72

Article

Serum chromium and selenium levels in type 2 diabetes mellitus

Abstract
Background: Emerging evidence suggests that several trace elements such as serum chromium (Cr)
and selenium (Se) levels are altered in type 2 DM and its deficiencies are associated with the development
of diabetes related complications. Objective: To assess the serum Cr and Se levels in patients of type
2 diabetes mellitus. Methods: This cross sectional study was conducted in the Department of Physiology,
Dhaka Medical College, Dhaka from July 2014 to June 2015. Fifty type 2 diabetic patients with age
ranging from 40 to 55 years were study group and fifty ages, BMI matched healthy subjects were
control group. Patients were selected from Bangladesh Institute of Research for Diabetic Endocrine
and Metabolic Disorders (BIRDEM) General Hospital, Dhaka. Serum Cr and Se levels were estimated
by flame atomic absorption spectrophotometry. For statistical analysis unpaired Student’s‘t’ test and
Chi square test were performed. Results: In this study, serum Cr and Se levels were significantly
(P<0.001) lower in patients than that of control group. In addition 20% patients had low Cr and 16%
had Se deficiencies. Moreover, 6% of control had low Cr and 4% had low Se. Conclusion: From this
study, it is concluded that serum Cr and Se deficiencies are associated with type 2 diabetes mellitus.
Key words: Serum chromium, serum selenium, type 2 diabetes mellitus.

J Bangladesh Soc Physiol. 2017, December; 12(2): 72-75

Introduction
developing countries3. In the year 2013, about

D
Diabetes mellitus (DM) is a metabolic
disease in which there is hyper- 5.1 million diabetic people in Bangladesh and the
glycemia, either because the body number will rise to 16.8 million by the year 20354.
does not produce enough insulin, or the cells do Patients with DM have increased risk for the
not respond to the insulin that is produced. This development of specific complications like
hyperglycemia produces the symptoms of atherosclerosis, hypertension and coronary
polyuria, polydipsia and polyphagia1. According heart disease5.
to American Diabetes Association (ADA), Chromium (Cr) is an essential trace element which
diagnostic criteria of diabetes mellitus are fasting is required for the normal action of insulin and
blood glucose level (FBG) of ≥7.0 mmol/l, 2 hour regulation of blood glucose level6. Chromium
after glucose of ≥11.1 mmol/l and glycosylated increases numbers of cell membrane insulin
hemoglobin (HbAIC) of ≥ 6.5%2. receptor and leads to increased insulin sensitivity,
glucose utilization and beta cell sensitivity 7.
Recent estimates suggest that the prevalence of
Chromium is powerful antioxidants and its
diabetes is rising globally, particularly in
deficiency increases oxidative stress in diabetic
Received 20 July 2017; Accepted 04 August. 2017 patients that could lead to atherosclerosis8.

