Urinary chromium loss associated with diabetes is offset by increases in absorption

In Vitro Evaluation of Bioavailability of Cr from Daily Food Rations and Dietary Supplements from the Polish Market

Only some of the nutrients consumed with food are able to be absorbed from the gastrointestinal (GI) tract and enter the systemic circulation (blood). Because some elements are essential minerals for humans, their beneficial effect on the body depends significantly on their bioavailable amount (the fraction that can be absorbed and used by the organism). The term bioavailability, which is very often used to describe the part of nutrients that is able to be absorbed, is influenced by various factors of exogenous and endogenous origin. The main purpose of the study was to assess the relative bioavailability of Cr from selected dietary supplements in the presence of various types of diets, which significantly influence the level of bioavailability. The research was performed using a previously developed and optimized two-stage in vitro digestion model using cellulose dialysis tubes of food rations with the addition of pharmaceutical products. Cr was determined using the ICP-OES and GF-AAS methods, depending on its concentration in particular fractions. The determined relative bioavailability ranged between 2.97 and 3.70%. The results of the study revealed that the type of diet, the chemical form of the molecule, and the pharmaceutical form of preparations have a significant influence on the bioavailability of Cr.

Urinary trace elements in association with disease severity and outcome in patients with COVID-19

BACKGROUND

The dynamics of urinary trace elements in patients with COVID-19 still remains to be investigated.

METHODS

A retrospective study was performed on a cohort of 138 confirmed COVID-19 patients for their urinary levels of essential and/or toxic metals including chromium, manganese, copper, arsenic, selenium, cadmium, mercury, thallium and lead according to the different disease severity (severe or non-severe) and outcome (recovered or deceased).

RESULTS

Urinary concentrations of chromium, manganese, copper, selenium, cadmium, mercury and lead after creatinine adjustment were found to be higher in severe patients than the non-severe cases with COVID-19. And among the severe cases, these elements were also higher in the deceased group than the recovered group. When the weeks of the post-symptom onset were taken in account, the changes of these urinary elements were existed across the clinical course since the disease onset. These urinary elements were found to be mostly positively inter-correlated, and further positively correlated with other laboratory inflammatory parameters including serum cytokines (IL-1B, IL2R, IL6, IL8, IL10, TNFα), ferritin, and neutrophil count and white blood cell count. As a independently predictive factor, urinary creatinine-adjusted copper of ≥25.57 μg/g and ≥99.32 μg/g were associated with significantly increased risk of severe illness and fatal outcome in COVID-19, respectively.

CONCLUSIONS

These results suggest abnormities in urinary levels of the trace metals were tightly associated with the severe illness and fatal outcome of COVID-19.

Serum Chromium Level is Increased in Jordanian Smokers, Decreased in Jordanians with Prediabetes and type 2 Diabetes, But not Altered in Jordanians with Hypertension, With Obesity, or With Family History of Diabetes

Background

Chromium was found to be crucial for several biochemical processes in the human body, including, in particular, carbohydrate and lipid metabolism whereas the exact mechanisms of its actions have yet to be explored. Here, we asked whether low serum chromium levels are present in Jordanian smokers and Jordanians with prediabetes and type 2 diabetes (T2D), with hypertension, with overweight and obesity, and with a family history of diabetes.

Methods

A total of 360 patients (120 with T2D, 120 with prediabetes, and 120 healthy controls) were recruited randomly based on the American Diabetes Association criteria. Smokers (n = 26), and patients with hypertension (n = 46), with overweight (n = 47) and obesity (n = 57), and with family history of diabetes (n = 63) were included in the tested population. Serum chromium concentration was measured using the graphite furnace atomic absorption spectrometry.

Results

The results from this study revealed significant increase (P = 0.001 univariate, P = 0.038 multivariate) and significant decrease (P = 0.046 univariate,P = 0.038 multivariate) in serum chromium concentrations in smokers and people with T2D and prediabetes, respectively. In addition, serum chromium insignificantly altered (P > 0.05) in people with hypertension, with a family history of diabetes, and with overweight or obesity.

Conclusions

Higher levels of serum chromium were observed in smokers, whereas lower levels were found to be present in patients with T2D and patients with prediabetes. In addition, serum chromium level may not be affected by hypertension, overweight and obesity, and family history of diabetes.

