Chromium picolinate for insulin resistance in subjects with HIV disease: a pilot study.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
The study shows that chromium picolinate therapy improves insulin resistance in some HIV-positive subjects, but with some concerns about safety in this population.
Feiner
J J
JJ
Department of Medicine, Division of Endocrinology, State University of New York at Stony Brook, Stony Brook, NY 11794-8154, USA.
McNurlan
M A
MA
Ferris
R E
RE
Mynarcik
D C
DC
Gelato
M C
MC
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D005260:Female; D015309:Glucose Clamp Technique / Q000295:instrumentation; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010848:Picolinic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010865:Pilot Projects; D016896:Treatment Outcome
D007502:Iron Chelating Agents; D010848:Picolinic Acids; C030614:picolinic acid