Serum Chromium Concentrations Research Articles

Minimum 15-year results of metasul 28-mm metal-on-metal total hip arthroplasty in patients younger than 50 years of age

BackgroundSome propitious mid- and long-term studies had been reported for MoM bearings; however, most studies have addressed specific patient groups rather than younger, active patients, who probably represent the most suitable population for investigations on wear and osteolysis. The purpose of this study to evaluate the long-term results of second-generation metal-on-metal cementless total hip arthroplasty (THA) in patients aged <50 years.MethodsFrom December 1997 to January 2004, primary THA using a metal-on-metal bearing cementless implant was performed in 63 patients (72 hips) aged <50 years. The mean follow-up duration was 18.6 (range, 15.9–22.1) years, and the mean age at initial operation was 39 (range, 22–49) years. Clinical results, complications, survivorship, osteolysis, and aseptic loosening were evaluated.ResultsThe mean Harris hip score and Western Ontario and McMaster Universities Arthritis Index scores were improved from 57.8 (range, 28–69) points and 73.4 (range, 63–94) points preoperatively to 91.7 (range, 80–100) points and 25.5 points (range, 17–38) points, respectively, at the last follow-up. Osteolysis lesions were found in 12 hips (acetabulum, 6 and femur, 6). The notching occurred on the femoral stem neck occurred in 12 hips. The mean serum cobalt and chromium concentrations were 2.3 (range, 0.2–10.6) μg/L and 1.7 (range, 0.4–8.1) μg/L, respectively, at a mean follow-up of 12.7 years in 32 patients (50.1%). The Kaplan-Meier survivorship curve analysis with revision for any reason as the endpoint revealed that 93.1% survived at 18.6 years’ follow-up.ConclusionsSecond-generation metal-on-metal cementless THA was found to produce satisfactory clinical and radiographic results with a low revision rate for osteolysis and aseptic loosening in patients aged less than 50 years.

Study of chromium, selenium and bromine concentrations in blood serum of patients with parenteral nutrition treatment using total reflection X-ray fluorescence analysis.

Total reflection X-ray fluorescence analysis (TXRF) was used to determine chromium, selenium and bromine concentrations in blood serum samples of 50 patients with parenteral nutrition treatment. The concentrations were measured two times, namely in the first day (I measurement) of the treatment and the seventh day (II measurement) after the chromium and selenium supplementation. For comparison purposes also serum samples of 50 patients without nutritional disorders, admitted to a planned surgical procedure to remove the gall bladder (cholecystectomy), were analyzed and treated as the control group. Descriptive statistics of measured concentrations of Cr, Se and Br both for the studied and control groups was determined. In order to check the effectiveness of Cr and Se supplementation, the results of the first and seventh day measurements for studied group were statistically compared with each other, with literature reference values and with the results of the control group (two-group comparison). These comparisons indicate the effectiveness of selenium supplementation in the applied treatment procedure. In the case of Cr and Br concentrations no statistically significant differences were observed. We conclude that monitoring of the concentration of the important trace elements in human serum should be standard procedure in parenteral nutrition treatment. In this monitoring the TXRF technique can be successfully used.

Evaluation of serum Cd, Zn, and Cr in male cement loaders in Benin City, Nigeria

Production of cement is a dusty industrial process and its effect on the health of workers has been studied for many years. The aim of this research is to study the effects of cement dust on serum heavy metal in cement loaders in Benin City. The level of serum heavy metals: Cadmium,, Zinc and Chromium of thirty(30) male cement loaders and apparently thirty(30) healthy non-cement loaders (controls) were measured using standard methods. The results revealed that significant difference was observed in serum cadmium(0.4980mg/L) and chromium(1.220mg/L) concentration of cement factory workers exposed to cement dust when compared with control (0.4030mg/L and 0.03434mg/L respectively) at p<0.05). Proper safety measures such as wearing of face mask and workshop coat is thus advised to minimize the health effects of the cement dust. Keywords: serum, heavy metals, cement, loaders

Comparison of serum copper, chromium and selenium concentrations in diabetic and nondiabetic population and their association with glycated hemoglobin levels

Comparison of serum copper, chromium and selenium concentrations in diabetic and nondiabetic population and their association with glycated hemoglobin levels

