# Clinical correlation of serum zinc and chromium levels in patients with type 2 diabetes mellitus and complications in Pakistan: a retrospective study

## TL;DR

This study found that lower levels of zinc and chromium in the blood are linked to type 2 diabetes and its complications, like neuropathy and heart disease, in Pakistan.

## Contribution

The study is the first to report specific associations between zinc and chromium levels and diabetic complications in a Pakistani population.

## Key findings

- T2DM patients had significantly lower zinc and chromium levels than healthy controls.
- Diabetic neuropathy was linked to the lowest zinc levels, while cardiovascular disease was linked to reduced chromium levels.
- Higher HbA1c levels were associated with lower zinc and chromium levels, indicating poor glycemic control.

## Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and hyperglycemia. The role of trace elements such as zinc and chromium in the pathophysiology of T2DM has garnered significant attention due to their involvement in glucose metabolism and insulin regulation.

This cross-sectional study evaluated the clinical correlation between serum zinc and chromium levels in T2DM patients with and without complications in Pakistan.

A total of 145 participants were included, comprising 100 T2DM patients (80 with complications: retinopathy, nephropathy, cardiovascular disease, and neuropathy; 20 without complications) and 45 healthy controls. Serum zinc and chromium levels were measured using atomic absorption spectrometry and their associations with glycated hemoglobin (HbA1c), demographic factors, and clinical profiles were evaluated.

The results showed that serum zinc and chromium levels were significantly lower in T2DM patients as compared to healthy controls (p value = 0.02 and p value = 0.001, respectively). Among diabetic subgroups, patients with diabetic neuropathy had the lowest zinc levels (p = 0.0001), while those with cardiovascular disease had significantly reduced chromium levels (p = 0.0002). Multivariate regression analysis showed that HbA1c levels were significantly associated with both zinc (β = 1.588, p value = 0.02) and chromium (β = 1.485, p value = 0.001), suggesting that deficiencies in these trace elements may contribute to poor glycemic control and the progression of diabetic complications.

These findings highlight the potential role of zinc and chromium supplementation as an adjunctive therapeutic approach in managing T2DM and preventing its complications. Further longitudinal studies are needed to establish causality and explore the underlying mechanisms of trace element deficiency in diabetic patients.