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Can Magnesium Enhance Exercise Performance? Nutrients 2017; 9:nu9090946. [PMID: 28846654 PMCID: PMC5622706 DOI: 10.3390/nu9090946] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 08/19/2017] [Accepted: 08/24/2017] [Indexed: 12/15/2022] Open
Abstract
Magnesium (Mg) is an essential mineral that plays a critical role in the human body. It takes part in the process of energy metabolism and assists the maintenance of normal muscle function. A number of studies evaluated the association between Mg status/supplementation and exercise performance and found that the need for Mg increased as individuals’ physical activity level went up. Animal studies indicated that Mg might improve exercise performance via enhancing glucose availability in the brain, muscle and blood; and reducing/delaying lactate accumulation in the muscle. The majority of human studies focused on physiological effects in blood pressure, heart rate and maximal oxygen uptake (VO2 max), rather than direct functional performances. Some cross-sectional surveys demonstrated a positive association between Mg status and muscle performance, including grip strength, lower-leg power, knee extension torque, ankle extension strength, maximal isometric trunk flexion, rotation, and jumping performance. Additionally, findings from intervention studies showed that Mg supplementation might lead to improvements in functional indices such as quadriceps torque. Moreover, Mg supplementation could improve gait speed and chair stand time in elderly women. This comprehensive review summarized the literature from both animal and human studies and aimed to evaluate scientific evidence on Mg status/supplementation in relation to exercise performance.
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Zhang J, Wang H, Wang Z, Zhang J, Zhang B. Association between Toenail Magnesium and Type 2 Diabetes in Chinese Adults. Nutrients 2017; 9:nu9080811. [PMID: 28749415 PMCID: PMC5579605 DOI: 10.3390/nu9080811] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 07/12/2017] [Accepted: 07/14/2017] [Indexed: 12/15/2022] Open
Abstract
Previous studies have showed an inverse association between magnesium level and type 2 diabetes, but the results are inconsistent, and the evidence relates only to dietary and serum magnesium. Moreover, it is not certain how these findings are applicable to Asian people. This study was designed to examine the association between toenail magnesium and type 2 diabetes in Chinese adults. The sample was 5683 adults aged 18 years or older from the 2009 China Health and Nutrition Survey. We used hemoglobin A1c equal to or greater than 6.5% as the diagnostic criterion for type 2 diabetes. Inductively coupled plasma–mass spectrometry determined toenail magnesium. Mean toenail magnesium in participants with and without type 2 diabetes was 263.0 ± 170.9 and 282.3 ± 191.9 micrograms per gram, respectively. The multivariable-adjusted odds ratio for type 2 diabetes comparing the highest to the lowest quartile of toenail magnesium was 0.72 (95% confidence interval, 0.52–0.99). We found a statistically significant interaction between toenail magnesium and geographic region on the prevalence of type 2 diabetes (p for interaction = 0.009). Our findings suggest that toenail magnesium is inversely associated with the prevalence of type 2 diabetes. Promoting the intake of magnesium-rich foods may bring considerable benefits for the prevention of type 2 diabetes, especially in those at high risk.
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Affiliation(s)
- Jiguo Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing 100050, China.
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing 100050, China.
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing 100050, China.
| | - Ji Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing 100050, China.
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Beijing 100050, China.
