin E cosupplementation for 6 weeks in women with GDM significantly improved insulin metabolism, lipid profile, and the gene expression levels of PPAR-γ and LDLR.
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Affiliation(s)
- Vahidreza Ostadmohammadi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Mansooreh Samimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Moein Mobini
- Department of Kinesiology, University of Calgary, Calgary, Canada
| | - Maryam Zarezade Mehrizi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Esmat Aghadavod
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Maryam Chamani
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Dastorani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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Diaf M, Khaled MB. Associations Between Dietary Antioxidant Intake and Markers of Atherosclerosis in Middle-Aged Women From North-Western Algeria. Front Nutr 2018; 5:29. [PMID: 29740584 PMCID: PMC5928482 DOI: 10.3389/fnut.2018.00029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 04/10/2018] [Indexed: 11/24/2022] Open
Abstract
Background: The role of several dietary antioxidants in preventing the development and the progression of atherosclerosis has recently aroused considerable interest. Although they are not yet conclusive, most of the existing suggestions support this hypothesis. Objective: The aim of the present work was to investigate the intake of dietary antioxidant nutrients in relation to atherogenic indices in a group of Algerian middle aged women with and without type 2 diabetes. Methods: A cross-sectional study was conducted on a group of middle-aged women from the north western region of Algeria. Anthropometric and biochemical parameters were measured. Dietary intake was assessed using a validated 3-days food record. Atherogenic indices -total cholesterol-to-high-density lipoprotein cholesterol ratio (TC/HDL) and apolipoprotein (apo) B-to-apo A1 ratio, were calculated. Associations between antioxidants dietary intake and atherogenic indices were examined using logistic regressions. Results: 95 women with type 2 diabetes were compared to 93 non-diabetic ones. Statistical differences (p < 0.05) were revealed for body weight, height, body mass index (BMI), glycosylated hemoglobin (HbA1c) and total cholesterol levels. Furthermore, significant differences were noted for vitamin C, E and copper dietary intakes. The TC/HDL ratio was significantly associated to the highest quartiles of vitamin C in all patients; 3.519[2.405–4.408], p = 0.009 and in non-diabetic women; 3.984[1.775–7.412], p = 0.020, respectively. The odd ratios of vitamin E intakes were about 2.425[2.017–5.715], p = 0.012 in all patients and 1.843[1.877–2.731], p = 0.019 in non-diabetic group, respectively. However, the Apo B/Apo A1 ratio was more correlated to the highest quartiles of zinc and copper in non-diabetic group; OR = 0.059[0.006–0.572], p = 0.015 and 0.192[0.048–0.766], p = 0.019, respectively. Conclusion: The estimated risk of atherosclerosis measured through the TC/HDL ratio was correlated to vitamins antioxidant intake, while the probable risk assessed by the Apo B/Apo A1 ratio was more associated to the mineral profile.
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Affiliation(s)
- Mustapha Diaf
- Department of Biology, Faculty of Natural and Life Sciences, Djillali Liabes University of Sidi-Bel-Abbes, Sidi Bel Abbes, Algeria
| | - Meghit Boumediene Khaled
- Department of Biology, Faculty of Natural and Life Sciences, Djillali Liabes University of Sidi-Bel-Abbes, Sidi Bel Abbes, Algeria
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Ranasinghe P, Wathurapatha WS, Galappatthy P, Katulanda P, Jayawardena R, Constantine GR. Zinc supplementation in prediabetes: A randomized double-blind placebo-controlled clinical trial. J Diabetes 2018; 10:386-397. [PMID: 29072815 DOI: 10.1111/1753-0407.12621] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/02/2017] [Accepted: 09/25/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study evaluated the effects of zinc supplementation on glycemic control, other cardiometabolic and anthropometric parameters, and disease progression in prediabetes. METHODS A randomized double-blind placebo-controlled Phase 2 clinical trial was conducted over a 12-month period in 200 subjects (43% male; mean [± SD] age 51.8 ± 7.3 years), randomly assigned (1: 1) to the treatment or control group. The treatment group received zinc (20 mg daily). Subjects were evaluated at baseline and at 1, 3, 6, and 12 months. The primary outcome was the change in glycemic control from baseline. Multiple regression analyses were performed, with change in outcome variables after intervention from baseline used as continuous dependent variables. RESULTS In both groups, mean serum zinc concentrations prior to the trial were below normal (15.29-21.41 μmol/L). During the 12-month follow-up, a significantly higher percentage of participants developed type 2 diabetes in the control compared with zinc-treated group (25.0% vs 11.0% respectively; P = 0.016). Fasting plasma glucose (FPG), 2-h glucose levels in the oral glucose tolerance test (OGTT), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) were significantly lower in the treated group, with significant improvement in β-cell function. In all four regression models, the best predictor of the dependent variables (i.e. change in FPG, 2-h glucose in the OGTT, HOMA-IR, and homeostatic model assessment of β-cell function) was zinc treatment. CONCLUSIONS Zinc supplementation reduced blood glucose and insulin resistance while improving β-cell function. Furthermore, supplementation reduced disease progression to diabetes and had beneficial effects on TC and LDL-C.