Effects of supplementation of chromium histidinate on glucose, lipid metabolism and oxidative stress in cats

In recent years, two meta-analyses of chromium (Cr) supplementation have shown beneficial effects on glucose metabolism. Chromium histidinate (CrHis) reduces serum glucose levels in rats fed a high-fat diet but no study has been conducted on cats until now. The aim of this study was to examine the effects of CrHis on glucose and lipid metabolism in cats. To challenge the glucose metabolism, 16 cats were fed a high-carbohydrate high-fat diet for three months. One group (n = 8) received 800 ug CrHis per day for two months, while the other group (n = 8) served as control group. An oral glucose tolerance test was conducted, blood samples were taken, and biochemical parameters and oxidative stress were measured. CrHis serum levels were significantly increased (p = 0.027) in the treatment group, while fructosamine levels were significantly lower (p = 0.029) in the control group. In both groups, glucose (p < 0.01), b-hydroxy-butyrate (p = 0.024) and 8-hydroxy-deoxyguanosine (p = 0.028) levels decreased significantly and cholesterol levels increased significantly (p < 0.01). In conclusion, CrHis did not improve glucose or lipid metabolism and did not affect oxidative stress in healthy cats.

New Evidence against Chromium as an Essential Trace Element

Nearly 60 y ago, chromium, as the trivalent ion, was proposed to be an essential element, but the results of new studies indicate that chromium currently can only be considered pharmacologically active and not an essential element. Regardless, articles still continue to appear in the literature claiming chromium is an essential element. Chromium has been marketed as an agent to reduce body mass and develop muscle; however, such marketing claims are no longer allowed in the United States because these claims, similar to claims of essential status, are not supported by experiments. Trivalent chromium has also been proposed as a therapeutic agent to increase insulin sensitivity and affect lipid metabolism. Although effective in certain rodent models, beneficial effects in humans have not been unequivocally established. Molecular mechanisms have been proposed for the beneficial effects but have not been definitively shown to occur in animals.

Maternal Chromium Restriction Leads to Glucose Metabolism Imbalance in Mice Offspring through Insulin Signaling and Wnt Signaling Pathways

An adverse intrauterine environment, induced by a chromium-restricted diet, is a potential cause of metabolic disease in adult life. Up to now, the relative mechanism has not been clear. C57BL female mice were time-mated and fed either a control diet (CD), or a chromium-restricted diet (CR) throughout pregnancy and the lactation period. After weaning, some offspring continued the diet diagram (CD-CD or CR-CR), while other offspring were transferred to another diet diagram (CD-CR or CR-CD). At 32 weeks of age, glucose metabolism parameters were measured, and the liver from CR-CD group and CD-CD group was analyzed using a gene array. Quantitative real-time polymerase chain reaction (qPCR) and Western blot were used to verify the result of the gene array. A maternal chromium-restricted diet resulted in obesity, hyperglycemia, hyperinsulinemia, increased area under the curve (AUC) of glucose in oral glucose tolerance testing and homeostasis model assessment of insulin resistance (HOMA-IR). There were 463 genes that differed significantly (>1.5-fold change, p < 0.05) between CR-CD offspring (264 up-regulated genes, 199 down-regulated genes) and control offspring. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and STRING (Search Tool for the Retrieval of Interacting Genes/Proteins) analysis revealed that the insulin signaling pathway and Wnt signaling pathway were in the center of the gene network. Our study provides the first evidence that maternal chromium deficiency influences glucose metabolism in pups through the regulation of insulin signaling and Wnt signaling pathways.

The Effects of High Dietary Doses of Chromium(III) Complex with Propionic Acid on Nutritional and Selected Blood Indices in Healthy Female Rats

People taking dietary supplements are usually determined to lose weight, supplement nutrition or reduce the risk of illness and negative effects of their state of health. Chromium(III) supplementation influence body composition and mass, glucose and lipid metabolism and it enhance insulin action. This fact could be of general interest because diabetes mellitus is an increasing health problem in many countries. The study describes the effects of high dietary doses of chromium(III) complex with propionic acid [Cr3] (from 100 to 1000 mg Cr · kg(-1) diet) on the organisms of healthy female rats, with special regard to overall nutritional, carbohydrate, lipid and blood biochemical and morphological and haematological indices. The study was carried out on 30 10-week-old female Wistar rats, which were divided into five equal groups (six animals in each): the control group and four groups of tested animals which had free access to the diet supplemented with 100, 200, 500 and 1000 mg Cr · kg(-1) (equivalent of 10, 20, 50 and 100 mg Cr · kg body weight (b.w.) · day(-1)), given as [Cr3O(O2CCH2CH3)6(H2O)3]⋅NO3, also known as Cr3, for 4 weeks. There were no significant differences in body mass gains, feeding efficiency ratio, internal organ masses or blood serum glucose concentrations, except for some changes in the serum triglycerides concentration, which decreased in the rats that received 500 and 1000 mg Cr · kg(-1) diet, as opposed to the group treated with 200 mg Cr · kg(-1) diet. The dietary supplementation of Cr3 for 4 weeks at doses of 100 to 1000 mg Cr · kg(-1) diet did not affect overall nutritional indices and most blood biochemical, morphological and haematological indices.