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53
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Pietrzyk Ł. Food properties and dietary habits in colorectal cancer prevention and development. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2017. [DOI: 10.1080/10942912.2016.1236813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Łukasz Pietrzyk
- Department of Didactics and Medical Simulation, Chair of Human Anatomy, Medical University of Lublin, Lublin, Poland
- Department of General, Oncological and Minimally Invasive Surgery, 1st Military Clinical Hospital in Lublin, Lublin, Poland
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Kieboom BCT, Ligthart S, Dehghan A, Kurstjens S, de Baaij JHF, Franco OH, Hofman A, Zietse R, Stricker BH, Hoorn EJ. Serum magnesium and the risk of prediabetes: a population-based cohort study. Diabetologia 2017; 60:843-853. [PMID: 28224192 PMCID: PMC6518103 DOI: 10.1007/s00125-017-4224-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 01/27/2017] [Indexed: 12/15/2022]
Abstract
AIMS/HYPOTHESIS Previous studies have found an association between serum magnesium and incident diabetes; however, this association may be due to reverse causation, whereby diabetes may induce urinary magnesium loss. In contrast, in prediabetes (defined as impaired fasting glucose), serum glucose levels are below the threshold for urinary magnesium wasting and, hence, unlikely to influence serum magnesium levels. Thus, to study the directionality of the association between serum magnesium levels and diabetes, we investigated its association with prediabetes. We also investigated whether magnesium-regulating genes influence diabetes risk through serum magnesium levels. Additionally, we quantified the effect of insulin resistance in the association between serum magnesium levels and diabetes risk. METHODS Within the population-based Rotterdam Study, we used Cox models, adjusted for age, sex, lifestyle factors, comorbidities, kidney function, serum levels of electrolytes and diuretic use, to study the association between serum magnesium and prediabetes/diabetes. In addition, we performed two mediation analyses: (1) to study if common genetic variation in eight magnesium-regulating genes influence diabetes risk through serum magnesium levels; and (2) to quantify the proportion of the effect of serum magnesium levels on diabetes that is mediated through insulin resistance (quantified by HOMA-IR). RESULTS A total of 8555 participants (mean age, 64.7 years; median follow-up, 5.7 years) with normal glucose levels (mean ± SD: 5.46 ± 0.58 mmol/l) at baseline were included. A 0.1 mmol/l decrease in serum magnesium level was associated with an increase in diabetes risk (HR 1.18 [95% CI 1.04, 1.33]), confirming findings from previous studies. Of interest, a similar association was found between serum magnesium levels and prediabetes risk (HR 1.12 [95% CI 1.01, 1.25]). Genetic variation in CLDN19, CNNM2, FXYD2, SLC41A2, and TRPM6 significantly influenced diabetes risk (p < 0.05), and for CNNM2, FXYD2, SLC41A2 and TRPM6 this risk was completely mediated by serum magnesium levels. We found that 29.1% of the effect of serum magnesium levels on diabetes was mediated through insulin resistance, whereas for prediabetes 13.4% was mediated through insulin resistance. CONCLUSIONS/INTERPRETATION Low serum magnesium levels are associated with an increased risk of prediabetes and this increased risk is similar to that of diabetes. Furthermore, common variants in magnesium-regulating genes modify diabetes risk through serum magnesium levels. Both findings support a potential causal role of magnesium in the development of diabetes, where the hypothesised pathway is partly mediated through insulin resistance.
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Affiliation(s)
- Brenda C T Kieboom
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
- Inspectorate for Health Care, Utrecht, the Netherlands
| | - Symen Ligthart
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Steef Kurstjens
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jeroen H F de Baaij
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Robert Zietse
- Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
- Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.
- Inspectorate for Health Care, Utrecht, the Netherlands.
| | - Ewout J Hoorn
- Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
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Boyle NB, Lawton C, Dye L. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress-A Systematic Review. Nutrients 2017; 9:E429. [PMID: 28445426 PMCID: PMC5452159 DOI: 10.3390/nu9050429] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/17/2017] [Accepted: 04/17/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Anxiety related conditions are the most common affective disorders present in the general population with a lifetime prevalence of over 15%. Magnesium (Mg) status is associated with subjective anxiety, leading to the proposition that Mg supplementation may attenuate anxiety symptoms. This systematic review examines the available evidence for the efficacy of Mg supplementation in the alleviation of subjective measures of anxiety and stress. METHODS A systematic search of interventions with Mg alone or in combination (up to 5 additional ingredients) was performed in May 2016. Ovid Medline, PsychInfo, Embase, CINAHL and Cochrane databases were searched using equivalent search terms. A grey literature review of relevant sources was also undertaken. RESULTS 18 studies were included in the review. All reviewed studies recruited samples based upon an existing vulnerability to anxiety: mildly anxious, premenstrual syndrome (PMS), postpartum status, and hypertension. Four/eight studies in anxious samples, four/seven studies in PMS samples, and one/two studies in hypertensive samples reported positive effects of Mg on subjective anxiety outcomes. Mg had no effect on postpartum anxiety. No study administered a validated measure of subjective stress as an outcome. CONCLUSIONS Existing evidence is suggestive of a beneficial effect of Mg on subjective anxiety in anxiety vulnerable samples. However, the quality of the existing evidence is poor. Well-designed randomised controlled trials are required to further confirm the efficacy of Mg supplementation.