Investigation of Hematological and Biochemical Profiles of Tannery Workers Exposed to Chromium in Hazaribagh, Bangladesh

Occupational exposure to chromium used in mineral tanning processes cause adverse health effects on workers of leather tanning industries. This study aimed to evaluate the hematological and biochemical profiles in tannery workers of Hazaribagh, Bangladesh compared with a control group. A total of 225 participants, 121 tannery workers and 104 controls, were enrolled. All subjects completed interviewer-administered questionnaires; their physical health was examined, blood samples were collected and the hematological and biochemical parameters were analyzed. The tannery workers had mean duration of work exposure at tanneries for 13.1±9.7 years, and working hours per day of 10.7±2.3 which were significantly higher than 7.6±2.2 of the controls. Previous results showed long-term exposed tannery workers had significantly higher serum chromium concentrations than controls. The tanners had dermatological problems, infections on body surfaces, and respiratory ailments, among other complaints. The red blood cell count, hematocrit (48.91 %) and mean corpuscular hemoglobin concentration (29.39 g/dL) were lower in tannery workers but hemoglobin (14.58±1.30 g/dL) was significantly lower than in the controls (15.96±0.88 g/dL). The tanners had significantly lower neutrophil (51.31 %), higher lymphocyte (41.82 %), monocyte (2.44 %) and eosinophil (4.17 %) counts. Their mean creatinine and alkaline phosphatase values were normal but markers of liver damage, alanine transaminase (42.7±39.3 U/L) and aspartate transaminase (44.3±20.5 U/L), and liver dysfunction marker - bilirubin (1.04±0.85 mg/dL) levels were significantly higher. These findings suggest that exposure to chromium poses serious threats to the health of tannery workers who are at risk of toxicity related liver damage and hematological disorders.

Study on the treatment for abnormality of metal ions with EDTA complexing agent-loaded microsphere sustained release system

Objective To construct a new sustained-release system, hollow mesoporous silica nanoparticles (HMSNs), to control the release of ethylene diamine tetraacetic acid (EDTA) continuously, effectively and intelligently to treat the abnormal increase of metal ions in vivo. The disulfide bond can be broken or reconstructed with the change of H+ concentration to realize the construction of receptor, and the is constructed by blocking cucurbituril and alpha-cyclodextrin through disulfide bond. Thus, the abnormal increase of chromium and cobalt ions in rats can be accurately controlled and maintained at normal levels. Methods HMSNs-EDTA sensitive to H+ was prepared. HMSNs containing functional groups of alpha-cyclodextrin were constructed. The disulfide bond was formed between the HS group at the end of cucurbituril and the HS group of alpha-cyclodextrin as a switch. Cucurbituril and alpha-cyclodextrin are connected by disulfide bond to form a valve system, which can block silica channels and thus close EDTA. A rat model of elevated chromium and cobalt ions was established by intraarticular injection of CoCrMo nanoparticles suspension into the knee joint. Rat models were randomly divided into three groups: intraperitoneal injection of saline (control group), intraperitoneal injection of traditional drug sustained release (IgG-HMSNs-EDTA group), and intraperitoneal injection of H+ sensitive cucurbituril-HMSNs-EDTA sustained release (intelligent sustained release system group). During this process, nanoparticle suspension was injected continuously to observe the changes of serum chromium and cobalt concentration in rats. Results From the release curve of EDTA, it was found that the higher the concentration of H+ was, the faster the drug release was (H+ concentration group: 2 mmol/L>1 mmol/L>0.5 mmol/L>0.1 mmol/L). It shows that the sensor does control the valve with the change of H+ concentration. Compared with the slow-release body without valve, the release of EDTA in the new intelligent slow-release body is gentler. Within 20 weeks, the concentration of metal ions in the control group increased continuously and slowly due to the absence of EDTA treatment (Chromium 1.08±0.07 ug/L and cobalt 41.14±0.79 ug/L). In the traditional valve group, the metal ions decreased rapidly within 8 weeks and were once lower than the normal values in rats. Subsequently, due to the release of EDTA, metal ions will still increase abnormally (Chromium ion 0.61±0.52 ug/L, cobalt ion 28.72±16.93 ug/L). The intelligent sustained-release system group can more effectively, continuously and accurately control the abnormal changes of chromium and cobalt ions in vivo, and the difference is statistically significant (Chromium ion 0.65±0.13 ug/L, cobalt ion 29.68±3.24 ug/L). Conclusion According to the principle that disulfide bond can be broken or reconstructed with the change of H+ concentration, the application of cucurbituril-HMSNs-EDTA intelligent microsphere sustained release system to treat patients with increased chromium and cobalt ions caused by plants in metal will control the drug release more accurately and intelligently. The intelligent sustained-release system can not only avoid the side effects caused by the rapid and excessive release of drugs, which lead to the disorder of normal trace metal elements in vivo, but also prolong the treatment time, and can maintain the chromium and cobalt ions in rats at normal levels for a long time. Key words: Metal; Coordination complexes; Nanostructures

