2型糖尿病和锌失调：从基础和流行病学证据到干预措施

IF 3.6 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Journal of Trace Elements in Medicine and Biology Pub Date : 2025-08-22 DOI:10.1016/j.jtemb.2025.127733

Irene Martinez-Morata , Katherine Dennehy , Oleg Chepurny , Tuncay Delibasi , Kathrin Schilling , Ana Navas-Acien , Malek El Muayed

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引用次数: 0

摘要

背景：在2型糖尿病（T2DM）发病和进展的不同阶段，锌水平发生复杂的细胞和全身变化。方法我们总结了锌和T2DM之间的关系，包括机制和流行病学/临床研究，重点是锌的病理生理，锌生物标志物的解释，以及不同人群中锌状态和T2DM之间的关系。结果锌在胰岛素生成ß-细胞中的不合理分布可能是导致T2DM ß-细胞衰竭的关键因素，其中ZnT8转运体的遗传变异起着重要作用。流行病学证据表明，T2DM患者尿锌升高，血浆和血锌降低。锌生物标志物的变化与糖尿病前期和健康成人在高血糖发生前发生T2DM的风险增加有前瞻性关联。一些研究表明，补充锌可以改变2型糖尿病患者的血糖终点，但在健康成人中证据不足。锌生物标志物，包括同位素，可以为T2DM不同疾病阶段的风险评估和管理提供新的方法。结论2型糖尿病早期发生锌代谢失调，ß-细胞衰竭起核心作用。需要进一步的研究来联系与T2DM不同阶段进展相关的机制证据和病理生理变化。

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Type 2 diabetes mellitus and zinc dysregulation: From basic and epidemiological evidence to interventions

Background

Complex cellular and systemic changes in Zn levels have been reported through different stages of Type 2 Diabetes (T2DM) onset and progression.

Methods

We summarize available evidence on Zn and T2DM, including mechanistic and epidemiological/clinical studies with a focus on Zn pathophysiology, interpretation of Zn biomarkers, and associations of Zn status and T2DM across different populations.

Results

Misdistribution of Zn in insulin-producing ß-cells are likely key contributors to ß-cell failure in T2DM, with genetic variants in ZnT8 transporters playing an important role. Epidemiological evidence has documented increased urinary Zn and decreased plasma and blood Zn in persons with established T2DM. Changes in Zn biomarkers have been prospectively associated with increased risk of T2DM in pre-diabetes and healthy adults before hyperglycemia occurs. Some studies suggest that Zn supplementation could modify glycemic endpoints in T2DM participants, but evidence is insufficient in healthy adults. Zn biomarkers, including isotopes, can provide novel approaches for T2DM risk assessment and management at different disease stages.

Conclusions

Dysregulation of Zn metabolism occurs early in T2DM development with ß-cell failure playing a central role. Additional research is needed to connect mechanistic evidence and pathophysiological changes associated with various stages of T2DM progression.

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来源期刊

Journal of Trace Elements in Medicine and Biology 医学-内分泌学与代谢

CiteScore

6.60

自引率

2.90%

发文量

202

审稿时长

85 days

期刊介绍： The journal provides the reader with a thorough description of theoretical and applied aspects of trace elements in medicine and biology and is devoted to the advancement of scientific knowledge about trace elements and trace element species. Trace elements play essential roles in the maintenance of physiological processes. During the last decades there has been a great deal of scientific investigation about the function and binding of trace elements. The Journal of Trace Elements in Medicine and Biology focuses on the description and dissemination of scientific results concerning the role of trace elements with respect to their mode of action in health and disease and nutritional importance. Progress in the knowledge of the biological role of trace elements depends, however, on advances in trace elements chemistry. Thus the Journal of Trace Elements in Medicine and Biology will include only those papers that base their results on proven analytical methods. Also, we only publish those articles in which the quality assurance regarding the execution of experiments and achievement of results is guaranteed.