Trace Elements in Diabetes Mellitus

Praveeena, S; Pasula, Sujatha; K, Sameera

doi:10.7860/jcdr/2013/5464.3335

Cited by 42 publications

(28 citation statements)

References 23 publications

(20 reference statements)

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“…A total of 97 articles were retrieved, with a final number of 52 case-control studies (1, 4, 19, 20, 22–25, 35–79) with 20183 participants were included in the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Impaired secretion of this protein affects glucose metabolism, and consequently, results in hyperglycemia. (1) Unregulated levels of blood glucose can lead to several debilitating conditions such as nephropathy, neuropathy, retinopathy, cardiovascular disease, stroke, and amputations of extremities. (2) About 90 to 95% of the patients are affected by type 2 diabetes (2) which is characterized primarily by insulin resistance, hyperinsulinemia, and beta-cell dysfunction.…”

Section: Introductionmentioning

confidence: 99%

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Trace Element Status in Type 2 Diabetes: A Meta-Analysis

Sanjeevi¹,

Freeland‐Graves²,

Beretvas³

et al. 2018

JCDR

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Introduction Type 2 diabetes is a chronic metabolic disorder that has been associated with alterations in the status of trace elements, including zinc, copper, iron and manganese. However, clinical studies reporting statuses of these trace elements in type 2 diabetes patients compared to controls have shown conflicting results. Objective This meta-analysis aimed to summarize the existing literature on the statuses of zinc, copper, iron, and manganese in Type 2 diabetes mellitus patients. Methods A literature search of Embase, PubMed, EBSCOHost, ScienceDirect, Scopus, Cochrane library and Web of Science electronic databases was conducted to find studies published from 1970 to November 2016 that compared the trace elements of interest between type 2 diabetic patients and healthy controls. Keywords used were type 2 diabetes, diabetes, hyperglycemia, insulin, glucose, HbA1c, trace elements, micronutrients, zinc, manganese, copper, ceruloplasmin, iron and ferritin. The bias corrected Hedges’ g, was utilized as the effect sizes. Due to the biological interaction between trace elements, it is important to collectively evaluate the statuses of these minerals in type 2 diabetes. Thus, the robust variance estimation method was chosen to handle dependency between multiple outcomes. Results A total of 52 studies met the inclusion criteria, amounting to 98 effect sizes. Diabetic patients (n=20183) had significantly lower zinc status when compared to controls (effect size = −1.73, p<0.01); whereas copper (effect size = 1.10, p<0.05) and ferritin levels (effect size = 1.05, p<0.01) were significantly higher. Although not significant, ceruloplasmin (effect size = 1.85, p=0.06) and iron (effect size = 1.42, p=0.06) levels were higher, and manganese (effect size = 0.27, p=0.34) was lower in patients. Conclusion Results from this meta-analysis indicate lower zinc status accompanied by increased copper and ferritin levels in patients with type 2 diabetes when compared to controls.

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“…A total of 97 articles were retrieved, with a final number of 52 case-control studies (1, 4, 19, 20, 22–25, 35–79) with 20183 participants were included in the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trace Element Status in Type 2 Diabetes: A Meta-Analysis

Sanjeevi¹,

Freeland‐Graves²,

Beretvas³

et al. 2018

JCDR

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“…However, some studies showed insignificant difference of serum zinc and magnesium among T2DM patients and nondiabetes study subjects,26–28 which are inconsistent with the current finding. Zinc and magnesium are essential trace metal elements crucial for the function of more than 300 enzymes 29–33. The trivalent chromium is often required for the maintenance of normal glucose34 and fat metabolism 35.…”

Section: Discussionmentioning

confidence: 99%

“…However, zinc, magnesium, and chromium deficiency often leads to insulin resistance 29–37. The exact physiologic mechanism of zinc, magnesium, and chromium deficiency among T2DM patients is unknown, but high urinary loss has been observed as a result of the osmotic effect of glycosuria 20,25,33. Increased serum iron and ferritin concentrations have been reported to be associated with insulin resistance 38–45.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of serum ferritin and some metal elements in type 2 diabetes mellitus patients: comparative cross-sectional study