Serum Chromium Level is Increased in Jordanian Smokers, Decreased in Jordanians with Prediabetes and type 2 Diabetes, But not Altered in Jordanians with Hypertension, With Obesity, or With Family History of Diabetes.

Background:Chromium was found to be crucial for several biochemical processes in the human body, including, in particular, carbohydrate and lipid metabolism whereas the exact mechanisms of its actions have yet to be explored. Here, we asked whether low serum chromium levels are present in Jordanian smokers and Jordanians with prediabetes and type 2 diabetes (T2D), with hypertension, with overweight and obesity, and with a family history of diabetes.Methods:A total of 360 patients (120 with T2D, 120 with prediabetes, and 120 healthy controls) were recruited randomly based on the American Diabetes Association criteria. Smokers (n = 26), and patients with hypertension (n = 46), with overweight (n = 47) and obesity (n = 57), and with family history of diabetes (n = 63) were included in the tested population. Serum chromium concentration was measured using the graphite furnace atomic absorption spectrometry.Results:The results from this study revealed significant increase (P = 0.001 univariate, P = 0.038 multivariate) and significant decrease (P = 0.046 univariate,P = 0.038 multivariate) in serum chromium concentrations in smokers and people with T2D and prediabetes, respectively. In addition, serum chromium insignificantly altered (P > 0.05) in people with hypertension, with a family history of diabetes, and with overweight or obesity.Conclusions:Higher levels of serum chromium were observed in smokers, whereas lower levels were found to be present in patients with T2D and patients with prediabetes. In addition, serum chromium level may not be affected by hypertension, overweight and obesity, and family history of diabetes.

Effects of nanoparticle chromium mixed with γ-polyglutamic acid on the chromium bioavailability, growth performance, serum parameters and carcass traits of pigs

Because chromium is a mineral that is difficult to absorb, nanotechnology was used to produce nanoparticle trivalent chromium, which has a reduced particle size and increased surface area to increase chromium bioavailability. The aim of the present study was to investigate the effect of dietary supplementation nanoparticle trivalent chromium with or without γ-polyglutamic acid (γ-PGA) on the chromium bioavailability, growth performance, serum parameters and carcass traits of pigs. In Trial 1, eight growing pigs (Landrace × Yorkshire × Duroc; LYD) with an initial average weight of 51.3 ± 2.0 kg were used in a 4 × 4 Latin square design as the control group (without chromium supplements), the chromium picolinate group (CrPic), the nanoparticle chromium picolinate group (NanoCrPic) and the nanoparticle chromium picolinate mixed with γ-polyglutamic acid (NanoCrPic–PGA) group. Chromium was added at a level of 200 μg/kg to a basal diet containing 728 µg Cr/kg DM, using different forms of chromium, so as to evaluate the chromium bioavailability. The results of Trial 1 indicated that the bioavailability of the supplemented chromium was as follows: NanoCrPic–PGA &amp;gt; NanoCrPic &amp;gt; CrPic (P &amp;lt; 0.05). In Trial 2, 64 LYD growing pigs (average bodyweight 74.46 ± 3.9 kg) were randomly allotted to the same four dietary treatment groups as in Trial 1 and the same levels of chromium were added to the diet. Each group contained four pens and there were four pigs in each pen. The experimental results indicated that the gain:feed ratio in the NanoCrPic–PGA group was better than that in the NanoCrPic group (P &amp;lt; 0.001). The serum chromium concentrations in the NanoCrPic–PGA group were higher than in the control group (P &amp;lt; 0.05), the serum insulin concentration in the chromium supplementation groups was lower than that in the control group (P &amp;lt; 0.05), and blood glucose in the NanoCrPic group was lower than that in the control group (P &amp;lt; 0.05). The carcass traits were not affected by chromium supplementation. In conclusion, nanoparticle trivalent chromium, either alone or together with γ-PGA, improved chromium bioavailability and feeding effectiveness.

