Essential and Non-essential Elements in Scalp Hair of Diabetics: Correlations with Glycated Hemoglobin (HbA1c)

Abstract

Essential elements (Ca, Mg, Zn, Cu, Fe, Cr, Mn and V) and non-essential elements (As, Cd, Hg and Pb) were measured in scalp hair samples of 45 diabetic subjects and 59 control subjects in Japan using inductively coupled plasma mass spectrometry. All diabetic subjects took insulin and/or antidiabetic agents, with glycated hemoglobin (HbA1c) ranging between 6.2 and 14.4%. The levels of Zn, Cu and Cr in the diabetic subjects (HbA1c>7) were significantly lower than those in the control subjects (p<0.05), and these concentrations decreased significantly with increases in HbA1c (p<0.01). The levels of Fe and Mg in the diabetic subjects were insignificantly lower, and the concentration of Fe decreased significantly with increases in HbA1c (p<0.05) and the concentration of Mn tended to decrease (p<0.10). In contrast, the concentration of As tended to increase with increases in HbA1c ( p<0.10). The concentrations of other elements, such as Ca, Mn, V, Pb, Cd and Hg, in the diabetic subjects were similar to those of control subjects, and did not correlate with HbA1c. The average of estimated glomerular filtration rate (eGFR) in the diabetic subjects was 77.7 29.7 mL/min/1.73 m 2 with large variation (12.7-148 mL/min/1.73 m 2 ), and previous study reported the increase of urinary excretion of Zn, Cr, Mn and Mg in diabetic subjects. The decreases of Zn, Cu, Cr, Fe and Mg concentrations in hair may reflect increased urinary excretion of these elements due to diabetic nephropathy.Key words diabetes; scalp hair; glycated hemoglobin (HbA1c); zinc; chromium; copper Diabetes mellitus is a serious and chronic metabolic disorder. Type 2 diabetes results from a disruption in glucose metabolism associated with a reduction in insulin production and utilization by tissues. Glycated hemoglobin (HbA1c) levels are used for screening and diagnostic purposes as HbA1c indicates the quality of blood glucose control over the previous 1-2 or 2-3 months. A HbA1c (%) value greater than 6.5 is a cut-off point for diabetic subjects and is highly prognostic for longterm diabetes-related complications such as nephropathy, retinopathy and neuropathy, and maintenance of the HbA1c value below 7.0 is a therapeutic guideline for the prevention of such complications of the Japan Diabetic Society. Estimated glomerular filtration rate (eGFR) is used for screening for nephropathy. The glomerular filtration rate (GFR) generally decreases as diabetes progresses, but the early stage of diabetic nephropathy is characterized by hyperfiltration (increase of GFR). 1) Deficiencies in trace elements such as Cr, Zn, Cu, Mg and Mn have been shown to predispose a person to glucose tolerance and to promote the development of diabetic complications. 2,3) Insulin resistance (IR) is defined as the condition in which insulin sensitive tissues become numb to insulin reception, and a Cr deficiency can induce IR. 2) Zn is known to synthesize insulin as well as stabilize insulin that has been stored in the beta cells of the pancreas. 4) Further, Zn has an important role in the sec...

Mercury Exposure and Risk of Type 2 Diabetes: A Systematic Review and Meta-Analysis

“…Some included studies reported different effect sizes based on their studied subgroups; for these studies, we extracted and analyzed all suitable effect sizes. Of the included studies, data on Hg levels in T2DM patients vs. healthy controls were reported in 10 studies with 15 effect sizes [ 14 – 16 , 19 , 32 , 33 , 40 – 42 , 44 ], and 11 studies (3 prospective cohorts and 8 case-control) with 17 effect sizes [ 15 , 18 , 28 , 29 , 32 , 34 – 36 , 42 – 44 ] reported risk estimates for the association between Hg exposure and the risk of T2DM. All studies reporting risk estimates for T2DM adjusted the analysis for the potential confounders.…”

“…In the pooled analysis of all eligible studies, Hg levels were significantly higher in T2DM patients compared with non-T2DM controls (random effects, SMD = 1.07; 95% CI = 0.59 to 1.55, P ≤ 0.001) ( Figure 2 ), with a significant heterogeneity across studies (I2 = 96.1%; P =≤0.001). In the stratified analysis by type of sample, compared with healthy controls, Hg levels were also significantly higher in blood (7 studies [ 16 , 19 , 32 , 40 – 42 , 44 ], SMD = 0.64 μ g/L; 95% CI = 0.05 to 1.22, P =0.03) and hair (3 studies [ 14 , 33 , 41 ], SMD = 3.15 μ g/L; 95% CI = 1.49 to 4.82, P ≤ 0.001) of patients with T2DM, but not in urine samples (based on 1 study [ 15 ]) ( Figure 2 ).…”

“…Some studies have assessed the presence of this metal in diabetic patient's scalp hair [14], urine [15], and blood [16][17][18][19] to examine any relationships between its levels with T2DM markers, but the results were heterogeneous. While some studies demonstrated positive relationships between T2DM and Hg levels in blood [20][21][22][23][24][25], urine [26], hair [27], and toenail [28], some other studies did not observe any relationship [29][30][31][32][33][34][35][36]. ese discrepancies might be due to the di erences in the population characteristics and sources of exposure (urine, blood, and nail).…”

Magnesium—A Potential Key Player in Inflammatory Bowel Diseases?

“…Consequently, we opted for evaluating magnesium status by measuring the hair concentration. This approach has been used in various diseases [31], ranging from diabetes [32] to autoimmune disorders, with evidence for its applicability in patients with psoriasis [33] and alopecia areata [34].…”

Hair EDX Analysis—A Promising Tool for Micronutrient Status Evaluation of Patients with IBD?

“…Considering these aspects, an alternative to be considered for evaluating trace elements status is measuring the hair concentration. The approach of the measurement of multiple elements in the scalp hair is being applied to several diseases [ 17 ], ranging from diabetes [ 18 ] to autoimmune disorders. There is evidence for the usefulness of trace element evaluation in patients with psoriasis [ 19 ] and alopecia areata [ 9 ].…”