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Non-Diyabetik, Pre-Diyabetik ve Diyabetik Hastalarda Serum Çinko Düzeyinin İncelenmesi

Yıl 2024, Cilt: 2 Sayı: 1, 19 - 23, 29.02.2024
https://doi.org/10.61845/agrimedical.1400162

Öz

Amaç: Çalışmanın amacı non-diyabetik, pre-diyabetik ve diyabetik hastaların serum çinko düzeyini tespit ederek serum çinko düzeyi ile glisemik durum arasındaki ilişkiyi ortaya koymaktır.

Gereç ve Yöntem: Çalışma tek merkezli, prospektif ve kesitsel bir çalışmadır. İç hastalıkları polikliniğine başvuran hastaların açlık kan şekeri, glikolize hemoglobin, insülin rezistansı ve serum çinko düzeyleri ölçülmüştür. Hastalar sonuçlarına göre non-diyabetik, pre-diyabetik ve diyabetik olarak kategorize edilmiş ve serum çinko düzeyleri açısından karşılaştırılmışlardır.

Bulgular: Çinko diyabetik grupta non-diyabetik ve pre-diyabetik gruba göre anlamlı olarak düşüktü (p<0.001). Pre-diyabetik ve non-diyabetik grup arasında serum çinko düzeyleri açısından anlamlı farklılık yoktu. Çinko açlık kan şekeri (r=-0.342, p<0.001), insülin direnci (r=-0.344, p<0.001) ve glikolize hemoglobin (r=-0.327, p<0.001) ile negatif korelasyon göstermekteydi. Çinkonun 73 kesme değeri için diyabeti öngörmede %65,0 duyarlılığı, %59,5 özgüllüğü, %61,3 doğruluğu, %44,5 pozitif öngörü değeri ve %77,3 negatif öngörü değeri olduğu tespit edildi (AUC: 0.654, 95% CI: 0.588-0.720, p<0.001). Ek olarak, çok değişkenli lojistik regresyon analizi, düşük çinkonun (<73) yaş ve cinsiyetten bağımsız olarak diyabetle ilişkili olduğunu göstermiştir (OR: 2.618, 95% CI: 1.571-4.365, p<0.001).

Sonuç: Serum çinko düzeyinin non-diyabetik ve pre-diyabetik hastalarda benzer düzeylerdeyken diyabetik hastalarda anlamlı olarak düşük olması glisemik kontrol kötüleştikçe çinko seviyesinin düştüğünü göstermektedir. Riskli grupta serum çinko düzeyini ölçmek ve eksikse replase etmek glisemik kontrole destek olarak ve oksidatif stresi azaltarak diyabet gelişimini önlemeye yardımcı olabilir.