Retrieval Findings of Recalled Dual-Taper Hips.

Background:The recent high-profile recalls of several dual-taper hip designs pose questions regarding why those designs perform poorly. We aimed to characterize taper damage in 1 recalled design to understand failure mechanisms to inform surgeons on which patients should be considered at risk of revision and when to revise.Methods:High-precision measurement equipment was used to characterize the metal loss from the neck-stem interface of 116 retrieved Rejuvenate femoral stems (Stryker Howmedica Osteonics) revised because of an adverse reaction to metal debris. Head-neck taper surfaces were also investigated, and clinical and laboratory data were examined.Results:The neck-stem junction of each implant was moderately to severely corroded and showed a characteristic wear pattern on both male and female taper surfaces. The severity of taper damage was positively correlated with time to revision (coefficient, 0.040 [95% confidence interval (CI), 0.028 to 0.051]; p < 0.0001) and with serum cobalt concentration (coefficient, 0.02 [95% CI, 0.01 to 0.02]; p < 0.0001) and serum chromium concentration (coefficient, 0.04 [95% CI, 0.009 to 0.070]; p = 0.0142).Conclusions:A forensic examination of the retrieved components that failed secondary to an adverse reaction to metal debris showed, in all cases, visible corrosion. Of the implant and patient factors investigated, we did not identify any predictors of corrosion. The severity of damage was found to increase with time; cobalt was significantly elevated over chromium.Clinical Relevance:Surgeons should scrupulously follow and consider revision for patients with this implant design to avoid extensive tissue excision. Blood metal ion tests may aid in identifying the mechanisms of taper corrosion.

Chromium and Nickel Concentrations in Subjects with a Stainless Steel Metal-on-Metal Cervical Disc Arthroplasty: Results from a Prospective Longitudinal Study with 7 Years Follow-Up.

Cervical disc arthroplasty (CDA) has emerged as an alternative to anterior cervical discectomy and fusion for degenerative cervical disc disease. The artificial discs provide intervertebral motion using multicomponent articulation and thus tend to generate particulate debris and soluble metal ions. Limited information is available on the long-term metal concentrations and associated systemic adverse events observed in metal-on-metal CDA. Serum chromium (Cr) and nickel (Ni) concentrations were assessed in patients implanted with ball-in-trough stainless steel-based cervical disc through 7 years. A prospective, nonrandomized longitudinal study was conducted that included 25 patients following rigorous exclusion criteria that included no previous permanent metal implants and no professional exposure to metal particles. Blood serum Cr and Ni concentrations were assayed preoperatively and at 3, 6, 12, 24, 36, 60, and 84 months postoperatively using high-resolution inductively coupled plasma-mass spectrometry. Longitudinal statistical comparisons were made using the Friedman test with statistical significance at P < .05. Median serum concentrations determined preoperatively and at 3, 6, 12, 24, 36, 60, and 84 months postoperatively were 0.074, 0.106, 0.132, 0.170, 0.172, 0.274, 0.192, and 0.203 ng/mL for Cr and 0.085, 0.178, 0.222, 0.175, 0.205, 0.284, 0.181, and 0.194 ng/mL for Ni. The serum Cr concentrations were statistically higher for all postoperative time periods compared to preoperative concentration (Friedman P <.01), whereas serum Ni concentration was statistically higher at the 84-month postoperative time period than the preoperative concentration (Friedman P <.01) and then the concentration at 3, 12, 24, and 60 months postoperatively (Friedman P < .03). The Cr concentrations detected at all postoperative times were statistically higher than preoperative concentrations, whereas Ni concentration was statistically higher than the preoperative concentration only at 84 months.

Outcomes after revision of metal on metal hip resurfacing to total arthroplasty using the direct anterior approach.