J Bangladesh Soc Physiol. 2017, December; 12(2): 72-75 72

Chromium & selenium in diabetes Eva et al

Selenium (Se) is a trace element which is involved vein by a disposable plastic syringe from each
in the complex system of defense against subject for estimation of biochemical tests.
oxidative stress through selenium dependent HbA 1c, FSG levels were estimated in the
glutathione peroxidases and other laboratory of the Department of Biochemistry,
9
selenoprotein . Selenium acts as a cofactor with BIRDEM General Hospital, Dhaka. Serum
chromium and selenium levels were estimated in
glutathione peroxidase, an active antioxidant
the laboratory of the Department of Soil, Water
enzyme that reduces formation of free radicals
and Environment, University of Dhaka, Dhaka.
and peroxides of lipoproteins10. Lower serum Se Statistical analysis were done by unpaired
levels are seen in diabetics together with Student’s ‘t’ test and Chi square test. P value <0.05
increased oxidative stress. In type 2 diabetics was accepted as level of significance. Statistical
with lower serum Se level increases the risk of analyses were performed by using a computer
hypertension and coronary heart disease11. based statistical program SPSS Version 20.
It is obvious that lower serum chromium and Results
selenium levels increase the risk of diabetic General characteristics are presented in Table I.
complications in type 2 diabetes mellitus. This In this study mean serum chromium and selenium
study aimed to create further awareness among levels were significantly (p<0.001) lower in
the physicians and type 2 diabetic patients in patients with diabetes mellitus (Table II). In
Bangladesh regarding the diabetic complications addition low serum chromium was found in 20%
that may occur due to chromium and selenium of diabetic patients and 6% of nondiabetic
deficiencies. subjects. Again low serum selenium was in 16%
diabetic and 4% control. The differences of low
Methods serum chromium and selenium between diabetic
This cross sectional study was done in the and nondiabetic subjects were significant
Department of Physiology, Dhaka Medical (Table III).
College, Dhaka from July 2014 to June 2015.
Protocol of this study was approved by Ethical Table I: General characteristics of the subjects in
review committee of Dhaka Medical College and both groups (n=100)
Diabetic Association of Bangladesh. For this Variables Control Diabetics
study 50 subjects (28 male and 22 female), age (n=50) (n=50)
(40-55 years), type 2 diabetic patients with FBG
Age (years) 47.58±3.59 48.00±3.49
level ≥ 7.0 mmol/l and HbA1C ≥ 6.5% were selected
Male 26 (52%) 28 (56%)
from the Out Patient Department (OPD) of
Female 24 (48%) 22 (44%)
BIRDEM General Hospital, Dhaka and 50 age,
Height (cm) 159.54±5.20 158.32±8.17
BMI matched healthy subjects (26 male and 24
Weight (kg) 64.62±5.51 64.54±8.21
female) were control. After selection of the
BMI (kg/m2) 25.44±2.06 25.80±3.06
subjects, the nature, purpose and benefit of the
SBP (mmHg) 121.70±5.31 123.40±7.45
study were explained to each subject in details
DBP (mmHg) 76.30±5.70 79.70±5.19
and informed written consent was taken. Before
taking blood, detailed family and medical history Sex distribution has been shown in number and
were taken. Anthropometric measurement of the percentage. All other results are expressed as
subjects was done and blood pressure was mean±SD. Figures in parentheses indicate
ranges. Unpaired Student’s ‘t’ test was performed
measured. All the information was recorded in a
for comparison between groups. n = Number of
data schedule. With aseptic precaution, 20 ml of subjects. BMI = Body mass index. SBP = Systolic
venous blood was collected from ante-cubital blood pressure. DBP = Diastolic blood pressure.

73 J Bangladesh Soc Physiol. 2017, December; 12(2): 72-75

Chromium & selenium in diabetes Eva et al

Table II: Serum chromium and selenium levels in this polyuria increased excretion of chromium and
both groups (n=100) selenium occur in type 2 diabetic patients21-24.
As a result lower serum chromium and selenium
Variables Control Diabetics
(n=50) (n=50)
levels increase the risk of diabetic complications
like atherosclerosis, hypertension and coronary
Serum chromium 0.17±0.05 0.13±0.06***
heart disease in type 2 diabetes mellitus.
(µg/L)
Serum selenium 94.22±16.67 78.72±21.85*** In the present study the poor chromium and
(µg/L) selenium levels in the diabetic subjects may be
related to the increased urinary excretion and
Data are expressed as mean±SD. Unpaired
without dietary replacement of these two mineral.
Student’s ‘t’ test was performed for comparison
between groups. ***p<0.001. Conclusion
From the results of the study, it may be concluded
Table III: Frequency distribution of low serum that chromium and selenium deficiencies may
chromium and selenium levels in both groups develop as diabetes related complications in type
(n=100) 2 diabetic patients.
Variables Control Diabetics Conflict of Interest None
(n=50) (n=50)
Acknowledgement
no. ( %) no. (%) The authors acknowledge the Department of
Low Serum 3 (6) 10 (20) *** Biochemistry, BIRDEM General Hospital, Dhaka
chromium and the Department of Soil, Water and
Environment, University of Dhaka, Dhaka, for
Low Serum 2 (4) 8 (16) ***
their kind cooperation to carry out the laboratory
selenium investigations.
Data was analyzed by Chi square test. ***p<0.001. Author Affiliations
Cut point for Cr≤0.04 µg/L25 and Se≤70 µg/L25. 1. *Hossneara Eva. Assistant Professor, Department
of Physiology, Brahmanbaria Medical College,
Discussion Brahmanbaria. email: [email protected]
In the present study, mean serum chromium and 2. Qazi Shamima Akhter. Professor and Head,
selenium levels were lower in type 2 diabetic Department of Physiology, Dhaka Medical College,
Dhaka.
patients than that of healthy subjects. These
3. Md. Khairul Alam. Professor and Head, Department
results are similar to others12-18. But some study
of Physiology, Army Medical College, Comilla.
did not find difference in serum chromium and
4. Shahriar Ahmed. Assistant Professor, Department
selenium levels in between type 2 diabetic of Physiology, CARE Medical College, Dhaka.
subjects and healthy control19, 20. *For correspondence
In addition, significant numbers of diabetic
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