Bahadoran Zahra, Ghafouri-Taleghani Fateme, Azizi Fereidoun, Ghasemi Asghar
Micronutrient Research Center, Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Endocrine Research Center, Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Biol Trace Elem Res. 2025 Feb 13. doi: 10.1007/s12011-025-04545-w.
This cohort study investigated the possible association between serum zinc (SZn) concentration and the risk of progression to type 2 diabetes (T2D) in subjects with isolated impaired glucose tolerance (iIGT). SZn was measured in 198 subjects with iIGT (mean age: 53.0 ± 14.4 years and 33.8% were men) at baseline (2009-2011), and they were followed for developing T2D up to 2017. A univariate unrestricted regression spline (UVRS) was used to assess the potential non-linear association and identify the best placement of SZn knots related to the incidence of T2D. Multivariable Cox proportional hazard models were used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of incident T2D across the best placement of knots. The predictive power of SZn for developing T2D was determined using receiver operating characteristic (ROC) analyses, and the Youden index identified the optimal cut-off values. Mean baseline SZn concentration was 115 ± 42.9 µg/dL. Over a median 6-year follow-up, 27.8% of subjects with iIGT developed T2D. A non-linear association was observed between SZn and the incidence of T2D (p from the likelihood ratio test < 0.001). Higher SZn ≥ 106 µg/dL and ≥ 134 µg/dL was associated with elevated risk of T2D by 127% (HR = 2.27, 95% CI = 1.01-5.10) and 144% (HR = 2.44, 95% CI = 1.05-5.69), respectively. According to the crude and multivariate-adjusted ROC analyses, the optimal cut-off values of SZn to identify incident T2D were ≥ 87.5 µg/dL (sensitivity of 83.6%, specificity of 30.1%) and 151.8 µg/dL (sensitivity of 64.4%, specificity of 76.3%), respectively. Elevated SZn levels at baseline were positively associated with the future risk of T2D in subjects with iIGT.
这项队列研究调查了单纯糖耐量受损（iIGT）患者血清锌（SZn）浓度与进展为2型糖尿病（T2D）风险之间的可能关联。在基线期（2009 - 2011年）对198例iIGT患者（平均年龄：53.0±14.4岁，33.8%为男性）测量了SZn，并对他们进行随访直至2017年，观察其是否发生T2D。使用单变量无限制回归样条（UVRS）评估潜在的非线性关联，并确定与T2D发病率相关的SZn节点的最佳位置。多变量Cox比例风险模型用于计算在节点最佳位置上T2D发病的调整风险比（HRs）和95%置信区间（CIs）。使用受试者工作特征（ROC）分析确定SZn对发生T2D的预测能力，并通过约登指数确定最佳临界值。平均基线SZn浓度为115±42.9μg/dL。在中位6年的随访期内，27.8%的iIGT患者发生了T2D。观察到SZn与T2D发病率之间存在非线性关联（似然比检验p<0.001）。较高的SZn≥106μg/dL和≥134μg/dL分别使T2D风险升高127%（HR = 2.27，95%CI = 1.01 - 5.10）和144%（HR = 2.44，95%CI = 1.05 - 5.69）。根据粗ROC分析和多变量调整后的ROC分析，识别T2D发病的SZn最佳临界值分别为≥87.5μg/dL（敏感性83.6%，特异性30.1%）和151.8μg/dL（敏感性64.4%，特异性76.3%）。基线时SZn水平升高与iIGT患者未来发生T2D的风险呈正相关。
