INSERM U870, INSA Lyon, 6 Bld J, Capelle, F-69621 Villeurbanne (France.
Diabetol Metab Syndr. 2010 Dec 19;2:70. doi: 10.1186/1758-5996-2-70.
Many trace elements, among which metals, are indispensable for proper functioning of a myriad of biochemical reactions, more particularly as enzyme cofactors. This is particularly true for the vast set of processes involved in regulation of glucose homeostasis, being it in glucose metabolism itself or in hormonal control, especially insulin. The role and importance of trace elements such as chromium, zinc, selenium, lithium and vanadium are much less evident and subjected to chronic debate. This review updates our actual knowledge concerning these five trace elements. A careful survey of the literature shows that while theoretical postulates from some key roles of these elements had led to real hopes for therapy of insulin resistance and diabetes, the limited experience based on available data indicates that beneficial effects and use of most of them are subjected to caution, given the narrow window between safe and unsafe doses. Clear therapeutic benefit in these pathologies is presently doubtful but some data indicate that these metals may have a clinical interest in patients presenting deficiencies in individual metal levels. The same holds true for an association of some trace elements such as chromium or zinc with oral antidiabetics. However, this area is essentially unexplored in adequate clinical trials, which are worth being performed.
许多微量元素，包括金属元素，对于无数生化反应的正常运作都是不可或缺的，特别是作为酶的辅助因子。这在涉及葡萄糖稳态调节的大量过程中尤其如此，无论是在葡萄糖代谢本身还是在激素控制中，特别是胰岛素。铬、锌、硒、锂和钒等微量元素的作用和重要性则不那么明显，而且一直存在争议。这篇综述更新了我们目前对这五种微量元素的认识。仔细查阅文献表明，虽然一些关键元素的理论假设导致了对治疗胰岛素抵抗和糖尿病的真正希望，但基于现有数据的有限经验表明，由于安全剂量和不安全剂量之间的差距很小，大多数微量元素的有益效果和使用都需要谨慎。这些疾病的明确治疗益处目前仍值得怀疑，但一些数据表明，对于个体金属水平缺乏的患者，这些金属可能具有临床意义。一些微量元素（如铬或锌）与口服抗糖尿病药物联合使用也是如此。然而，这方面在充分的临床试验中基本上没有得到探索，值得进行这些试验。
