The "Trace Mineral Fingerprint" as a Predictor of Homeostatic Model Assessment of Insulin Resistance Progression in Type 2 Diabetics

Eworo RE; Usoro AJ; Iyaji MO; Okoye FC; Ugochukwu GD; Egwu SI; Igwe SM

doi:10.61386/imj.v19i3.1189

Authors

Eworo RE Department of Clinical Chemistry & Immunology, University of Calabar, PMB 1115, Calabar, Cross River State, Nigeria https://orcid.org/0000-0003-2139-665X
Usoro AJ Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Uyo, Akwa Ibom State
Iyaji MO Department of Clinical Chemistry & Immunology, Faculty of Medical Laboratory science, University of Calabar, Nigeria
Okoye FC Department of Clinical Chemistry & Immunology, Faculty of Medical Laboratory science, University of Calabar, Nigeria
Ugochukwu GD Department of Clinical Chemistry & Immunology, Faculty of Medical Laboratory science, University of Calabar, Nigeria
Egwu SI Department of Clinical Chemistry & Immunology, Faculty of Medical Laboratory science, University of Calabar, Nigeria
Igwe SM Department of Clinical Chemistry & Immunology, Faculty of Medical Laboratory science, University of Calabar, Nigeria

DOI:

https://doi.org/10.61386/imj.v19i3.1189

Keywords:

Type 2 diabetes mellitus, oxidative stress, trace minerals, glycemic control, insulin resistance

Abstract

Context: Trace minerals imbalance has been implicated in the progression of type 2 diabetes mellitus (T2DM). Aim: This study assessed the levels of copper (Cu), zinc (Zn), iron (Fe), superoxide dismutase (SOD), insulin (INS), HbA1c and chromium (Cr) in subjects with T2DM.

Materials and Methods: This case-control study enrolled 45 T2DM patients attending diabetes Clinic at the University of Calabar Teaching Hospital and 45 age-matched non-diabetic controls. The fasting plasma glucose (FPG), HbA1c and Super oxide dismutase, SOD were determined by colorimetry and insulin by ELISA method. Serum Cu, Zn, Fe, and Cr were determined by Atomic Absorption Mass Spectrometry. The HOMA-IR, HOMA-IR/HbA1c, Cu/Zn, Fe/Zn and Cu/Fe ratios were computed. Data generated were analyzed using SPSS version 27, (IBM, USA). The ANOVA and Bonferroni post hoc analyses, Receiver Operator Characteristic curve (ROC) was utilized to determine the performance metrics of the indices. The normality of the data was determined by Shapiro-Wilk test. The confidence interval was set to 95% at α =0.05.

Results: The FPG, INS, Cu, Fe, Fe/Zn Cu/Zn, HOMA-IR, and HOMA-IR/HbA1c levels were significantly higher while Zn, SOD and Cr were significantly lower in diabetics subjects with HbA1c <7% and ≥ 7% than in controls (p<0.05). The HbA1c correlated positively with Fe/Zn (r=0.582, p=0.000). At potential cutoff of 1.558 Cu/Zn demonstrated AUC of 0.781, with a sensitivity of 71%%, Gini index of 0.562 and K-S metrics of 0.622 in predicting poor glycaemic control.

Conclusion: Trace mineral fingerprint may complement HbA1c and HOMA-IR in monitoring glycaemic control and rising insulin resistance in T2DM.