Function after revision total hip arthroplasty (THA) in failed metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) is variable, but post-operative complication rates are reportedly high. We hypothesized HRA conversion to THA using the direct anterior approach (DAA) would be associated with optimal outcome. Seventeen MoM-HRAs in 15 patients (seven males, eight females) were revised through the DAA. The mean age was 45years (28-59yrs). The most common indications for revision were aseptic loosening of the acetabular component or of the femoral component and femoral neck fracture. In 16 hips, a conversion to a ceramic-on-ceramic (CoC) (13 hips) or to a metal-on polyethylene (MOP) (2), or to a large-head MoM (1) THA was done. An isolated femoral revision was done in one hip. After 6.7 ± 3years, no hip had required a re-revision. The Postel-Merle d'Aubigne (PMA) functional score improved from 9 (4-14) to 16 (12-18) (p < 0.001). An intra-operative fracture of the greater trochanter (one hip) and dysesthesia of the lateral femoral cutaneous nerve (four hips) were reported. Mean serum chromium concentration decreased from 33.2μg/L (11.8-62μg/L) pre-operatively to 5.8μg/L (0.4-35.5μg/L) post-operatively (p < 0.001), and mean serum cobalt concentration decreased from 35.8μg/L (6.3-85.5μg/L) to 4.7μg/L (0.26-25.7μg/L) (p = 0.003). Revision of failed MoM-HRA using the DAA resulted in an acceptable clinical outcome, no specific complication and no further surgery. A consistent decline in serum ion levels may be expected following HRA conversion to THA.

Metal-on-Metal Hip Joint Prostheses: a Retrospective Case Series Investigating the Association of Systemic Toxicity with Serum Cobalt and Chromium Concentrations.

There have been concerns about prosthesis failure and the potential for systemic toxicity due to release of cobalt and chromium from metal-on-metal hip joint prostheses (MoM-HP). There is conflicting evidence on whether there is a correlation between higher cobalt and chromium concentrations and systemic toxicity. We undertook a retrospective review of consecutive patients with MoM-HP referred for outpatient review in toxicology clinics in London, UK, and in the USA recorded in the Toxicology Investigators Consortium (ToxIC) Registry from June 2011 to June 2015. Thirty-one cases were identified; the median (IQR) serum cobalt concentration was 10.0 (3.8-32.8)mcg/L, and the median (IQR) serum chromium concentration was 6.9 (3.7-18.7)mcg/L. Twenty-three (74.2%) had symptoms, most commonly lethargy, hearing loss, and tinnitus. The odds ratios of symptomatic/asymptomatic patients for metal ion concentrations above/below 7mcg/L were 1.87 (95% CI 0.37-9.57, p=0.45) and 0.60 (95% CI 0.10-3.50, p=0.57) for cobalt and chromium, respectively. Two (6.5%) patients with systemic cobalt toxicity had median (IQR) serum cobalt concentrations significantly higher than those without systemic features (630.4 [397.6-863.2]mcg/L versus 9.8 [2.9-16.4]mcg/L; p=0.017). However, overall, there were no differences between cobalt (p=0.38) or chromium (p=0.92) concentrations between symptomatic and asymptomatic patients and no clinical features or investigation results correlated with cobalt or chromium concentration. Two (6.5%) of 31 individuals referred for assessment of MoM-HP were diagnosed with systemic cobalt toxicity. However, despite a high prevalence of reported symptoms, neither symptoms nor investigation results correlated with serum cobalt or chromium concentrations.

Effects of nanoparticle chromium on chromium absorbability, growth performance, blood parameters and carcass traits of pigs

