Sains Malaysiana 48(2)(2019): 337–345

http://dx.doi.org/10.17576/jsm-2019-4802-10

 

Evaluation of Trace Elements in Malay Women with Type 2 Diabetes Mellitus

(Penilaian terhadap Unsur Surih dalam Kalangan Wanita Melayu dengan Diabetes Melitus Jenis 2)

 

MOHAMMED NASHIRY1*, ISMARULYUSDA ISHAK1, JAMALUDIN MOHAMED1, SITI BALKIS BUDIN1, MOHD FAIRULNIZAL M.N.2, SAZLINA KAMARALZAMAN1 & HESHAM M. AL-MEKHLAFI3

 

1Department of Biomedical Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Federal Territory, Malaysia

 

2Nutrition Unit, Cardiovascular, Diabetes, and Nutrition Research Centre, Institute of Medical Research, 50588 Kuala Lumpur, Federal Territory, Malaysia

 

3Medical Research Centre, Jazan University, Kingdom of Saudi Arabia

 

Diserahkan: 20 Jun 2018/Diterima: 3 Oktober 2018

 

ABSTRACT

Trace elements are essential for human health. This study determines the level of chromium (Cr), zinc (Zn), selenium (Se), copper (Cu), ferrum (Fe) and manganese (Mn) in the hair and nails of married Malay women with type 2 diabetes mellitus from Hulu Langat, Selangor, Malaysia. The trace elements were analysed using inductively coupled plasma mass spectrometry (ICP-MS) after an acid digestion treatment. The levels of all trace elements measured were higher in the hair samples than in nails except for Se. Mean levels of Zn and Se were significantly higher in the hair of non-working women (84.91 ± 10.32 μg/g and 0.42 ± 0.15 μg/g, respectively) compared to working women (64.98 ± 11.10 μg/g and 0.30 ± 0.18 μg/g). Copper levels in hair were significantly higher among women with good and satisfactory diabetes control (20.41 ± 4.20 μg/g) compared to the poor diabetes control group (15.67 ± 4.31 μg/g). However, a contradictory result was obtained from the nails of women with good and satisfactory diabetes control with a Cu level of 3.35 ± 0.46 μg/g and 4.69 ± 0.33 μg/g for the poor diabetes control group. In hair samples, significant positive correlations were obtained with Cr-Cu (r = 0.55), Zn-Mn (r = 0.46) and Se-Mn (r = 0.38). In nails, significant positive correlations were also obtained between Cr-Zn (r = 0.31), Zn-Fe (r = 0.30) and Fe-Mn (r = 0.47). In conclusion, age, educational status, number of children and duration of diabetes did not influence trace elements levels.

 

Keywords: Diabetes mellitus; female; HbA1c; ICP-MS; trace elements

 

ABSTRAK

Unsur surih adalah penting untuk kesihatan manusia. Kajian ini akan menentukan tahap kromium, zink (Zn), selenium (Se), kuprum (Cu), ferum (Fe) dan mangan (Mn) dalam rambut dan kuku wanita Melayu yang sudah berkahwin dengan diabetes melitus jenis 2 dari Hulu Langat, Selangor, Malaysia. Unsur surih telah dianalisis dengan menggunakan spektrometri jisim plasma gandingan aruhan (ICP-MS) selepas rawatan asid penghadaman. Tahap semua unsur surih yang diukur adalah lebih tinggi dalam sampel rambut daripada kuku kecuali Se. Tahap min Zn dan Se adalah jauh lebih tinggi dalam rambut wanita tidak bekerja (masing-masing 84.91 ± 10.32 μg/g dan 0.42 ± 0.15 μg/g,) berbanding wanita bekerja (64.98 ± 11.10 μg/g dan 0.30 ± 0.18 μg/g). Tahap kuprum dalam rambut adalah jauh lebih tinggi dalam kalangan wanita dengan kawalan diabetes yang baik dan memuaskan (20.41 ± 4.20 μg/g) berbanding dengan kumpulan kawalan diabetes melitus yang tidak dikawal (15.67 ± 4.31 μg/g). Walau bagaimanapun, keputusan bercanggah telah diperoleh daripada kuku wanita dengan kawalan diabetes yang baik dan memuaskan dengan tahap Cu ialah 3.35 ± 0.46 μg/g dan 4.69 ± 0.33 μg/g bagi kumpulan kawalan diabetes melitus yang tidak dikawal. Pada sampel rambut, korelasi positif yang signifikan diperoleh dengan Cr-Cu (r = 0.55), Zn-Mn (r = 0.46) dan Se-Mn (r = 0.38). Pada kuku, korelasi positif yang signifikan juga diperoleh antara Cr-Zn (r = 0.31), Zn-Fe (r = 0,30) dan Fe-Mn (r = 0.47). Kesimpulannya, umur, tahap pendidikan, bilangan anak dan tempoh diabetes tidak mempengaruhi tahap unsur surih.

