Role of zinc supplementation in type II diabetes mellitus

Niewoehner, Catherine; Allen, John I.; Boosalis, Maria G.; Levine, Allen S.; Morley, John E.

doi:10.1016/0002-9343(86)90183-x

Cited by 116 publications

(47 citation statements)

References 27 publications

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“…Previous studies have shown that serum zinc level is lower in diabetic patients than in nondiabetic subjects, increased urinary zinc excretion being the main reason (2,(11)(12). There are studies where zinc supplementation in diabetic patients shows antioxidant properties (13,14).…”

Section: Results -mentioning

confidence: 99%

Serum Zinc Level and Coronary Heart Disease Events in Patients With Type 2 Diabetes

Marniemi²,

et al. 2007

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OBJECTIVE -Low serum zinc level may predispose nondiabetic subjects to cardiovascular diseases. Our aim was to investigate whether serum zinc level predicts coronary heart disease (CHD) events in subjects with type 2 diabetes RESEARCH DESIGN AND METHODS -The original study population consisted of 1,059 patients with type 2 diabetes, aged 45-64 years. Mean duration of diabetes was 8 years.Serum zinc values were available from 1,050 subjects. CHD mortality and the incidence of nonfatal myocardial infarction (MI) were assessed in a 7-year follow-up.RESULTS -During the follow-up, 156 patients died from CHD and 254 patients had a fatal or nonfatal MI. Patients with serum zinc concentration Յ14.1 mol/l at baseline had a higher risk for death from CHD than patients with serum zinc level Ͼ14.1 mol/l (20.8 and 12.8%, respectively; P ϭ 0.001) The risks for fatal or nonfatal MI were 30.5 and 22.0%, respectively (P ϭ 0.005). In Cox regression analyses, low serum zinc concentration was significantly associated with CHD mortality (relative risk [RR] 1.7, P ϭ 0.002) and all CHD events (RR 1.37, P ϭ 0.030), even after adjustment for confounding variables.CONCLUSIONS -In this large cohort of type 2 diabetic patients, low serum zinc level was an independent risk factor for CHD events. Diabetes Care 30:523-528, 2007C oronary heart disease (CHD) is a major cause of death in type 2 diabetic patients, and the risk of CHD is two-to fourfold higher among patients with type 2 diabetes than in nondiabetic subjects. This enhanced risk is partly explained by traditional risk factors, e.g., hypertension, plasma lipid and lipoprotein abnormalities, smoking, and obesity, but all of the excess risk cannot be explained by these conventional risk factors. Nontraditional risk factors may be important in the pathogenesis of CHD in patients with type 2 diabetes.Because serum zinc is a micronutrient with known antioxidant activity (1), it might be relevant to assess its role in the atherogenesis in type 2 diabetes. Patients with diabetes have lower serum levels of zinc (2).In nondiabetic subjects there are studies suggesting that low serum level of zinc is associated with increased incidence of cardiovascular disease (3-5). To our knowledge, there are no studies in type 2 diabetic patients on the association between low serum levels of zinc and cardiovascular events. In this large prospective study with type 2 diabetic patients, we examined the association between serum zinc level and CHD events. RESEARCH DESIGN AND METHODSBaseline study A detailed description of study participants has been given elsewhere (6). Patients with type 2 diabetes, aged 45-64 years, who were born and living in the Turku University Central Hospital district in West Finland or in the Kuopio University Hospital district in East Finland were identified through a national drug reimbursement register. The final population consisted of 1,059 type 2 diabetic subjects. Of these, 328 men and 221 women were from West Finland (participation rate 79%), and 253 men and 257 women were fr...

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Section: Results -mentioning

confidence: 99%

Serum Zinc Level and Coronary Heart Disease Events in Patients With Type 2 Diabetes

Marniemi²,

et al. 2007

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“…Similar inconsistencies regarding an effect on serum Zn concentration are also evident (1)(2)(3)(4)(5)(6)(7)(8)(10)(11)(12)(13)(14)(15)(16). Conclusive evidence of high urinary Zn loss combined with limited evidence of depressed Zn absorption has prompted speculation that diabetics may be at greater risk of Zn deficiency (3,10,15,17), and that dietary Zn supplementation should be recommended (15,17). However, because excessive Zn intake may inhibit normal Cu metabolism (18,19), more conclusive evidence of decreased Zn absorption and risk of Zn deficiency is needed before dietary Zn supplements can be confidently recommended to diabetic patients.…”

