Dietary Copper and Selenium Intakes and the Risk of Type 2 Diabetes Mellitus: Findings from the China Health and Nutrition Survey

Zhixin, Cui; Zhou, Haïyan; Liu, Ke; Wu, Man; Li, Shun; Meng, Shuangli; Meng, Huicui

doi:10.3390/nu14102055

Cited by 19 publications

(19 citation statements)

References 60 publications

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“…The higher dietary copper intake may be related to the different dietary habits of adults in Western countries and China. Chinese Accepted manuscript diets tend to include large amounts of grains and legumes (26) , which are major sources of dietary copper (27) , while Western diets are animal-based and rich in red and processed meats (28) . It's giving us an opportunity to explore the association between relatively high levels of dietary copper intake and all-cause mortality.…”

Section: Discussionmentioning

confidence: 99%

J-shaped association between dietary copper intake and all-cause mortality: a prospective cohort study in Chinese adults

Gan

Zhou

et al. 2022

Br J Nutr

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The association between dietary copper intake and mortality risk remains uncertain. We aimed to investigate the relationship of dietary copper intake with all-cause mortality among Chinese adults. A total of 17,310 participants from the China Health and Nutrition Survey (CHNS), a national ongoing open cohort of Chinese participants, were included in the analysis. Dietary intake was measured by 3 consecutive 24-h dietary recalls in combination with a weighing inventory over the same 3 days. The average intakes of the 3-day dietary macronutrients and micronutrients were calculated. The study outcome was all-cause mortality. During a median follow-up of 9.0 years, 1324 (7.6%) participants died. After adjusting for sex, age, body mass index, ever alcohol drinking, ever smoking, education levels, occupations, urban or rural residents, systolic blood pressure, diastolic blood pressure, and the intakes of fat, protein, and carbohydrate, the association between dietary copper intake and all-cause mortality followed a J-shape (P for nonlinearity=0.047). When dietary copper intake was assessed as quartiles, compared with those in the first quartile (<1.60 mg/day), the adjusted hazard ratios (HRs) for all-cause mortality were 0.87 (95%CI: 0.71-1.07), 0.98 (95%CI: 0.79-1.21), and 1.49 (95%CI: 1.19-1.86), respectively, in participants in the second (1.60-<1.83 mg/day), third (1.83-<2.09 mg/day), and fourth (≥2.09 mg/day) quartiles. A series of subgroup analyses and sensitivity analyses showed similar results. Overall, there was a J-shaped relationship of dietary copper intake with risk of all-cause mortality in general Chinese adults, emphasizing the importance of maintaining optimal dietary copper intake levels for prevention of premature death.

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Section: Discussionmentioning

confidence: 99%

J-shaped association between dietary copper intake and all-cause mortality: a prospective cohort study in Chinese adults

Gan

Zhou

et al. 2022

Br J Nutr

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“…European and Middle Eastern countries have suboptimal selenium intake and status ( 33 ). China is a country of selenium deficiency, with an average selenium intake of 41.1 μg/day according to national surveys ( 34 ). It is estimated that 39–61% of Chinese residents' daily selenium intake is lower than the WHO/FAO recommendation (26–34 μg/day) ( 35 ), and the health problems caused by selenium deficiency in China needed special attention.…”

Section: Introductionmentioning

confidence: 99%

Association of habitually low intake of dietary selenium with new-onset stroke: A retrospective cohort study (2004–2015 China Health and Nutrition Survey)

Zhang

Qiu

Wang

et al. 2023

Front. Public Health

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BackgroundAs an essential trace element in the body, selenium is associated with the development of many diseases. The purpose of this study was to explore the association between dietary selenium intake and new-onset stroke risk in Chinese adults.MethodsAdults aged ≥18 years in the China Health and Nutrition Survey (CHNS) from 2004 to 2015 were enrolled. Participants were divided into five groups according to the quintile of dietary selenium intake: Q1 (≤ 29.80 μg/day), Q2 (29.80–38.53 μg/day), Q3 (38.53–47.23 μg/day), Q4 (47.23–60.38 μg/day), Q 5(>60.38 μg/day). Cox proportional-hazards model was used to explore the effect of dietary selenium on new-onset stroke. Restricted cubic spline (RCS) was used to visualize the dose-response relationship between dietary selenium and the risk of morbidity.ResultsA total of 11,532 subjects were included, and 271 (2.35%) of them developed stroke during a mean follow-up of 6.78 person-years. Compared with the lowest selenium intake group, the HR and 95%CI of stroke in the participants with selenium intake of Q2, Q3, Q4 and Q5 were: 0.85 (0.59, 1.21), 0.62 (0.42, 0.92), 0.43 (0.28, 0.68), 0.49 (0.30, 0.82), respectively. There was an L-shaped relationship between dietary selenium and stroke (nonlinear P-value = 0.0420). The HR and 95%CI of developing stroke was 0.75 (0.65, 0.87) in participants with selenium intake ≤ 60 μg/day.ConclusionsThe L-shaped negative association between dietary selenium and stroke in Chinese adults which indicated that dietary selenium should be improved to a certain level to prevent stroke.