 

Kata kunci: Diabetes melitus; HbA1c; ICP-MS; perempuan; unsur surih

RUJUKAN

 

Abou-Seif, Mosaad, A. & Abd-Allah, Youssef. 2004. Evaluation of some biochemical changes in diabetic patients. Clinica Chimica Acta 346(2): 161-170.

Altamura, S., Stefan, K., Schmidt, J., Müdder, K., da Silva, A.R., Nawroth, P. & Muckenthaler, M.U. 2017. Uncoupled iron homeostasis in type 2 diabetes mellitus. Journal of Molecular Medicine 95(12): 1387-1398.

Alwan, I.F. & Hamood, A.M. 2017. Serum trace elements in patients with Type 2 diabetes mellitus. In Proceeding of 1st National Conference of Science and Art University of Babylon Mesopotemia Environmental Journal, Special Issue C. pp. 16-23.

Atieh Makhlough, Marjan Makhlough, Mohammad Shokrzadeh, Mozhdeh Mohammadian, Omid Sedighi & Mansooreh Faghihan. 2015. Comparing the levels of trace elements in patients with diabetic nephropathy and healthy individuals. Nephro-Urology Monthly 7(4): e28576.

Batista, B.L., Rodrigues, J.L., Nunes, J.A., Tormen, L., Curtius, A.J. & Barbosa, F. 2008. Simultaneous determination of Cd, Cu, Mn, Ni, Pb and Zn in nail samples by inductively coupled plasma mass spectrometry (ICP-MS) after tetramethylammonium hydroxide solubilisation at room temperature: Comparison with ETAAS. Talanta 76(3): 575-579.

Bolajoko, E.B., Akinosun, O.M., Anetor, J. & Mossanda, K.S. 2017. Relationship between selected micronutrient deficiencies and oxidative stress biomarkers in diabetes mellitus patients with foot ulcers in Ibadan, Nigeria. Turkish Journal of Medical Sciences 47(4): 1117-1123.

Boosalis, M.G., Solem, L.D., Cerra, F.B., Konstantinides, F., Ahrenholz, D.H., McCall, J.T. & McClain, C.J. 1991. Increased urinary zinc excretion after thermal injury. The Journal of Laboratory and Clinical Medicine 118(6): 538- 545.

Burlet, E. & Jain, S.K. 2013. Manganese supplementation reduces high glucose-induced monocyte adhesion to endothelial cells and endothelial dysfunction in Zucker diabetic fatty rats. Journal of Biological Chemistry 288(9): 6409-6416.

De Vega, R.Z., Fernández-Sánchez, M.L., Fernández, J.C., Menéndez, F.V.Á. & Sanz-Medel, A. 2016. Selenium levels and glutathione peroxidase activity in the plasma of patients with type II diabetes mellitus. Journal of Trace Elements in Medicine and Biology 37: 44-49.

Ekmekcioglu, C., Prohaska, C., Pomazal, K., Steffan, I., Schernthaner, G. & Wolfgang Marktl. 2001. Concentrations of seven trace elements in different hematological matrices in patients with type 2 diabetes as compared to healthy controls. Biological Trace Element Research 79(3): 205-219.

Fatma Hussain, Mohammad Arif Maan, Munir Ahmed Sheikh, Haq Nawaz & Amer Jamil. 2009. Trace elements status in type 2 diabetes. Bangladesh Journal of Medical Science 8(3): 52.

Flores, C.R., Puga, M.P., Wrobel, K., Sevilla, M.E.G. & Wrobel, K. 2011. Trace elements status in diabetes mellitus type 2: Possible role of the interaction between molybdenum and copper in the progress of typical complications. Diabetes Research and Clinical Practice 91(3): 333-341.

Gahlot, N.K. & Bhatnagar, V. 2018. A study of trace elements in serum of diabetic patients. IOSR Journal of Dental and Medical Sciences 17(2): 04-07.

Garg, A.N., Kumar, A., Maheshwari, G. & Sharma, S. 2005. Isotope dilution analysis for the determination of zinc in blood samples of diabetic patients. Journal of Radioanalytical and Nuclear Chemistry 263(1): 39-43.