The aim of this study was to investigate the effect of dietary supplementation of nanoparticle trivalent chromium on chromium absorbability, growth performance, blood parameters and carcass characteristics of pigs. In Trial 1, five growing pigs (Landrace × Yorkshire × Duroc) (initial average weight was 31.3 ± 2.0 kg) were used in a 5 × 5 Latin square design as the Control group (without supplement of chromium), the chromium chloride group (CrCl3), the chromium picolinate group (CrPic), the nanoparticle chromium chloride group (NanoCrCl3), and the nanoparticle chromium picolinate group (NanoCrPic). The pigs were adapted for 7 days, followed by a 5-day test period and a collection period. The chromium was added at a 200 μg/kg level to the diet using different chromium sources for evaluating the chromium absorbability. The results of Trial 1 indicated that there were no differences in feed components digestibility among the groups, but the absorbability of chromium in the NanoCrPic (27.5%) group was the highest, whereas that in the CrCl3 group was the lowest (4.91%). Moreover, the chromium source, nanoparticle size and interaction effects were observed between these two factors (P &lt; 0.001). In Trial 2, 60 Landrace × Yorkshire × Duroc growing pigs (average bodyweight was 76.7 ± 4.5 kg) were randomly allotted to five dietary treatment groups as used in Trial 1, each group with four pens (three pigs/pen). The study was conducted for 60 days. Their growth performance, carcass and meat traits were also evaluated. Trial 2 results indicated that feed intake in the chromium-added groups was greater (P &lt; 0.007) than that in the Control group. The average daily bodyweight gain in the chromium-added groups was greater than that in the Control group (P = 0.046). The serum non-esterified fatty acids level was lower (P &lt; 0.0001) in the NanoCr groups. Serum chromium concentration was increased by dietary chromium supplementation, and the chromium source, nanoparticle size and their interaction effects (P &lt; 0.001) were observed. The average back fat thickness in the CrPic and NanoCrPic groups was lower (P &lt; 0.05) than that of the Control group. Meat chromium content was elevated by dietary chromium supplementation, particularly in the CrPic and NanoCrPic groups (P &lt; 0.05). The chromium source, nanoparticle size and interaction effects between these two factors were observed in serum non-esterified fatty acids and chromium content. The muscle chromium content also affected by chromium source and displayed interaction of source and nanoparticle size. In conclusion, chromium supplementation could increase feed intake and average daily gain, serum and longissimus muscle chromium content, as well as reduce back fat thickness of pigs. In addition, nanoparticle organic trivalent chromium could increase chromium absorbability and decrease serum non-esterified fatty acids concentrations. Organic form was better than inorganic form in chromium absorbability, serum and longissimus muscle chromium content and average back fat thickness.

Differences in concentration of metal debris in blood, serum, and plasma samples of patients with metal-on-metal hip resurfacing arthroplasty

Background/aimsCobalt and chromium are released from MOM hips and their precise nature (ions/particles) is not known. Their distribution in serum, plasma, and whole blood may help to determine their nature. MethodsWe measured cobalt and chromium concentrations in plasma, serum, and whole blood samples of patients with resurfacing MOM hips. ResultsWe found that chromium concentration was highest in plasma, followed by serum and whole blood. Chromium and cobalt concentrations were higher in serum and plasma, compared to whole blood. ConclusionWe, therefore, suggest that in future cobalt and chromium concentrations shall be reported using plasma samples.

Magnesium, zinc, and chromium levels in children, adolescents, and young adults with type 1 diabetes

Several trace elements are involved in insulin signal transduction and glucose metabolism. Our aim for this present study was to determine the levels of three important elements-magnesium, chromium, and zinc-as well as one oxidative stress marker-malondialdehyde (MDA)-in young type 1 diabetic patients at different periods of their growth, and to realize the relationships between trace elements, oxidative stress, and growth stages. A total of 88 patients with type 1 diabetes mellitus in different growth stages and 76 gender- and age-matched healthy subjects were included in this study. The levels of MDA were measured through HPLC using a C-18 column. Zinc, magnesium, and chromium concentrations in serum were assessed using atomic absorption spectrophotometry. We found higher levels of blood malondialdehyde (MDA; p<0.001), significantly lower levels of magnesium (p<0.001), and no differences in zinc and chromium levels (p=0.153 and 0.515, respectively) in younger type 1 diabetic subjects relative to those of control subjects. Only 3.4% (3/88) of younger diabetic subjects exhibited hypomagnesemia; similar results were obtained when comparing different subgroups: children, adolescents, and adults. We also observed no differences in the levels of the three elements between the genders and among the growth stages (p>0.05) of the diabetic subjects. There were no correlations between the three trace elements and HbA1C, diabetes duration, and insulin dose/BMI (all p>0.05), but there was a significant difference between zinc levels and insulin dose/BMI (p=0.043) in the diabetic patients. We found elevated blood MDA, decreased magnesium, and no changes in zinc and chromium levels in younger type 1 diabetic subjects relative to those of control subjects. Only 3.4% of younger diabetic subjects exhibited hypomagnesemia. Whether magnesium supplementation is suitable for improving insulin sensitivity and decreasing oxidative stress and inflammation will require confirmation through additional studies.

