Zinc supplementation improves markers of glucose homeostasis in thalassaemia

Fung, Ellen B.; Ahmad, Tariq; Killilea, David W.; Hussain, Rahim; Lal, Ashutosh

doi:10.1111/bjh.16771

Cited by 6 publications

(12 citation statements)

References 18 publications

(35 reference statements)

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“…Similar to previous observations with hepatic iron stores, Goldberg et al18 found serum zinc negatively correlated with liver iron concentration. Zinc deficiency in Thal is partly caused by elevated urinary zinc excretion and reduced zinc binding capacity to serum carrier proteins in the face of increased requirements 32,69–71. Oral chelator use has also been implicated in zinc deficiency though research to support this claim is limited 72.…”

Section: Resultsmentioning

confidence: 99%

“…Glucose clearance, insulin sensitivity, and fasting C-peptide are additionally increased postsupplementation, while fasting glucose, insulin resistance, and circulating fructosamine dropped. [31][32][33] In 2013, Fung et al 31 reported that 25 mg zinc for 18 months increased BMD in adolescent and young adults with low bone mass. Nausea has been reported in 2 adult subjects who subsequently dropped from their respective zinc supplementation studies.…”

Section: Zincmentioning

confidence: 99%

“…Zinc deficiency in Thal is partly caused by elevated urinary zinc excretion and reduced zinc binding capacity to serum carrier proteins in the face of increased requirements. 32,[69][70][71] Oral chelator use has also been implicated in zinc deficiency though research to support this claim is limited. 72 Al-Refaie et al 73 reported up to 14% prevalence of zinc deficiency in Thal treated with DFP, with 67% of those with low serum zinc developing symptoms of zinc deficiency which improved with supplementation.…”

Section: Zincmentioning

confidence: 99%

“…In a subsequent study, a positive association between beta-cell function and serum zinc was observed. 32 Supplementation with high-dose zinc (2 to 3× RDA) has led to significant increases in serum zinc within cohorts of subjects with Thal. Glucose clearance, insulin sensitivity, and fasting C-peptide are additionally increased postsupplementation, while fasting glucose, insulin resistance, and circulating fructosamine dropped.…”

Section: Zincmentioning

confidence: 99%

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Nutrition in Thalassemia: A Systematic Review of Deficiency, Relations to Morbidity, and Supplementation Recommendations

Goldberg¹,

Lal

Fung

2021

Journal of Pediatric Hematology/Oncology

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Background: Reports of nutritional deficiencies in patients with thalassemia (Thal) are common. Despite its importance, however, nutritionally focused research in Thal has been limited by inadequate sample size, inconsistent methodology, a lack of control comparisons, and few interventional trials. Due to these limitations, clinicians lack evidence-based nutrition recommendations to support clinical decision-making. This systematic review summarizes observed relationships between nutrition and morbidity in Thal published in the last 3 decades.Methods: PubMed, Web of Science, and Embase were screened for articles pertaining to nutrition in Thal using comprehensive search terms. Studies performed in humans, written in English, and published between 1990 and 2020 were included. Over 2100 manuscripts were identified, from which 97 were included.Results: Patients with Thal were most often deficient in vitamins A, C, D, selenium, and zinc. Prevalence of nutritional deficiency was positively correlated with age and iron overload. Evidence to support the role of vitamin D and zinc for bone health was observed; zinc was also found to improve glucose metabolism.Conclusions: Due to the risk for multinutrient deficiency, nutritional status should be assessed annually in patients with Thal with prompt nutrient replacement when deficiency is detected. Routine supplementation with vitamin D and zinc is recommended.

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Section: Resultsmentioning

confidence: 99%

Section: Zincmentioning

confidence: 99%

Section: Zincmentioning

confidence: 99%

Section: Zincmentioning

confidence: 99%

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Nutrition in Thalassemia: A Systematic Review of Deficiency, Relations to Morbidity, and Supplementation Recommendations

Goldberg¹,

Lal

Fung

2021

Journal of Pediatric Hematology/Oncology

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“…Some studies demonstrated that Zn supplementation may provide an important protection against diabetes as complications of diabetes were highly linked with Zn deficiency [ 39 ]. This relationship, however, is not clear [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Patterns and Associations of Essential Trace Elements (Cu, Fe and Zn) in Saudi Adults with Varying Levels of Glycemia

et al. 2021

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The homeostasis of trace elements were observed to contribute to certain diabetic outcomes. This cross-sectional study determined the differences and associations between serum levels of copper (Cu), iron (Fe) and zinc (Zn) in Saudi patients with and without type 2 diabetes mellitus (T2DM) as well as those with prediabetes. Anthropometrics were measured, and fasting blood samples were collected from 119 patients with T2DM (aged 41–64 years), 95 non-T2DM (aged 27–55 years) and 80 with prediabetes (aged 35–57 years). Circulating trace minerals were determined using an inductively coupled plasma–mass spectrometer. Serum levels of Cu and Fe were significantly lower in T2DM than non-T2DM (adjusted p-values < 0.001). There was no difference in the Zn levels of the T2DM and non-T2DM groups. The serum Cu levels were significantly lower in the prediabetes group than the non-T2DM group (p < 0.05). The serum levels of Cu, Fe and Zn were inversely associated with circulating glucose in the T2DM and prediabetes subjects (p-values < 0.001). In conclusion, the differences in circulating trace elements were observed in Saudi subjects with varying glycemic statuses, suggesting an inverse association between T2DM progression and the decreasing serum Cu, Fe and Zn levels. Intervention trials are warranted to determine whether early correction of trace mineral deficiencies is beneficial in populations at higher risk for T2DM.

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Cellular zinc metabolism and zinc signaling: from biological functions to diseases and therapeutic targets

Chen,

Yu,

Chan

et al. 2024

Sig Transduct Target Ther

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Zinc metabolism at the cellular level is critical for many biological processes in the body. A key observation is the disruption of cellular homeostasis, often coinciding with disease progression. As an essential factor in maintaining cellular equilibrium, cellular zinc has been increasingly spotlighted in the context of disease development. Extensive research suggests zinc’s involvement in promoting malignancy and invasion in cancer cells, despite its low tissue concentration. This has led to a growing body of literature investigating zinc’s cellular metabolism, particularly the functions of zinc transporters and storage mechanisms during cancer progression. Zinc transportation is under the control of two major transporter families: SLC30 (ZnT) for the excretion of zinc and SLC39 (ZIP) for the zinc intake. Additionally, the storage of this essential element is predominantly mediated by metallothioneins (MTs). This review consolidates knowledge on the critical functions of cellular zinc signaling and underscores potential molecular pathways linking zinc metabolism to disease progression, with a special focus on cancer. We also compile a summary of clinical trials involving zinc ions. Given the main localization of zinc transporters at the cell membrane, the potential for targeted therapies, including small molecules and monoclonal antibodies, offers promising avenues for future exploration.

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Zinc supplementation improves markers of glucose homeostasis in thalassaemia

Cited by 6 publications

References 18 publications

Nutrition in Thalassemia: A Systematic Review of Deficiency, Relations to Morbidity, and Supplementation Recommendations

Nutrition in Thalassemia: A Systematic Review of Deficiency, Relations to Morbidity, and Supplementation Recommendations

Patterns and Associations of Essential Trace Elements (Cu, Fe and Zn) in Saudi Adults with Varying Levels of Glycemia

Cellular zinc metabolism and zinc signaling: from biological functions to diseases and therapeutic targets

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