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Serum zinc levels and multiple health outcomes: Implications for zinc-based biomaterials.

ABSTRACT: Background:Zinc-based biomaterials, including biodegradable metal, nanoparticles, and coatings used in medical implants release zinc ions that may increase the whole-body and serum zinc concentrations. The impact of serum zinc concentrations on major health outcomes can provide insights for device design and clinical transformation of zinc-based biomaterials. Methods:This nationally representative cross-sectional study enrolled participants from the National Health and Nutrition Examination Survey (NHANES, 2011-2014) including 3607 participants. Using unadjusted and multivariate-adjusted logistic regression analyses, two-piecewise linear regression model with a smoothing function and threshold level analysis, we evaluated the associations between elevated serum zinc levels and major health outcomes. Results:Elevated serum zinc levels were significantly associated with an increase in total spine and total femur bone mineral density (BMD). Every 10 ?g/dL increase was associated with a 1.12-fold increase in diabetes mellitus (DM) and 1.23-fold and 1.29-fold increase in cardiovascular diseases (CVD) and coronary heart disease (CHD), in participants with serum zinc levels ? 100 ?g/dL. It had no significant linear or nonlinear associations with risk of fractures, congestive heart failure, heart attack, thyroid disease, arthritis, osteoarthritis, rheumatoid arthritis, dyslipidemia and cancer. Conclusion:Serum zinc levels are significantly associated with increased BMD in the total spine and total femur, and risk of DM, and CVD/CHD among participants with serum zinc levels ?100 ?g/dL.

SUBMITTER: Qu X

PROVIDER: S-EPMC7114479 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Serum zinc levels and multiple health outcomes: Implications for zinc-based biomaterials.

Qu Xinhua X Yang Hongtao H Yu Zhifeng Z Jia Bo B Qiao Han H Zheng Yufeng Y Dai Kerong K

Bioactive materials 20200331 2

<h4>Background</h4>Zinc-based biomaterials, including biodegradable metal, nanoparticles, and coatings used in medical implants release zinc ions that may increase the whole-body and serum zinc concentrations. The impact of serum zinc concentrations on major health outcomes can provide insights for device design and clinical transformation of zinc-based biomaterials.<h4>Methods</h4>This nationally representative cross-sectional study enrolled participants from the National Health and Nutrition E ...[more]

PMID: 32258830

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Project description:Objective To map the diverse health outcomes associated with serum uric acid (SUA) levels.Design Umbrella review.Data sources Medline, Embase, Cochrane Database of Systematic Reviews, and screening of citations and references.Eligibility criteria Systematic reviews and meta-analyses of observational studies that examined associations between SUA level and health outcomes, meta-analyses of randomised controlled trials that investigated health outcomes related to SUA lowering treatment, and Mendelian randomisation studies that explored the causal associations of SUA level with health outcomes.Results 57 articles reporting 15 systematic reviews and144 meta-analyses of observational studies (76 unique outcomes), 8 articles reporting 31 meta-analyses of randomised controlled trials (20 unique outcomes), and 36 articles reporting 107 Mendelian randomisation studies (56 unique outcomes) met the eligibility criteria. Across all three study types, 136 unique health outcomes were reported. 16 unique outcomes in meta-analyses of observational studies had P<10-6, 8 unique outcomes in meta-analyses of randomised controlled trials had P<0.001, and 4 unique outcomes in Mendelian randomisation studies had P<0.01. Large between study heterogeneity was common (80% and 45% in meta-analyses of observational studies and of randomised controlled trials, respectively). 42 (55%) meta-analyses of observational studies and 7 (35%) meta-analyses of randomised controlled trials showed evidence of small study effects or excess significance bias. No associations from meta-analyses of observational studies were classified as convincing; five associations were classified as highly suggestive (increased risk of heart failure, hypertension, impaired fasting glucose or diabetes, chronic kidney disease, coronary heart disease mortality with high SUA levels). Only one outcome from randomised controlled trials (decreased risk of nephrolithiasis recurrence with SUA lowering treatment) had P<0.001, a 95% prediction interval excluding the null, and no large heterogeneity or bias. Only one outcome from Mendelian randomisation studies (increased risk of gout with high SUA levels) presented convincing evidence. Hypertension and chronic kidney disease showed concordant evidence in meta-analyses of observational studies, and in some (but not all) meta-analyses of randomised controlled trials with respective intermediate or surrogate outcomes, but they were not statistically significant in Mendelian randomisation studies.Conclusion Despite a few hundred systematic reviews, meta-analyses, and Mendelian randomisation studies exploring 136 unique health outcomes, convincing evidence of a clear role of SUA level only exists for gout and nephrolithiasis.

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Serum zinc levels and multiple health outcomes: Implications for zinc-based biomaterials.

Publications

Serum zinc levels and multiple health outcomes: Implications for zinc-based biomaterials.

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