Beneficial effects of oral chromium picolinate supplementation on glycemic control in patients with type 2 diabetes: A randomized clinical study

BackgroundChromium is an essential mineral that contributes to normal glucose function and lipid metabolism. This study evaluated the effect of chromium picolinate (CrPic) supplementation in patients with type 2 diabetes mellitus (T2DM). MethodsA four month controlled, single blind, randomized trial was performed with 71 patients with poorly controlled (hemoglobin A1c [HbA1c]>7%) T2DM divided into 2 groups: Control (n=39, using placebo), and supplemented (n=32, using 600μg/day CrPic). All patients received nutritional guidance according to the American Diabetes Association (ADA), and kept using prescribed medications. Fasting and postprandial glucose, HbA1c, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides and serum ferritin were evaluated. ResultsCrPic supplementation significantly reduced the fasting glucose concentration (−31.0mg/dL supplemented group; −14.0mg/dL control group; p<0.05, post- vs. pre-treatment, in each group) and postprandial glucose concentration (−37.0mg/dL in the supplemented group; −11.5 mg/dL in the control group; p<0.05). HbA1c values were also significantly reduced in both groups (p<0.001, comparing post- vs. pre-treatment groups). Post-treatment HbA1c values in supplemented patients were significantly lower than those of control patients. HbA1c lowering in the supplemented group (−1.90), and in the control group (−1.00), was also significant, comparing pre- and post-treatment values, for each group (p<0.001 and p<0.05, respectively). CrPic increased serum chromium concentrations (p<0.001), when comparing the supplemented group before and after supplementation. No significant difference in lipid profile was observed in the supplemented group; however, total cholesterol, HDL-c and LDL-c were significantly lowered, comparing pre- and post-treatment period, in the control group (p<0.05). ConclusionsCrPic supplementation had a beneficial effect on glycemic control in patients with poorly controlled T2DM, without affecting the lipid profile. Additional studies are necessary to investigate the effect of long-term CrPic supplementation.

Serum Chromium Levels in Type 2 Diabetic Patients and Its Association with Glycaemic Control.

Chromium is an essential micronutrient which is required for the normal functioning of insulin and regulation of blood sugar levels. It acts as a vital antioxidant for maintaining insulin homeostasis. In diabetes mellitus, the free radical production is increased and levels of antioxidants like chromium, vanadium, selenium and manganese are reduced. There have been previous studies to suggest that low serum levels of chromium are associated with poorer glycaemic control. To study the level of serum chromium in newly diagnosed patients with type 2 diabetes mellitus and its association with glycaemic control. Serum chromium concentration was determined by using inductively coupled Plasma - Optical Emission Spectophotometry in 42 newly diagnosed type 2 diabetes mellitus patients without any pre-existing complications. They were divided into 2 groups - well controlled (HbA1c ≤7.0%) and uncontrolled groups (HbA1c >7.0%). Mean serum chromium concentration measured in uncontrolled type 2 diabetic patients was significantly lower (0.065 ± 0.03 mcg/L vs 0.103 ± 0.04 mcg/L, p< 0.05). There was a statistically significant inverse linear correlation of the HbA1c values and the serum chromium concentration (r= -0.6514, p < 0.0001). There was also a decrease in chromium levels across both the groups with advancing age and the decrease being significant beyond 40 years of age (p<0.05). The results of our study describes the relationship between serum chromium levels and control of type 2 diabetes mellitus. Significant reduction in chromium levels are probable indicators of metabolic response to oxidative stress in patients with type 2 diabetes mellitus. Further large scale studies relating serum chromium and type 2 diabetes mellitus may help to understand more about the exact relationship.

Effects of supplemental nanoparticle trivalent chromium on the nutrient utilization, growth performance and serum traits of broilers.