The Potential of Cr3 [Triaqua-μ3 -Oxo-Hexa-μ-Propionatotrichromium(III) Chloride] to Reduce Birth Defects in the Offspring of Diabetic CD-1 Mice

Diabetes mellitus is a growing concern worldwide and leads to multiple complications during pregnancy. Pharmacologic doses of chromium (Cr) have been linked with improving insulin sensitivity and other positive benefits in the treatment of diabetes in animal models. By using streptozotocin induced hyperglycemia in female CD-1 mice, reproductive outcomes of diabetic and chromium-dosed diabetic females were examined. After dosing 10 mg/kg Cr in the form of triaqua-μ3 -oxo-hexa-μ-propionatotrichromium(III) chloride or Cr3 during gestation days 8-16 (GD8-GD16), all females were sacrificed on gestation day 17 (GD17) and examined for maternal weight gain. The fetuses were examined for gross malformations and for skeletal malformations. The offspring of Cr3-dosed females tended to have a reduction in the incidence of supernumerary ribs. While hyperglycemia still had negative impacts on the health of dams and their offspring, administration of Cr led to an apparent trend in the reduction in the number of malformations and incidence of supernumerary ribs compared to those of untreated diabetic mothers.

Chromium

Chromium is ubiquitous in the environment as Cr(III) and Cr(VI) oxidation states, which interconvert under environmentally and biologically relevant conditions (although Cr(III) usually predominates). While Cr(VI) is an established human carcinogen and a major occupational and environmental hazard, Cr(III) has long been regarded as an essential human micronutrient, although recent literature has cast serious doubts on the validity of this postulate. Despite five decades of research, no functional Cr-containing enzymes or cofactors have been characterized conclusively, and several hypotheses on their possible structures have been refuted. Gastrointestinal absorption pathways for both Cr(III) and Cr(VI) are apparent and whole-blood speciation can involve Cr(VI) uptake and reduction by red blood cells, as well as Cr(III) binding to both proteins and low-molecular-mass ligands in the plasma. DNA-damaging effects of Cr(VI) and anti-diabetic activities of Cr(III) are likely to arise from common mechanistic pathways that involve reactive Cr(VI/V/IV) intermediates and kinetically inert Cr(III)-protein and Cr(III)-DNA adducts. Both Cr(III) and Cr(VI) are toxic to plants and microorganisms, particularly Cr(VI) due to its higher bioavailability and redox chemistry. Some bacteria reduce Cr(VI) to Cr(III) without the formation of toxic Cr(V) intermediates and these bacteria are being considered for use in the bioremediation of Cr(VI)-polluted environments.

Urinary chromium excretion in response to an insulin challenge is not a biomarker for chromium status

Over 50 years ago, chromium (Cr) was proposed to be an essential trace element; however, recent studies indicate that this status should be removed as the effects of Cr supplementation appear to be pharmacological rather than nutritional. The pharmacological basis for Cr's effects can explain the inability of investigators to discover a biomarker for Cr status. One potential biomarker has not been examined to date. Cr is known to be mobilized in the body in response to insulin (or insulin release in response to a glucose challenge), resulting in an increase in urinary Cr excretion. The magnitude of increase in urinary Cr loss as a function of dietary Cr intake was tested as a potential biomarker for Cr. Zucker lean rats housed in carefully controlled metal-free conditions were provided a series of purified diets containing variable Cr contents (from 16 μg/kg diet to 2,000 μg/kg) for 23 weeks. The 16 μg/kg diet contained less Cr than any diet examined to date. Urine samples were collected before and after insulin and glucose challenges (0, 2, 6, and 12 h postinjection). Urinary Cr levels were analyzed by the standard method of addition using graphite furnace atomic absorption. The rate of urinary Cr loss after a glucose or insulin challenge was found to not be dependent on the Cr content of the rats' diets. Blood iron levels of the rats were also measured to determine if the addition of Cr to the diet altered iron status. The Cr content of the diet was found to have no affect on blood iron levels. Overall, the study demonstrated that insulin-stimulated urinary Cr excretion cannot be used as a biomarker for Cr status.