Kaynakça

  • Lovic D, Piperidou A, Zografou I, Grassos H, Pittaras A, Manolis A. The growing epidemic of diabetes mellitus. Curr Vasc Pharmacol. 2020;18(2):104-109.
  • Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes research and clinical practice. 2010;87(1):4-14.
  • Ley SH, Hamdy O, Mohan V, Hu FB. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. The Lancet. 2014;383(9933):1999-2007.
  • Dubey P, Thakur V, Chattopadhyay M. Role of minerals and trace elements in diabetes and insulin resistance. Nutrients. 2020 Jun 23;12(6):1864.
  • Jansen J, Karges W, Rink L. Zinc and diabetes-Clinical links and molecular mechanisms. J Nutr Biochem 2009; 20:399-417.
  • Beagley J, Guariguata L, Weil C, Motala AA. Global estimates of undiagnosed diabetes in adults. Diabetes Res Clin Pract. 2014;103 150–160.
  • ElSayed NA, Aleppo G, Aroda VR, et al. 2. Classification and diagnosis of diabetes: Standards of care in diabetes-2023. Diabetes Care. 2023;46(Suppl 1):19-40.
  • Ikle JM, Gloyn AL. 100 years of insulin: A brief history of diabetes genetics: insights for pancreatic beta-cell development and function. J Endocrinol. 2021;250(3):23-35.
  • Attie AD, Tang QQ, Bornfeldt KE. The insulin centennial-100 years of milestones in biochemistry. J Biol Chem. 2021;297(5):101278.
  • Zalewski PD, Millard SH, Forbes IJ, et al. Video image analysis of labile zinc in viable pancreatic islet cells using a specific fluorescent probe for zinc. J Histochem Cytochem. 1994 Jul;42(7):877-84.
  • Li YV. Zinc and insulin in pancreatic beta-cells. Endocrine. 2014; 45:178-89.
  • Kelleher SL, McCormick NH, Velasquez V, Lopez V. Zinc in specialized secretory tissues: roles in thepancreas, prostate, andmammarygland. Adv Nutr. 2011;2(2):101-11.
  • Kloubert V, Rink L. Zinc as a micronutrient and its preventive role of oxidative damage in cells. Food Funct. 2015;6(10):3195-204.
  • Menke A, Guallar E, Cowie CC. Metals in urine and diabetes in US adults. Diabetes. 2016;65(1):164-71.
  • da Silva Bandeira V, Pires LV, Hashimoto LL, et al. Association of reduced zinc status with poor glycemic control in individuals with type 2 diabetes mellitus. J Trace Elem Med Biol. 2017;1(44):132-6.
  • Rungby J. Zinc, zinc transporters and diabetes. Diabetologia. 2010;53(8):1549-51.
  • Kumar DA, Priya VS, Jaiprabhu J, Ramalingam K. Serum copper and zinc levels significance in type 2 diabetic patients. Jour of Med Sc Tech; 2014;3(2):79-81.
  • Gagandeep DS, Shailaza S, Rahul R. Evaluation of trace elements and glycated hemoglobin in type 2 diabetes mellitus. World J Pharm Pharm Sci. 2015;4(5):940-7.
  • Puri M, Gujral U, Nayyar SB. Comparative study of serum zinc, magnesium and copper levels among patients of type 2 diabetes mellitus with and without microangiopathic complications. Innovative Journal of Medical and Health Science. 2013;3(6):274-8.
  • Chu A, Foster M, Samman S. Zincstatusand risk of cardiovascular diseases and type 2 diabetes mellitus-A systematic review of prospective cohort studies. Nutrients. 2016;8(11):707.
  • Liu F, Ma F, Kong G, Wu K, Deng Z, Wang H. Zinc supplementation alleviates diabetic peripheral neuropathy by inhibiting oxidative stress and upregulating metallothionein in peripheral nerves of diabetic rats. Biol Trace Elem Res. 2014;158:211-8.
  • Parham M, Amini M, Aminorroaya A, Heidarian E. Effect of zinc supplementation on microalbuminuria in patients with type 2 diabetes: A double blind, randomized, placebocontrolled, cross-over trial. Rev Diabet Stud. 2008;5(2):102-9.
  • Barman S, Srinivasan K. Zinc supplementation ameliorates diabetic cataract through modulation of crystallin proteins and polyol pathway in experimental rats. Biol Trace Elem Res. 2019;187:212-23.
  • Park JS, Xun P, Li J, et al. Longitudinal association between toenail zinc levels and the incidence of diabetes among American young adults: The CARDIA Trace Element Study. Sci Rep. 2016;6(1):23155.
  • Jayawardena R, Ranasinghe P, Galappatthy P, Malkanthi RL, Constantine GR, Katulanda P. Effects of zinc supplementation on diabetes mellitus: A systematic review and meta-analysis. Diabetol Metab Syndr. 2012;4(1):1-2.
  • Czernichow S, Couthouis A, Bertrais S, et al. Antioxidant supplementation does not affect fasting plasma glucose in the Supplementation with Antioxidant Vitamins and Minerals (SU. VI. MAX) study in France: Association with dietary intake and plasma concentrations. Am J Clin Nutr. 2006;84(2):395-9.
  • Sun Q, van Dam RM, Willett WC, Hu FB. Prospective study of zinc intake and risk of type 2 diabetes in women. Diabetes Care. 2009;32: 629-634.

