Rajpathak Swapnil, Rimm Eric B, Li Tricia, Morris J Steven, Stampfer Meir J, Willett Walter C, Hu Frank B
Department of Nutrition, Harvard School of Public Health, 655 Huntington Ave., Boston, MA 02120, USA.
Diabetes Care. 2004 Sep;27(9):2211-6. doi: 10.2337/diacare.27.9.2211.
Chromium may improve insulin sensitivity, which can modify the risk of diabetes and cardiovascular disease (CVD). Therefore, we evaluated the association between toenail chromium and CVD in diabetic men.
We performed cross-sectional and nested case-control analyses among men aged 40-75 years within the Health Professionals Follow-up Study. The cross-sectional analysis compared men with diabetes only (n = 688), diabetes with prevalent CVD (n = 198), and healthy control subjects (n = 361). The nested case-control study included 202 men with baseline diabetes who developed incident CVD and 361 matched control subjects.
Mean toenail chromium (microg/g) was 0.71 in healthy control subjects, 0.61 in diabetes-only subjects, and 0.52 in diabetic subjects with prevalent CVD (P for trend = 0.003). In the cross-sectional analysis, the multivariate odds ratio (OR) between extreme quartiles was 0.74 (95% CI 0.49-1.11; P for trend = 0.18), comparing diabetes only with healthy control subjects. A similar comparison between diabetic subjects with prevalent CVD and healthy control subjects yielded an OR of 0.45 (0.24-0.84; P for trend = 0.003). In the nested case-control study, comparing diabetic men with incident CVD with healthy control subjects, the multivariate OR was 0.65 (0.36-1.17; P for trend = 0.16) between extreme quartiles. When we combined prevalent and incident CVD cases among diabetic men and compared them with healthy control subjects, the OR was 0.62 (0.39-1.01; P for trend = 0.02) between extreme quartiles.
Our results suggest that diabetic men with CVD have lower toenail chromium than healthy control subjects. However, this study could not distinguish between the effects of chromium on diabetes and those on CVD. Long-term clinical trials are needed to determine whether chromium supplementation is beneficial for preventing CVD among diabetic patients.
铬可能会改善胰岛素敏感性，进而改变糖尿病和心血管疾病（CVD）的风险。因此，我们评估了糖尿病男性患者趾甲铬含量与心血管疾病之间的关联。
我们在健康专业人员随访研究中，对40至75岁的男性进行了横断面分析和巢式病例对照分析。横断面分析比较了仅患有糖尿病的男性（n = 688）、患有糖尿病且伴有CVD的男性（n = 198）以及健康对照者（n = 361）。巢式病例对照研究纳入了202名患有基线糖尿病且发生新发CVD的男性以及361名匹配的对照者。
健康对照者的平均趾甲铬含量（μg/g）为0.71，仅患有糖尿病的受试者为0.61，患有糖尿病且伴有CVD的受试者为0.52（趋势P值 = 0.003）。在横断面分析中，仅患有糖尿病的受试者与健康对照者相比，极端四分位数之间的多变量比值比（OR）为0.74（95%CI 0.49 - 1.11；趋势P值 = 0.18）。患有糖尿病且伴有CVD的受试者与健康对照者之间的类似比较得出的OR为0.45（0.24 - 0.84；趋势P值 = 0.003）。在巢式病例对照研究中，将患有新发CVD的糖尿病男性与健康对照者进行比较，极端四分位数之间的多变量OR为0.65（0.36 - 1.17；趋势P值 = 0.16）。当我们将糖尿病男性中的CVD现患病例和新发病例合并，并与健康对照者进行比较时，极端四分位数之间的OR为0.62（0.39 - 1.01；趋势P值 = 0.02）。
我们的结果表明，患有CVD的糖尿病男性的趾甲铬含量低于健康对照者。然而，本研究无法区分铬对糖尿病和对CVD的影响。需要进行长期临床试验来确定补充铬是否有助于预防糖尿病患者的CVD。
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