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Affiliation(s)
- Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | | | - Prasad Katulanda
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Godwin R Constantine
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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29
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Shah M, Vasandani C, Adams-Huet B, Garg A. Comparison of nutrient intakes in South Asians with type 2 diabetes mellitus and controls living in the United States. Diabetes Res Clin Pract 2018; 138:47-56. [PMID: 29382587 DOI: 10.1016/j.diabres.2018.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/19/2017] [Accepted: 01/23/2018] [Indexed: 10/18/2022]
Abstract
AIMS Despite having a high risk for type 2 diabetes mellitus (T2DM), little is known about the relationship between nutrient intakes and T2DM in South Asians (SA) in the U.S. In addition, the available data are limited to a few macronutrients and collected using subjective measures. Therefore, we compared macro- and micro-nutrient intakes of SA migrants with and without T2DM using an objective measure. METHODS SA in the U.S. with T2DM (n = 44) and controls (n = 33) reported their dietary intake using image-assisted dietary assessment method. They took pictures of all foods/drinks consumed on two weekdays and one weekend day. Age, gender distribution, and body mass index were similar across the two groups. RESULTS SA with T2DM, as compared to controls, consumed less total energy (mean difference: 499 kcal/d; p < .0001), linoleic acid (3.6 g/d; p = .003), dietary fiber (8.6 g/d; p < .0001), vitamin A (262 µg/d; p = .003), vitamin E (2.7 mg/d; p = .007), calcium (133 mg/d; p = .01), magnesium (116 mg/d; p < .0001), zinc (1.4 mg/d; p = .004), potassium (754 mg/d; p < .0001), and β-carotene (1761 µg/d; p = .03). SA with T2DM, as compared to controls, were significantly more likely not to meet the requirements for linoleic acid, dietary fiber, vitamin E, calcium, magnesium, zinc, and potassium (p < .05). CONCLUSIONS SA with T2DM, compared to controls, consume less total energy and have lower consumption of many nutrients associated with reduced risk of T2DM. Dietary interventions to reduce risk for T2DM are warranted in SA.
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Affiliation(s)
- Meena Shah
- Division of Nutrition and Metabolic Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States; Center for Human Nutrition, UT Southwestern Medical Center, Dallas, TX, United States; Department of Kinesiology, Texas Christian University, Fort Worth, TX, United States.
| | - Chandna Vasandani
- Division of Nutrition and Metabolic Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States; Center for Human Nutrition, UT Southwestern Medical Center, Dallas, TX, United States
| | - Beverley Adams-Huet
- Division of Biostatistics, Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, United States
| | - Abhimanyu Garg
- Division of Nutrition and Metabolic Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States; Center for Human Nutrition, UT Southwestern Medical Center, Dallas, TX, United States.
