{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T19:53:10Z","timestamp":1769629990083,"version":"3.49.0"},"reference-count":34,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and hyperglycemia. The role of trace elements such as zinc and chromium in the pathophysiology of T2DM has garnered significant attention due to their involvement in glucose metabolism and insulin regulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This cross-sectional study evaluated the clinical correlation between serum zinc and chromium levels in T2DM patients with and without complications in Pakistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 145 participants were included, comprising 100 T2DM patients (80 with complications: retinopathy, nephropathy, cardiovascular disease, and neuropathy; 20 without complications) and 45 healthy controls. Serum zinc and chromium levels were measured using atomic absorption spectrometry and their associations with glycated hemoglobin (HbA1c), demographic factors, and clinical profiles were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results showed that serum zinc and chromium levels were significantly lower in T2DM patients as compared to healthy controls (\n                      <jats:italic>p<\/jats:italic>\n                      value = 0.02 and\n                      <jats:italic>p<\/jats:italic>\n                      value = 0.001, respectively). Among diabetic subgroups, patients with diabetic neuropathy had the lowest zinc levels (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0001), while those with cardiovascular disease had significantly reduced chromium levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0002). Multivariate regression analysis showed that HbA1c levels were significantly associated with both zinc (\u03b2 = 1.588,\n                      <jats:italic>p<\/jats:italic>\n                      value = 0.02) and chromium (\u03b2 = 1.485,\n                      <jats:italic>p<\/jats:italic>\n                      value = 0.001), suggesting that deficiencies in these trace elements may contribute to poor glycemic control and the progression of diabetic complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings highlight the potential role of zinc and chromium supplementation as an adjunctive therapeutic approach in managing T2DM and preventing its complications. Further longitudinal studies are needed to establish causality and explore the underlying mechanisms of trace element deficiency in diabetic patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.20184","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T08:04:12Z","timestamp":1769587452000},"page":"e20184","source":"Crossref","is-referenced-by-count":0,"title":["Clinical correlation of serum zinc and chromium levels in patients with type 2 diabetes mellitus and complications in Pakistan: a retrospective study"],"prefix":"10.7717","volume":"14","author":[{"given":"Humma","family":"Nayyar","sequence":"first","affiliation":[{"name":"Department of Biomedicine\/Atta Ur Rehman School of Applied Biosciences, National University of Science and Technology, Islamabad, Punjab, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Attya","family":"Bhatti","sequence":"additional","affiliation":[{"name":"Department of Biomedicine\/Atta Ur Rehman School of Applied Biosciences, National University of Science and Technology, Islamabad, Punjab, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"John","sequence":"additional","affiliation":[{"name":"Department of Biomedicine\/Atta Ur Rehman School of Applied Biosciences, National University of Science and Technology, Islamabad, Punjab, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gohar","family":"Khan","sequence":"additional","affiliation":[{"name":"NUST School of Health Sciences, National University of Science and Technology, Islamabad, Punjab,  Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"issue":"16","key":"10.7717\/peerj.20184\/ref-1","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.3390\/cells13161359","article-title":"Zinc and diabetes: a connection between micronutrient and metabolism","volume":"13","author":"Ahmad","year":"2024","journal-title":"Cell"},{"key":"10.7717\/peerj.20184\/ref-2","first-page":"24","article-title":"Chromium status and insulin resistance as the risk factors of ischemic heart disease in type 2 diabetes mellitus patients","volume":"15","author":"Al-Janabi","year":"2023","journal-title":"Journal of Biotech Research"},{"issue":"8","key":"10.7717\/peerj.20184\/ref-3","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.25122\/jml-2023-0081","article-title":"A comparative study to assess the use of chromium in type 2 diabetes mellitus","volume":"16","author":"Alkhalidi","year":"2023","journal-title":"Journal of Medicine and Life"},{"issue":"4","key":"10.7717\/peerj.20184\/ref-4","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.jegh.2017.10.001","article-title":"Incidence and prevalence rates of diabetes mellitus in Saudi Arabia: an overview","volume":"7","author":"Alotaibi","year":"2017","journal-title":"Journal of Epidemiology and Global Health"},{"key":"10.7717\/peerj.20184\/ref-5","doi-asserted-by":"publisher","first-page":"126985","DOI":"10.1016\/j.jtemb.2022.126985","article-title":"The impact of zinc on the molecular signaling pathways in the diabetes disease","volume":"72","author":"Asghari","year":"2022","journal-title":"Journal of Trace Elements in Medicine and Biology"},{"issue":"2","key":"10.7717\/peerj.20184\/ref-6","doi-asserted-by":"publisher","first-page":"247","DOI":"10.21649\/akemu.v28i2.5117","article-title":"Type 2 diabetes mellitus (T2DM) in Pakistan: prevalence, trends and management strategies","volume":"28","author":"Aslam","year":"2022","journal-title":"Annals of King Edward Medical University"},{"issue":"4","key":"10.7717\/peerj.20184\/ref-7","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1007\/s13300-023-01384-7","article-title":"The association between obesity and the 5-year prevalence of morbidity and mortality among adults with type 2 diabetes","volume":"14","author":"Boye","year":"2023","journal-title":"Diabetes Therapy"},{"issue":"Supplement_1","key":"10.7717\/peerj.20184\/ref-8","doi-asserted-by":"publisher","first-page":"S10","DOI":"10.2337\/dc23-S001","article-title":"1. 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