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Zinc Intake and Status and Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Department of Nutrition and Dietetics, Faculty of Heath Sciences, University of Atacama, Av. Copayapu 2862, Copiapó, 1530000 Atacama Region, Chile
Nutrition and Public Health, Universitat Rovira i Virgili, C/ Sant Llorenç 21, Reus, 43201 Tarragona, Spain
Food Databanks National Capability, Quadram Institute Bioscience, Norwich Research Park, Norwich, Norfolk NR4 7UA, UK
International Institute of Nutritional Sciences and Food Safety Studies, University of Central Lancashire, Darwin Building c/o Psychology Scholl Office, Preston, Lancashire PR1 2HE, UK
Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, Lancashire PR 1 2HE, UK
Research Group in Nutrition and Mental Health (NUTRISAM), Institut d’Investigació Sanitària Pere Virgili (IISPV), Rovira i Virgili University, Reus, 43201 Tarragona, Spain
Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria and CHUIMI, Canarian Health Service, 35016 Las Palmas de Gran Canaria, Spain
Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
Author to whom correspondence should be addressed.
Nutrients 2019, 11(5), 1027;
Received: 26 March 2019 / Revised: 23 April 2019 / Accepted: 25 April 2019 / Published: 8 May 2019
(This article belongs to the Special Issue Dietary Intake and Type 2 Diabetes)
Zinc could have a protective role against type 2 diabetes mellitus (T2DM). This systematic review and meta-analysis aimed to evaluate the association between dietary, supplementary, and total zinc intake, as well as serum/plasma and whole blood zinc concentration, and risk of T2DM. Observational studies, conducted on cases of incident diabetes or T2DM patients and healthy subjects that reported a measure of association between zinc exposure and T2DM, were selected. Random effects meta-analyses were applied to obtain combined results. Stratified meta-analyses and meta-regressions were executed to assess sources of heterogeneity, as well as the impact of covariates on the findings. From 12,136 publications, 16 studies were selected. The odds ratio (OR) for T2DM comparing the highest versus lowest zinc intake from diet was 0.87 (95% CI: 0.78–0.98). Nevertheless, no association between supplementary or total zinc intake from both diet and supplementation, and T2DM was observed. A direct relationship was found between serum/plasma zinc levels and T2DM (OR = 1.64, 95% CI: 1.25–2.14). A moderately high dietary zinc intake, in relation to the Dietary Reference Intake, could reduce by 13% the risk of T2DM, and up to 41% in rural areas. Conversely, elevated serum/plasma zinc concentration was associated with an increased risk of T2DM by 64%, suggesting disturbances in zinc homeostasis. View Full-Text
Keywords: zinc intake; zinc status; trace elements; type 2 diabetes mellitus; systematic review; meta-analysis; epidemiology zinc intake; zinc status; trace elements; type 2 diabetes mellitus; systematic review; meta-analysis; epidemiology
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MDPI and ACS Style

Fernández-Cao, J.C.; Warthon-Medina, M.; H. Moran, V.; Arija, V.; Doepking, C.; Serra-Majem, L.; Lowe, N.M. Zinc Intake and Status and Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Nutrients 2019, 11, 1027.

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