BACKGROUND: The role of chromium in human nutrition was first reported in 1977 on a patient on total parenteral nutrition manifesting with neuropathy and impaired glucose tolerance attributed to chromium deficiency. After correction, nerve conduction and glucose tolerance tests normalized. Chromium is postulated to act as a cofactor for insulin action by enhancing insulin receptor phosphorylation and stimulating insulin receptor tyrosine kinase.
OBJECTIVE: To compare the effect of chromium picolinate versus placebo on glycated hemoglobin (HbA1C), fasting blood sugar (FBS), 2-hours postprandial blood sugar (2HPPBS), fasting insulin (FI) and lipid profile among T2DM patients.
METHODS: Literature search in Medicine, Cochrane and Herdin was made using terms such as chromium, chromium picolinate intake of >= 3 months among T2DM patients. Two reviewers independently screened abstracts and full articles. Results were plotted using Revman 4.2.
RESULTS: Thirty four trials were found and six trials were included in the meta-analysis. The pooled data for 467 patients with T2DM reported lowering of HbA1c -0.34% (CI -0.45, 0.24 p0.06); FBS -16.6 mg/dl (CI -18.9, -14.41 p 0.30); 2HPPBS -17.33 mg/dL (CI -20.21, -18..81 p <0.01) and FI -19.51 mg/dL (CI -20.21, -18.81 p<0.01). Chromium picolinate has no effect on lipids.
CONCLUSION: Chromium picolinate lowers HbA1c, FBS, 2HPPBS and FI moderately but it has no effect on lipids, However, the short duration of studies, variable quality and large heterogeneity across these data limits the strength of our conclusion, hence further studies are recommended.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Blood Glucose ; Chromium ; Glucose Intolerance ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated ; Insulin ; Lipids ; Phosphorylation ; Picolinic Acids ; Postprandial Period ; Protein-tyrosine Kinases ; Receptor, Insulin

OBJECTIVE: To describe the clinical characteristics of patients diagnosed with hepatocellular cancer admitted at the Philippine General Hospital from January 2001 to December 2006

BACKGROUND: Hepatocellular carcinoma (HCC) is the third leading site of the cancer in the Philippines. Although risk factors of HCC are already established, significance of risk factors may vary among regions. Diabetes has also not been examined as a risk factor among Filipinos.

METHODOLOGY: This is a descriptive study with data collection done through chart review. All charts with the diagnosis of hepatocellular carcinoma admitted from 2001 to 2006 were retrieved from the Medical Records Section. Participants included all adult hepatocellular carcinoma patients, diagnosed with HCC either by: (1) biopsy or (2) mass > 2cm and elevated -fetoprotein > 200.Demographic data, risks factors, and laboratory exams were collated. Descriptive statistics were generated using SPSS 15.0.

RESULTS: Two hundred twenty two patients were included in the study. Males were older than 50 years old. The most common symptomis abdominal pain. Two thirds had a history of drinking alcohol. Almost half were smokers. Thirty eight patients (40.0 %) had previos hepatitis B and 66 patients (52.3%) had chronic Hepatitis B. Only 3 (6.2%) patients had hepatitis C infection. Two thirds had no evidence of cirrhosis. Thirteen percent of the population had diabetes mellitus while 20% of the HBsAg-negative patients had diabetes mellitus. Eighty seven percent were in the advanced stage and 11.7% were terminal stage.

CONCLUSION: The most common risk factors for HCC are still hepatitis B infection and alcohol drinking. Diabetes mellitus deserves to be investigated as an important contributing factor to the development of HCC, especially in HBsAg -negative patients. Most patients belonged to late stages of the disease but a selection bias is recognized patients at risk so early-stage disease can be detected.

Carcinoma