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30
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Eshak ES, Iso H, Yamagishi K, Maruyama K, Umesawa M, Tamakoshi A. Associations between copper and zinc intakes from diet and mortality from cardiovascular disease in a large population-based prospective cohort study. J Nutr Biochem 2018. [PMID: 29529560 DOI: 10.1016/j.jnutbio.2018.02.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Several studies have related cardiovascular disease (CVD) to serum concentrations of copper and zinc but not to their dietary intakes. We thought to examine the association between dietary intakes of copper and zinc with risk of mortality from CVD in a prospective study encompassing 58,646 healthy Japanese men and women aged 40-79 years. The intakes of copper and zinc were determined by a validated self-administered food frequency questionnaire, and their associations with risk of mortality from CVD were evaluated by Cox proportional hazard modelling. During 965, 970 person-years of follow-up between 1989-2009, we documented 3,388 CVD deaths [1,514 from stroke, 702 from coronary heart disease (CHD) and 1,172 from other CVD]. Copper intake was not associated with CHD mortality; however, the multivariable hazard ratios (HRs) with 95% confidence intervals (CIs) for mortality from stroke, other CVD and total CVD in the highest versus the lowest quintiles of copper intake among men were 1.78 (1.16-2.77; P-trend=0.007), 1.61 (1.01-2.81; P-trend =0.03) and 1.63 (1.21-2.33; P-trend=0.001), respectively, and those among women were 1.49 (1.00-2.19; P-trend=0.04), 1.59 (1.09-2.55; P-trend =0.02) and 1.36 (1.06-1.69; P-trend=0.01), respectively. Higher intakes of zinc was inversely associated with mortality from CHD in men; 0.68 (0.58-1.03; P-trend=0.05) but not women; 1.13 (0.71- 1.49; P-trend=0.61). No associations were observed with other mortality endpoints. In conclusion, dietary copper intake was positively associated with mortality from CVD in both genders; whereas, higher dietary zinc intake was inversely associated with mortality from CHD in men but not women.
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Affiliation(s)
- Ehab S Eshak
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita Shi, Osaka 565-0871, Japan; Department of Public Health and Preventive Medicine, Faculty of Medicine, Minia University, Shalaby land, Minia, 61511, Egypt.
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita Shi, Osaka 565-0871, Japan.
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
| | - Koutatsu Maruyama
- Laboratory of Community Health and Nutrition, Special Course of Food and Health Science, Department of Bioscience, Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan.
| | - Mitsumasa Umesawa
- Department of Public Health, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan.
| | - Akiko Tamakoshi
- Public Health, Department of Social Medicine, Graduate School of Medicine, Hokkaido University, Kita 15 Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
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Milton AH, Vashum KP, McEvoy M, Hussain S, McElduff P, Byles J, Attia J. Prospective Study of Dietary Zinc Intake and Risk of Cardiovascular Disease in Women. Nutrients 2018; 10:nu10010038. [PMID: 29300299 PMCID: PMC5793266 DOI: 10.3390/nu10010038] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/08/2017] [Accepted: 12/15/2017] [Indexed: 11/16/2022] Open
Abstract
Several animal and human studies have shown that zinc is associated with cellular damage and cardiac dysfunction. This study aims to investigate dietary zinc and the zinc-iron ratio, as predictors of incident cardiovascular disease (CVD) in a large longitudinal study of mid-age Australian women (aged 50-61 years). Data was self-reported and validated food frequency questionnaires were used to assess dietary intake. Energy-adjusted zinc was ranked using quintiles and predictors of incident CVD were examined using stepwise logistic regression. After six years of follow-up, 320 incident CVD cases were established. A positive association between dietary zinc intake, zinc-iron ratio and risk of CVD was observed even after adjusting for potential dietary and non-dietary confounders. Compared to those with the lowest quintile of zinc, those in the highest quintile (Odds Ratio (OR) = 1.67, 95% Confidence Interval (CI) = 1.08-2.62) and zinc-iron ratio (OR = 1.72, 95% CI = 1.05-2.81) had almost twice the odds of developing CVD (p trend = 0.007). This study shows that high dietary zinc intake and zinc-iron ratio is associated with a greater incidence of CVD in women. Further studies are required detailing the source of zinc and iron in diet and their precise roles when compared to other essential nutrients.
