Feiner J J, McNurlan M A, Ferris R E, Mynarcik D C, Gelato M C
Department of Medicine, Division of Endocrinology, State University of New York at Stony Brook, Stony Brook, NY 11794-8154, USA.
Diabetes Obes Metab. 2008 Feb;10(2):151-8. doi: 10.1111/j.1463-1326.2006.00681.x.
Multidrug regimens in HIV disease are associated with an increased incidence of insulin resistance, by as much as 50%. Not only does insulin resistance predisposes subjects to diabetes but also it is associated with the metabolic syndrome and increased risk of cardiovascular disease. Previous studies suggest that chromium picolinate can improve insulin resistance in patients with type 2 diabetes. The objective was to study the efficacy and safety of chromium picolinate as a treatment of insulin resistance in subjects infected with HIV.
The ability of chromium picolinate (1000 mug/day) to improve insulin sensitivity, determined with a hyperinsulinaemic-euglycaemic insulin clamp, was determined in eight HIV-positive subjects on highly active antiretroviral therapy.
The mean rate of glucose disposal during the clamp was 4.41 mg glucose/kg lean body mass (LBM)/min (range 2.67-5.50), which increased to 6.51 mg/kg LBM/min (range 3.19-12.78, p = .03), an increase of 25% after 8 weeks of treatment with chromium picolinate. There were no significant changes in blood parameters, HIV viral burden or CD4+ lymphocytes with chromium picolinate treatment. Two subjects experienced abnormalities of liver function during the study. Another subject experienced an elevation in blood urea nitrogen.
The study shows that chromium picolinate therapy improves insulin resistance in some HIV-positive subjects, but with some concerns about safety in this population.
艾滋病多药治疗方案与胰岛素抵抗发生率增加有关,增幅高达50%。胰岛素抵抗不仅使患者易患糖尿病,还与代谢综合征及心血管疾病风险增加相关。既往研究表明,吡啶甲酸铬可改善2型糖尿病患者的胰岛素抵抗。本研究旨在探讨吡啶甲酸铬治疗艾滋病患者胰岛素抵抗的疗效及安全性。
采用高胰岛素-正葡萄糖钳夹技术,测定8例接受高效抗逆转录病毒治疗的艾滋病病毒阳性患者服用吡啶甲酸铬(1000微克/天)后胰岛素敏感性的变化。
钳夹期间葡萄糖处置的平均速率为4.41毫克葡萄糖/千克去脂体重(LBM)/分钟(范围2.67 - 5.50),服用吡啶甲酸铬治疗8周后增至6.51毫克/千克LBM/分钟(范围3.19 - 12.78,p = 0.03),增幅为25%。吡啶甲酸铬治疗后血液参数、艾滋病病毒载量及CD4 +淋巴细胞无显著变化。研究期间有2例患者出现肝功能异常。另1例患者血尿素氮升高。
本研究表明,吡啶甲酸铬治疗可改善部分艾滋病病毒阳性患者的胰岛素抵抗,但该人群的安全性存在一定问题。