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A cross-sectional study of the correlation between diabetic therapy and serum zinc concentrations

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Abstract

Aim

Zinc, an essential trace element, has various functions in humans. Zinc deficiency is associated with the elderly, patients with diabetes, and patients with frailty, a common geriatric syndrome. As few studies have reported the effects of anti-diabetic medication on zinc levels, we examined serum zinc concentrations in patients with diabetes and their correlation with anti-diabetic medications, especially in the elderly and patients with frailty, in Japan.

Methods

This cross-sectional study was conducted in 2014 and included 1033 patients with diabetes. Blood samples were taken, and a survey for the 8-item Short Form Health Survey of the Medical Outcomes Study was conducted.

Results

Because of renal dysfunction (with an estimated glomerular filtration rate of < 60 mL/min/1.73 m2), 337 patients out of 1033 were excluded. Hypozincemia was observed in 43.8% of the patients with diabetes. In 177 elderly patients with a low physical component summary score, multivariable logistic regression analysis revealed two anti-diabetic medications associated with hypozincemia: GLP-1RA (multivariable-adjusted odds ratio [OR] 0.08, 95% confidence interval [CI] 0.010–0.657, p = 0.019) and metformin (OR 0.415, 95% CI 0.222–0.774, p = 0.006). In addition, metformin had a dose-dependent correlation with zinc levels (R = 0.3067, p < 0.0001).

Conclusions

Oral administration of metformin in the elderly with diabetes and non-progressive renal dysfunction was not associated with hypozincemia, even at high doses.

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Acknowledgements

This study was supported by a grant from the Research Project on Development of Agricultural Products and Foods with Health-Promoting Benefits (NARO), Japan. We would like to take this opportunity to thank Yuichi Inoue, Hajime Narisawa, and Yoko Komada.

Author information

Authors and Affiliations

  1. Department of Diabetes, Endocrinology and Metabolism, Tokyo Medical University Hospital, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Mamoru Sakurai, Junko Sasaki, Hirotsugu Suwanai, Jumpei Shikuma, Rokuro Ito, Masato Odawara, Takashi Miwa & Ryo Suzuki

  2. Department of Diabetes, Endocrinology and Metabolism, Sanno Hospital, 8-10-16 Akasaka, Minato-ku, Tokyo, 107-0052, Japan

    Masato Odawara

Authors
  1. Mamoru Sakurai
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  2. Junko Sasaki
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  4. Jumpei Shikuma
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  7. Takashi Miwa
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Contributions

All the authors contributed to the study conception and design. Material preparation and data collection and analysis were performed by MS, JS, JS, and RI. The first draft of the manuscript was written by MS, and all the authors commented on previous versions of the manuscript. HS contributed to writing reviews and editing. TM, MO, and RS performed the supervision of this study. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Takashi Miwa.

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Conflict of interest

The authors declare the following financial interests/personal relationships, which may be considered as potential competing interests: M Sakurai, J Sasaki, H Suwanai, J Shikuma, and T Miwa have no conflict of interest. R Ito received donation from Nippon Boehringer Ingelheim Co., Ltd. M Odawara received honoraria, subsidies, or donations from Novo Nordisk Pharma Ltd., Sanofi K.K., MSD K.K., Ono Pharmaceutical Co., Ltd., Novartis Pharma K.K., Astellas Pharma Inc., AstraZeneca K.K., Kowa Pharmaceutical Co. Ltd., Takeda Pharmaceutical Company, Ltd., Mitsubishi Tanabe Pharma Corp., Eli Lilly Japan K.K., Nippon Boehringer Ingelheim Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Kyowa Kirin Co., Ltd., Daiichi Sankyo Co., Ltd., and Teijin Home Healthcare Ltd. R Suzuki received honoraria, subsidies, or donations from Novo Nordisk Pharma Ltd., Sanofi K.K., MSD K.K., Ono Pharmaceutical Co., Ltd., Novartis Pharma K.K., Takeda Pharmaceutical Company, Ltd., Mitsubishi Tanabe Pharma Corp., Eli Lilly Japan K.K., and Sumitomo Dainippon Pharma Co., Ltd., and Daiichi Sankyo Co., Ltd. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Research involving human participants

The study protocol was approved by the ethics committees of Tokyo Medical University with the number of T2020-0191. All the procedures followed were according to the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Informed consent

Informed consent or substitute for it was obtained from all the patients for being included in this study.

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Sakurai, M., Sasaki, J., Suwanai, H. et al. A cross-sectional study of the correlation between diabetic therapy and serum zinc concentrations. Diabetol Int 13, 177–187 (2022). https://doi.org/10.1007/s13340-021-00521-6

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  • DOI: https://doi.org/10.1007/s13340-021-00521-6

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