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Affiliation(s)
| | - Clare Lawton
- School of Psychology, University of Leeds, Leeds LS2 9JT, UK.
| | - Louise Dye
- School of Psychology, University of Leeds, Leeds LS2 9JT, UK.
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Hayes W, Boyle S, Carroll A, Bockenhauer D, Marks SD. Hypomagnesemia and increased risk of new-onset diabetes mellitus after transplantation in pediatric renal transplant recipients. Pediatr Nephrol 2017; 32:879-884. [PMID: 28039534 PMCID: PMC5368209 DOI: 10.1007/s00467-016-3571-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/14/2016] [Accepted: 12/16/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND New-onset diabetes after transplantation (NODAT) is a significant co-morbidity following kidney transplantation. Lower post-transplant serum magnesium levels have been found to be an independent risk factor for NODAT in adult kidney transplant recipients. METHODS We undertook a retrospective analysis of risk factors for NODAT in pediatric renal transplant recipients at our institution with the aim of determining if hypomagnesemia confers a significant risk of developing NODAT in this patient population. RESULTS A total of 173 children with a median age at transplantation of 7.0 (range 1.3-17.5) years were included. Hypomagnesemia was found to be a significant independent risk factor for NODAT (p = 0.01). High trough tacrolimus levels were also independently associated with NODAT (p < 0.001). There was no significant association between NODAT and body mass index at the time of transplantation, monthly cumulative steroid dose or post-transplant cytomegalovirus viremia (p = 0.9, 0.6 and 0.7, respectively). CONCLUSIONS This study identifies hypomagnesemia as a significant independent risk factor for the development of NODAT in pediatric renal transplant recipients. Given the clear association between hypomagnesemia and NODAT in both adults and children following renal transplantation, further studies are merited to clarify the etiology of this association and to examine the effect of magnesium supplementation on NODAT.
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Affiliation(s)
- Wesley Hayes
- Great Ormond Street Hospital for Children, London, WC1N 3JH, UK. .,University College London Institute of Child Health, London, UK.
