Abstract
ObjectivesThere are controversies about the role of zinc in the development of both types 1 and 2 diabetes. The aim of this study was to assess serum zinc level in diabetic patients with and without peripheral neuropathy in comparison to healthy controls and to explore the possible relationship between serum zinc level and severity of peripheral neuropathy.MethodsThis case control study was conducted on 120 subjects: 40 patients fulfilled the criteria for diagnosis of probable diabetic polyneuropathy (DPN), 40 diabetic patients without polyneuropathy (N‐DPN) and 40 healthy controls. DPN patients were submitted to clinical assessment of diabetic neuropathy using neuropathy symptom and change (NSC) scale, Michigan Neuropathy Screening Instrument Physical Assessment (MNSI) scale and electrophysiological assessment using nerve conduction study. Zinc serum level was measured in all subjects included in this study using direct colorimetric test method.ResultsDiabetic patients with and without neuropathy were found to have significantly lower mean values of serum zinc than healthy controls (p = .025, .03 respectively). There is a statistically significant negative correlation between zinc serum level and hemoglobin A1C (HA1C) (p ˂ .001), NSC score (p = .001) and MNSI score (p = .003) in DPN group. There were also statistically significant correlations between zinc serum level and nerve conduction study values.ConclusionZinc deficiency significantly correlates with the severity of DPN and glycemic control.
Highlights
Diabetes mellitus (DM) is a leading cause of morbidity and mortality all over the world
It is evident from the literature that zinc plays an important role in β-cell function, insulin action, glucose homeostasis and affecting pathogenesis of DM
Our results revealed that diabetic patients with and without neuropathy have significantly lower serum zinc level than healthy control group
Summary
Diabetes mellitus (DM) is a leading cause of morbidity and mortality all over the world. According to the International Diabetes Federation, by 2015, about 8.8% of adults aged 20–79 or 415 million people worldwide are estimated to have DM. Diabetic peripheral neuropathy (DPN) affects approximately 30%– 50% of all patients with DM (Deshpande et al, 2008). It can involve all peripheral nerves including sensory and motor neurons, and the autonomic nervous system as well. Multiple clinical trials on patients with diabetic neuropathy revealed that oral supplementation with zinc helps in achieving better glycemic control and improvement in the severity of DPN as assessed by neurophysiological studies (Gupta et al, 1998; Hayee et al, 2005)
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