The aim of this study was to investigate the effect of dietary supplementation of nanoparticle trivalent chromium on nutrient utilization, growth performance and serum traits of broilers. This study included two trials. In trial 1, 32 three-week-old broilers were divided into four groups: the control, chromium chloride (CrCl3), chromium picolinate (CrPic) and nanoparticle chromium picolinate (NanoCrPic). Chromium was added at a 1200 μg/kg level to evaluate the nutrient and chromium utilization. In trial 2, 160 one-day-old broilers were randomly divided into four groups as in trial 1, with four replicates. The results of trial 1 indicated that the chromium utilization is as follows: NanoCrPic > CrPic > CrCl3 and control groups, with significant differences between groups (p < 0.05). Crude fat utilization in CrCl3 group was lower than in that the control group (p < 0.05). The results of trial 2 indicated that feed intake of 4-5 weeks showed better result in the CrCl3 group than that in the CrPic group (p < 0.05). The results of serum traits indicated that the LDL-cholesterol in the NanoCrPic groups was lower than that in the CrPic group (p < 0.05). The NanoCrpic and CrPic groups showed significantly increased serum chromium concentration when compared with the control and CrCl3 groups; the triglyceride level in the CrCl3 group was lower than that in the CrPic group (p < 0.05). This study concluded that compared with CrPic, NanoCrpic supplementation could increase chromium utilization and lower the serum LDL-cholesterol of broilers.

High Frequency of Serum Chromium Deficiency and Association of Chromium with Triglyceride and Cholesterol Concentrations in Patients Awaiting Bariatric Surgery

To our knowledge, the frequency of serum chromium deficiency in patients awaiting bariatric surgery has not been determined. This study was designed to assess chromium concentration and its association with glycemic levels and lipid profile in patients prior to bariatric surgery. This study recruited 73 candidates for bariatric surgery between March and September 2012. Their sociodemographic, anthropometric, and biochemical data were collected. Of the 73 patients, 55 (75.3%) were women (75.34%). Mean patient age was 37.20 ± 9.92 years, and mean body mass index was 47.48 kg/m2 (range, 43.59 to 52.50 kg/m2). Chromium deficiency was observed in 64 patients (87.7%). Correlation analysis showed significant negative relationships between chromium concentration and BMI and zinc concentration and a significant positive relationship between chromium and glycated hemoglobin. Multiple linear regression analysis showed that serum chromium concentration was significantly associated with total cholesterol (β = 0.171, p = 0.048) and triglyceride (β = -0.181, p = 0.039) concentrations. Serum chromium deficiency is frequent in candidates for bariatric surgery and is associated with total cholesterol and triglyceride concentrations. Early nutritional interventions are needed to reduce nutritional deficiencies and improve the lipid profile of these patients.

Chromium Nicotinate Has No Effect on Insulin Sensitivity, Glycemic Control, and Lipid Profile in Subjects with Type 2 Diabetes

Objective: To investigate the effect of chromium nicotinate supplementation on insulin sensitivity, glycemic control, and lipid profile in subjects with type 2 diabetes. Materials and Methods: In a double-blind clinical trial, 56 overweight individuals with type 2 diabetes were randomized into 3 groups: placebo (NC0), 50 μg (NC50), and 200 μg (NC200) of chromium as chromium nicotinate. Chromium status, sensitivity to insulin, glycemic control, and lipid profile were assessed at the beginning of the study and 45 days and 90 days after. Results: In the beginning, most subjects showed low concentrations of serum chromium (71.88%), regular levels of urinary chromium (80.65%), and insulin resistance (73.80%). The serum chromium concentrations did not differ among the groups over time (p = 0.2549). The changes in serum chromium and urine concentrations did not relate to changes in fasting glucose (p > 0.05). At 90 days of intervention, there was no significant difference between groups in fasting glucose, glycosylated hemoglobin, homeostasis model assessment insulin resistance (HOMA-IR), total cholesterol, and low-density lipoprotein (LDL); there was increase in homeostasis model assessment β-cell function (HOMA-β; p = 0.0349) and high-density lipoprotein (HDL; p = 0.0425) in the NC0 group and a reduction of triglycerides in the NC0 (p = 0.0177) and NC50 (p = 0.0336) groups. Conclusion: Supplementation at 50 and 200 μg of chromium as chromium nicotinate did not promote glycemic control, increase insulin sensitivity, or change the lipid profile of subjects with diabetes.