| | - Sheila Boyle
- 0000 0004 0426 7394grid.424537.3Great Ormond Street Hospital for Children, London, WC1N 3JH UK
| | - Adrian Carroll
- 0000 0004 0426 7394grid.424537.3Great Ormond Street Hospital for Children, London, WC1N 3JH UK
| | - Detlef Bockenhauer
- 0000 0004 0426 7394grid.424537.3Great Ormond Street Hospital for Children, London, WC1N 3JH UK ,0000000121901201grid.83440.3bUniversity College London Institute of Child Health, London, UK
| | - Stephen D. Marks
- 0000 0004 0426 7394grid.424537.3Great Ormond Street Hospital for Children, London, WC1N 3JH UK ,0000000121901201grid.83440.3bUniversity College London Institute of Child Health, London, UK
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57
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Fang X, Wang K, Han D, He X, Wei J, Zhao L, Imam MU, Ping Z, Li Y, Xu Y, Min J, Wang F. Dietary magnesium intake and the risk of cardiovascular disease, type 2 diabetes, and all-cause mortality: a dose-response meta-analysis of prospective cohort studies. BMC Med 2016; 14:210. [PMID: 27927203 PMCID: PMC5143460 DOI: 10.1186/s12916-016-0742-z] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 11/09/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although studies have examined the association between dietary magnesium intake and health outcome, the results are inconclusive. Here, we conducted a dose-response meta-analysis of prospective cohort studies in order to investigate the correlation between magnesium intake and the risk of cardiovascular disease (CVD), type 2 diabetes (T2D), and all-cause mortality. METHODS PubMed, EMBASE, and Web of Science were searched for articles that contained risk estimates for the outcomes of interest and were published through May 31, 2016. The pooled results were analyzed using a random-effects model. RESULTS Forty prospective cohort studies totaling more than 1 million participants were included in the analysis. During the follow-up periods (ranging from 4 to 30 years), 7678 cases of CVD, 6845 cases of coronary heart disease (CHD), 701 cases of heart failure, 14,755 cases of stroke, 26,299 cases of T2D, and 10,983 deaths were reported. No significant association was observed between increasing dietary magnesium intake (per 100 mg/day increment) and the risk of total CVD (RR: 0.99; 95% CI, 0.88-1.10) or CHD (RR: 0.92; 95% CI, 0.85-1.01). However, the same incremental increase in magnesium intake was associated with a 22% reduction in the risk of heart failure (RR: 0.78; 95% CI, 0.69-0.89) and a 7% reduction in the risk of stroke (RR: 0.93; 95% CI, 0.89-0.97). Moreover, the summary relative risks of T2D and mortality per 100 mg/day increment in magnesium intake were 0.81 (95% CI, 0.77-0.86) and 0.90 (95% CI, 0.81-0.99), respectively. CONCLUSIONS Increasing dietary magnesium intake is associated with a reduced risk of stroke, heart failure, diabetes, and all-cause mortality, but not CHD or total CVD. These findings support the notion that increasing dietary magnesium might provide health benefits.
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Affiliation(s)
- Xuexian Fang
- Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing Advanced Innovation Center for Food Nutrition and Human Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kai Wang
- The First Affiliated Hospital, Institute of Translational Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Dan Han
- Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing Advanced Innovation Center for Food Nutrition and Human Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xuyan He
- Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing Advanced Innovation Center for Food Nutrition and Human Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jiayu Wei
- Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing Advanced Innovation Center for Food Nutrition and Human Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lu Zhao
- Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing Advanced Innovation Center for Food Nutrition and Human Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Mustapha Umar Imam
- Precision Nutrition Innovation Center, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhiguang Ping
- Precision Nutrition Innovation Center, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yusheng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junxia Min
- The First Affiliated Hospital, Institute of Translational Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fudi Wang
- Department of Nutrition, Nutrition Discovery Innovation Center, Institute of Nutrition and Food Safety, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing Advanced Innovation Center for Food Nutrition and Human Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China. .,Precision Nutrition Innovation Center, College of Public Health, Zhengzhou University, Zhengzhou, China.
