Abstract
The serum copper (Cu) to zinc (Zn) ratio could be an important determinant of Type 2 diabetes (T2D) risk, but prospective epidemiological data are scarce. We aimed to investigate the association between T2D incidence and the dietary Cu/Zn ratio. A total of 70,991 women from the E3N cohort study were followed for 20 years. The intakes of copper and zinc were estimated at baseline using a validated food frequency questionnaire. We identified and validated 3292 incident T2D cases. Spline analysis showed that a Cu/Zn ratio < 0.55 was associated with a lower risk of T2D. Subgroup analyses comparing women in the highest versus the lowest quintile of Cu/Zn ratio showed the same pattern of association for obese women and those with zinc intake ≥8 mg/day. However, for women with zinc intake <8 mg/day, higher Cu/Zn ratio appeared to be associated with higher T2D risk. Our findings suggest that a lower dietary Cu/Zn ratio is associated with a lower T2D risk, especially among obese women and women with zinc intake >8 mg/day. Further studies are warranted to validate our results.
Highlights
Type 2 diabetes (T2D), a chronic disease resulting from complex gene–environment interactions, is becoming a major global health threat
We aimed to investigate the association between the dietary Cu/Zn ratio and T2D incidence in women, with potential effect modification by other factors
The Cu/Zn ratio does not necessarily reflect the serum/plasma circulating levels; in line with our findings, previous studies reported that an imbalance between serum/plasma levels of copper and zinc were associated with altered glucose metabolism markers in obese patients with T2D [20]
Summary
Type 2 diabetes (T2D), a chronic disease resulting from complex gene–environment interactions, is becoming a major global health threat. A considerable body of evidence suggests that oxidative stress plays a key role in the development of T2D [1,2] Trace elements such as copper (Cu) and zinc (Zn), essential minerals involved in many enzymatic processes and oxidant/antioxidant balance [3], have been linked to the pathogenesis of T2D [4]. Evidence for copper intake is limited; a prospective study reported a positive association with potential effect modification by age, smoking status, and family history of diabetes [9]. Taken together, these findings suggest an antagonistic relationship between copper and zinc, and the risk of diabetes; studying suboptimal intakes of these trace elements may provide useful information. We aimed to investigate the association between the dietary Cu/Zn ratio and T2D incidence in women, with potential effect modification by other factors
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