Examination of the Effects of Chromium Levels on Glucose Metabolism, Lipid Metabolism, Morbidity and Mortality Rates in Patients Followed in Intensive Care Unit
Conditions: Chromium Deficiency, Diabetes Mellitus, Hyperlipidemias, Hypercholesterolemia
Sponsor: Oguzhan Kahveci

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Examination of the Effects of Chromium Levels on Glucose Metabolism, Lipid 
Metabolism, Morbidity and Mortality Rates in Patients Followed in Intensive 
Care Unit 
 
 
 
 
Hacettepe University, Department of Anesthesiology and Intensive Care 
Turkey 
 
 
 
 
 
 
 
 
 
 
ClinicalTrials.gov #NCT06334042 
Document Date: 24 December 2024 

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This study was approved by the Hacettepe University Non – Interventional Clinical 
Research Ethics Committee on July 25, 2023, with the reference number GO 23/488 
(Decision Number: 2023/13 – 54) and was supported by the Hacettepe University 
Scientific Research Projects Coordination Unit (Project Number: 21026). The study is 
non – interventional, prospective, and observational. It included 309 patients followed 
in the Anesthesiology Intensive Care Unit of Hacettepe University Hospital between 
February 7, 2024, and August 8, 2024. 
Study Location 
The evaluation of patients for eligibility, recording of parameters, and collection of blood 
samples were conducted in the Anesthesiology Intensive Care Unit of Hacettepe 
University Hospital. 
Lipid profile and HbA1c measurements were performed in the Department of 
Biochemistry Laboratory of the same hospital. Blood samples for chromium 
measurement were also stored in this laboratory before analysis. 
Blood chromium levels were measured at the Department of Pharmaceutical 
Toxicology, School of Pharmacy, Hacettepe University. 
Study Population, Sample, and Research Group 
Inclusion Criteria 
• 
Age ≥ 18 years, 
• 
Being followed up in the Anesthesiology Intensive Care Unit of Hacettepe 
University Hospital, 
• 
Availability of required data (medical history, laboratory results, etc.) for 
analysis, 
• 
Not taking chromium supplements. 
Exclusion Criteria 
• 
Age < 18 years, 
• 
Refusal to participate in the study, 
• 
Taking chromium supplements. 

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Research Method and Data Collection Tools 
Data of patients meeting the inclusion criteria in the Anesthesiology Intensive Care Unit 
were obtained from: blood samples sent to the laboratory during the patient's stay, 
medical history collected from the patient or relatives, and nurse follow – up forms. The 
patients were followed up by Dr. Oğuzhan KAHVECİ during their stay, with data 
recorded both physically and digitally. Blood samples were sent to the laboratory 
weekly, starting from the patient’s admission. 
Data Collection 
Data Collection 
Parameters shown in Table 1 were monitored throughout the ICU stay. 
Table 1. Data Collection Form 
Parameters 
Timing 
Date 
Upon Admission and Weekly 
Age 
Upon Admission 
Gender 
Upon Admission 
Height (cm) 
Upon Admission 
Weight (kg) 
Upon Admission 
Body Mass Index (BMI) 
Upon Admission 
Comorbidities 
Upon Admission 
Reason for ICU Admission 
Upon Admission 
SOFA Score 
24 Hours Post-Admission 
APACHE – II Score 
Upon Admission 
Nutritional Status 
During Stay 
Triglycerides (mg/dL) 
Upon Admission and Weekly 

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Parameters 
Timing 
HDL (mg/dL) 
Upon Admission and Weekly 
LDL (mg/dL) 
Upon Admission and Weekly 
VLDL (mg/dL) 
Upon Admission and Weekly 
Total Cholesterol (mg/dL) 
Upon Admission and Weekly 
HbA1c (%) 
Upon Admission 
Blood Glucose (mg/dL) 
Daily During Stay 
Coefficient of Variation (CV) (%) 
During Stay 
Blood Chromium Level (μg/L) 
Upon Admission and Weekly 
ICU Stay Duration 
Throughout ICU Stay 
Post-Discharge Outcome (Discharge, Transfer, Death) Upon Discharge 
Hospital Stay Duration 
ICU and Ward Duration 
Power Analysis 
Based on a study by Chen et al., which examined plasma chromium levels in relation 
to metabolic syndrome components in a large patient group, the effect size (Cohen's 
D) was calculated as 0.202. With a 0.05 error margin and 0.95 power, the minimum 
sample size required to detect significant differences in repeated measures was 
calculated as 277. The sample size estimation was performed using G*Power 3.1.9.7. 
Blood Sample Analysis 
Capillary Blood Glucose 
Measurements (mg/dL) taken from fingertip blood by nurses using FreeStyle Optium 
Neo H glucometer and Abbott Blood Glucose Test Strips. 
 
 
 

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Lipid Profile 
Triglycerides (mg/dL), Total Cholesterol (mg/dL), HDL (mg/dL), LDL (mg/dL), and VLDL 
(mg/dL) were analyzed in the Beckman Coulter AU 5800 device in the Biochemistry 
Laboratory. 
HbA1c 
Analyzed (%) using the Tosoh G11 device in the Biochemistry Laboratory. 
Blood Chromium Level 
Analyzed (μg/L) using the Thermo Scientific iCAP Q ICP – MS device in the 
Department of Pharmaceutical Toxicology, School of Pharmacy. 
Statistical Analysis 
Data were analyzed using IBM SPSS Statistics 25 © Copyright SPSS Inc. 1989, 2017. 
Normal distribution of continuous variables was examined using Kolmogorov – 
Smirnov and Shapiro – Wilk tests, depending on sample size. Categorical variables 
were presented as frequency (n) and percentage (%), and continuous variables were 
expressed as mean ± standard deviation (SD), median (IQR 25 – 75), and minimum – 
maximum values. Mann – Whitney U test, a non – parametric test, was used for 
analyzing independent two – group data as the data did not show normal distribution. 
Pearson Chi – Square Test, Fisher’s Exact Test, Fisher’s Freeman – Halton Exact Test, 
Yates’ Correction, and Post – Hoc Bonferroni adjustments were used for independent 
categorical variable analysis. For correlation analysis between continuous variables, 
Spearman Rho Correlation Analysis was applied. Friedman Test and Post – Hoc 
Bonferroni adjustments were used for comparing dependent variables in more than 
two groups when parametric test assumptions were not met. Statistical significance 
was set at 0.05.