Abstract
Zinc is an essential trace element with proposed therapeutic effects in Type 2 diabetes mellitus (DM), however, the associations between zinc status and the prospective risks of cardiovascular diseases (CVD) and Type 2 DM have not been evaluated. The current systematic review aims to determine the relationships between zinc intake or plasma/serum zinc levels and prospective incidence of CVD and Type 2 DM. Fourteen papers describing prospective cohort studies were included, reporting either CVD (n = 91,708) and/or Type 2 DM (n = 334,387) outcomes. Primary analyses from four out of five studies reported no association between zinc intake and CVD events, when adjusted for multiple variables. Higher serum zinc level was associated with lower risk of CVD in three out of five studies; pronounced effects were observed in vulnerable populations, specifically those with Type 2 DM and patients referred to coronary angiography. The limited evidence available suggests no association between zinc status and Type 2 DM risk. Further investigations into the mechanisms of zinc’s action on the pathogenesis of chronic diseases and additional evidence from observational studies are required to establish a recommendation for dietary zinc in relation to the prevention of CVD and Type 2 DM.
Highlights
Chronic metabolic diseases, such as cardiovascular diseases (CVD) and Type 2 diabetes mellitus (DM), represent a significant proportion of non-communicable disease (NCD) deaths around the world [1]
Two of the identified papers [26,29] report on different aspects of the same study and both were included in the current systematic review
To the best of our knowledge, the current report is the first systematic review of prospective cohort studies assessing the relationship between zinc status and risks of CVD and Type 2 DM
Summary
Chronic metabolic diseases, such as cardiovascular diseases (CVD) and Type 2 diabetes mellitus (DM), represent a significant proportion of non-communicable disease (NCD) deaths around the world [1]. The role of diet and physical activity in the prevention and management of chronic metabolic diseases is recognised by numerous health organisations [2,3]. Zinc has been shown to serve a regulatory role in many signalling pathways, including potentiation of leptin and insulin signalling [5]. The involvement of zinc in immunity has been demonstrated consistently in cellular studies [6]; a protective role of zinc was shown for autoimmune diseases, including multiple sclerosis [7] and Type 1 DM [8]. Recent genome-wide association studies identified the potential roles of Zinc Transporter-8 (ZnT8; SLC30A8)
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