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Affiliation(s)
- Abul Hasnat Milton
- Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
| | - Khanrin P Vashum
- Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
| | - Mark McEvoy
- Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
| | - Sumaira Hussain
- Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
| | - Patrick McElduff
- Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
| | - Julie Byles
- Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
| | - John Attia
- Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
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Giacconi R, Cai L, Costarelli L, Cardelli M, Malavolta M, Piacenza F, Provinciali M. Implications of impaired zinc homeostasis in diabetic cardiomyopathy and nephropathy. Biofactors 2017; 43:770-784. [PMID: 28845600 DOI: 10.1002/biof.1386] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/12/2017] [Accepted: 07/27/2017] [Indexed: 12/18/2022]
Abstract
Impaired zinc homeostasis is observed in diabetes mellitus (DM2) and its complications. Zinc has a specific role in pancreatic β-cells via insulin synthesis, storage, and secretion. Intracellular zinc homeostasis is tightly controlled by zinc transporters (ZnT and Zip families) and metallothioneins (MT) which modulate the uptake, storage, and distribution of zinc. Several investigations in animal models demonstrate the protective role of MT in DM2 and its cardiovascular or renal complications, while a copious literature shows that a common polymorphism (R325W) in ZnT8, which affects the protein's zinc transport activity, is associated with increased DM2 risk. Emerging studies highlight a role of other zinc transporters in β-cell function, suggesting that targeting them could make a possible contribution in managing the hyperglycemia in diabetic patients. This article summarizes the current findings concerning the role of zinc homeostasis in DM2 pathogenesis and development of diabetic cardiomyopathy and nephropathy and suggests novel therapeutic targets. © 2017 BioFactors, 43(6):770-784, 2017.
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Affiliation(s)
- Robertina Giacconi
- Translational Research Center of Nutrition and Ageing, Scientific and Technological Pole, Italian National Institute of Health and Science on Aging (INRCA), Ancona, Italy
| | - Lu Cai
- Pediatric Research Institute at the Department of Pediatrics, Wendy L. Novak Diabetes Care Center, University of Louisville, Louisville, KY, USA
| | - Laura Costarelli
- Translational Research Center of Nutrition and Ageing, Scientific and Technological Pole, Italian National Institute of Health and Science on Aging (INRCA), Ancona, Italy
| | - Maurizio Cardelli
- Advanced Technology Center for Aging Research, Scientific and Technological Pole, Italian National Institute of Health and Science on Aging (INRCA), Ancona, Italy
| | - Marco Malavolta
- Translational Research Center of Nutrition and Ageing, Scientific and Technological Pole, Italian National Institute of Health and Science on Aging (INRCA), Ancona, Italy
| | - Francesco Piacenza
- Translational Research Center of Nutrition and Ageing, Scientific and Technological Pole, Italian National Institute of Health and Science on Aging (INRCA), Ancona, Italy
| | - Mauro Provinciali
- Advanced Technology Center for Aging Research, Scientific and Technological Pole, Italian National Institute of Health and Science on Aging (INRCA), Ancona, Italy
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Drake I, Hindy G, Ericson U, Orho-Melander M. A prospective study of dietary and supplemental zinc intake and risk of type 2 diabetes depending on genetic variation in SLC30A8. GENES AND NUTRITION 2017; 12:30. [PMID: 29093761 PMCID: PMC5661924 DOI: 10.1186/s12263-017-0586-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/19/2017] [Indexed: 11/26/2022]
Abstract
Background The solute carrier family 30 member 8 gene (SLC30A8) encodes a zinc transporter in the pancreatic beta cells and the major C-allele of a missense variant (rs13266634; C/T; R325W) in SLC30A8 is associated with an increased risk of type 2 diabetes (T2D). We hypothesized that the association between zinc intake and T2D may be modified by the SLC30A8 genotype. Results We carried out a prospective study among subjects with no history cardio-metabolic diseases in the Malmö Diet and Cancer Study cohort (N = 26,132, 38% men; 86% with genotype data). Zinc intake was assessed using a diet questionnaire and food record. During a median follow-up of 19 years, 3676 T2D cases occurred. A BMI-stratified Cox proportional hazards regression model with attained age as the