Chromium deficiency during total parenteral nutrition

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Abstract
Chromium is required for maintenance of normal glucose tolerance. After complete bowel resection and five months of total parenteral nutrition, severe glucose intolerance, weight loss, and a metabolic encephalopathylike confusional state developed in a patient. Serum chromium levels were at the lowest normal level. Supplementation of 150 μg of chromium per day reversed the glucose intolerance, reduced insulin requirements, and resulted in weight gain and the disappearance of encephalopathy. The low levels of chromium and response to chromium supplementation suggest that chromium deficiency can arise in long-term total parenteral nutrition. (JAMA241:496-498, 1979)