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Minerva Endocrinology 2021 Mar 16

DOI: 10.23736/S2724-6507.21.03234-X


lingua: Inglese

Zinc supplementation in pre-diabetes mellitus: a systematic review and meta-analysis

Ranil JAYAWARDENA 1, 2 , Priyanga RANASINGHE 3, Wasana KODITHUWAKKU 1, Chamila DALPATADU 1, John ATTIA 4

1 Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; 2 Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; 3 Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka; 4 Division of Medicine, Hunter New England Local Health District, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.


INTRODUCTION: Certain pharmacological and lifestyle interventions have been shown to reduce progression of pre-diabetes. We aimed to perform a systematic review and meta-analyses of studies assessing the outcomes of zinc supplementation in individuals with pre-diabetes.
EVIDENCE ACQUISITION: A comprehensive search was conducted in PubMed, SciVerse Scopus and Web of Science databases. Controlled clinical trials in pre-diabetics, on zinc supplement with or without other nutrients, assessing at least one accepted glycaemic parameter as an outcome were deemed eligible.
EVIDENCE SYNTHESIS: Three papers were included in the systematic review and meta analysis, with a total of 265 participants. Duration of zinc supplementation ranged from 6-12 months. The zinc dose ranged from 20-30 mg/day. In the pooled analysis, zinc supplementation significantly reduced FBG both when given alone (-10.86 mg/dL; 95% CI, -14.74 to -6.98; p<0.001) and with other micronutrients (-11.77 mg/dL; p<0.001). Similarly, 2hr-OGTT blood glucose was reduced by 21.08 mg/dL (95% CI, -40.05 to -2.11; p=0.03) in the pooled analysis of studies using zinc alone and in combination with other micronutrients. One study demonstrated a significant reduction of HbA1c by 0.5% with combined supplementation, while another reported a significant reduction in CRP with zinc supplementation. When all trials were considered, TC, HDL-c and HOMA-β showed significant improvement. Zinc supplementation significantly improved the zinc status from baseline.
CONCLUSIONS: Zinc supplementation demonstrated beneficial effects on glycaemic and lipid parameters in individuals with pre-diabetes. It may have the potential to reduce the prevalence of pre-diabetes and control associated morbidity and mortality.

KEY WORDS: Zinc; Pre-diabetes; Blood glucose; Supplementation; Clinical trial

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