time scale was used to model the association between total and dietary zinc intake, zinc supplement use, zinc to iron ratio, and risk of T2D adjusting for putative confounding factors. The median total zinc intake was 11.4 mg/day, and the median dietary zinc intake was 10.7 mg/day. Zinc supplement users (17%) had a median total zinc intake of 22.4 mg/day. Dietary zinc intake was associated with increased risk of T2D (Ptrend < 0.0001). In contrast, we observed a lower risk of T2D among zinc supplement users (HR = 0.79, 95% CI 0.70–0.89). The SLC30A8 CC genotype was associated with a higher risk of T2D (HR = 1.16, 95% CI 1.07–1.24), and the effect was stronger among subjects with higher BMI (Pinteraction = 0.007). We observed no significant modification of the zinc-T2D associations by SLC30A8 genotype. However, a three-way interaction between SLC30A8 genotype, BMI, and zinc to iron ratio was observed (Pinteraction = 0.007). A high zinc to iron ratio conferred a protective associated effect on T2D risk among obese subjects, and the effect was significantly more pronounced among T-allele carriers. Conclusions Zinc supplementation and a high zinc to iron intake ratio may lower the risk of T2D, but these associations could be modified by obesity and the SLC30A8 genotype. The findings implicate that when considering zinc supplementation for T2D prevention, both obesity status and SLC30A8 genotype may need to be accounted for. Electronic supplementary material The online version of this article (10.1186/s12263-017-0586-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Isabel Drake
- Diabetes and Cardiovascular Disease - Genetic Epidemiology, Lund University Diabetes Centre, Department of Clinical Sciences in Malmö, Lund University, Clinical Research Center 60:13, Jan Waldenströms gata 35, SE-205 02 Malmö, Sweden
| | - George Hindy
- Diabetes and Cardiovascular Disease - Genetic Epidemiology, Lund University Diabetes Centre, Department of Clinical Sciences in Malmö, Lund University, Clinical Research Center 60:13, Jan Waldenströms gata 35, SE-205 02 Malmö, Sweden
| | - Ulrika Ericson
- Diabetes and Cardiovascular Disease - Genetic Epidemiology, Lund University Diabetes Centre, Department of Clinical Sciences in Malmö, Lund University, Clinical Research Center 60:13, Jan Waldenströms gata 35, SE-205 02 Malmö, Sweden
| | - Marju Orho-Melander
- Diabetes and Cardiovascular Disease - Genetic Epidemiology, Lund University Diabetes Centre, Department of Clinical Sciences in Malmö, Lund University, Clinical Research Center 60:13, Jan Waldenströms gata 35, SE-205 02 Malmö, Sweden
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Eshak ES, Iso H, Maruyama K, Muraki I, Tamakoshi A. Associations between dietary intakes of iron, copper and zinc with risk of type 2 diabetes mellitus: A large population-based prospective cohort study. Clin Nutr 2017; 37:667-674. [PMID: 28285974 DOI: 10.1016/j.clnu.2017.02.010] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 02/08/2017] [Accepted: 02/10/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND & AIMS Abnormal homeostasis of iron, copper and zinc has been included in the pathogenesis of type 2 diabetes mellitus (T2DM). However, the evidence of associations between dietary intakes of these elements and T2DM is limited. We thought to examine the association between dietary intakes of iron, copper and zinc with risk of T2DM in Japanese population. METHODS A prospective study encompassing 16,160 healthy Japanese men and women aged 40-65 years in whom the associations between dietary intakes of iron, copper and zinc, determined by a validated self-administered food frequency questionnaire, with risk of 5-year cumulative incidence of validated physician-diagnosed T2DM, were evaluated by logistic regression model. RESULTS We ascertained 396 self-reported new cases of diabetes within 5-year period. Dietary intakes of iron (total and nonheme but not heme iron) and copper were positively associated with risk of T2DM; the multivariable OR in the highest versus lowest quartiles of intakes were 1.32 (1.04, 1.70; P-trend = 0.03) and 1.55 (1.13, 2.02; P-trend = 0.003), respectively. These associations were more evident in the high risk group; older, overweight, smokers and those with family history of diabetes. The dietary intake of zinc was inversely associated with risk of T2DM; the multivariable OR was 0.64 (0.54, 1.00; P-trend = 0.003), and such association was evident among younger subjects (age 40-55 years) only. CONCLUSIONS Dietary intakes of iron and copper were associated with a higher risk, while dietary intake of zinc was associated with a reduced risk of T2DM in Japanese population.
