Aghdassi Elaheh, Arendt Bianca M, Salit Irving E, Mohammed Saira S, Jalali Pegah, Bondar Helena, Allard Johane P
The University Health Network, The Toronto General Hospital, 200 Elizabeth St. 9-N-973, Toronto, Ontario M5G2C4, Canada.
Curr HIV Res. 2010 Mar;8(2):113-20. doi: 10.2174/157016210790442687.
Chromium is an essential micronutrient; chromium deficiency has been reported to cause insulin resistance, hyperglycemia and hyperlipidemia. The aim was to investigate the effect of chromium supplementation on insulin-resistance, other metabolic abnormalities, and body composition in people living with HIV. This was a randomized, double-blind, placebo-controlled trial. Fifty-two HIV-positive subjects with elevated glucose, lipids, or evidence of body fat redistribution, and who had insulin-resistance based on the calculation of homeostasis model of assessment (HOMA-IR > or = 2.5) were assessed. Subjects who were on insulin or hypoglycemic medications were excluded. Subjects were randomized to receive either 400 microg/day chromium-nicotinate or placebo for 16 weeks. Forty-six subjects, 23 in each group, completed the study. Fasting blood insulin, glucose, lipid profile and body composition were measured before and after intervention. Chromium was tolerated without side effects and resulted in a significant decrease in HOMA-IR (median (IQR) (pre:4.09 (3.02-8.79); post: 3.66 (2.40-5.46), p=0.004), insulin (pre: 102 (85-226); post: 99 (59-131) pmol/L, p=0.003), triglycerides, total body fat mass (mean+/-SEM) (pre: 17.3+/-1.7; post: 16.3+/-1.7 kg; p=0.002) and trunk fat mass (pre: 23.8+/-1.9; post: 22.7+/-2.0 %; p=0.008). Blood glucose, C-peptide, total, HDL and LDL cholesterol, and hemoglobin A1c remained unchanged. Biochemical parameters did not change in the placebo group except for LDL cholesterol which increased significantly. Body weight and medication profile remained stable throughout the study for both groups. In summary, chromium improved insulin resistance, metabolic abnormalities, and body composition in HIV+ patients. This suggests that chromium supplements alleviate some of the antiretroviral-associated metabolic abnormalities.
铬是一种必需的微量营养素；据报道，铬缺乏会导致胰岛素抵抗、高血糖和高脂血症。本研究旨在探讨补充铬对HIV感染者胰岛素抵抗、其他代谢异常及身体成分的影响。这是一项随机、双盲、安慰剂对照试验。对52名血糖、血脂升高或有体脂重新分布证据且根据稳态模型评估（HOMA-IR≥2.5）计算存在胰岛素抵抗的HIV阳性受试者进行了评估。正在使用胰岛素或降糖药物的受试者被排除在外。受试者被随机分为两组，分别接受每日400微克的烟酸铬或安慰剂，为期16周。46名受试者（每组23名）完成了研究。在干预前后测量空腹血胰岛素、血糖、血脂谱和身体成分。铬耐受性良好，无副作用，导致HOMA-IR显著降低（中位数（IQR）（干预前：4.09（3.02 - 8.79）；干预后：3.66（2.40 - 5.46），p = 0.004）、胰岛素（干预前：102（85 - 226）；干预后：99（59 - 131）pmol/L，p = 0.003）、甘油三酯、全身脂肪量（均值±SEM）（干预前：17.3±1.7；干预后：16.3±1.7 kg；p = 0.002）和躯干脂肪量（干预前：23.8±1.9；干预后：22.7±2.0 %；p = 0.008）。血糖、C肽、总胆固醇、高密度脂蛋白和低密度脂蛋白胆固醇以及糖化血红蛋白A1c保持不变。安慰剂组除低密度脂蛋白胆固醇显著升高外，生化参数无变化。两组受试者的体重和用药情况在整个研究过程中保持稳定。总之，铬改善了HIV阳性患者的胰岛素抵抗、代谢异常和身体成分。这表明补充铬可缓解一些与抗逆转录病毒治疗相关的代谢异常。
