Chromium supplementation in non-obese non-diabetic subjects is associated with a decline in insulin sensitivity

Umesh Masharani, Christine Gjerde, Shelley McCoy, Betty A Maddux, Danielle Hessler, Ira D Goldfine, Jack F Youngren, Umesh Masharani, Christine Gjerde, Shelley McCoy, Betty A Maddux, Danielle Hessler, Ira D Goldfine, Jack F Youngren

Abstract

Background: 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 the present studies, we test the hypothesis that chromium supplementation raises serum chromium levels and correspondingly improves insulin sensitivity.

Methods: A 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.

Results: After 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.

Conclusions: Chromium 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 registration: The study was registered on the NIH registry (clinicaltrials.gov) and the identifier is NCT00846248.

Figures

Figure 1
Figure 1
Boxplot of pre and post insulin sensitivity as measured by euglycemic hyperinsulinemic clamp (M LBM/I) by group (0 = placebo group, 1 =chromium group) after 16 weeks of chromium picolinate versus placebo. There was no significant change in insulin sensitivity. -1.63 mg/min/kg/mU insulin (-8.9 to + 5.57) in the placebo group and -1.14 mg/min/kg/mU insulin (-5.22 to + 4.11) in the chromium group (p=0.83). The serum chromium levels ranged from less than 0.5 to 1.0 μg/L in the placebo group and 0.8 to 5.5 μg/L (mean 3.0) in the chromium treated group.
Figure 2
Figure 2
Scatterplot of the delta change in insulin sensitivity (M LBM/I) chromium group against fasting serum chromium levels at 16 weeks. High serum chromium levels are associated with increase in insulin resistance, r=0.85, p=0.01.
Figure 3
Figure 3
Boxplot of the delta change in insulin sensitivity (M LBM/I by group: Chromium therapy group is divided into high serum chromium group (>3.1 μg/L); low serum chromium group (≤ 3.1 μg/L); and placebo group. High serum chromium group had had greater insulin resistance than participants in the low serum chromium group or the placebo group, p=0.02, p=0.05 respectively.

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