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Affiliation(s)
- Ehab S Eshak
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan; Public Health and Community Medicine Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Koutatsu Maruyama
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Isao Muraki
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Akiko Tamakoshi
- Public Health, Department of Social Medicine, Graduate School of Medicine, Hokkaido University, Japan
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Mispireta ML, Caulfield LE, Zavaleta N, Merialdi M, Putnick DL, Bornstein MH, DiPietro JA. Effect of maternal zinc supplementation on the cardiometabolic profile of Peruvian children: results from a randomized clinical trial. J Dev Orig Health Dis 2017; 8:56-64. [PMID: 27748235 PMCID: PMC5822716 DOI: 10.1017/s2040174416000568] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Zinc is an essential micronutrient for the development of the fetal renal, cardiovascular and metabolic systems; however, there is limited evidence of its effects on the postnatal cardiometabolic function. In this study, we evaluated the effect of maternal zinc supplementation during pregnancy on the cardiometabolic profile of the offspring in childhood. A total of 242 pregnant women were randomly assigned to receive a daily supplement containing iron+folic acid with or without zinc. A follow-up study was conducted when children of participating mothers were 4.5 years of age to evaluate their cardiometabolic profile, including anthropometric measures of body size and composition, blood pressure, lipid profile and insulin resistance. No difference in measures of child cardiometabolic risk depending on whether mothers received supplemental zinc during pregnancy. Our results do not support the hypothesis that maternal zinc supplementation reduces the risk of offspring cardiometabolic disease.
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Affiliation(s)
- M L Mispireta
- 1Kasiska School of Health Professions,Idaho State University,Pocatello,ID,USA
| | - L E Caulfield
- 2Department of International Health,Center for Human Nutrition,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA
| | - N Zavaleta
- 4Instituto de Investigación Nutricional,Lima,Peru
| | - M Merialdi
- 5Global Health Division,Becton Dickinson, Franklin Lakes,NJ,USA
| | - D L Putnick
- 6Eunice Kennedy ShriverNational Institute of Child Health and Human Development,National Institutes of Health,Bethesda,MD,USA
| | - M H Bornstein
- 6Eunice Kennedy ShriverNational Institute of Child Health and Human Development,National Institutes of Health,Bethesda,MD,USA
| | - J A DiPietro
- 3Department of Population, Family and Reproductive Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA
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Chu A, Foster M, Samman S. Zinc Status and Risk of Cardiovascular Diseases and Type 2 Diabetes Mellitus-A Systematic Review of Prospective Cohort Studies. Nutrients 2016; 8:E707. [PMID: 27827959 PMCID: PMC5133094 DOI: 10.3390/nu8110707] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/25/2016] [Accepted: 10/26/2016] [Indexed: 12/03/2022] Open
Abstract
Zinc is an essential trace element with proposed therapeutic effects in Type 2 diabetes mellitus (DM), however, the associations between zinc status and the prospective risks of cardiovascular diseases (CVD) and Type 2 DM have not been evaluated. The current systematic review aims to determine the relationships between zinc intake or plasma/serum zinc levels and prospective incidence of CVD and Type 2 DM. Fourteen papers describing prospective cohort studies were included, reporting either CVD (n = 91,708) and/or Type 2 DM (n = 334,387) outcomes. Primary analyses from four out of five studies reported no association between zinc intake and CVD events, when adjusted for multiple variables. Higher serum zinc level was associated with lower risk of CVD in three out of five studies; pronounced effects were observed in vulnerable populations, specifically those with Type 2 DM and patients referred to coronary angiography. The limited evidence available suggests no association between zinc status and Type 2 DM risk. Further investigations into the mechanisms of zinc's action on the pathogenesis of chronic diseases and additional evidence from observational studies are required to establish a recommendation for dietary zinc in relation to the prevention of CVD and Type 2 DM.
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Affiliation(s)
- Anna Chu
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand.
| | - Meika Foster
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand.
| | - Samir Samman
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand.
- Discipline of Nutrition and Metabolism, School of Life and Environmental Sciences, University of Sydney, Sydney 2006, NSW, Australia.
