Dietary zinc intake and 10-year atherosclerotic cardiovascular disease risk in diabetes mellitus patients: evidence from NHANES database.

Objective: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in diabetes mellitus (DM) patients. Oxidative stress and inflammation are important pathological mechanisms affecting the occurrence and development of ASCVD in DM patients. Dietary zinc acts a key role in anti-oxidation, anti-inflammation and blood glucose regulation. This study purposes to explore the relationship between dietary zinc intake and 10-year ASCVD in DM patients.

Methods: Based on the National Health and Nutrition Examination Survey (NHANES) 2007-2018, the 10-year risk of ASCVD was assessed using the 2018 ACC/AHA guidelines & pooled cohort equations model. The total dietary zinc intake was calculated through 24-h dietary recall. Weighted univariable, multivariate logistic regression and restricted cubic splines (RCS) were performed to evaluate the association between dietary zinc intake and 10-year risk of ASCVD among patients with DM. Stratified analysis based on the history of hypertension, dyslipidemia and hypoglycemic agent's treatment were further evaluated these associations.

Results: Finally, we included 3,053 DM patients, of which 1,245 (40.78%) had high risk of 10-year ASCVD. We found higher dietary zinc intake was related to lower 10-year ASCVD risk among patients with DM (OR = 0.77, 95%CI: 0.61-0.99, P = 0.044), especially in patients with hypertension (OR = 0.53, 95%CI: 0.36-0.80), dyslipidemia (OR = 0.74, 95%CI: 0.58-0.95, P = 0.019), and hypoglycemic agent's treatment (OR = 0.71, 95%CI: 0.54-0.93, P = 0.016).

Conclusion: Sufficient dietary zinc intake has potential benefits for cardiovascular health among patients with DM. Further large-scale and well-designed prospective study are needed to further explore these associations.