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Fang X, Han H, Li M, Liang C, Fan Z, Aaseth J, He J, Montgomery S, Cao Y. Dose-Response Relationship between Dietary Magnesium Intake and Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Regression Analysis of Prospective Cohort Studies. Nutrients 2016; 8:nu8110739. [PMID: 27869762 PMCID: PMC5133122 DOI: 10.3390/nu8110739] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 11/09/2016] [Accepted: 11/14/2016] [Indexed: 12/15/2022] Open
Abstract
The epidemiological evidence for a dose-response relationship between magnesium intake and risk of type 2 diabetes mellitus (T2D) is sparse. The aim of the study was to summarize the evidence for the association of dietary magnesium intake with risk of T2D and evaluate the dose-response relationship. We conducted a systematic review and meta-analysis of prospective cohort studies that reported dietary magnesium intake and risk of incident T2D. We identified relevant studies by searching major scientific literature databases and grey literature resources from their inception to February 2016. We included cohort studies that provided risk ratios, i.e., relative risks (RRs), odds ratios (ORs) or hazard ratios (HRs), for T2D. Linear dose-response relationships were assessed using random-effects meta-regression. Potential nonlinear associations were evaluated using restricted cubic splines. A total of 25 studies met the eligibility criteria. These studies comprised 637,922 individuals including 26,828 with a T2D diagnosis. Compared with the lowest magnesium consumption group in the population, the risk of T2D was reduced by 17% across all the studies; 19% in women and 16% in men. A statistically significant linear dose-response relationship was found between incremental magnesium intake and T2D risk. After adjusting for age and body mass index, the risk of T2D incidence was reduced by 8%–13% for per 100 mg/day increment in dietary magnesium intake. There was no evidence to support a nonlinear dose-response relationship between dietary magnesium intake and T2D risk. The combined data supports a role for magnesium in reducing risk of T2D, with a statistically significant linear dose-response pattern within the reference dose range of dietary intake among Asian and US populations. The evidence from Europe and black people is limited and more prospective studies are needed for the two subgroups.
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Affiliation(s)
- Xin Fang
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden.
| | - Hedong Han
- Department of Health Statistics, Second Military Medical University, Shanghai 200433, China.
| | - Mei Li
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
| | - Chun Liang
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
| | - Jan Aaseth
- Faculty of Public Health, Hedmark University of Applied Sciences, Elverum 2411, Norway.
- Innlandet Hospital Trust, Kongsvinger Hospital Division, Kongsvinger 2226, Norway.
| | - Jia He
- Department of Health Statistics, Second Military Medical University, Shanghai 200433, China.
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro 70182, Sweden.
- Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm 17177, Sweden.
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
| | - Yang Cao
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden.
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro 70182, Sweden.
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Wei J, Zeng C, Li XX, Gong QY, Lei GH, Yang TB. Association among dietary magnesium, serum magnesium, and diabetes: a cross-sectional study in middle-aged and older adults. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2016; 35:33. [PMID: 27756380 PMCID: PMC5069897 DOI: 10.1186/s41043-016-0071-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/04/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND A number of studies have reported the association between magnesium (Mg) and diabetes. However, the various conclusions were inconsistent and the data on the Chinese population was limited. The objective of this study was to evaluate the association among dietary Mg, serum Mg, and diabetes in Chinese adults. METHODS A cross-sectional study that contained 2904 subjects was conducted. Biochemical test results and dietary intakes of subjects were collected for analysis. The adjusted odds ratios (ORs) and the corresponding 95 % confidence intervals (95 % CIs) were used to determine the relationship between Mg status and diabetes by logistic regression. RESULTS The prevalence of diabetes of the investigated population was 10.1 %. Dietary Mg intake was not significantly correlated with diabetes (P > 0.05). The significant negative association between serum Mg and diabetes existed, and the multivariate adjusted OR was 0.34 (95 % CI 0.24, 0.49) in model 3 for the highest quartile of serum Mg compared with the lowest. The P values for trend were all less than 0.001 for the relationship between serum Mg and diabetes. Dietary Mg intake and serum Mg were not significantly correlated in the diabetes population (P = 0.936). CONCLUSIONS Dietary Mg was not significantly correlated with diabetes, while serum Mg was inversely correlated with diabetes in the Chinese population. Meanwhile, dietary Mg intake and serum Mg were not significantly correlated in the diabetes population.
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Affiliation(s)
- Jie Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410008, China
- Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Xiao-Xiao Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410008, China
| | - Qian-Yi Gong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410008, China
| | - Guang-Hua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Tu-Bao Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410008, China.