Investigation of Serum Zinc Level in Non-Diabetic, Pre-Diabetic And Diabetic Patients: A Prospective Cross-Sectional Study

Yıl 2024, Cilt: 2 Sayı: 1, 19 - 23, 29.02.2024
https://doi.org/10.61845/agrimedical.1400162

Öz

Aim: The aim of the study was to determine the serum zinc level in non-diabetic, pre-diabetic and diabetic patients and reveal the relationship between serum zinc level and glycemic status.

Material and Method: The study was a single-center, prospective, cross-sectional study. Fasting blood sugar, glycated hemoglobin, insulin resistance, and serum zinc levels of patients admitted to the internal medicine outpatient clinic were measured. Patients were categorized as non-diabetic, pre-diabetic, and diabetic according to their results, and compared regarding serum zinc levels.

Results: Zinc was significantly lower in the diabetes group than in the other groups (p<0.001), while there was no significant difference between non-diabetes and prediabetes groups. Zinc was negatively correlated with fasting blood sugar (r=-0.342, p<0.001), HOMA-IR (r=-0.344, p<0.001), and HbA1c (r=-0.327, p<0.001). Zinc had a sensitivity of 65.0%, specificity of 59.5%, accuracy of 61.3%, positive predictive value of 44.5%, and negative predictive value of 77.3% to predict diabetes for the cut-off point of 73 (AUC: 0.654, 95% CI: 0.588-0.720, p<0.001). In addition, multivariable logistic regression analysis revealed that low zinc (<73) was independently associated with the diabetes after adjusted by age and gender (OR: 2.618, 95% CI: 1.571-4.365, p<0.001).

Conclusion: While serum zinc levels were at similar levels in non-diabetic and prediabetic patients, they were significantly lower in diabetic patients, indicating that zinc levels decreased as glycemic control worsens. Measuring the serum zinc level in the risk group and replacing it if deficient may help prevent the development of diabetes by supporting glycemic control and reducing oxidative stress.