mentioning

confidence: 79%

“…Using a variety of methods, experimental models, and measures of Zn absorption, different investigators have interpreted their results to indicate decreased (9-ll), increased (4,12), or no difference (13,14) in Zn absorption by diabetics. Similar inconsistencies regarding an effect on serum Zn concentration are also evident (1)(2)(3)(4)(5)(6)(7)(8)(10)(11)(12)(13)(14)(15)(16). Conclusive evidence of high urinary Zn loss combined with limited evidence of depressed Zn absorption has prompted speculation that diabetics may be at greater risk of Zn deficiency (3,10,15,17), and that dietary Zn supplementation should be recommended (15,17).…”

mentioning

confidence: 97%

Role of Metallothionein and Cysteine-Rich Intestinal Protein in the Regulation of Zinc Absorption by Diabetic Rats

et al. 1995

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Hyperzincuria and low Zn absorption in diabetic animals and humans have prompted speculation that diabetics are more susceptible to Zn deficiency. There is little information, however, describing the effects of diabetes on the biochemical mechanisms of intestinal Zn transport. We evaluated Zn absorption in streptozotocin-induced diabetic rats based on a model of Zn transport in which cysteine-rich intestinal protein serves as an intracellular carrier that is inhibited by metallothionein (MT). Apparent absorption and retention of Zn and Cu in rats fed a purified diet were measured in a balance study 15-17 d after induction of diabetes. The rate of 65Zn absorption from isolated intestinal segments, molecular distribution of 65Zn in mucosal cytosol, and tissue MT levels were measured on d 20-22. Food consumption, and thus Zn and Cu intake, by diabetic rats was twice that of controls. Although fractional absorption (percent) of Zn and Cu was lower in the diabetic rats, net absorption (~g1100 g body weightld) was higher. The higher net absorption in the diabetic group was offset, however, by higher urinary excretion, so that Zn and Cu retention was similar in both groups of animals. Low fractional absorption is attributable to the down-regulation of intestinal Zn transport, as indicated by the lower rate of 65Zn absorption from isolated intestinal segments in the diabetic rats. Down-regulation of intestinal transport is in turn attributable to higher concentrations of intestinal MT, which resulted in more 65Zn in the mucosal cytosol bound to MT, an inhibitor of Zn transport, and less to cysteine-rich intestinal protein. These observations are similar to those previously described in rats consuming normal amounts of a diet containing excess Zn and are consistent with an antagonistic relationship between cysteinerich intestinal protein and MT in Zn transport. The results suggest that decreased Zn absorption in diabetic rats is not a disease-related defect in Zn transport but instead is a homeostatic response to high Zn intake caused by overconsumption of a diet with a moderate Zn content. (Pediatr Res 37: 321-327, 1995) Abbreviations I

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“…(20), testando os efeitos da suplementação de Zn em pacientes com DM tipo 2, não constataram diferença significativa nos níveis de HbA1c no grupo de pacientes após a suplementação. O efeito agudo da suplementação oral de Zn em pessoas saudáveis com doses de 25, 37,5 e 50mg/dia também não alterou o metabolismo da glicose nem da insulina plasmática (21).…”

Section: Discussionunclassified

Efeito da suplementação com zinco sobre a zincúria de pacientes com diabetes tipo 1

Sena

Arrais

Brito

et al. 2003

Arq Bras Endocrinol Metab

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572Arq ABSTRACT Effect of Zinc Supplementation on Urinary Zinc Excretion of Patients With Type 1 Diabetes.The effect of oral zinc (Zn) supplementation was investigated in children and adolescents with type 1 diabetes (DM1), evaluating their metabolic control and urinary Zn concentrations. Twenty DM1 patients were compared with a control group (n=17); the metabolic control included fasting glucose levels, 24h urinary glucose levels and HbA1c. Zn concentrations were measured in 24h urine before (T1) and after (T2) supplementation. DM1 patients were given oral supplements of tasteless bis-glycine chelated Zn during a 4 month period after the initial collection of baseline data. Doses were established based on the Dietary Reference Intakes. The results demonstrated unsatisfactory metabolic control due to higher HbA1c levels in some patients, after Zn supplementation. Urinary Zn excretion was higher in DM1 patients and disclosed a positive correlation with disease duration and HbA1c levels. Zn supplementation did not correct the heterogeneity of circadian variation in the studied patients, suggesting that inadequate metabolic control in DM may cause disturbances in Zn metabolism, regardless of the dietary or supplemental source.

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Role of zinc supplementation in type II diabetes mellitus

Cited by 116 publications

References 27 publications

Serum Zinc Level and Coronary Heart Disease Events in Patients With Type 2 Diabetes

Serum Zinc Level and Coronary Heart Disease Events in Patients With Type 2 Diabetes

Role of Metallothionein and Cysteine-Rich Intestinal Protein in the Regulation of Zinc Absorption by Diabetic Rats

Efeito da suplementação com zinco sobre a zincúria de pacientes com diabetes tipo 1

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