Wolide¹,

Zawdie²,

Alemayehu

et al. 2016

DMSO

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BackgroundThe chronic hyperglycemia of diabetes has been associated with an imbalance of some trace metal elements in the blood sample of type 2 diabetes patients.AimTo evaluate the status of serum ferritin and some selected metal elements among type 2 diabetes mellitus (T2DM) patients.MethodsFacility-based comparative cross-sectional study was conducted from February 15, 2015 to October 30, 2015, at Jimma University Specialized Hospital, Ethiopia. A total of 428 type 2 diabetes and nondiabetes study subjects were recruited to the study. After overnight fasting, 10 mL of venous blood samples were taken for biochemical and trace metal element analysis. Data were entered into EpiData version 3.5.1 and exported to SPSS version 20 for Windows for analysis.ResultsSerum concentration of Zn+2, Mg+2, Cr+3, ferritin, and Fe+3 in patients with type 2 diabetes was significantly lower (p<0.0001) than nondiabetes patients. In contrast, serum Cu+2 was significantly higher (p<0.0001) in type 2 diabetes patients than nondiabetics. In addition, significant differences were not seen in both groups with regard to serum Mn+2, Ca+2, and Po4−3. Waist-to-hip ratio (WHR), serum Fe+3, ferritin, and Mn+2 were significantly higher among oral hypoglycemic agent users of type 2 diabetes patients than the injectable insulin users. Serum Zn+2 had significant positive correlation with serum Mg+2 (r=0.738), Cr+3 (r=0.233), Ca+2 (r=0.238), and Po4−3 (r=0.222). In addition, serum Zn+2 had shown significant and negative correlation with body mass index (BMI, r=−0.331), WHR (r=−0.340), and fasting blood glucose (FBG, r=−0.186). Likewise, serum Mg+2 and Po4−3 are significantly and negatively correlated with BMI, WHR, and FBG.ConclusionThe imbalance of trace metal elements in the blood sample of diabetes is uncertain. Thus, we recommend a prospective cohort study to find out the principal factors behind the problem.

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“…Hypomagnesemia and hypozincemia have been noted repeatedly (13–15). Concentrations in blood plasma, which is the source for most clinical tests, do not necessarily reflect the status of biometals or biominerals in tissues.…”

Section: Biometals In Diabetesmentioning

confidence: 99%

Zinc in Pancreatic Islet Biology, Insulin Sensitivity, and Diabetes

Maret

2017

JFN

104

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About 20 chemical elements are nutritionally essential for humans with defined molecular functions. Several essential and nonessential biometals are either functional nutrients with antidiabetic actions or can be diabetogenic. A key question remains whether changes in the metabolism of biometals and biominerals are a consequence of diabetes or are involved in its etiology. Exploration of the roles of zinc (Zn) in this regard is most revealing because 80 years of scientific discoveries link zinc and diabetes. In pancreatic β- and α-cells, zinc has specific functions in the biochemistry of insulin and glucagon. When zinc ions are secreted during vesicular exocytosis, they have autocrine, paracrine, and endocrine roles. The membrane protein ZnT8 transports zinc ions into the insulin and glucagon granules. ZnT8 has a risk allele that predisposes the majority of humans to developing diabetes. In target tissues, increased availability of zinc enhances the insulin response by inhibiting protein tyrosine phosphatase 1B, which controls the phosphorylation state of the insulin receptor and hence downstream signalling. Inherited diseases of zinc metabolism, environmental exposures that interfere with the control of cellular zinc homeostasis, and nutritional or conditioned zinc deficiency influence the patho-biochemistry of diabetes. Accepting the view that zinc is one of the many factors in multiple gene-environment interactions that cause the functional demise of β-cells generates an immense potential for treating and perhaps preventing diabetes. Personalized nutrition, bioactive food, and pharmaceuticals targeting the control of cellular zinc in precision medicine are among the possible interventions.

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Trace Elements in Diabetes Mellitus

Cited by 42 publications

References 23 publications

Trace Element Status in Type 2 Diabetes: A Meta-Analysis

Trace Element Status in Type 2 Diabetes: A Meta-Analysis

Evaluation of serum ferritin and some metal elements in type 2 diabetes mellitus patients: comparative cross-sectional study

Zinc in Pancreatic Islet Biology, Insulin Sensitivity, and Diabetes

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