Long-term exposure to [Cr(3)O(O (2)CCH (2)CH (3)) (6)(H (2)O) (3)] (+) in Wistar rats fed normal or high-fat diets does not alter glucose metabolism

The essentiality of chromium(III) has been the subject of much debate, particularly in healthy subjects. Chromium(III)-containing supplements are widely used for body mass loss, building of lean muscle mass, and improving glucose and lipid metabolism. [Cr(3)O(O(2)CCH(2)CH(3))(6)(H(2)O)(3)](+), Cr3, is one of the most-studied chromium nutritional supplements. The current study evaluates the effects of long-term (15 months) supplementation with Cr3 on body mass and glucose metabolism in Wistar rats on traditional and cafeteria-style (high fat, high carbohydrate) diets. Male Wistar rats were randomly assigned to one of four treatment groups: (1) control diet (milled Harlan Teklad LM-485 rodent diet), (2) control diet+1 mg Cr3/kg body mass/day, (3) a cafeteria-style (CAF) diet (high fat, high carbohydrate), or (4) CAF diet+1 mg Cr3/kg/day. Cr3 supplementation had no effect on fasting blood glucose levels or blood glucose levels in response to glucose and insulin challenges. Rats consuming the CAF+Cr3 diet tended to have a significantly higher body mass than rats consuming the CAF diet, but necropsy results showed no difference in visceral fat or body wall thickness between groups. These data suggest that long-term Cr3 supplementation does not significantly affect body mass in rats consuming a normal diet or glucose levels or metabolism in rats consuming either diet.

Chromium: is it essential, pharmacologically relevant, or toxic?

Over fifty years ago, the element chromium (as the trivalent ion) was proposed to be an essential element for mammals with a role in maintaining proper carbohydrate and lipid metabolism. Evidence for an essential role came from dietary studies with rodents, studies on the effects of chromium on subjects on total parenteral nutrition, and studies of the absorption and transport of chromium. Over the next several decades, chromium-containing nutritional supplements became so popular for weight loss and muscle development that sales were second only to calcium among mineral supplements. However, the failure to identify the responsible biomolecules(s) that bind chromium(III) and their mode of action, particularly a postulated species named glucose tolerance factor or GTF, resulted in the status of chromium being questioned in recent years, such that the question of its being essential needs to be formally readdressed. At the same time as chromium(III)'s popularity as a nutritional supplement was growing, concerns over its safety appeared. While chromium has been conclusively shown not to have beneficial effects on body mass or composition and should be removed from the list of essential trace elements, chromium(III) compounds are generally nontoxic and have beneficial pharmacological effects in rodents models of insulin insensitivity, although human studies have not conclusively shown any beneficial effects. Mechanisms have been proposed for these pharmacological effects, but all suffer from a lack of consistent supporting evidence.

Physiologically based pharmacokinetic model for rats and mice orally exposed to chromium

A multi-compartment physiologically based pharmacokinetic (PBPK) model was developed to describe the behavior of Cr(III) and Cr(VI) in rats and mice following long-term oral exposure. Model compartments were included for GI lumen, oral mucosa, forestomach/stomach, small intestinal mucosa (duodenum, jejunum, ileum), blood, liver, kidney, bone, and a combined compartment for remaining tissues. Data from ex vivo Cr(VI) reduction studies were used to characterize reduction of Cr(VI) in fed rodent stomach fluid as a second-order, pH-dependent process. For model development, tissue time-course data for total chromium were collected from rats and mice exposed to Cr(VI) in drinking water for 90 days at six concentrations ranging from 0.1 to 180 mg Cr(VI)/L. These data were used to supplement the tissue time-course data collected in other studies with oral administration of Cr(III) and Cr(VI), including that from recent NTP chronic bioassays. Clear species differences were identified for chromium delivery to the target tissue (small intestines), with higher concentrations achieved in mice than in rats, consistent with small intestinal tumor formation, which was observed upon chronic exposures in mice but not in rats. Erythrocyte:plasma chromium ratios suggest that Cr(VI) entered portal circulation at drinking water concentrations equal to and greater than 60 mg/L in rodents. Species differences are described for distribution of chromium to the liver and kidney, with liver:kidney ratios higher in mice than in rats. Overall, the PBPK model provides a good description of chromium toxicokinetics, with model predictions for tissue chromium within a factor of 3 for greater than 80% of measurements evaluated. The tissue data and PBPK model predictions indicate a concentration gradient in the small intestines (duodenum > jejunum > ileum), which will be useful for assessing the tumor response gradient observed in mouse small intestines in terms of target tissue dose. The rodent PBPK model presented here, when used in conjunction with a human PBPK model for Cr(VI), should provide a more robust characterization of species differences in toxicokinetic factors for assessing the potential risks associated with low-dose exposures of Cr(VI) in human populations.

