Clinical effectiveness of zinc supplementation on the biomarkers of oxidative stress: a systematic review and meta-analysis of randomized controlled trials

Seyed Mohammad Mousavi; Maryam Hajishafiee; Cain C T Clark; Israel Júnior Borges do Nascimento; Alireza Milajerdi; Mohammad Reza Amini; Ahmad Esmaillzadeh

doi:10.1016/j.phrs.2020.105166

Clinical effectiveness of zinc supplementation on the biomarkers of oxidative stress: a systematic review and meta-analysis of randomized controlled trials

Seyed Mohammad Mousavi, Maryam Hajishafiee, Cain C T Clark, Israel Júnior Borges do Nascimento, Alireza Milajerdi, Mohammad Reza Amini, Ahmad Esmaillzadeh

Research output: Contribution to journal › Review article › peer-review

13 Citations (Scopus)

193 Downloads (Pure)

Abstract

Background: Oxidative stress plays an important role in the occurrence of chronic diseases. Zinc supplementation is also known to be an antioxidant agent. While, there is no review on the effects of zinc supplementation on oxidative stress, this study aimed to systematically summarize randomized clinical trials (RCTs) which have evaluated the impacts of zinc supplementation on oxidative stress biomarkers. Methods: Systematic searches were performed using the PubMed/Medline, Scopus, and Google Scholar databases, up to April 2020. All RCTs assessed the effect of oral zinc supplementation on serum malondialdehyde (MDA), total antioxidant capacity (TAC), glutathione (GSH), and nitric oxide (NO) levels, were included. For each variable, mean differences (MD) and standard deviations (SDs) were combined using the random-effects model, and the fractional polynomial model was used to implement the dose-response analysis. Results: Ten RCTs were included. The pooled analysis of data showed that zinc supplementation significantly reduced MDA levels (MD: -0.42 μmol/L; 95 % CI: -0.71 to -0.13), increased serum TAC (MD: 225.96 mmol/L; 95 % CI: 68.42–383.5) and GSH levels (MD: 49.99 μmol/L; 95 % CI: 2.25 t 97.73), compared with the placebo group. In contrast, no significant changes were seen in NO levels following zinc supplementation (MD: -1.66 μmol/L; 95 % CI: -5.89 to 2.57). Dose-response analysis showed a significant non-linear relationship between zinc supplementation dosage and serum levels of MDA (p < 0.01), but not other biomarkers. Conclusions: The current study showed that zinc supplementation would significantly decrease MDA and increase TAC and GSH, but not NO levels. Thus, it encourages the use of zinc supplementation in oxidative stress-related diseases.

Original language	English
Article number	105166
Journal	Pharmacological Research
Volume	161
Early online date	21 Aug 2020
DOIs	https://doi.org/10.1016/j.phrs.2020.105166
Publication status	Published - Nov 2020

Bibliographical note

NOTICE: this is the author’s version of a work that was accepted for publication in Pharmacological Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in
Pharmacological Research, 161, (2020)
DOI: 10.1016/j.phrs.2020.105166

© 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercialNoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/

Keywords

Antioxidants
Malondialdehyde
Oxidative stress
Reactive oxygen species
Zinc

ASJC Scopus subject areas

Pharmacology

Access to Document

10.1016/j.phrs.2020.105166

Post-PrintAccepted author manuscript, 853 KBLicence: CC BY-NC-ND

Cite this

Mousavi, S. M., Hajishafiee, M., Clark, C. C. T., do Nascimento, I. J. B., Milajerdi, A., Amini, M. R., & Esmaillzadeh, A. (2020). Clinical effectiveness of zinc supplementation on the biomarkers of oxidative stress: a systematic review and meta-analysis of randomized controlled trials. Pharmacological Research, 161, Article 105166. https://doi.org/10.1016/j.phrs.2020.105166

@article{155a74ce6aed44baa94a934d5440ac97,

title = "Clinical effectiveness of zinc supplementation on the biomarkers of oxidative stress: a systematic review and meta-analysis of randomized controlled trials",

abstract = "Background: Oxidative stress plays an important role in the occurrence of chronic diseases. Zinc supplementation is also known to be an antioxidant agent. While, there is no review on the effects of zinc supplementation on oxidative stress, this study aimed to systematically summarize randomized clinical trials (RCTs) which have evaluated the impacts of zinc supplementation on oxidative stress biomarkers. Methods: Systematic searches were performed using the PubMed/Medline, Scopus, and Google Scholar databases, up to April 2020. All RCTs assessed the effect of oral zinc supplementation on serum malondialdehyde (MDA), total antioxidant capacity (TAC), glutathione (GSH), and nitric oxide (NO) levels, were included. For each variable, mean differences (MD) and standard deviations (SDs) were combined using the random-effects model, and the fractional polynomial model was used to implement the dose-response analysis. Results: Ten RCTs were included. The pooled analysis of data showed that zinc supplementation significantly reduced MDA levels (MD: -0.42 μmol/L; 95 % CI: -0.71 to -0.13), increased serum TAC (MD: 225.96 mmol/L; 95 % CI: 68.42–383.5) and GSH levels (MD: 49.99 μmol/L; 95 % CI: 2.25 t 97.73), compared with the placebo group. In contrast, no significant changes were seen in NO levels following zinc supplementation (MD: -1.66 μmol/L; 95 % CI: -5.89 to 2.57). Dose-response analysis showed a significant non-linear relationship between zinc supplementation dosage and serum levels of MDA (p < 0.01), but not other biomarkers. Conclusions: The current study showed that zinc supplementation would significantly decrease MDA and increase TAC and GSH, but not NO levels. Thus, it encourages the use of zinc supplementation in oxidative stress-related diseases.",