Kaynakça

  • Lovic D, Piperidou A, Zografou I, Grassos H, Pittaras A, Manolis A. The growing epidemic of diabetes mellitus. Curr Vasc Pharmacol. 2020;18(2):104-109.
  • Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes research and clinical practice. 2010;87(1):4-14.
  • Ley SH, Hamdy O, Mohan V, Hu FB. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. The Lancet. 2014;383(9933):1999-2007.
  • Dubey P, Thakur V, Chattopadhyay M. Role of minerals and trace elements in diabetes and insulin resistance. Nutrients. 2020 Jun 23;12(6):1864.
  • Jansen J, Karges W, Rink L. Zinc and diabetes-Clinical links and molecular mechanisms. J Nutr Biochem 2009; 20:399-417.
  • Beagley J, Guariguata L, Weil C, Motala AA. Global estimates of undiagnosed diabetes in adults. Diabetes Res Clin Pract. 2014;103 150–160.
  • ElSayed NA, Aleppo G, Aroda VR, et al. 2. Classification and diagnosis of diabetes: Standards of care in diabetes-2023. Diabetes Care. 2023;46(Suppl 1):19-40.
  • Ikle JM, Gloyn AL. 100 years of insulin: A brief history of diabetes genetics: insights for pancreatic beta-cell development and function. J Endocrinol. 2021;250(3):23-35.
  • Attie AD, Tang QQ, Bornfeldt KE. The insulin centennial-100 years of milestones in biochemistry. J Biol Chem. 2021;297(5):101278.
  • Zalewski PD, Millard SH, Forbes IJ, et al. Video image analysis of labile zinc in viable pancreatic islet cells using a specific fluorescent probe for zinc. J Histochem Cytochem. 1994 Jul;42(7):877-84.
  • Li YV. Zinc and insulin in pancreatic beta-cells. Endocrine. 2014; 45:178-89.
  • Kelleher SL, McCormick NH, Velasquez V, Lopez V. Zinc in specialized secretory tissues: roles in thepancreas, prostate, andmammarygland. Adv Nutr. 2011;2(2):101-11.
  • Kloubert V, Rink L. Zinc as a micronutrient and its preventive role of oxidative damage in cells. Food Funct. 2015;6(10):3195-204.
  • Menke A, Guallar E, Cowie CC. Metals in urine and diabetes in US adults. Diabetes. 2016;65(1):164-71.
  • da Silva Bandeira V, Pires LV, Hashimoto LL, et al. Association of reduced zinc status with poor glycemic control in individuals with type 2 diabetes mellitus. J Trace Elem Med Biol. 2017;1(44):132-6.
  • Rungby J. Zinc, zinc transporters and diabetes. Diabetologia. 2010;53(8):1549-51.
  • Kumar DA, Priya VS, Jaiprabhu J, Ramalingam K. Serum copper and zinc levels significance in type 2 diabetic patients. Jour of Med Sc Tech; 2014;3(2):79-81.
  • Gagandeep DS, Shailaza S, Rahul R. Evaluation of trace elements and glycated hemoglobin in type 2 diabetes mellitus. World J Pharm Pharm Sci. 2015;4(5):940-7.
  • Puri M, Gujral U, Nayyar SB. Comparative study of serum zinc, magnesium and copper levels among patients of type 2 diabetes mellitus with and without microangiopathic complications. Innovative Journal of Medical and Health Science. 2013;3(6):274-8.
  • Chu A, Foster M, Samman S. Zincstatusand risk of cardiovascular diseases and type 2 diabetes mellitus-A systematic review of prospective cohort studies. Nutrients. 2016;8(11):707.
  • Liu F, Ma F, Kong G, Wu K, Deng Z, Wang H. Zinc supplementation alleviates diabetic peripheral neuropathy by inhibiting oxidative stress and upregulating metallothionein in peripheral nerves of diabetic rats. Biol Trace Elem Res. 2014;158:211-8.
  • Parham M, Amini M, Aminorroaya A, Heidarian E. Effect of zinc supplementation on microalbuminuria in patients with type 2 diabetes: A double blind, randomized, placebocontrolled, cross-over trial. Rev Diabet Stud. 2008;5(2):102-9.
  • Barman S, Srinivasan K. Zinc supplementation ameliorates diabetic cataract through modulation of crystallin proteins and polyol pathway in experimental rats. Biol Trace Elem Res. 2019;187:212-23.
  • Park JS, Xun P, Li J, et al. Longitudinal association between toenail zinc levels and the incidence of diabetes among American young adults: The CARDIA Trace Element Study. Sci Rep. 2016;6(1):23155.
  • Jayawardena R, Ranasinghe P, Galappatthy P, Malkanthi RL, Constantine GR, Katulanda P. Effects of zinc supplementation on diabetes mellitus: A systematic review and meta-analysis. Diabetol Metab Syndr. 2012;4(1):1-2.
  • Czernichow S, Couthouis A, Bertrais S, et al. Antioxidant supplementation does not affect fasting plasma glucose in the Supplementation with Antioxidant Vitamins and Minerals (SU. VI. MAX) study in France: Association with dietary intake and plasma concentrations. Am J Clin Nutr. 2006;84(2):395-9.
  • Sun Q, van Dam RM, Willett WC, Hu FB. Prospective study of zinc intake and risk of type 2 diabetes in women. Diabetes Care. 2009;32: 629-634.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Ece Yiğit 0000-0002-8293-3554

Yayımlanma Tarihi 29 Şubat 2024
Gönderilme Tarihi 4 Aralık 2023
Kabul Tarihi 20 Şubat 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 2 Sayı: 1

Kaynak Göster

AMA Yiğit E. Investigation of Serum Zinc Level in Non-Diabetic, Pre-Diabetic And Diabetic Patients: A Prospective Cross-Sectional Study. Ağrı Med J. Şubat 2024;2(1):19-23. doi:10.61845/agrimedical.1400162