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Guerrero-Romero F, Flores-García A, Saldaña-Guerrero S, Simental-Mendía LE, Rodríguez-Morán M. Obesity and hypomagnesemia. Eur J Intern Med 2016; 34:29-33. [PMID: 27353277 DOI: 10.1016/j.ejim.2016.06.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 05/15/2016] [Accepted: 06/15/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Whether low serum magnesium is an epiphenomenon related with obesity or, whether obesity per se is cause of hypomagnesemia, remains to be clarified. OBJECTIVE To examine the relationship between body weight status and hypomagnesemia in apparently healthy subjects. METHODS A total of 681 healthy individuals aged 30 to 65years were enrolled in A cross-sectional study. Extreme exercise, chronic diarrhea, alcohol intake, use of diuretics, smoking, oral magnesium supplementation, diabetes, malnutrition, hypertension, liver disease, thyroid disorders, and renal damage were exclusion criteria. Based in the Body Mass Index (BMI), body weight status was defined as follows: normal weight (BMI <25kg/m2); overweight (BMI ≥25<30 BMIkg/m2); and obesity (BMI ≥30kg/m2). Hypomagnesemia was defined by serum magnesium concentration ≤0.74mmol/L. A multiple logistic regression analysis was used to compute the odds ratio (OR) between body weight status (independent variables) and hypomagnesemia (dependent variable). RESULTS The multivariate logistic regression analysis showed that dietary magnesium intake (OR 2.11; 95%CI 1.4-5.7) but no obesity (OR 1.53; 95%CI 0.9-2.5), overweight (OR 1.40; 95%CI 0.8-2.4), and normal weight (OR 0.78; 95%CI 0.6-2.09) were associated with hypomagnesemia. A subsequent logistic regression analysis adjusted by body mass index, waist circumference, total body fat, systolic and diastolic blood pressure, and triglycerides levels showed that hyperglycemia (2.19; 95%CI 1.1-7.0) and dietary magnesium intake (2.21; 95%CI 1.1-8.9) remained associated with hypomagnesemia. CONCLUSIONS Our results show that body weight status is not associated with hypomagnesemia and that, irrespective of obesity, hyperglycemia is cause of hypomagnesemia in non-diabetic individuals.
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Affiliation(s)
- Fernando Guerrero-Romero
- Biomedical Research Unit, Mexican Social Security Institute, Predio Canoas # 100, Col. Los Angeles, ZC 34067, Durango, Mexico
| | - Araceli Flores-García
- Biomedical Research Unit, Mexican Social Security Institute, Predio Canoas # 100, Col. Los Angeles, ZC 34067, Durango, Mexico
| | - Stephanie Saldaña-Guerrero
- Biomedical Research Unit, Mexican Social Security Institute, Predio Canoas # 100, Col. Los Angeles, ZC 34067, Durango, Mexico
| | - Luis E Simental-Mendía
- Biomedical Research Unit, Mexican Social Security Institute, Predio Canoas # 100, Col. Los Angeles, ZC 34067, Durango, Mexico
| | - Martha Rodríguez-Morán
- Biomedical Research Unit, Mexican Social Security Institute, Predio Canoas # 100, Col. Los Angeles, ZC 34067, Durango, Mexico.
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Fang C, Wang X, Wu W, Gu X, Ye T, Deng H, Wang X, Shen F. Association of Serum Magnesium Level with Odds of Prediabetes and Diabetes in a Southern Chinese Population: a Prospective Nested Case-Control Study. Biol Trace Elem Res 2016; 172:307-314. [PMID: 26706038 DOI: 10.1007/s12011-015-0594-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 12/14/2015] [Indexed: 12/15/2022]
Abstract
Although emerging clinical evidence supports that magnesium deficiency is a risk factor for the development of type 2 diabetes, there are sparse studies concerning the dynamic change of serum magnesium with the risk of diabetes and its early stages. In this nested case-control study, we performed a 75-g oral glucose tolerance test or a standardized steamed bread meal test in 178 subjects with incident glucose metabolism impairment (33 with type 2 diabetes and 145 with prediabetes) and 178 matched controls at baseline and at 3-year follow-up and determined the associations between baseline serum magnesium levels as well as changes in serum magnesium levels at follow-up and odds of prediabetes and diabetes. After adjusting for potential confounders, the odds ratios of risk for prediabetes and type 2 diabetes in the highest quartile of serum magnesium levels were 0.22 (95 % confidence intervals [CI] 0.10-0.49; p for trend <0.001) and 0.02 (95 % CI 0.00-0.29; p for trend = 0.009), respectively, as compared with the lowest quartile. In addition, a significant decline in the serum magnesium level was detected in type 2 diabetes cases (p = 0.015) at 3 years as compared with at baseline. These results suggest that a low magnesium level is an independent risk factor for prediabetes and type 2 diabetes, and that the reduction of serum magnesium is associated with type 2 diabetes in a southern Chinese population.
