Intervention Review

Zinc supplementation for the prevention of type 2 diabetes mellitus

  1. Vânia Beletate1,*,
  2. Regina El Dib2,
  3. Álvaro N Atallah3

Editorial Group: Cochrane Metabolic and Endocrine Disorders Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 29 JUN 2005

DOI: 10.1002/14651858.CD005525.pub2

Database Title

Additional Information

How to Cite

Beletate V, El Dib R, Atallah ÁN. Zinc supplementation for the prevention of type 2 diabetes mellitus. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD005525. DOI: 10.1002/14651858.CD005525.pub2.

Author Information

  1. 1

    Universidade Federal de São Paulo, Programa de graduacao de Medicina Interna e Terapeutica, Piracicaba, Brazil

  2. 2

    St. Joseph's Healthcare Hamilton, McMaster Institute of Urology, Toronto, ON, Canada

  3. 3

    Universidade Federal de São Paulo / Escola Paulista de Medicina, Brazilian Cochrane Centre, São Paulo, SP, Brazil

*Vânia Beletate, Programa de graduacao de Medicina Interna e Terapeutica, Universidade Federal de São Paulo, Aquilino Pacheco 1516, apto 43, Piracicaba, Brazil. vaniabeletate@uol.com.br.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

The chronic hyperglycaemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels. The risk of developing type 2 diabetes increases with age, obesity, and lack of physical activity. Insulin resistance is a fundamental aspect of the aetiology of type 2 diabetes. Insulin resistance has been shown to be associated with atherosclerosis, hypertriglyceridaemia, glucose intolerance, dyslipidaemia, hyperuricaemia, hypertension and polycystic ovary syndrome. The mineral zinc plays a key role in the synthesis and action of insulin, both physiologically and in diabetes mellitus. Zinc seems to stimulate insulin action and insulin receptor tyrosine kinase activity.

Objectives

To assess the effects of the zinc supplementation in the prevention of type 2 diabetes mellitus.

Search methods

Studies were obtained from computerised searches of MEDLINE, EMBASE, LILACS and The Cochrane Library.

Selection criteria

Studies were included if they had a randomised or quasi-randomised design and if they investigated zinc supplementation in adults living in the community, 18 years or older with insulin resistance (compared to placebo or no intervention).

Data collection and analysis

Two authors selected relevant trials, assessed methodological quality and extracted data.

Main results

Only one study met the inclusion criteria of this review. There were 56 normal glucose tolerant obese women (aged 25 to 45 years, body mass index 36.2 ± 2.3 kg/m2). Follow-up was four weeks. The outcomes measured were decrease of insulin resistance, anthropometric and diet parameters, leptin and insulin concentration, zinc concentration in the plasma and urine, lipid metabolism and fasting plasma glucose. There were no statistically significant differences favouring participants receiving zinc supplementation compared to placebo concerning any outcome measured by the study.

Authors' conclusions

There is currently no evidence to suggest the use of zinc supplementation in the prevention of type 2 diabetes mellitus. Future trials will have to standardise outcomes measures such as incidence of type 2 diabetes mellitus, decrease of the insulin resistance, quality of life, diabetic complications, all-cause mortality and costs.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Zinc supplementation for the prevention of type 2 diabetes mellitus

Currently no evidence to suggest the use of zinc for the primary prevention of type 2 diabetes. Diabetes mellitus is associated with long-term complications, especially eye, kidney, nerve, heart and blood vessel disease. Type 2 diabetes is mainly characterised by a reduced ability of the hormone insulin to stimulate glucose uptake in body fat and muscles (insulin resistance) and affects most people suffering from diabetes. Type 2 diabetes may not cause symptoms for some time and may remain undetected for many years. Zinc, an important mineral, plays a relevant role in the synthesis and action of insulin. The human body does not produce zinc on its own, so it must be obtained from outside sources. The mineral zinc can be found in both animal and plant food sources, but the richest source of zinc comes from animal food sources.
We assessed the effects of the zinc supplementation in the prevention of type 2 diabetes mellitus. Only one relevant study was detected. There were no significant differences favouring people receiving zinc supplementation compared to placebo concerning any outcome measured in the study. Thus, there is currently no evidence to suggest the use of zinc supplementation in the prevention of type 2 diabetes mellitus.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

補充鋅與第二型糖尿病的預防

慢性高血糖或糖尿病會造成各種器官的損害,特別是眼睛、腎臟、神經、心臟,和血管等器官的傷害。罹患第二型糖尿病的風險隨著年齡、肥胖,缺乏活動而增加。胰島素抗性是發生第二型糖尿病的主要原因。此外,動脈粥樣硬化、高三酸甘油脂血症、葡萄糖不耐症、脂肪代謝異常、高尿酸血症、高血壓和多囊性卵巢症也和胰島素抗性有所關聯。礦物鋅不論是在正常生理中或在糖尿病中,對胰島素的合成和作用,都扮演了關鍵角色。鋅似乎刺激胰島素作用和胰島素感受器tyrosine kinase的活性。

目標

評估鋅的補充與第二型糖尿病的預防

搜尋策略

此研究經由電腦搜尋MEDLINE, EMBASE, LILACS and The Cochrane Library等資料庫。

選擇標準

研究選擇出隨機或半隨機化的設計,居住在社區18歲以上有胰島素抗性的成人,有鋅的補充(與安慰劑或沒有介入做比較)試驗。

資料收集與分析

由二位作者選擇相關的試驗,評估方法的品質與擷取資料。

主要結論

只有一項研究符合選擇標準。共有56名正常葡萄糖耐受性的肥胖婦女(年齡在25到45歲間,身體質量指數(body mass index)為36.2+/−2.3kg/m2)。一共追蹤四週,測量了包括胰島素抗性,人體計測(anthropometric),飲食參數(diet parameters),瘦素(leptin),胰島素濃度、血漿和尿中的鋅含量,脂肪代謝,和空腹血糖值等參數。與安慰劑比較,並沒有統計學上的意義顯示接受鋅的補充對研究結果有益。

作者結論

目前為止並沒有證據指出鋅的補充能預防第二型糖尿病。未來必須有標準化的試驗評估鋅的補充對於包括第二型糖尿病發生率,胰島素抗性的減退,生活品質,糖尿病併發症, 總死亡率和花費等的差異。

翻譯人

本摘要由臺灣大學附設醫院張涵軒翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

目前為止並沒有證據顯示鋅的補充能預防第2型糖尿病發生。糖尿病會造成許多長期的併發症,特別是眼睛、腎臟、神經、心臟和血管疾病。第2型糖尿病主要的特性為胰島素對於刺激脂肪和肌肉對葡萄糖吸收的能力減少(胰島素抗性)並且是造成多數人發生糖尿病的原因。第2型糖尿病患者可能沒有明顯症狀,罹病多年而不自知。鋅,一種重要的礦物質,在胰島素的合成和作用扮演重要的角色。人體不能產生鋅,故必須自外界獲得。礦物鋅可來自動物和植物,但鋅最豐富的來源是動物。我們評估了鋅的補充對第2型糖尿病的預防效果。我們只搜尋出一個相關研究,在這個研究中,接受鋅補充或使用安慰劑對預後並無相差.因此,目前為止並沒有足夠證據顯示鋅的補充能預防第2型糖尿病發生。

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