High insulin requirement versus high chromium requirement in patients nourished with total parenteral nutrition

Dietary supplementation of organic or inorganic chromium modulates the immune responses of broilers vaccinated with Avian Influenza virus vaccine

Dietary supplementation with the organic chromium (Cr) has been shown to positively affect the immune function of poultry. However, to our knowledge, no experiment has been done to directly compare the impacts of Cr chloride and chromium picolinate (CrPic) on the immune responses of broilers vaccinated with Avian Influenza (AI) virus vaccine. Therefore, the present experiment was conducted to investigate the effects of supplemental Cr sources (Cr chloride and CrPic) and levels on the growth performance and immune responses of broilers vaccinated with AI virus vaccine so as to provide an effective nutritional strategy for improving immune function of broilers. A total of 432 1-day (d)-old male broiler chicks were used in a 1 plus 2×4 design. Chickens were given either a diet without Cr supplementation (control) or diets supplemented with 0.4, 0.8, 1.6, or 3.2 mg Cr/kg as either Cr chloride or CrPic for 42 d. Compared to the control, dietary Cr supplementation had no effect (P>0.05) on average daily gain, average daily feed intake and gain : feed of broilers during the starter and grower phases, but increased (P<0.05) the relative weights of bursa of fabricius on d 21 and thymus, spleen, or bursa of fabricius on d 42, serum antibody titers against AI virus on d 21, 28, 35 and 42, blood T-lymphocyte transformation rate on d 28 and 42, blood T-lymphocyte percentage on d 42, and serum interleukin-2 contents on d 28. Broilers fed the diets supplemented with the inorganic Cr chloride had higher (P<0.05) weights of thymus, spleen and bursa of fabricius than those fed the diets supplemented with the CrPic on d 42. In addition, broilers fed the diets supplemented with the CrPic had higher (P<0.05) antibody titers against AI virus than those fed the diets supplemented with the inorganic Cr chloride on d 21 and 35. These results indicate that dietary Cr supplementation improved immune responses of broilers vaccinated with AI virus, and the inorganic Cr chloride was more effective than the CrPic in increasing the relative weights of lymphoid organs, however, the CrPic was more effective than the inorganic Cr chloride in enhancing the serum antibody titer against AI virus.

Dietary Supplementation with Chromium Picolinate Influences Serum Glucose and Immune Response of Brown-Egg Laying Hens

To investigate the effect of chromium picolinate (CrPic) on egg production performance, egg quality, blood indices, and immune function of laying hens, 270 23-week-old Beijing Red brown-egg laying hens were randomly assigned to one of three treatments with six replicates of 15 birds per replicate for each treatment in a completely randomized design. Laying hens were fed a Cr-unsupplemented corn-soybean meal basal diet (control, containing 0.45 mg Cr/kg by analysis) or the basal diet supplemented with 0.4 or 0.6 mg Cr/kg from CrPic for 10 weeks. Laying hens fed diets supplemented with CrPic had a lower (P < 0.05) serum glucose (GLU) concentration and higher (P < 0.03) serum antibody titer against Newcastle disease than those fed the control diet at 33 weeks of age. However, supplemental CrPic had no effect (P > 0.05) on egg production and egg quality of brown-egg laying hens from 24 to 33 weeks of age. The results from this study indicated that supplemental CrPic decreased serum GLU and enhanced the immune function of brown-egg laying hens.

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.

Micronutrient Assessment in Long-Term Home Parenteral Nutrition Patients

Assessment of micronutrient status of patients requiring long-term parenteral nutrition (PN) continues to be a challenge for clinicians. The scientific literature primarily consists of small studies and case reports. There are no evidence-based guidelines available. Clinicians rely on clinical assessment according to the patient's disease process, medication regimen, physical examination, and history of nutrient intake to determine existence or risk of micronutrient deficiency and toxicity. This paper will examine current scientific evidence and existing recommendations for the micronutrient assessment and management of patients requiring long-term PN.

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.

Severe insulin resistance treatment with intravenous chromium in septic shock patient

Insulin resistance has been well documented in critically ill patients. Adequate blood sugar control has been associated with better wound healing, and better outcomes in selected patient populations. Chromium is an essential component of human diet. It is believed to affect changes in glucose uptake. Several studies have shown beneficial effects of oral chromium in diabetic patients with insulin resistance, but role of intravenous chromium infusion has not been completely evaluated. We present a case of extreme insulin resistance in a 62-year-old woman with history of diabetes who suffered a cardiac arrest and respiratory failure, leading to aspiration pneumonia and septic shock requiring greater than 7000 units of insulin over a period of 12 h which was successfully treated with intravenous chromium replacement.