Association of serum zinc level with severity of chronic kidney disease in diabetic patients: a cross-sectional study Original paper
Researched by:
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Dr. Umar
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Dr. Umar
Read MoreClinical Pharmacist and Clinical Pharmacy Master’s candidate focused on antibiotic stewardship, AI-driven pharmacy practice, and research that strengthens safe and effective medication use. Experience spans digital health research with Bloomsbury Health (London), pharmacovigilance in patient support programs, and behavioral approaches to mental health care. Published work includes studies on antibiotic use and awareness, AI applications in medicine, postpartum depression management, and patient safety reporting. Developer of an AI-based clinical decision support system designed to enhance antimicrobial stewardship and optimize therapeutic outcomes.
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Dr. Umar
Read More
Researched by:
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Dr. Umar
ID
Dr. Umar
Read More
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Dr. Umar
What was studied?
This cross-sectional study investigated the association between serum zinc level and the severity of chronic kidney disease in diabetic patients, a focus highly relevant to the development of a microbiome signatures database because zinc availability influences microbial balance and host–microbe interactions. The central analysis examined how zinc concentration varies with renal function, albuminuria, and diabetic nephropathy stage, recognizing that altered zinc status may shift microbial ecology, oxidative stress, and metabolic signaling.
Who was studied?
The study evaluated 227 hospitalized Japanese diabetic patients, including individuals with type 1 diabetes, type 2 diabetes, and diabetes of other etiologies. Participants were older adults with poor glycemic control (mean HbA1c 10.5%), spanning diabetic nephropathy stages 1–4. Extensive biochemical and anthropometric data—including zinc, eGFR, albuminuria, lipid status, and skeletal muscle mass—were collected to characterize the metabolic and renal milieu in which zinc deficiency may arise and advance disease.
Most important findings
The most important findings show that serum zinc levels decrease steadily as chronic kidney disease progresses, especially after the onset of overt nephropathy. This decline aligns with increased urinary zinc loss from albuminuria, decreased intake from protein restriction, and impaired absorption. The study’s detailed biochemical correlations reveal that zinc levels are positively associated with eGFR, skeletal muscle index, and lipid markers, while inversely associated with age, indicating nutritional and metabolic vulnerability. Microbiome-relevant insights include the likelihood that zinc deficiency amplifies oxidative stress via reduced Cu/Zn superoxide dismutase activity, alters insulin signaling, and perturbs microbial stability in the gut—especially in albuminuric states where zinc availability diminishes. Figures on page 5 show clear graphical trends of lower zinc in stage 3 nephropathy and CKD albuminuria category A3.
| Variable Compared | Zinc-Level Relationship |
|---|---|
| eGFR | Positive correlation; zinc declines as filtration worsens |
| Albuminuria (A1–A3) | Significant decline in zinc at A3 macroalbuminuria |
| Nephropathy stage | Sharp reduction after overt nephropathy (stage 3) |
| Skeletal muscle index | Lower zinc linked to sarcopenia-risk SMI levels |
Key implications
The findings imply that zinc deficiency is both a marker and contributor to diabetic kidney disease progression. Clinically, this raises the need for proactive zinc assessment in diabetic patients, particularly those with macroalbuminuria or sarcopenia. For microbiome research, zinc’s decline in CKD suggests predictable microbial shifts involving reduced zinc-dependent enzymatic activity, heightened oxidative stress, and altered gut barrier function. Understanding zinc-associated microbial signatures may help identify early indicators of diabetic nephropathy progression and guide nutritional or supplementation strategies that support metabolic and microbial resilience.
Citation
Kubota M, Matsuda S, Matsuda M, Yamamoto K, Yoshii Y. Association of serum zinc level with severity of chronic kidney disease in diabetic patients: a cross-sectional study.BMC Nephrology. 2022;23:407. doi:10.1186/s12882-022-03040-x
Chronic Kidney Disease (CKD)
Dysbiosis in chronic kidney disease (CKD) reflects a shift toward reduced beneficial taxa and increased pathogenic, uremic toxin-producing species, driven by a bidirectional interaction in which the uremic environment disrupts microbial composition and dysbiotic metabolites accelerate renal deterioration.