Chromium therapy for insulin resistance associated with HIV-disease

Objective. With the advent of highly active anti-retroviral therapy, HIV disease has become a chronic condition, but with a number of metabolic complications including insulin resistance and diabetes mellitus, dyslipidemia and hypertension and an increased incidence of atherosclerosis. The aim of the current study was to test the safety and efficacy of chromium picolinate for HIV- associated insulin resistance. Materials/Methods: The study was a randomized, double-blind, placebo-controlled trial with subjects receiving 500μg of chromium picolinate or placebo twice daily for two months. HIV- infected subjects were selected based on a fasting concentration of plasma glucose greater than 5.5mmol/L or a plasma glucose concentration of greater than 7.7mmol/L (but less than 11mmol/L) 2h after oral ingestion of 75g of glucose. Insulin sensitivity was assessed with a hyper-insulinemic-euglycemic clamp and glucose tolerance was assessed with the oral glucose tolerance test. Subjects were monitored closely for alterations in viral load, CD4+ cells, hemoglobin and hematocrit, kidney and liver function, and fasting lipid profiles. Results: Forty-three subjects were enrolled and 39 completed the protocol (20 in the chromium-supplemented and 19 in the placebo arm). Following chromium-supplementation, there were no significant changes in either insulin sensitivity or glucose tolerance. There was a significant improvement in serum HDL cholesterol concentration in the group supplemented with chromium. Conclusions: Chromium picolinate supplementation at this level was well-tolerated, but overall was not an effective therapy for insulin resistance in these HIV-infected subjects.