Gibson, R. 1998. Ultratrace elements. In Essentials of Human Nutrition, edited by Mann, J. & Truswell, S. New York: Oxford University Press. pp. 176-178.

Heyland, D.K., Jones, N., Cvijanovich, N.Z. & Wong, H. 2008. Zinc supplementation in critically ill patients: A key pharmaconutrient? Journal of Parenteral & Enteral Nutrition 32(5): 509-519.

Jun Yoshinaga, Hideki Imai, Minato Nakazawa, Tsuguyoshi Suzuki & Masatoshi Morita. 1990. Lack of significantly positive correlations between elemental concentrations in hair and in organs. Science of the Total Environment 99(1- 2): 125-135.

Khalid Siddiqui, Nahla Bawazeer & Salini Scaria Joy. 2014. Variation in macro and trace elements in progression of type 2 diabetes. The Scientific World Journal 2014: 461591.

LeBlanc, A., Dumas, P. & Lefebvre, L. 1999. Trace element content of commercial shampoos: Impact on trace element levels in hair. Science of the Total Environment 229(1): 121-124.

Lee, Soh-Hyun, Jouihan, H.A., Cooksey, R.C., Jones, D., Kim, H.J., Winge, D.R. & McClain, D.A. 2013. Manganese supplementation protects against diet-induced diabetes in wild type mice by enhancing insulin secretion. Endocrinology 154(3): 1029-1038.

Lowe, J., da-Silva, R.T. & Souza, E.H. 2017. Dissecting copper homeostasis in diabetes mellitus. IUBMB Life 69(4): 255-262.

McClain, C.J., McClain, M.L., Boosalis, M.G. & Hennig, B. 1993. Zinc and the stress response. Scandinavian Journal of Work Environment & Health 19: 132.

Miekeley, N., Dias Carneiro, M.T.W. & da Silveira, C.L.P.1998. How reliable are human hair reference intervals for trace elements? Science of the Total Environment 218(1): 9-17.

Ministry of Health Malaysia. 2015. National Health and Morbidity Survey.

Namrata Sanjeevi, Freeland-Graves, J., Beretvas, S.N. & Sachdev, P.K. 2018. Trace element status in type 2 diabetes: A meta-analysis. Journal of Clinical & Diagnostic Research 12(5): OE01- OE08.

Nsonwu, A.C., Opera Usoro, C.A., Etukudo, M.H. & Usoro, I.N. 2006. Influence of age, gender and duration of diabetes on serum and urine levels of zinc, magnesium, selenium and chromium in type 2 diabetics in Calabar, Nigeria. Turkish Journal of Biochemistry 31(3): 107-114.

Ömer Akyol, Mustafa Kavutçu, Orhan Canbolat, Bünyamin Işik & İlker Durak. 1993. A study on the relationships between some of the trace element levels of hair, nail, serum and urine in healthy subjects. Turkiye Klinikleri Journal of Case Reports 11(2): 75-81.

Persell, S.D., Keating, N.L., Landrum, M.B., Landon, B.E., Ayanian, J.Z. & Guadagnoli, E. 2004. Relationship of diabetes-specific knowledge to self-management activities, ambulatory preventive care, and metabolic outcomes. Preventive Medicine 39(4): 746-752.

Praveeena, S., PaSula, S. & Sameera, K. 2013. Trace elements in diabetes mellitus. Journal of Clinical & Diagnostic Research 7(9): 1863-1865.

Qiu, Q., Zhang, F., Zhu, W., Wu, J. & Liang, M. 2017. Copper in diabetes mellitus: A meta-analysis and systematic review of plasma and serum studies. Biological Trace Element Research 177(1): 53-63.

Rampal, S., Rampal, L., Rahmat, R., Azhar Md Zain, Yee Guan Yap, Mafauzy Mohamed & Mohamad Taha. 2010. Variation in the prevalence, awareness, and control of diabetes in a multiethnic population: A nationwide population study in Malaysia. Asia Pacific Journal of Public Health 22(2): 194-202.

Rayman, M.P. 2000. The importance of selenium to human health. The Lancet 356(9225): 233-241.

Rhee, E-J. 2015. Diabetes in Asians. Endocrinology and Metabolism 30(3): 263-269.

Rohn, R.D., Pleban, P. & Jenkins. L.L. 1993. Magnesium, zinc and copper in plasma and blood cellular components in children with IDDM. Clinica Chimica Acta 215(1): 21-28.

Rowin, J. & Lewis, S.L. 2005. Copper deficiency myeloneuropathy and pancytopenia secondary to overuse of zinc supplementation. Journal of Neurology, Neurosurgery & Psychiatry 76(5): 750-751.

