ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
This article is part of the Research TopicThe Role of Normal Blood Lipid Levels in Metabolic and Endocrine DiseasesView all 9 articles
Is it possible for type 2 diabetic patients with low level of copper to have better glycemic control under different apolipoprotein B levels?
Provisionally accepted
- 1The Graduate School, Fujian Medical University, Fuzhou, China
- 2Department of Endocrinology, The First Hospital of Putian City, Putian, China
- 3Medical Department, Putian University, Putian, China
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Objective: Copper overload has been implicated in impaired β-cell function and insulin resistance through oxidative stress and inflammatory pathways. As a major lipoprotein component involved in lipid oxidation, apolipoprotein B (apoB) may influence copper-related metabolic effects. This study aimed to examine the association between whole blood copper concentration and glycemic control in patients with type 2 diabetes mellitus (T2DM), and to assess whether apoB levels influence this association. Methods: A total of 117 patients with T2DM (mean age 55.15 ± 10.70 years; 62.4% male) were included. Whole blood copper concentration was measured using inductively coupled plasma mass spectrometry. Associations between blood copper and glycemic indicators, including glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG), were evaluated using multivariable linear regression models. Stratified and interaction analyses were performed according to apoB and other lipid-related parameters. Results: After adjustment for potential confounders, a significant interaction between blood copper and apoB was observed in relation to HbA1c (P for interaction < 0.001). Stratified analyses showed that higher blood copper concentration was significantly associated with higher HbA1c levels among patients with lower apoB levels below the study median, whereas no significant association was observed among those with higher apoB levels. Exploratory analyses further indicated that apoB also influenced the association between blood copper and FPG (P for interaction < 0.05), showing a consistent pattern. Conclusion: In patients with T2DM, a significant association between blood copper concentration and glycemic control was observed among individuals with lower apoB levels, whereas no such association was found among those with higher apoB levels. These findings suggest that apoB status may influence the relationship between blood copper and glycemic control and merit further investigation in longitudinal studies.
Keywords: Apolipoprotein B, Copper, Effect modifier, Glycated hemoglobin, type 2 diabetes
Received: 09 Dec 2025; Accepted: 11 Feb 2026.
Copyright: © 2026 Wu, He, Zhu, Gan and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sumei Li
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