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“…This study showed that those who had higher dietary intakes of copper and iron had a higher risk of T2DM, with the risk being more pronounced among those who were older, overweight, smokers, and who had a family history of diabetes [ 24 ]. In the second cohort study, Cui et al assessed the diet of 14,711 adults free of diabetes, with or without hypertension, and without any cardiovascular diseases in the China Health and Nutrition Survey and assessed the risk of those newly diagnosed with T2DM between 2000 and 2015 [ 25 ]. They found that the association between dietary copper and T2DM risk in healthy Chinese adults was not independent, but rather that copper was positively associated with a higher risk of developing T2DM, especially when selenium intake was lower than the medium ( p interaction = 0.0292) [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…In the second cohort study, Cui et al assessed the diet of 14,711 adults free of diabetes, with or without hypertension, and without any cardiovascular diseases in the China Health and Nutrition Survey and assessed the risk of those newly diagnosed with T2DM between 2000 and 2015 [ 25 ]. They found that the association between dietary copper and T2DM risk in healthy Chinese adults was not independent, but rather that copper was positively associated with a higher risk of developing T2DM, especially when selenium intake was lower than the medium ( p interaction = 0.0292) [ 25 ]. The final cohort study by Laouali et al monitored 70,991 women with or without hypertension or hypercholesteremia for 20 years, examining the association between T2DM incidence and dietary copper-to-zinc ratio [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

The Role of Copper Intake in the Development and Management of Type 2 Diabetes: A Systematic Review

et al. 2023

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Diabetes mellitus is a worldwide public health issue with numerous complications. Several risk factors are associated with diabetes, mainly due to patients following an unhealthy lifestyle. Copper is a crucial trace element, with various physiological actions. Different intake levels of copper might contribute to diabetes development due to its dual action as both an anti- and pro-oxidant. Aim: Due to the inconclusive findings regarding the relationship between copper consumption and the management of diabetes, we decided to conduct this extensive systematic review. Up to this date, no similar study has been available in the literature. In this review, we used the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Relevant articles were identified by searching the electronic databases CINAHL, EMBASE and Medline from their respective index dates to September 2022 using keywords such as “Copper Intake” and “Type 2 Diabetes”. Any paper that has investigated copper exposure through supplementation or any other method that indicates copper intake in human subjects with type 2 diabetes and measures at least one of the outcomes of interest related to diabetes was included in this review. This review is comprised of 4 cross-sectional studies, 3 cohort studies, 2 RCTs, and 2 interventional studies. Two cohort studies found positive associations between copper intake and the risk of developing T2DM, while no significant association was found in the third study. Regarding diabetes outcomes in the four cross-sectional studies, two found inverse associations, one found a positive relationship, and one found no significant association. In interventional studies, all studies found a protective effect of copper, including the RCT, while one found no significant association. The results are inconsistent concerning the association between copper consumption and the likelihood of developing diabetes are inconsistent. Individuals should receive an adequate dietary amount of copper that is within the RDA levels (900 µg/day) to avoid copper deficiency or toxicity. Further studies, especially RCTs, are strongly needed to enable researchers to elucidate more robust conclusions regarding this association.

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Dietary Copper and Selenium Intakes and the Risk of Type 2 Diabetes Mellitus: Findings from the China Health and Nutrition Survey

Cited by 19 publications

References 60 publications

J-shaped association between dietary copper intake and all-cause mortality: a prospective cohort study in Chinese adults

J-shaped association between dietary copper intake and all-cause mortality: a prospective cohort study in Chinese adults

Association of habitually low intake of dietary selenium with new-onset stroke: A retrospective cohort study (2004–2015 China Health and Nutrition Survey)

The Role of Copper Intake in the Development and Management of Type 2 Diabetes: A Systematic Review

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