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! " " ZINC%HOMEOSTASIS!IN#HEALTH,!EXERCISE!AND$ CHRONIC'DISEASES! " " " " " " Anna Kit Yung Chu BAppSc (Ex&SpSc) / BSc (Nutr) (Hons I) The University of Sydney, 2012 A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy (PhD) Department of Human Nutrition Division of Sciences University of Otago 2016 i" " """""" """""! " Table&of&Contents& & Abstract&...................................................................................................................................&iv" Acknowledgments&...............................................................................................................&vi" List&of&abbreviations&........................................................................................................&viii" List&of&tables&............................................................................................................................&x" List&of&figures&.......................................................................................................................&xii" Publications&arising&from&this&thesis&............................................................................&xv" List&of&other&publications&arising&from&this&thesis&.................................................&xvi" Chapter&1&&&Introduction&and&Literature&Review&.............................................................&1" Introduction&............................................................................................................................&2" Whole&body&zinc&homeostasis&...........................................................................................&5" Absorption"and"excretion".............................................................................................................."5" Tissue"distribution"............................................................................................................................"9" Biomarkers"of"zinc"status"............................................................................................................"11" Models"for"the"study"of"zinc"status"........................................................................................."13" Cellular&zinc&homeostasis&................................................................................................&14" Metallothionein"..............................................................................................................................."15" Zinc"transporters"............................................................................................................................"15" Zinc"transport"by"calciumAconducting"channels"..............................................................."24" Extracellular"zinc"sensor"............................................................................................................."24" Zinc&and&Chronic&Diseases&...............................................................................................&27" Zinc"and"Type"2"Diabetes"Mellitus".........................................................................................."27" Zinc"and"Cardiovascular"Diseases"..........................................................................................."32" Zinc"and"LowAgrade"Inflammation".........................................................................................."34" Zinc&and&Exercise&................................................................................................................&36" Summary&...............................................................................................................................&39" Thesis&Aims&..........................................................................................................................&41" Chapter&2&Zinc&status&and&risk&of&cardiovascular&diseases&and&diabetes& mellitus:&a&systematic&review&.............................................................................................&42" Abstract&.................................................................................................................................&43" Introduction&.........................................................................................................................&44" Methods&.................................................................................................................................&46" Results&...................................................................................................................................&49" Discussion&.............................................................................................................................&60" Chapter&3&Immediate&effects&of&aerobic&exercise&on&plasma/serum&zinc&levels:& a&systematic&review&and&metaSanalysis&...........................................................................&64" Abstract&.................................................................................................................................&65" Introduction&.........................................................................................................................&66" Methods&.................................................................................................................................&68" Results&...................................................................................................................................&71" Discussion&.............................................................................................................................&84" Chapter&4&Plasma/serum&zinc&status&during&aerobic&exercise&recovery:&a& systematic&review&and&metaSanalysis&..............................................................................&87" Abstract&.................................................................................................................................&88" Introduction&.........................................................................................................................&89" Methods&.................................................................................................................................&91" Results&...................................................................................................................................&94" Discussion&...........................................................................................................................&104" " ii" " """""" """""! " Chapter&5&Effect&of&zinc&supplementation&on&gene&expression&of&zinc& transporters&and&metallothionein:&a&time&course&trial&............................................&109" Abstract&...............................................................................................................................&110" Introduction&.......................................................................................................................&111" Methods&...............................................................................................................................&113" Results&.................................................................................................................................&117" Discussion&...........................................................................................................................&126" Chapter&6&Effect&of&zinc&supplementation&on&gene&expression&of&cytokines&in& Type&2&diabetes&mellitus&....................................................................................................&132" Abstract&...............................................................................................................................&133" Introduction&.......................................................................................................................&134" Methods&...............................................................................................................................&136" Results&.................................................................................................................................&139" Discussion&...........................................................................................................................&147" Chapter&7&Interrelationships&among&mediators&of&cellular&zinc&homeostasis&in& healthy&and&Type&2&diabetes&mellitus&populations&...................................................&152" Abstract&...............................................................................................................................&153" Introduction&.......................................................................................................................&154" Methods&...............................................................................................................................&156" Results&.................................................................................................................................&160" Discussion&...........................................................................................................................&167" Chapter&8&Conclusions&.........................................................................................................&171" Summary&of&findings&.......................................................................................................&172" Limitations&of&studies&.....................................................................................................&177"