PMID- 37183697
OWN - NLM
STAT- Publisher
LR  - 20230515
IS  - 1549-7852 (Electronic)
IS  - 1040-8398 (Linking)
DP  - 2023 May 15
TI  - Effect of zinc supplementation in the management of type 2 diabetes: A grading of 
      recommendations assessment, development, and evaluation-assessed, dose-response 
      meta-analysis of randomized controlled trials.
PG  - 1-12
LID - 10.1080/10408398.2023.2209802 [doi]
AB  - The question of whether zinc supplementation may improve cardio-metabolic health 
      in patients with type 2 diabetes mellitus (T2DM) remains controversial and 
      require further evaluation. This study aimed to summarize the effectiveness of 
      oral zinc supplementation in improving cardio-metabolic risk markers in people 
      with T2DM. We searched PubMed, Scopus, and Web of Science from inception to April 
      2023, for randomized controlled trials (RCTs). RCTs of type 2 diabetic adults 
      (aged >/=18 years) comparing zinc supplementation with placebo were included. We 
      excluded studies if not randomized, involved co-supplementation, and were 
      conducted in children or pregnant women. Glycemic indices, lipid profiles, blood 
      pressure, anthropometric measure, c-reactive protein (CRP), creatinine, and serum 
      zinc were extracted. Certainty of evidence was assessed using the Grading of 
      Recommendations, Assessment, Development, and Evaluation (GRADE) methods. We used 
      a random-effect model to perform the dose-response analysis. Effect sizes were 
      presented as mean difference (MD) and 95% confidence interval (CI). 22 studies 
      (n = 1442 participants) were included. The certainty of the evidence was rated as 
      moderate to high. Zinc supplementation significantly reduced glycemic indices: 
      including two-hour postprandial glucose (2hpp) (mean difference (MD): 
      -34.34 mg/dl; 95%CI: -51.61 approximately  -17.07), fast blood sugar (FBS) (MD: -23.32 mg/dl; 
      95% CI: -33.81 approximately  -12.83), and hemoglobin A1c (HbA1c) (MD: -0.47; 95% CI: -0.71 approximately  
      -0.23). Zinc had a favorable effect on lipid profiles low-density lipoprotein 
      (LDL) (MD: -10.76 mg/dl; CI: -17.79 approximately -3.73), triglyceride (TG) (MD: -18.23 mg/dl; 
      CI: -32.81 approximately -3.65), total cholesterol (TC) (MD: -12.74 mg/dl; CI: -21.68 approximately -3.80), 
      VLDL (MD: -5.39 mg/dl; CI: -7.35 approximately -3.43) and high-density lipoprotein (HDL) (MD: 
      4.04 mg/dl; CI: 0.96  approximately  7.12). Systolic blood pressure (SBP) (MD): -3.64 mmHg; 95% 
      CI: -6.77 approximately  -0.52), weight (MD: 1.00 kg; 95% CI: 0.34 approximately 1.66), CRP (MD: -3.37 mg/l, 
      95% CI: -4.05 approximately  -2.70), and serum zinc (MD: 15.38 microg/dl; 95% CI: 10.74 approximately  20.02) 
      changed to a statistically significant extent with zinc supplementation. There 
      was also a linear association between additional 10 mg/d zinc treatment with FBS, 
      HbA1c, HDL, LDL, TG, TC, and serum zinc. A non-linear dose-response gradient was 
      seen for FBS, HDL, and SBP (p < 0.05). Egger's test showed no substantial 
      publication bias. Our findings strongly suggest a potential beneficial effect of 
      zinc supplementation on type 2 diabetic patients. Further high-quality research 
      is needed to determine the optimal form, dosage, and duration of zinc 
      supplementation for this population.
FAU - Ghaedi, Kimia
AU  - Ghaedi K
AUID- ORCID: 0000-0003-1031-1374
AD  - Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
FAU - Ghasempour, Dorsa
AU  - Ghasempour D
AUID- ORCID: 0000-0001-6989-6616
AD  - Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
FAU - Jowshan, Mohammadreza
AU  - Jowshan M
AUID- ORCID: 0000-0001-8603-5674
AD  - Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, 
      Tehran University of Medical Sciences, Tehran, Iran.
FAU - Zheng, Miaobing
AU  - Zheng M
AUID- ORCID: 0000-0002-4151-3502
AD  - Institute for Physical Activity and Nutrition, School of Exercise and Nutrition 
      Sciences, Deakin University, Melbourne, Victoria, Australia.
FAU - Ghobadi, Saeed
AU  - Ghobadi S
AUID- ORCID: 0000-0002-3492-9980
AD  - Institute for Physical Activity and Nutrition, School of Exercise and Nutrition 
      Sciences, Deakin University, Melbourne, Victoria, Australia.
FAU - Jafari, Alireza
AU  - Jafari A
AUID- ORCID: 0000-0003-2475-1928
AD  - Physiology Research Center, Institute of Neuropharmacology, Kerman University of 
      Medical Sciences, Kerman, Iran.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230515
PL  - United States
TA  - Crit Rev Food Sci Nutr
JT  - Critical reviews in food science and nutrition
JID - 8914818
SB  - IM
OTO - NOTNLM
OT  - Cardio-metabolic
OT  - diabetes
OT  - meta-analysis
OT  - zinc
EDAT- 2023/05/15 06:42
MHDA- 2023/05/15 06:42
CRDT- 2023/05/15 05:27
PHST- 2023/05/15 06:42 [medline]
PHST- 2023/05/15 06:42 [pubmed]
PHST- 2023/05/15 05:27 [entrez]
AID - 10.1080/10408398.2023.2209802 [doi]
PST - aheadofprint
SO  - Crit Rev Food Sci Nutr. 2023 May 15:1-12. doi: 10.1080/10408398.2023.2209802.