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

Abstract

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...

Preventing Diabetes and Diabetic Cardiovascular Diseases with Dietary Zinc

“…Hyperglycemia increases free radicals, which have been implicated as a cause of complications from diabetes [1,9]. This is supported by the earlier study showing an increased risk of diabetes related complications in adults with zinc deficiency [10]. For instance, in this large cohort of patients with type 2 diabetes [T2D], low serum zinc level was an independent risk factor for coronary heart disease [CHD] events [10].…”

“…This is supported by the earlier study showing an increased risk of diabetes related complications in adults with zinc deficiency [10]. For instance, in this large cohort of patients with type 2 diabetes [T2D], low serum zinc level was an independent risk factor for coronary heart disease [CHD] events [10]. In this study, 1,050 patients with T2D with serum zinc values available were followed up for 7 years for their CHD mortality.…”

“…T2D Patients with serum zinc concentration ≤ 14.1 μmol/l at baseline had a higher risk for death from CHD (156/1050, 20.8%) than T2D patients with serum zinc level >14.1 μmol/l (254/1050, 12.8%), respectively (P=0.001). Graph was made by the author based on published data [10].…”

Determinants of serum zinc concentrations in a population of French middle-age subjects (SU.VI.MAX cohort)

“…Zinc is also crucial for immunity (Fraker and King, 2004;Haase and Rink, 2009) and hormonal excretions. Decreases in serum zinc levels have been reported to be associated with a number of chronic diseases of older adults such as cancer (Ho, 2004;Costello et al, 2005) and cardiovascular diseases (Leone et al, 2006;Soinio et al, 2007). With regard to France, zinc intake of healthy adults was estimated in the 1990s to be around 10.5 mg/day in men (Hercberg et al, 1991;Pelus et al, 1994) and 9 mg/day in women (Hercberg et al, 1991); which is lower than the French recommendations (12 mg/day in men and 10 mg/day in women, (Martin, 2001)).…”

EFFECT OF <i>CATHA EDULIS</i> ON INSULIN, RESISTIN AND CORTISOL LEVELS IN TYPE-2 DIABETICS AND NON-DIABETICS

“…Copper acts as a prooxidant and may participate in metal-catalyzed formation of free radicals. Copper (Cu) and Zinc (Zn) play a pivotal role in the oxidant/antioxidant mechanism, imbalance leads to increased susceptibility to oxidative damage of tissues, resulted in pathogenesis of diabetes mellitus or diabetic complications (Soinio et al, 2007). Some investigators have reported the hypothesis that glycated proteins bind transition metals such as copper and iron, playing an important role in the etiology of peripheral vascular dysfunction and peripheral neuropathies in diabetes mellitus (Zheng et al, 2008).…”