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P82 Background: Chromium, an essential heavy metal, is a cofactor  of insulin that increases insulin sensitivity at the receptor level.  Chromium has been shown to help control blood glucose and insulin in  patients with type 2 diabetes mellitus and glucose intolerance, and it  may also improve lipid variables. Although an inverse association  between chromium and cardiovascular endpoints has long been  hypothesized, no epidemiologic studies have been reported on this  association. Objective: To evaluate the association between toenail  chromium concentrations and the risk of a first myocardial infarction  in men. Setting: The EURAMIC study, a large case-control study  conducted in 10 European countries and Israel. Cases (n = 684)  were men with a first diagnosis of myocardial infarction recruited  within 24 hours of admission to the coronary units of participating  hospitals. Controls (n = 724) were men selected to be  representative of the populations that originated the cases. Toenail  chromium was assessed by instrumental neutron activation analysis.  Results: Average concentrations of toenail chromium were 1.10 mg/kg in  cases (95% confidence interval [CI] 1.02 - 1.18) and 1.30 mg/kg in  controls (1.21 - 1.40). Age and center-adjusted odds ratios (95% CI)  of myocardial infarction for quintiles 2-5 of toenail chromium with  respect to the first quintile were 0.74 (0.54-1.03), 0.77 (0.56-1.06),  0.53 (0.38-0.75), and 0.65 (0.46-0.91). The p for trend was 0.005. This  inverse association was essentially unchanged after further adjustment  for smoking, body mass index, HDL cholesterol, diabetes, and history of  hypertension. Multivariate adjusted odds ratios for quintiles 2-5 were  0.84 (0.56-1.26), 0.70 (0.46-1.05), 0.56 (0.37-0.87), and 0.65  (0.42-0.99), with a p for trend of 0.049. Conclusions: Toenail chromium  was inversely associated to the risk of a first myocardial infarction  in men. Further studies are needed to replicate these findings and to  elucidate the potential protective mechanisms of chromium on  cardiovascular risk.

The association of chromium with the risk of a first myocardial infaction in men. The EURAMIC Study.