Ameliorating effect of chromium administration on hepatic glucose metabolism in streptozotocin-induced experimental diabetes

Chromium has been recognized as an essential trace element that plays an important role in carbohydrate metabolism. However, the molecular mechanisms involved in its action are not clear. This study was undertaken to understand the mechanism of chromium action in experimental diabetes. Streptozotocin-induced diabetic animals were administered chromium as chromium picolinate (CrP) at a daily dose of 1 mg/kg body weight for a period of 4 weeks. It was observed that chromium complexed with picolinate was effective in lowering plasma glucose levels as well as was able to alleviate polyphagia, polydipsia, and weight loss in diabetic animals. Administration of chromium was also found to normalize glycogen content in liver of diabetic animals to near control levels. The reduction in plasma glucose levels by chromium was accompanied by increase in activity of glycolytic enzymes (e.g., glucokinase, phosphofructokinase, and pyruvate kinase) and by suppression in activity of gluconeogenic enzymes (e.g., glucose-6-phosphatase and phosphoenolpyruvate carboxykinase) in liver. Hepatic glucose uptake was found to be increased by chromium supplementation as demonstrated by decrease in Km and increase in Vmax values in diabetic animals. Chromium levels were lower in the liver of diabetic rats when compared with that of control rats. A negative correlation was observed between plasma glucose and chromium concentration in patients with diabetes. The data suggests that chromium supplementation as CrP is beneficial in correcting hyperglycemia, implying that the modulation of the glucose metabolism by chromium may be therapeutically beneficial in the treatment of diabetes.

Evaluation of the acute oral toxicity class of trinuclear chromium(III) glycinate complex in rat

Chromium(III) is considered as an essential element playing a role in carbohydrate and lipid metabolism, and various chemical forms of this element are widely used in dietary supplements. A new trinuclear chromium(III) glycinate complex [Cr(3)O(NH(2)CH(2)CO(2))(6)(H(2)O)(3)](+)NO(3)(-) (CrGly), an analogue of Cr3 (trinuclear Cr(III) propionate complex) has been synthesized as a potential source of supplementary Cr. In this study, we evaluated the acute toxicity class of CrGly in Wistar rats applying the OECD 423 procedure. Male and female Wistar rats (n = 12, 6 ♀ and 6 ♂) were given by gavage either a single dose of CrGly 2,000 mg/kg body mass (equals to 300 mg Cr(III)/kg body mass; in aqueous solution) or equivalent volumes of distilled water and fed ad libitum commercial Labofeed B diet, and observed carefully for 14 days, then sacrificed to collect blood and internal organs for biochemical and histologic examination. No death cases were detected. No abnormalities in animal behavior, body mass gains, gross organ histology, or blood morphology and biochemistry were observed. The results demonstrate that LD(50) of CrGly is greater than 2,000 mg/kg when administrated orally to rat; thus, this compound appears to belong to the fifth category in the GHS system or the fourth class ("unclassified") in the EU classification system.

Evidence that chromium modulates cellular cholesterol homeostasis and ABCA1 functionality impaired by hyperinsulinemia--brief report

OBJECTIVE

Trivalent chromium (Cr3+) is an essential micronutrient. Findings since the 1950s suggest that Cr3+ might benefit cholesterol homeostasis. Here we present mechanistic evidence in support of this role of Cr3+.

METHODS AND RESULTS

High-density lipoprotein cholesterol generation in 3T3-L1 adipocytes, which are rendered ineffective by the hyperinsulinemia that is known to accompany disorders of lipid metabolism, was corrected by Cr3+. Mechanistically, Cr3+ reversed hyperinsulinemia-induced cellular cholesterol accrual and associated defects in cholesterol transporter ATP-binding cassette transporter-A1 trafficking and apolipoprotein A1-mediated cholesterol efflux. Moreover, direct activation of AMP-activated protein kinase, which is known to be activated by Cr3+, or inhibition of hexosamine biosynthesis pathway activity, which is known to be elevated by hyperinsulinemia, mimics Cr3+ action.

CONCLUSIONS

These findings suggest a mechanism of Cr3+ action that fits with long-standing claims of its role in cholesterol homeostasis. Furthermore, these data imply a mechanistic basis for the coexistence of dyslipidemia with hyperinsulinemia.