A 30-year-old man on long-term total parenteral nutrition develops insulin-resistant hyperglycemia, peripheral neuropathy, and weight loss. Supplementation with a trace element resolves his symptoms. This trace element potentiates insulin action by enhancing insulin receptor signaling. Which trace element is deficient?

• A Manganese
• B Cobalt
• C Molybdenum
• D Chromium ✓

Explanation

Chromium deficiency causes insulin resistance and impaired glucose tolerance. Chromium potentiates insulin signaling by enhancing insulin receptor kinase activity and downstream phosphorylation. Manganese is a cofactor for glycosyltransferases and superoxide dismutase, molybdenum for xanthine oxidase and sulfite oxidase, and cobalamin for methylmalonyl-CoA mutase and methionine synthase.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.