Journal List > J Nutr Health > v.51(1) > 1081558

J Nutr Health. 2018 Feb;51(1):40-49. Korean.
Published online February 28, 2018.  https://doi.org/10.4163/jnh.2018.51.1.40
© 2018 The Korean Nutrition Society
Independent correlates of the toenail chromium level and the association between the chromium level and dyslipidemia
Yeji Kang,** Yujin Lee,** Jakyung Son and Kyong Park
Department of Food and Nutrition, Yeungnam University, Gyeongsan, Gyeongbuk 38541, Republic of Korea.

To whom correspondence should be addressed. tel: +82-53-810-2879, Email: kypark@ynu.ac.kr

**These authors contributed equally to this article.

Received October 24, 2017; Revised November 25, 2017; Accepted February 08, 2018.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose

The number of patients with dyslipidemia have been increasing steadily over the past few decades in South Korea. The association between the chromium level and chronic disease has attracted considerable interest, but few studies have been conducted on the Korean population. The aim of this study was to identify the dietary and non-dietary correlates of the toenail chromium level, and evaluate the association between the toenail chromium level and dyslipidemia.

Methods

The baseline data of an ongoing prospective cohort study in Yeungnam area in South Korea were analyzed. A total of 500 participants aged 35 years or older who completed questionnaires on their demographics, lifestyle characteristics, and medical information were included. The toenail chromium level was analyzed by neutron activation analysis. The dietary intake was assessed using a validated 146-item semi-quantitative food frequency questionnaire. The blood lipid profiles were obtained from medical examinations conducted by the Korean National Health Insurance Service or medical institutions.

Results

Higher chromium levels were associated with the residential area (urban), higher education level, higher intakes of noodles and vegetables, and lower intake of fruits. Multiple logistic regression analysis showed that the toenail chromium levels were not associated significantly with the prevalence of dyslipidemia (odds ratio: 0.99, 95% confidence interval: 0.61 ~ 1.60).

Conclusion

This study is the first study in Korea to determine the independent correlates of the toenail chromium levels and the association between chromium exposure and dyslipidemia. These findings provide useful scientific evidence for the development of chromium intake guidelines for the Korean population.

Keywords: chromium; dyslipidemia; toenail; correlates; Korea

Tables


Table 1
General characteristics of the study participants according to tertiles of toenail chromium levels
Click for larger image


Table 2
General characteristics of the study participants with and without dyslipidemia
Click for larger image


Table 3
Dietary and non-dietary correlates of toenail chromium levels
Click for larger image


Table 4
Odds ratio and 95% confidence interval for dyslipidemia and its components according to toenail chromium levels
Click for larger image

Notes

This work was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2017R1A1A3A04069759). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

