MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
Br J Nutr. 2023 Oct 14;130(7):1220-1227. doi: 10.1017/S0007114523000223. Epub 2023 Jan 25.
An abnormal Zn status has been suggested to play a role in the pathogenesis of type 2 diabetes. However, epidemiological studies of the relationship between plasma Zn concentrations and diabetes are sparse and inconclusive. We aimed to investigate the association between plasma Zn concentrations and glycaemic markers (fasting glucose, 2-h glucose and homeostatic model assessment of insulin resistance) in rural and urban Cameroon. We studied 596 healthy adults (63·3 % women) aged 25-55 years in a population-based cross-sectional study. The mean plasma Zn concentration was 13·7 ± 2·7 µmol/L overall, with higher levels in men (14·4 ± 2·9 µmol/l) than in women (13·2 ± 2·6 µmol/l), -value < 0·0001. There was an inverse relationship between tertiles of plasma Zn and 2-h glucose concentrations (-value for linear trend = 0·002). The difference in 2-h glucose between those in the highest tertile of plasma Zn compared to the lowest was -0·63 (95 % CI - 1·02, -0·23) mmol/l. This remained significant after adjusting for age, sex, smoking status, alcohol intake, education level, area of residence, adiposity and objectively measured physical activity -0·43(-0·82, -0·04). Similar inverse associations were observed between plasma Zn concentrations and fasting glucose and homeostatic model assessment of insulin resistance when adjusted for socio-demographic and health-related behavioural characteristics. The current findings of an inverse association between plasma Zn concentrations and several markers of glucose homeostasis, together with growing evidence from intervention studies, suggest a role for Zn in glucose metabolism. If supported by further evidence, strategies to improve Zn status in populations may provide a cheap public health prevention approach for diabetes.
锌稳态异常被认为在 2 型糖尿病发病机制中起作用。然而,关于血浆锌浓度与糖尿病之间关系的流行病学研究很少且结果不一致。本研究旨在探讨喀麦隆农村和城市健康成年人中血浆锌浓度与血糖标志物(空腹血糖、2 小时血糖和稳态模型评估的胰岛素抵抗)之间的关系。我们在一项基于人群的横断面研究中对 596 名年龄在 25-55 岁的健康成年人(63.3%为女性)进行了研究。总体而言,平均血浆锌浓度为 13.7±2.7µmol/L,男性(14.4±2.9µmol/L)高于女性(13.2±2.6µmol/L),-值<0.0001。血浆锌三分位与 2 小时血糖浓度呈负相关(线性趋势值=-0.002)。与最低三分位相比,最高三分位的 2 小时血糖差值为-0.63(95%CI-1.02,-0.23)mmol/L。在校正年龄、性别、吸烟状况、饮酒量、教育程度、居住区域、肥胖和客观测量的体力活动后,差异仍有统计学意义-0.43(-0.82,-0.04)。当调整社会人口学和与健康相关的行为特征后,也观察到血浆锌浓度与空腹血糖和稳态模型评估的胰岛素抵抗之间存在类似的负相关关系。目前的研究结果表明,血浆锌浓度与葡萄糖稳态的几个标志物之间呈负相关,加上干预研究的不断增多的证据,提示锌在葡萄糖代谢中发挥作用。如果进一步的证据支持这一观点,那么改善人群中锌状态的策略可能为糖尿病提供一种廉价的公共卫生预防方法。