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ARS Home » Northeast Area » Beltsville, Maryland (BHNRC) » Beltsville Human Nutrition Research Center » Diet, Genomics and Immunology Laboratory » Research » Publications at this Location » Publication #247705

Title: Characterization of the metabolic and physiologic response to chromium supplementation in subjects with type 2 diabetes mellitus

Author
item CAFALU, WILLIAM - Pennington Biomedical Research Center
item ROOD, JENNIFER - Pennington Biomedical Research Center
item PINSONAT, PATRICIA - Pennington Biomedical Research Center
item QIN, JIANHUA - Pennington Biomedical Research Center
item SEREDA, O - Pennington Biomedical Research Center
item LEVITAN, LILLIAN - Pennington Biomedical Research Center
item Anderson, Richard
item ZHANG, XIAN - Pennington Biomedical Research Center
item MARTIN, J - Pennington Biomedical Research Center
item MARTIN, CORBY - Pennington Biomedical Research Center
item WANG, Z - Pennington Biomedical Research Center
item NEWCOMER, B - Pennington Biomedical Research Center

Submitted to: Metabolism
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/25/2009
Publication Date: 5/5/2010
Citation: Cafalu, W.T., Rood, J., Pinsonat, P., Qin, J., Sereda, O., Levitan, L., Anderson, R.A., Zhang, X.H., Martin, J.M., Martin, C.K., Wang, Z.Q., Newcomer, B. 2010. Characterization of the metabolic and physiologic response to chromium supplementation in subjects with type 2 diabetes mellitus. Metabolism. 59(3):755-762.

Interpretive Summary: Several studies have demonstrated the beneficial effects of chromium (Cr) on glucose and fat; however, not all people respond to supplemental Cr. The objective of this study was to provide a comprehensive evaluation of Cr supplementation on metabolic and physical parameters in subjects with Type 2 diabetes (type 2 DM) and evaluate changes in “responders” and “non-responders”. After testing to assess blood sugar and fat, insulin sensitivity, Cr status, and body composition, 137 subjects were randomized in a double-blind fashion to placebo or 1,000 µg of Cr for 6 months. Insulin sensitivity was negatively correlated to fat found in the muscle and liver. Specific muscle fats were significantly lower in subjects randomized to Cr. “Responders”, defined as those with changes in insulin sensitivity greater than 10%, had significantly lower insulin sensitivity and higher fasting glucose levels when compared to placebo and “non-responders”, i.e., insulin sensitivity change was less than 10%. Clinical response was significantly correlated to the baseline insulin sensitivity and fasting glucose values. Cr did not alter hepatic glucose production, body weight, or fat distribution. In conclusion, clinical response to Cr is more likely in insulin-resistant individuals with more elevated fasting glucose levels. Cr may reduce cellular lipid content and enhance insulin sensitivity in subjects with type 2 DM independent of effects on weight or liver glucose production. Thus, modulation of lipid metabolism by Cr in peripheral tissues may represent a novel mechanism of action. This work should be of benefit to the millions of people who have type 2 DM as well as those who are prediabetic as a potential means to alleviate the time of onset and severity of type 2 DM.

Technical Abstract: The objective of this study was to provide a comprehensive evaluation of chromium (Cr) supplementation on metabolic, physiologic, and phenotypic parameters in subjects with Type 2 DM and evaluate changes in “responders” and “non-responders”. After pre-intervention testing to assess glycemia, insulin sensitivity, Cr status, and body composition, 137 subjects were randomized in a double-blind fashion to a placebo or 1,000 µg Cr for 6 months. A sub-study was performed to evaluate 24-hour energy balance/substrate oxidation, and myocellular/intra-hepatic lipid content. Insulin sensitivity was negatively correlated to soleus and tibialis muscle intramyocellular lipids and intra-hepatic lipid content. Myocellular lipids were significantly lower in subjects randomized to Cr. At pre-intervention, “responders”, defined as those with an insulin sensitivity change > 10%, had significantly lower insulin sensitivity and higher fasting glucose and A1c when compared to placebo and “non-responders”, i.e., insulin sensitivity change < 10%. Clinical response was significantly correlated (p < 0.001) to the baseline insulin sensitivity, fasting glucose, and A1c. Cr did not alter hepatic glucose production, body weight, or fat distribution. In conclusion, clinical response to Cr is more likely in insulin- resistant individuals with more elevated fasting glucose and A1c levels. Cr may reduce myocellular lipid content and enhance insulin sensitivity in subjects with type 2 DM independent of effects on weight or hepatic glucose production. Thus, modulation of lipid metabolism by Cr in peripheral tissues may represent a novel mechanism of action.