Clinical Outcomes in Diabetic Patients with Zinc Deficiency: A Multi-Institutional Population-Based Study

Abstract

Objective: This study aimed to investigate the association between zinc deficiency (ZD) and the risks of all-cause mortality, major adverse cardiovascular events (MACEs), major adverse kidney events (MAKEs), and all-cause hospitalization in diabetic patients.

Methods: This retrospective cohort study utilized the TriNetX research network to identify adult patients with diabetes mellitus (DM) between January 1, 2010, and August 31, 2024. Propensity score matching was used to match patients with serum zinc levels below 70 µg/dL (ZD group) to those with serum zinc levels between 70 and 120 µg/dL (control group).

Results: Each group comprised 11,698 matched patients with balanced baseline characteristics. During the 1-year follow-up period, the ZD group exhibited significantly higher risks of all-cause mortality (hazard ratio [HR]: 1.788, 95% confidence interval [CI]: 1.591-2.009), MACEs (HR: 1.641, 95% CI: 1.278-2.105), and MAKEs (HR: 1.534, 95% CI: 1.293-1.821), as well as a higher risk of hospitalization (HR: 1.272, 95% CI: 1.216-1.330).

Conclusion: Zinc deficiency in diabetic patients is associated with increased risks of all-cause mortality, MACEs, MAKEs, and all-cause hospitalization. These findings underscore the importance of assessing zinc status in the clinical management of patients with DM.

Keywords: Zinc deficiency; diabetes mellitus; major adverse cardiovascular events; major adverse kidney events; mortality.