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Abstract
Zinc (Zn) is important in a number of processes related to insulin secretion and insulin activity in peripheral tissues, making this element an interesting potential co-adjuvant in the treatment of patients with type 2 diabetes (T2D). This issue has been matter of interest in recent years. The available evidence is analyzed in this review. Information from epidemiologic studies evaluating the relationship between Zn and T2D is inconsistent. Furthermore, few studies examined the association between Zn status and insulin action and/or glucose homeostasis. In terms of usefulness of Zn as a preventive agent for T2D development, information is insufficient to reach firm conclusions. Results from Zn supplementation trials found some positive effects only in those with initial sub normal Zn status in a significant proportion of individuals. In conclusion, the effect of Zn on patients with type 2 diabetes is still an open question, and better study designs are needed to clarify the real impact and characteristics of the Zn-diabetes interaction.
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Affiliation(s)
- Manuel Ruz
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Postal Code 8380453, Santiago, Chile.
| | - Fernando Carrasco
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Postal Code 8380453, Santiago, Chile
| | - Andrés Sánchez
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Postal Code 8380453, Santiago, Chile
| | - Alvaro Perez
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Postal Code 8380453, Santiago, Chile
| | - Pamela Rojas
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Postal Code 8380453, Santiago, Chile
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Ho M, Baur LA, Cowell CT, Samman S, Garnett SP. Zinc status, dietary zinc intake and metabolic risk in Australian children and adolescents; Nepean Longitudinal Study. Eur J Nutr 2016; 56:2407-2414. [DOI: 10.1007/s00394-016-1280-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 07/21/2016] [Indexed: 12/01/2022]
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Park JS, Xun P, Li J, Morris SJ, Jacobs DR, Liu K, He K. Longitudinal association between toenail zinc levels and the incidence of diabetes among American young adults: The CARDIA Trace Element Study. Sci Rep 2016; 6:23155. [PMID: 26980156 PMCID: PMC4793256 DOI: 10.1038/srep23155] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 02/25/2016] [Indexed: 01/04/2023] Open
Abstract
Data on primary prevention of zinc status and diabetes risk are sparse and inconsistent. Of note, the previous studies measured either dietary zinc intake with questionnaire or zinc status in serum or hair. Toenail zinc levels are reliable biomarkers of a relatively long-term exposure. A total of 3,960 American young adults, aged 20-32 years, free of diabetes at baseline in 1987 when toenail clippings were collected, were examined for incident diabetes through 2010. Toenail zinc levels were measured with an inductively-coupled-plasma mass spectroscopy method. Incident diabetes cases were identified by fasting or non-fasting plasma glucose levels, oral glucose tolerance tests, hemoglobin A1C levels, and/or antidiabetic medications. During the 23-year follow-up, 418 incident diabetes occurred. After adjusted for age, sex, ethnicity, study center, body mass index, education, smoking status, alcohol consumption, physical activity, family history of diabetes, homeostasis model assessment of insulin resistance, and other dietary and non-dietary potential confounders, the hazard ratio of incident diabetes comparing the highest to the lowest quartile of toenail zinc levels was 1.21 (95% CI: 0.90-1.63; Ptrend = 0.20). Findings from this study do not support the hypothesis that zinc status is inversely and longitudinally associated with the incidence of diabetes in American young adults.
