Abstract
BackgroundThe use of chromium supplements is widespread for the prevention and treatment of diabetes mellitus but there are conflicting reports on efficacy, possibly reflecting discrepant effects across different populations. In the present studies, we test the hypothesis that chromium supplementation raises serum chromium levels and correspondingly improves insulin sensitivity.MethodsA double blind placebo-controlled randomized trial was conducted on 31 non-obese, normoglycemic subjects. After baseline studies, the subjects were randomized to placebo or chromium picolinate 500 μg twice a day. The primary endpoint was change in insulin sensitivity as measured by euglycemic hyperinsulinemic clamp. Pre-specified secondary endpoints included fasting lipids, blood pressure, weight, body composition measured by DXA scan.ResultsAfter 16 weeks of chromium picolinate therapy there was no significant change in insulin sensitivity between groups (p=0.83). There was, however, a strong association between serum chromium and change in insulin resistance (β = -0.83, p=0.01), where subjects with the highest serum chromium had a worsening of insulin sensitivity. This effect could not be explained by changes in physiological parameters such as body weight, truncal fat and serum lipids with chromium therapy.ConclusionsChromium therapy did not improve insulin sensitivity in non-obese normoglycemic individuals. Further, subjects who have high serum chromium levels paradoxically had a decline in insulin sensitivity. Caution therefore should be exercised in recommending the use of this supplement.Trial registrationThe study was registered on the NIH registry (clinicaltrials.gov) and the identifier is NCT00846248
Highlights
The use of chromium supplements is widespread for the prevention and treatment of diabetes mellitus but there are conflicting reports on efficacy, possibly reflecting discrepant effects across different populations
We performed a double blind placebo controlled clinical trial of chromium picolinate therapy in a non-diabetic, non-obese population, and employed the euglycemic hyperinsulinemic clamp to precisely measure insulin sensitivity. We studied this population because of the presence of a range of insulin sensitivities, the likelihood that insulin resistance could result from multiple factors beyond overt obesity, and the previously established relationship between insulin sensitivity and chromium excretion in non-obese, nondiabetic subjects
We did not find evidence that serum chromium levels had a significant impact on insulin sensitivity in this population, nor did we find evidence that high chromium excretion was associated with insulin resistance
Summary
The use of chromium supplements is widespread for the prevention and treatment of diabetes mellitus but there are conflicting reports on efficacy, possibly reflecting discrepant effects across different populations. In 1996 it was estimated that about 10 million people in the United States took chromium supplements at a cost of $ 150 million dollars per year [1], largely as a result of claims of beneficial effects on insulin action and glucose tolerance [2]. A recent study of non-diabetic Saudi men and women reported that insulin resistance in this population was associated with increased urinary excretion of chromium. The authors postulated that chromium supplementation might be recommended to prevent or delay the progression of insulin resistance into diabetes
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