You will be provided with a reference and some statements. Please determine whether each statement is 'supported', 'unsupported', or 'unknown' with respect to the reference. Please note:
First, assess whether the reference contains any valid content. If the reference contains no valid information, such as a 'page not found' message, then all statements should be considered 'unknown'.
If the reference is valid, for a given statement: if the facts or data it contains can be found entirely or partially within the reference, it is considered 'supported' (data accepts rounding); if all facts and data in the statement cannot be found in the reference, it is considered 'unsupported'.

You should return the result in a JSON list format, where each item in the list contains the statement's index and the judgment result, for example:
[
    {
        "idx": 1,
        "result": "supported"
    },
    {
        "idx": 2,
        "result": "unsupported"
    }
]

Below are the reference and statements:
<reference>
1. J Trace Elem Med Biol. 2023 Sep;79:127244. doi: 10.1016/j.jtemb.2023.127244. 
Epub 2023 Jun 15.

Zinc supplementation and cardiovascular disease risk factors: A GRADE-assessed 
systematic review and dose-response meta-analysis.

Nazari M(1), Ashtary-Larky D(2), Nikbaf-Shandiz M(3), Goudarzi K(4), Bagheri 
R(5), Dolatshahi S(4), Omran HS(4), Amirani N(6), Ghanavati M(7), Asbaghi O(8).

Author information:
(1)Department of Nutrition, Science and Research Branch, Islamic Azad 
University, Tehran, Iran.
(2)Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur 
University of Medical Sciences, Ahvaz, Iran.
(3)Student Research Committee, Tabriz University of Medical Sciences, Tabriz, 
Iran.
(4)Faculty of Medicine, Shahid Beheshti University of Medical Science, Tehran, 
Iran.
(5)Department of Exercise Physiology, University of Isfahan, Iran.
(6)Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
(7)National Nutrition and Food Technology Research Institute, Shahid Beheshti 
University of Medical Sciences, Tehran, Iran. Electronic address: 
matina_844@yahoo.com.
(8)Cancer Research Center, Shahid Beheshti University of Medical Sciences, 
Tehran, Iran; Student Research Committee, Shahid Beheshti University of Medical 
Sciences, Tehran, Iran. Electronic address: omid.asbaghi@gmail.com.

BACKGROUND AND OBJECTIVE: A deficit in zinc has been related to a higher 
probability of developing cardiovascular diseases (CVDs). The anti-inflammatory 
and anti-oxidative capabilities of zinc may have a wide range of therapeutic 
impacts on CVDs. We conducted a comprehensive systematic review and 
meta-analysis of the possible impacts that zinc supplementation may have on the 
risk factors associated with CVDs.
METHODS: To identify eligible randomized clinical trials (RCTs) evaluating the 
effects of zinc supplementation on CVDs risk factors, electronic databases 
including PubMed, Web of Science, and Scopus were systematically searched up to 
January 2023. The heterogeneity of trials was checked using the I2 statistic. 
According to the heterogeneity tests, random effects models were estimated and 
pooled data were defined as the weighted mean difference (WMD) with a 95% 
confidence interval (CI).
RESULTS: Of 23165 initial records, 75 studies that met inclusion criteria were 
analyzed in this meta-analysis. The pooled findings indicated the significant 
lowering effects of zinc supplementation on triglycerides (TG), total 
cholesterol (TC), fasting blood glucose (FBG), Hemoglobin A1C (HbA1C), 
Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), C-reactive 
protein (CRP), interleukin-6 (IL-6), Tumor necrosis factor-α (TNF-α), nitric 
oxide (NO), malondialdehyde (MDA), total antioxidant capacity (TAC), and 
glutathione (GSH), with no noticeable effects on low-density lipoprotein (LDL), 
high-density lipoprotein (HDL), insulin, systolic blood pressure (SBP), 
diastolic blood pressure (DBP), aspartate transaminase (AST), and Alanine 
aminotransferase (ALT).
CONCLUSION: Overall, zinc supplementation may boost recognized coronary risk 
factors that contribute to the development of CVDs. Future research should be 
conducted to bolster our results.

Copyright © 2023 Elsevier GmbH. All rights reserved.

DOI: 10.1016/j.jtemb.2023.127244
PMID: 37399684 [Indexed for MEDLINE]

Conflict of interest statement: Declaration of Competing Interest The authors 
declare no conflict of interest.
</reference>

<statements>
1. With respect to zinc, meta-analyses of randomized trials indicate that supplementation reduces surrogate cardiometabolic markers, including triglycerides (standardized mean difference -0.66), total cholesterol, fasting blood glucose, and circulating markers of systemic inflammation such as high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6)
2. Oral Zinc: Antioxidant protection; SOD activation; insulin signaling
3. Oral Zinc: Surrogate marker meta-analyses (n>1,500)
4. Oral Zinc: Reductions in TG, fasting glucose, IL-6; zero hard-outcome data
</statements>

Begin the assessment now. Output only the JSON list, without any conversational text or explanations.