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Assays / Trace
Metals/ Chromium
Chromium and chromium compounds are widely used in a number
of industrial processes, such as chrome plating, pigment production,
timber impregnation and photography. They are also present in small
amounts in cement.
Chromium is thought to be an essential trace element
which, although reasonably abundant in the environment, is present
in the human body in relatively small amounts. Measurement of the
element is difficult in view of the low concentrations and the possibility
of contamination. It is probable that the element is poorly absorbed
in its inorganic form, but more bioavailable when present as an
organic complex. It may be transported in the blood bound to transferrin.
Deficiency
Chromium deficiency was first documented in
animals when it resulted in impaired glucose tolerance. Deficiency
of an organic complex of chromium, the so-called glucose tolerance
factor, was considered to be responsible. A deficiency state in
man was only revealed by the increasing use of total parenteral
nutrition, (TPN) where patients presumed to be deficient in this
element developed insulin resistance and neuropathy. In animals
chromium deficiency has also been shown to impair growth and fertility
and to be associated with hypercholesterolaemia.
In clinical practice there is some evidence that diabetes
mellitus and hypercholesterolaemia may be associated with chromium
deficiency, and evidence that supplementation may improve these
conditions.
Toxicity
Chromium salts may have acute and chronic
effects, producing both corrosive damage to mucus membranes and
skin ('chrome ulcers'), and also allergic responses. A serious long-term
effect is the increased incidence of malignancy in respiratory organs
amongst workers inhaling chromium dust or fumes. There may also
be an increased incidence of gastrointestinal tumours.
Laboratory Indices
Measurement of serum chromium concentration
is the best available index of excess exposure, and concentrations
may still be high some weeks after the incident. Urine chromium
concentrations decline rapidly after removal from exposure, but
appropriately collected samples are suitable for occupational monitoring.
For the assessment of deficiency, please note the special
sampling precautions that need to be taken. The considerable doubt
regarding nutritional requirements for chromium, and the variable
concentration of contaminating chromium in TPN fluids, suggest that
regular monitoring of serum chromium in patients receiving long
term TPN is desirable. Supplementation should be adjusted accordingly.
References
Anderson RA. Chromium metabolism and its role
in disease processes in man. Clin Physiol Biochem 1986; 4: 31-41
Angerer J, Amin W, Heinrich-Ramm R, Szadkowski D, Lehnert
G. Occupational exposure to metals. 1. Chromium exposure of stainless
steel welders - biological monitoring. Int Arch Occup Environ Health
1987; 59: 503-12
Mertz W. Chromium in human nutrition: a review. J Nutr
1993; 123: 626-33
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