The Effect of Zinc Supplementation on Lipid Profiles in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Dose–Response Meta-Analysis of Randomized Clinical Trials

Abstract

Research on the effects of zinc supplementation on lipid profiles in people with type 2 diabetes mellitus (T2DM) has been inconsistent. This systematic review and meta-analysis was performed to summarize the current data on the effects of zinc supplementation on lipid profiles in patients with T2DM. Three online databases including PubMed, Scopus, and Web of Science were searched to find relevant studies published until September 2022. The exposure was zinc supplementation, and the outcomes were low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and total cholesterol (TC). Fourteen randomized clinical trials consisting of 1067 patients were included in the statistical analysis. Significant improvement was observed in all 4 lipid profile components. Following zinc supplementation, a significant decrease was observed in TC (weighted mean difference [WMD]: 16.16; 95% confidence interval [CI]: 26.43, 5.89; P ¼ 0.002), LDL (WMD: 6.18; 95% CI: 9.35, 3.02; P < 0.001), and TG (WMD: 13.08; 95% CI: 21.83, 4.34; P ¼ 0.003). After analyzing 13 studies reporting HDL, a significant increase was seen (WMD: 3.76; 95% CI: 1.30, 6.22; P ¼ 0.003). In a nonlinear dose–response analysis, a significant inverse association was observed between <12 wk zinc supplementation and TC, LDL, and TG (TC: WMD: 5, Pnonlinearity < 0.001; LDL: WMD: 5, Pnonlinearity ¼ 0.07, TG: WMD: 16.5, Pnonlinearity ¼ 0.006). Nonlinear dose–response analysis shows that the optimum elemental zinc dosage for the best response to the supplementation for TC, LDL, and TG are 120, 100, and 140 mg/d, respectively (TC: WMD: 5, Pnonlinearity < 0.001; LDL: WMD: 10, Pnonlinearity ¼ 0.006, TG: WMD: 50, Pnonlinearity ¼ 0.031). In conclusion, we found significant changes in all 4 components of the lipid profile through zinc supplementation in T2DM patients. Based on our findings, zinc supplementation may have profound favorable consequences on the lipid profile of T2DM patients, especially in the zinc-deficient group.