Manganese, zinc, selenium and cooper involvement in the metabolic profile and glycemic control of patients with and without use of insulin

Author(s)

Livia Fernandes de Lima

• Document type: Master's Dissertation
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina de Ribeirão Preto (PCARP/BC)
• Defense date: 2015-08-25

Examining board members

Anderson Marliere Navarro; Fernando Barbosa Junior; Marcus Vinícius Simões

• Advisor: Anderson Marliere Navarro

Abstract

Diabetes Mellitus (DM) is a pathology characterized by constant hyperglycemia and can present complications such as inflammation and the development of oxidative stress, which is controlled by some minerals such as zinc, manganese, iron, copper and selenium. The imbalance of these micronutrients can increase oxidative stress and contribute to increased insulin resistance and the development of diabetic complications. Therefore, the objective of this study was to evaluate the effect of micronutrients manganese, zinc, selenium and copper on the metabolic profile and consequently glycemic control in patients with type 2 DM with and without use of insulin. For this, 67 patients were selected at the DM outpatient clinic of the HCRP, who were separated into two groups: using insulin (GCI; n = 34) and without using insulin (GSI; n = 33). Anthropometric data, three-day dietary records, biochemical tests related to the clinical, inflammatory and oxidative stress profiles, and serum and erythrocyte concentrations of minerals were analyzed by the volunteers using the ICP-MS method. For data analysis, the independent variables had the T-Student test applied or Mann-Whitney and for the categorical variables the exact X2 test was used. In assessing the correlations between the variables, Spearman\'s correlation coefficient was used. Significant differences were obtained with a significance level of 5% (p <0.05). Of the 67 patients analyzed with DM2, the majority (90%) were overweight or obese. These patients on average had high serum concentrations of glycemia, glycated hemoglobin and triglycerides and serum selenium deficiency (88.27 &micro;g / L) and calcium (7.61mg / dL). In the analysis of the enzymes involved in oxidative stress, there was an increase in the serum level of MDA (malonaldehyde) and a decrease in the activity of GPX (glutathione peroxidase). When comparing the groups, it can be seen that the GCI presents a significantly higher percentage of females (X2 = 4.35; p = 0.04), older ages, higher serum concentrations of glycemia and glycated hemoglobin. Regarding minerals, GCI has higher concentrations of zinc (14.71&micro;g / L; p = 0.001), manganese (23.34&micro;g / L; p = 0.01) and erythrocyte iron (727.6 mg / L; p = 0.008) and lower concentrations of erythrocyte copper (0.012 &micro;g / dL; p = 0.012) than GSI. In addition, GCI has significantly higher levels of MDA (7.46 nmol / mL; p <0.0001), GSSG (30.97 nmol / mL; p = 0.004), GPX (33.63U / mL; p <0, 0001) and smaller than FRAP (0.97 nmol / mL; p = 0.03) and C-peptide (1776.22pg / mL; p = 0.0001) than GSI. Patients with DM2 have a higher oxidative power and less antioxidant power, however, patients with insulin use demonstrated a better antioxidant defense than patients without insulin. The oxidative stress activation pathway seems to depend on the profile of micronutrients that are cofactors of antioxidant enzymes and therefore, the metabolic profile of the diabetic patient appears to be influenced by glycemic control, which will depend on the patient\'s lifestyle associated with the type of treatment and also due to the micronutrient profile, mainly zinc and manganese. (AU)

• FAPESP's process: 13/09094-8 - Thyroid dysfunction in patients with heart failure: involvement of iodine, zinc and selenium
• Grantee: Livia Fernandes de Lima
• Support Opportunities: Scholarships in Brazil - Master