Sánchez, C., López-Jurado, M., Pilar, A. & Llopis, J. 2010. Plasma levels of copper, manganese and selenium in an adult population in southern Spain: Influence of age, obesity and lifestyle factors. Science of the Total Environment 408(5): 1014-1020.

Sarmani, S.B., Abugassa, I., Hamzah, A. & Yahya, M.D. 1999. Elemental analysis of herbal preparations for traditional medicines by neutron activation analysis with the k0 standardization method. Biological Trace Element Research 71(1): 365-376.

Skalnaya, M.G. & Skalny, A.V. 2018. Essential Trace Elements in Human Health: A Physician’s View. Tomsk, Lenin Ave.: Publishing House of Tomsk State University. pp. 36-224.

Skalnaya, M.G. & Demidov, V.A. 2007. Hair trace element contents in women with obesity and type 2 diabetes. Journal of Trace Elements in Medicine & Biology 21: 59-61.

Sukumar, A. & Subramanian, R. 2007. Relative element levels in the paired samples of scalp hair and fingernails of patients from New Delhi. Science of the Total Environment 372(2-3): 474-479.

Talbot, J. & Weiss, A. 1994. Laboratory Methods for ICP-MS Analysis of Trace Metals in Precipitation. East Hazelwood, Champaign, IL: Hazardous Materials Lab, Hazardous Waste Research and Information Center.

Tan Mun Chieng, Ooi Chuan Ng, Teck Wee Wong, Anthony Joseph, Abdul Rahman Hejar & Abdul Aziz Rushdan. 2015. Dietary compliance, dietary supplementation and traditional remedy usage of type 2 diabetic patients with and without cardiovascular disease. Clinical Nutrition Research 4(1): 18-31.

Tasneem Kazi, Hassan Imran Afridi, Naveed Kazi, Mohammad Khan Jamali, Mohammad Bilal Arain, Nussarat Jalbani & Ghulam Abbas Kandhro. 2008. Copper, chromium, manganese, iron, nickel, and zinc levels in biological samples of diabetes mellitus patients. Biological Trace Element Research 122(1): 1-18.

Tran, C.D. 2008. Advances of zinc in health research. In Micronutrient and Health Research, edited by Yoshida, T. New York: Nova Science Publishers, Inc. pp. 23-70.

Unjiati, Bambang Wirjatmadi & Merryana Adriani. 2015. Chromium and zinc level of patients with type 2 diabetes and non-diabetes. Biochemistry & Physiology doi:10.4172/2168- 9652.S5-010.

Watts, D.L. 1990. Nutrient interrelationships: Minerals, vitamins, endocrines. Journal of Orthomolecular Medicine 5(1): 11-19.

Wellen, K.E. & Hotamisligil, G.S. 2005. Inflammation, stress, and diabetes. Journal of Clinical Investigation 115(5): 1111-1119.

Wilhelm, M., Hafner, D., Lombeck, I. & Ohnosorge, F.K. 1991. Monitoring of cadmium, copper, lead and zinc status in young children using toenails: Comparison with scalp hair. Science of the Total Environment 103(2-3): 199-207.

Willis, M.S., Monaghan, S.A., Miller, M.L., McKenna, R.W., Perkins, W.D., Levinson, B.S., Vikas Bhushan. & Kroft, S.H. 2005. Zinc-induced copper deficiency: A report of three cases initially recognized on bone marrow examination. American Journal of Clinical Pathology 123(1): 125-131.

Wolfgang, M. 2017. Zinc in pancreatic islet biology, insulin sensitivity, and diabetes. Preventive Nutrition and Food Science 22(1): 1-8.

World Health Organization 2016. Global Report on Diabetes. Geneva: World Health Organization.

World Health Organization 2001. The World Health Report 2001: Mental Health: New Understanding, New Hope. Geneva: World Health Organization.

Yerlikaya, F.H., Aysun Toker & Alpay Ar?baş. 2013. Serum trace elements in obese women with or without diabetes. The Indian Journal of Medical Research 137(2): 339-345.

Zargar, A.H., Shah, N.A., Masoodi, S.R., Laway, B.A., Dar, F.A., Khan, A.R., Sofi, F.A. & Wani, A.I. 1998. Copper, zinc, and magnesium levels in non-insulin dependent diabetes mellitus. Postgraduate Medical Journal 74(877): 665-668.

 

*Pengarang untuk surat-menyurat; email: ismarul@ukm.edu.my

 

 

 

 

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