Clinical Significance of Elevated Serum Chromium Levels: A Retrospective Study of Serum Chromium Concentrations and Clinical Toxicity

Alex, Renju Mathew; Jayakaran, Jonathan Arul Jeevan; Manoj A, Sam Arul; Iyadurai, Ramya

doi:10.22038/apjmt.2026.96466.1565

Clinical Significance of Elevated Serum Chromium Levels: A Retrospective Study of Serum Chromium Concentrations and Clinical Toxicity

Document Type : Original Article

Authors

Renju Mathew Alex

Jonathan Arul Jeevan Jayakaran

Sam Arul Manoj A

Ramya Iyadurai

Department of Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India

10.22038/apjmt.2026.96466.1565

Abstract

Background: Elevated serum chromium levels are occasionally detected during clinical evaluation; however, their relationship with clinical toxicity remains uncertain. Potential confounders, including complementary and alternative medicine (CAM) use and underlying comorbidities, may influence the interpretation of elevated chromium concentrations. Hence, we aim to evaluate the association between serum chromium levels and clinical manifestations in these patients.
Methods: We performed a retrospective analysis of 22 patients with elevated serum chromium levels (>10 µg/L) at a tertiary care hospital in South India from January to December 2015. Clinical records were reviewed for symptoms associated with chromium toxicity and possible confounders. Correlation analyses were used to examine links between chromium concentrations and clinical findings.
Results: Only 2 of 22 patients (9.1%) exhibited symptoms considered attributable to chromium exposure. Mean serum chromium concentrations were similar in symptomatic and asymptomatic patients (40.45 µg/L vs. 35.16 µg/L; p = 0.83). Stratified analyses demonstrated no serum concentration–response relationship between chromium levels and symptom prevalence. CAM use was reported in 36.4% of patients and was associated with significantly higher chromium concentrations than in non-users (53.40 ± 34.55 µg/L vs. 25.50 ± 25.68 µg/L; p = 0.0185). Comorbidities were present in 50.0% of patients and may have contributed to clinical manifestations independently of chromium exposure.
Conclusion: No significant association was observed between elevated serum chromium levels and clinical toxicity in this cohort. Clinical interpretation should therefore rely on comprehensive assessment rather than serum chromium concentrations alone.

Keywords

Chromium

Heavy Metal Toxicity

Complementary and Alternative Medicine

Occupational Exposure

Environmental Exposure

Subjects