title: Is serum zinc level associated with prediabetes and diabetes?: a cross-sectional study from Bangladesh.
abstract: OBJECTIVE
  To determine serum zinc level and other relevant biological markers in normal, prediabetic and diabetic individuals and their association with Homeostasis Model Assessment (HOMA) parameters.
  
  
  METHODS
  This cross-sectional study was conducted between March and December 2009. Any patient aged ≥ 30 years attending the medicine outpatient department of a medical university hospital in Dhaka, Bangladesh and who had a blood glucose level ordered by a physician was eligible to participate.
  
  
  RESULTS
  A total of 280 participants were analysed. On fasting blood sugar results, 51% were normal, 13% had prediabetes and 36% had diabetes. Mean serum zinc level was lowest in prediabetic compared to normal and diabetic participants (mean differences were approximately 65 ppb/L and 33 ppb/L, respectively). In multiple linear regression, serum zinc level was found to be significantly lower in prediabetes than in those with normoglycemia. Beta cell function was significantly lower in prediabetes than normal participants. Adjusted linear regression for HOMA parameters did not show a statistically significant association between serum zinc level, beta cell function (P = 0.07) and insulin resistance (P = 0.08). Low serum zinc accentuated the increase in insulin resistance seen with increasing BMI.
  
  
  CONCLUSIONS
  Participants with prediabetes have lower zinc levels than controls and zinc is significantly associated with beta cell function and insulin resistance. Further longitudinal population based studies are warranted and controlled trials would be valuable for establishing whether zinc supplementation in prediabetes could be a useful strategy in preventing progression to Type 2 diabetes.
authors.affiliation: Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, The University of Newcastle, New Lambton Heights, New South Wales, Australia.
authors.forename: Md Rafiqul
authors.initials: MR
authors.lastname: Islam
authors.forename: Iqbal
authors.initials: I
authors.lastname: Arslan
authors.forename: John
authors.initials: J
authors.lastname: Attia
authors.forename: Mark
authors.initials: M
authors.lastname: McEvoy
authors.forename: Patrick
authors.initials: P
authors.lastname: McElduff
authors.forename: Ariful
authors.initials: A
authors.lastname: Basher
authors.forename: Waliur
authors.initials: W
authors.lastname: Rahman
authors.forename: Roseanne
authors.initials: R
authors.lastname: Peel
authors.forename: Ayesha
authors.initials: A
authors.lastname: Akhter
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Akter
authors.forename: Khanrin P
authors.initials: KP
authors.lastname: Vashum
authors.forename: Abul Hasnat
authors.initials: AH
authors.lastname: Milton
mesh_terms: D001459:Bangladesh; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D050417:Insulin-Secreting Cells / Q000378:metabolism / Q000473:pathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood*; D015032:Zinc / Q000097:blood*
chemical_list: D007328:Insulin; D015032:Zinc