Effect of Zinc Supplementation on Serum Homocysteine in Type 2 Diabetic Patients with Microalbuminuria

Abstract

■ AbstractOBJECTIVES: Elevated homocysteine levels are considered to be an independent risk factor for cardiovascular complications in diabetic patients. The aim of this study was to find out if zinc supplementation improves homocysteine levels, which may exert vascular-protective effects in type 2 diabetes subjects with microalbuminuria. METHODS: In a randomized, double-blind, controlled, crossover study, 50 type 2 diabetic patients with microalbuminuria were subdivided into two groups and supplemented with 30 mg/d of zinc (group 1) or placebo (group 2) for three months with a fourweek wash out period. Serum creatinine, vitamin B 12 , folate, fasting plasma glucose, HbA1c, lipid profiles, zinc, homocysteine levels and random urine albumin were measured before and after the first and second phase of the study in all participants. RESULTS: Mean serum zinc was significantly increased after zinc supplementation (from 76 ± 16 µg/dl to 93 ± 20 µg/dl; p < 0.05), while there was no change in the placebo group (75 ± 16 µg/dl to 75 ± 15 µg/dl). With zinc supplementation, homocysteine levels reduced significantly (from 13.71 ± 3.84 µmol/l to 11.79 ± 3.06 µmol/l; p < 0.05), which did not occur on placebo (from 12.59 ± 2.13 µmol/l to 13.36 ± 2.03 µmol/l). Simple regression was used to show a positive correlation between urine albumin excretion and serum homocysteine (r = 0.37, p = 0.023). Vitamin B 12 and folate levels increased significantly in patients who received zinc in comparison to those who received placebo. A negative correlation was observed between homocysteine and vitamin B 12 concentration (r = -0.36, p = 0.025). CON-CLUSION: Zinc supplementation reduced serum homocysteine and increased vitamin B 12 and folate concentrations in type 2 diabetic patients with microalbuminuria.

Serum Vitamins and Heavy Metals in Blood and Urine, and the Correlations among Them in Parkinson’s Disease Patients in China

“…Morning blood and urine samples were collected before breakfast and used to measure concentrations of Fe, Cu, Zn, Mn, vitamin E and vitamin B 12 . Serum and urine Fe, Cu and Zn levels were measured by inductively coupled plasma atomic emission spectrometry.…”

“…A negative correlation was observed between homocysteine and vitamin B 12 concentration in diabetic patients. Zinc (Zn) supplementation reduced serum homocysteine and increased vitamin B 12 [12] . From these results, Zn intake and its peripheral metabolism may be important to increase vitamin B 12 and consequently prevent PD reducing homocysteine.…”

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“…These enzymes belong to zinc-containing metalloenzymes and the binding of Hcy to BHMT is carried out by zinc. Moreover, Hcy is activated through zinc for conversion to methionine (Heidarian et al, 2009). The zinc deficiency can describe Hcy enhancement.…”

The Role of Zinc in Renal Pathological Changes in Diabetic Status

“…Several studies have investigated the effects of Zn supplementation on microalbuminuria in DM patients [41,[44][45][46]. Results from studies show a significant decrease in UAE in subjects given Zn, whereas subjects not given Zn exhibited consistent high UAE levels [41].…”

“…Also high homocysteine concentrations in plasma are associated with glomerular filtration impairment [45]. Hence a decrease in this amino acid after Zn supplementation shows promising results.…”