keywords = "Antioxidants, Malondialdehyde, Oxidative stress, Reactive oxygen species, Zinc",

author = "Mousavi, {Seyed Mohammad} and Maryam Hajishafiee and Clark, {Cain C T} and {do Nascimento}, {Israel J{\'u}nior Borges} and Alireza Milajerdi and Amini, {Mohammad Reza} and Ahmad Esmaillzadeh",

note = "NOTICE: this is the author{\textquoteright}s version of a work that was accepted for publication in Pharmacological Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Pharmacological Research, 161, (2020) DOI: 10.1016/j.phrs.2020.105166 {\textcopyright} 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercialNoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ ",

year = "2020",

month = nov,

doi = "10.1016/j.phrs.2020.105166",

language = "English",

volume = "161",

journal = "Pharmacological Research",

issn = "1043-6618",

publisher = "Elsevier",

}

TY - JOUR

T1 - Clinical effectiveness of zinc supplementation on the biomarkers of oxidative stress

T2 - a systematic review and meta-analysis of randomized controlled trials

AU - Mousavi, Seyed Mohammad

AU - Hajishafiee, Maryam

AU - Clark, Cain C T

AU - do Nascimento, Israel Júnior Borges

AU - Milajerdi, Alireza

AU - Amini, Mohammad Reza

AU - Esmaillzadeh, Ahmad

N1 - NOTICE: this is the author’s version of a work that was accepted for publication in Pharmacological Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Pharmacological Research, 161, (2020) DOI: 10.1016/j.phrs.2020.105166 © 2020, Elsevier. Licensed under the Creative Commons Attribution-NonCommercialNoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/

PY - 2020/11

Y1 - 2020/11

N2 - Background: Oxidative stress plays an important role in the occurrence of chronic diseases. Zinc supplementation is also known to be an antioxidant agent. While, there is no review on the effects of zinc supplementation on oxidative stress, this study aimed to systematically summarize randomized clinical trials (RCTs) which have evaluated the impacts of zinc supplementation on oxidative stress biomarkers. Methods: Systematic searches were performed using the PubMed/Medline, Scopus, and Google Scholar databases, up to April 2020. All RCTs assessed the effect of oral zinc supplementation on serum malondialdehyde (MDA), total antioxidant capacity (TAC), glutathione (GSH), and nitric oxide (NO) levels, were included. For each variable, mean differences (MD) and standard deviations (SDs) were combined using the random-effects model, and the fractional polynomial model was used to implement the dose-response analysis. Results: Ten RCTs were included. The pooled analysis of data showed that zinc supplementation significantly reduced MDA levels (MD: -0.42 μmol/L; 95 % CI: -0.71 to -0.13), increased serum TAC (MD: 225.96 mmol/L; 95 % CI: 68.42–383.5) and GSH levels (MD: 49.99 μmol/L; 95 % CI: 2.25 t 97.73), compared with the placebo group. In contrast, no significant changes were seen in NO levels following zinc supplementation (MD: -1.66 μmol/L; 95 % CI: -5.89 to 2.57). Dose-response analysis showed a significant non-linear relationship between zinc supplementation dosage and serum levels of MDA (p < 0.01), but not other biomarkers. Conclusions: The current study showed that zinc supplementation would significantly decrease MDA and increase TAC and GSH, but not NO levels. Thus, it encourages the use of zinc supplementation in oxidative stress-related diseases.

AB - Background: Oxidative stress plays an important role in the occurrence of chronic diseases. Zinc supplementation is also known to be an antioxidant agent. While, there is no review on the effects of zinc supplementation on oxidative stress, this study aimed to systematically summarize randomized clinical trials (RCTs) which have evaluated the impacts of zinc supplementation on oxidative stress biomarkers. Methods: Systematic searches were performed using the PubMed/Medline, Scopus, and Google Scholar databases, up to April 2020. All RCTs assessed the effect of oral zinc supplementation on serum malondialdehyde (MDA), total antioxidant capacity (TAC), glutathione (GSH), and nitric oxide (NO) levels, were included. For each variable, mean differences (MD) and standard deviations (SDs) were combined using the random-effects model, and the fractional polynomial model was used to implement the dose-response analysis. Results: Ten RCTs were included. The pooled analysis of data showed that zinc supplementation significantly reduced MDA levels (MD: -0.42 μmol/L; 95 % CI: -0.71 to -0.13), increased serum TAC (MD: 225.96 mmol/L; 95 % CI: 68.42–383.5) and GSH levels (MD: 49.99 μmol/L; 95 % CI: 2.25 t 97.73), compared with the placebo group. In contrast, no significant changes were seen in NO levels following zinc supplementation (MD: -1.66 μmol/L; 95 % CI: -5.89 to 2.57). Dose-response analysis showed a significant non-linear relationship between zinc supplementation dosage and serum levels of MDA (p < 0.01), but not other biomarkers. Conclusions: The current study showed that zinc supplementation would significantly decrease MDA and increase TAC and GSH, but not NO levels. Thus, it encourages the use of zinc supplementation in oxidative stress-related diseases.

KW - Antioxidants

KW - Malondialdehyde

KW - Oxidative stress

KW - Reactive oxygen species

KW - Zinc

UR - http://www.scopus.com/inward/record.url?scp=85089812396&partnerID=8YFLogxK

U2 - 10.1016/j.phrs.2020.105166

DO - 10.1016/j.phrs.2020.105166

M3 - Review article

C2 - 32828910

SN - 1043-6618

VL - 161

JO - Pharmacological Research

JF - Pharmacological Research

M1 - 105166

ER -

Clinical effectiveness of zinc supplementation on the biomarkers of oxidative stress: a systematic review and meta-analysis of randomized controlled trials

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this