References
1. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2015: Korea National Health and Nutrition Examination Survey (KNHANES VI-3) [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2016 [cited 2017 Dec 18].
2. Korean Society of Lipidology and Atherosclerosis. Dyslipidemia fact sheet in Korea [Internet]. Seoul: Korean Society of Lipidology and Atherosclerosis; 2015 [cited 2016 Mar 22].
3. Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, Pasternak RC, Smith SC Jr, Stone NJ. National Heart, Lung, and Blood Institute; American College of Cardiology Foundation; American Heart Association. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 2004;110(2):227–239.
4. Tripathy JP, Thakur JS, Jeet G, Jain S. Prevalence and determinants of comorbid diabetes and hypertension: Evidence from non communicable disease risk factor STEPS survey, India. Diabetes Metab Syndr 2017;11 Suppl 1:S459–S465.
5. Stamler J, Daviglus ML, Garside DB, Dyer AR, Greenland P, Neaton JD. Relationship of baseline serum cholesterol levels in 3 large cohorts of younger men to long-term coronary, cardiovascular, and all-cause mortality and to longevity. JAMA 2000;284(3):311–318.
6. Guallar E, Jiménez FJ, van't Veer P, Bode P, Riemersma RA, Gómez-Aracena J, Kark JD, Arab L, Kok FJ, Martín-Moreno JM. EURAMIC-Heavy Metals and Myocardial Infraction Study Group. Low toenail chromium concentration and increased risk of nonfatal myocardial infarction. Am J Epidemiol 2005;162(2):157–164.
7. Lombardo YB, Chicco AG. Effects of dietary polyunsaturated n-3 fatty acids on dyslipidemia and insulin resistance in rodents and humans. A review. J Nutr Biochem 2006;17(1):1–13.
8. Sirtori CR, Galli C, Anderson JW, Arnoldi A. Nutritional and nutraceutical approaches to dyslipidemia and atherosclerosis prevention: focus on dietary proteins. Atherosclerosis 2009;203(1):8–17.
9. Lewicki S, Zdanowski R, Krzyzowska M, Lewicka A, Debski B, Niemcewicz M, Goniewicz M. The role of Chromium III in the organism and its possible use in diabetes and obesity treatment. Ann Agric Environ Med 2014;21(2):331–335.
10. Anderson RA. Chromium, glucose intolerance and diabetes. J Am Coll Nutr 1998;17(6):548–555.
11. Cefalu WT, Hu FB. Role of chromium in human health and in diabetes. Diabetes Care 2004;27(11):2741–2751.
12. Stoecker BJ. Chromium absorption, safety, and toxicity. J Trace Elem Exp Med 1999;12(2):163–169.
13. Anderson RA, Polansky MM, Bryden NA, Patterson KY, Veillon C, Glinsmann WH. Effects of chromium supplementation on urinary Cr excretion of human subjects and correlation of Cr excretion with selected clinical parameters. J Nutr 1983;113(2):276–281.
14. Kozlovsky AS, Moser PB, Reiser S, Anderson RA. Effects of diets high in simple sugars on urinary chromium losses. Metabolism 1986;35(6):515–518.
15. Ginsberg HN. Insulin resistance and cardiovascular disease. J Clin Invest 2000;106(4):453–458.
16. Suksomboon N, Poolsup N, Yuwanakorn A. Systematic review and meta-analysis of the efficacy and safety of chromium supplementation in diabetes. J Clin Pharm Ther 2014;39(3):292–306.
17. Park K, Seo E. Association between toenail mercury and metabolic syndrome is modified by selenium. Nutrients 2016;8(7):E424.
18. Park K, Seo E. Toenail mercury and dyslipidemia: interaction with selenium. J Trace Elem Med Biol 2017;39:43–49.
19. Jang J, Morris JS, Park K. Toenail selenium levels and prevalence of dyslipidaemia among Korean adults. Br J Nutr 2017;118(6):473–480.
20. Willett W. In: Nutritional epidemiology. 3rd edition. New York (NY): Oxford University Press; 2012.
21. World Health Organization Western Pacific Region; International Association for the Study of Obesity; International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment [Internet]. Sydney: Health Communications Australia Pty Limited; 2000 [cited 2017 February 27].
22. Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, Buchner D, Ettinger W, Heath GW, King AC, Kriska A, Leon AS, Marcus BH, Morris J, Paffenbarger RS, Patrick K, Pollock ML, Rippe JM, Sallis J, Wilmore JH. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995;273(5):402–407.
23. Cheng TP, Morris JS, Koirtyohann SR, Spate VL, Baskett CK. The analysis of human nails for 24 elements via k0 and cyclic neutron activation analysis. Nucl Instrum Methods Phys Res A 1994;353(1-3):457–460.
24. Garland M, Morris JS, Rosner BA, Stampfer MJ, Spate VL, Baskett CJ, Willett WC, Hunter DJ. Toenail trace element levels as biomarkers: reproducibility over a 6-year period. Cancer Epidemiol Biomarkers Prev 1993;2(5):493–497.
25. Lee Y, Park K. Reproducibility and validity of a semiquantitative FFQ for trace elements. Br J Nutr 2016;116(5):864–873.
26. Smart GA, Sherlock JC. Chromium in foods and the diet. Food Addit Contam 1985;2(2):139–147.
27. Kumpulainen JT. Chromium content of foods and diets. Biol Trace Elem Res 1992;32(1-3):9–18.
28. Lendinez E, Lorenzo ML, Cabrera C, López MC. Chromium in basic foods of the Spanish diet: seafood, cereals, vegetables, olive oils and dairy products. Sci Total Environ 2001;278(1-3):183–189.
29. Bratakos MS, Lazos ES, Bratakos SM. Chromium content of selected Greek foods. Sci Total Environ 2002;290(1-3):47–58.
30. Bai J, Xun P, Morris S, Jacobs DR Jr, Liu K, He K. Chromium exposure and incidence of metabolic syndrome among American young adults over a 23-year follow-up: the CARDIA Trace Element Study. Sci Rep 2015;5:15606.
31. Rajpathak S, Rimm EB, Li T, Morris JS, Stampfer MJ, Willett WC, Hu FB. Lower toenail chromium in men with diabetes and cardiovascular disease compared with healthy men. Diabetes Care 2004;27(9):2211–2216.
32. Garcia E, Cabrera C, Lorenzo ML, Sánchez J, López MC. Daily dietary intake of chromium in southern Spain measured with duplicate diet sampling. Br J Nutr 2001;86(3):391–396.
33. Schuhmacher M, Domingo JL, Llobet JM, Corbella J. Chromium, copper, and zinc concentrations in edible vegetables grown in Tarragona Province, Spain. Bull Environ Contam Toxicol 1993;50(4):514–521.
34. Zayed A, Lytle CM, Qian JH, Terry N. Chromium accumulation, translocation and chemical speciation in vegetable crops. Planta 1998;206(2):293–299.
35. Lima KV, Lima RP, Gonçalves MC, Faintuch J, Morais LC, Asciutti LS, Costa MJ. High frequency of serum chromium deficiency and association of chromium with triglyceride and cholesterol concentrations in patients awaiting bariatric surgery. Obes Surg 2014;24(5):771–776.
36. Krzysik M, Grajeta H, Prescha A, Weber R. Effect of cellulose, pectin and chromium(III) on lipid and carbohydrate metabolism in rats. J Trace Elem Med Biol 2011;25(2):97–102.
37. He K. Trace elements in nails as biomarkers in clinical research. Eur J Clin Invest 2011;41(1):98–102.
38. Ministry of Health and Welfare (KR); The Korean Nutrition Society. Dietary reference intakes for Koreans 2015 [Internet]. Sejong: Ministry of Health and Welfare; 2016 [cited 2017 Apr 29].