Balk Ethan M, Tatsioni Athina, Lichtenstein Alice H, Lau Joseph, Pittas Anastassios G
Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, 750 Washington St., NEMC #63, Boston, MA 02111, USA.
Diabetes Care. 2007 Aug;30(8):2154-63. doi: 10.2337/dc06-0996. Epub 2007 May 22.
A systematic review of the effect of chromium supplementation on glucose metabolism and lipid levels.
A literature search was conducted in MEDLINE and the Commonwealth Agricultural Bureau. Eligible studies were English language randomized controlled trials of chromium supplement intake > or = 3 weeks, with > or = 10 participants receiving chromium. All trials with glucose metabolism outcomes and trials of individuals with diabetes or glucose intolerance for lipid outcomes were included. Meta-analyses were performed as appropriate.
Forty-one studies met criteria, almost half of which were of poor quality. Among participants with type 2 diabetes, chromium supplementation improved glycosylated hemoglobin levels by -0.6% (95% CI -0.9 to -0.2) and fasting glucose by -1.0 mmol/l (-1.4 to -0.5) but not lipids. There was no benefit in individuals without diabetes. There were some indications of dose effect and differences among chromium formulations. Larger effects were more commonly observed in poor-quality studies. The evidence was limited by poor study quality, heterogeneity in methodology and results, and a lack of consensus on assessment of chromium status.
No significant effect of chromium on lipid or glucose metabolism was found in people without diabetes. Chromium supplementation significantly improved glycemia among patients with diabetes. However, future studies that address the limitations in the current evidence are needed before definitive claims can be made about the effect of chromium supplementation.
系统评价补充铬对葡萄糖代谢和血脂水平的影响。
在MEDLINE和英联邦农业局进行文献检索。纳入的合格研究为英文随机对照试验,补充铬的时间≥3周,且≥10名参与者接受铬补充。纳入所有有葡萄糖代谢结果的试验以及针对糖尿病或葡萄糖不耐受个体的血脂结果试验。酌情进行荟萃分析。
41项研究符合标准,其中近一半质量较差。在2型糖尿病参与者中,补充铬可使糖化血红蛋白水平降低0.6%(95%置信区间 -0.9至 -0.2),空腹血糖降低1.0 mmol/L(-1.4至 -0.5),但对血脂无影响。在无糖尿病个体中无益处。有一些迹象表明存在剂量效应以及铬制剂之间的差异。在质量较差的研究中更常观察到较大的效应。证据受到研究质量差、方法和结果的异质性以及铬状态评估缺乏共识的限制。
在无糖尿病的人群中未发现铬对脂质或葡萄糖代谢有显著影响。补充铬可显著改善糖尿病患者的血糖水平。然而,在能够就补充铬的效果做出明确论断之前,需要进一步研究解决当前证据中的局限性。