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Affiliation(s)
- Jong Suk Park
- Department of Epidemiology and Biostatistics, School of Public Health–Bloomington, Indiana University, Bloomington, Indiana, USA
- Department of Endocrinology and Metabolism, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, School of Public Health–Bloomington, Indiana University, Bloomington, Indiana, USA
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health–Bloomington, Indiana University, Bloomington, Indiana, USA
| | - Steve J. Morris
- The Research Reactor Center, University of Missouri-Columbia and Harry S. Truman Memorial Veterans Hospital, Columbia, Missouri, USA
| | - David R. Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kiang Liu
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ka He
- Department of Epidemiology and Biostatistics, School of Public Health–Bloomington, Indiana University, Bloomington, Indiana, USA
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Zhang M, Zhu Y, Li P, Chang H, Wang X, Liu W, Zhang Y, Huang G. Associations between Dietary Patterns and Impaired Fasting Glucose in Chinese Men: A Cross-Sectional Study. Nutrients 2015; 7:8072-89. [PMID: 26402695 PMCID: PMC4586577 DOI: 10.3390/nu7095382] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/12/2015] [Accepted: 09/15/2015] [Indexed: 12/15/2022] Open
Abstract
Few studies have examined the association between Asian dietary pattern and prediabetes, in particular, the Chinese diet. We conducted a cross-sectional study to identify dietary patterns associated with impaired fasting glucose (IFG) which considered a state of prediabetes in Chinese men. The study included 1495 Chinese men aged 20 to 75 years. Information about diet was obtained using an 81-item food frequency questionnaire (FFQ), and 21 predefined food groups were considered in a factor analysis. Three dietary patterns were generated by factor analysis: (1) a vegetables-fruits pattern; (2) an animal offal-dessert pattern; and (3) a white rice-red meat pattern. The multivariate-adjusted odds ratio (OR) of IFG for the highest tertile of the animal offal-dessert pattern in comparison with the lowest tertile was 3.15 (95% confidence intervals (CI): 1.87-5.30). The vegetables-fruits dietary pattern was negatively associated with the risk of IFG, but a significant association was observed only in the third tertile. There was no significant association between IFG and the white rice-red meat pattern. Our findings indicated that the vegetables-fruits dietary pattern was inversely associated with IFG, whereas the animal offal-dessert pattern was associated with an increased risk of IFG in Chinese men. Further prospective studies are needed to elucidate the diet-prediabetes relationships.
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Affiliation(s)
- Meilin Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
| | - Yufeng Zhu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
| | - Ping Li
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
| | - Hong Chang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, 22 Qixiangtai Road, Heping District,Tianjin 300070, China.
| | - Xuan Wang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
| | - Weiqiao Liu
- Health Education and Guidance Center of Heping District, 97 Hualong Road, Heping District, Tianjin 300040, China.
| | - Yuwen Zhang
- Health Education and Guidance Center of Heping District, 97 Hualong Road, Heping District, Tianjin 300040, China.
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
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McCarty MF, DiNicolantonio JJ. The protection conferred by chelation therapy in post-MI diabetics might be replicated by high-dose zinc supplementation. Med Hypotheses 2015; 84:451-5. [DOI: 10.1016/j.mehy.2015.01.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 01/23/2015] [Accepted: 01/26/2015] [Indexed: 12/20/2022]
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Abdali D, Samson SE, Grover AK. How effective are antioxidant supplements in obesity and diabetes? Med Princ Pract 2015; 24:201-15. [PMID: 25791371 PMCID: PMC5588240 DOI: 10.1159/000375305] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 01/18/2015] [Indexed: 12/19/2022] Open
Abstract
Obesity is a central health issue due to its epidemic prevalence and its association with type 2 diabetes and other comorbidities. Obesity is not just being overweight. It is a metabolic disorder due to the accumulation of excess dietary calories into visceral fat and the release of high concentrations of free fatty acids into various organs. It represents a state of chronic oxidative stress and low-grade inflammation whose intermediary molecules may include leptin, adiponectin and cytokines. It may progress to hyperglycemia, leading to type 2 diabetes. Whether or not dietary antioxidant supplements are useful in the management of obesity and type 2 diabetes is discussed in this review. Only the benefits for obesity and diabetes are examined here. Other health benefits of antioxidants are not considered. There are difficulties in comparing studies in this field because they differ in the time frame, participants' ethnicity, administration of antioxidant supplements, and even in how obesity was measured. However, the literature presents reasonable evidence for marginal benefits of supplementation with zinc, lipoic acid, carnitine, cinnamon, green tea, and possibly vitamin C plus E, although the evidence is much weaker for omega-3 polyunsaturated fatty acids, coenzyme Q10, green coffee, resveratrol, or lycopene. Overall, antioxidant supplements are not a panacea to compensate for a fast-food and video-game way of living, but antioxidant-rich foods are recommended as part of the lifestyle. Such antioxidant foods are commonly available.
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Affiliation(s)
| | | | - Ashok Kumar Grover
- *Dr. Ashok K. Grover, Department of Medicine, HSC 4N41, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 (Canada), E-Mail
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