Is Zinc an Important Trace Element on Bone-Related Diseases and Complications? A Meta-analysis and Systematic Review from Serum Level, Dietary Intake, and Supplementation Aspects

Biol Trace Elem Res. 2021 Feb;199(2):535-549. doi: 10.1007/s12011-020-02193-w. Epub 2020 May 25.


Bone-related diseases are very common problems, especially in the elderly population. Zinc takes part in the growth and maintenance of healthy bones. This meta-analysis aims to evaluate the effects of zinc supplementation or dietary zinc intake on serum zinc levels and bone turnover markers. A systematical research was performed with 2899 articles in PubMed, WoS, and Scopus for relevant articles in English which have mean/standard deviation values of serum zinc levels, dietary zinc intake/zinc supplementation (mg/day), and bone turnover markers up to February 2020. In the overall analysis, serum zinc level was significantly lower in patients with osteoporosis compared with controls (p 0.0002). Dietary zinc intake decreased in the fracture group compared with controls according to subgroup analysis patients with fracture (p 0.02). Zinc supplementation was effective on the femoral neck (p < 0.0001) and lumbar spine (p 0.05) bone mineral density (BMD). In the correlation analysis of the data obtained from all of the included studies, serum osteocalcin (p 0.0106, r - 0.9148) correlated with serum zinc level. In conclusion, serum zinc level and dietary zinc intake could have an essential role in preventing osteoporosis. Zinc supplementation might improve bone turnover markers for bone formation such as serum osteocalcin and serum alkaline phosphatase and also, BMD at the site of the femoral neck.

Keywords: Bone; Diet; Fracture; Osteopenia; Osteoporosis; Zinc.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Aged
  • Biomarkers
  • Bone Density
  • Dietary Supplements
  • Eating
  • Humans
  • Osteocalcin
  • Trace Elements*
  • Zinc


  • Biomarkers
  • Trace Elements
  • Osteocalcin
  • Zinc