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Affiliation(s)
- Chenchen Fang
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xuebao Wang
- Analytical and Testing Center, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wenjun Wu
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xuejiang Gu
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Tingting Ye
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huihui Deng
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xianqin Wang
- Analytical and Testing Center, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Feixia Shen
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Simental-Mendía LE, Sahebkar A, Rodríguez-Morán M, Guerrero-Romero F. A systematic review and meta-analysis of randomized controlled trials on the effects of magnesium supplementation on insulin sensitivity and glucose control. Pharmacol Res 2016; 111:272-282. [PMID: 27329332 DOI: 10.1016/j.phrs.2016.06.019] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/17/2016] [Accepted: 06/17/2016] [Indexed: 12/15/2022]
Abstract
A systematic review and meta-analysis was conducted to evaluate the effect of oral magnesium supplementation on insulin sensitivity and glucose control in both diabetic and non-diabetic individuals. PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases were searched (from inception to November 25, 2015) to identify RCTs evaluating the effect of magnesium on insulin sensitivity and glucose control. A random-effects model and generic inverse variance method were used to compensate for the heterogeneity of studies. Publication bias, sensitivity analysis, and meta-regression assessments were conducted using standard methods. The impact of magnesium supplementation on plasma concentrations of glucose, glycated hemoglobin (HbA1c), insulin, and HOMA-IR index was assessed in 22, 14, 12 and 10 treatment arms, respectively. A significant effect of magnesium supplementation was observed on HOMA-IR index (WMD: -0.67, 95% CI: -1.20, -0.14, p=0.013) but not on plasma glucose (WMD: -0.20mmol/L, 95% CI: -0.45, 0.05, p=0.119), HbA1c (WMD: 0.018mmol/L, 95% CI: -0.10, 0.13, p=0.756), and insulin (WMD: -2.22mmol/L, 95% CI: -9.62, 5.17, p=0.556). A subgroup analysis comparing magnesium supplementation durations of <4 months versus ≥4 months, exhibited a significant difference for fasting glucose concentrations (p<0.001) and HOMA-IR (p=0.001) in favor of the latter subgroup. Magnesium supplementation for ≥4 months significantly improves the HOMA-IR index and fasting glucose, in both diabetic and non-diabetic subjects. The present findings suggest that magnesium may be a beneficial supplement in glucose metabolic disorders.
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Affiliation(s)
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
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Das UN. Beneficial actions of magnesium in metabolic syndrome: Why and how? Nutrition 2016; 32:1308-10. [PMID: 27236634 DOI: 10.1016/j.nut.2016.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 03/20/2016] [Accepted: 03/23/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Undurti N Das
- UND Life Sciences, Federal Way, Washington, USA; BioScience Research Centre GVP College of Engineering Campus and Department of Medicine, GVP Hospital Visakhapatnam, India
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64
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Sarrafzadegan N, Khosravi-Boroujeni H, Lotfizadeh M, Pourmogaddas A, Salehi-Abargouei A. Magnesium status and the metabolic syndrome: A systematic review and meta-analysis. Nutrition 2016; 32:409-17. [DOI: 10.1016/j.nut.2015.09.014] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 09/19/2015] [Accepted: 09/21/2015] [Indexed: 12/18/2022]
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Osonoi Y, Mita T, Osonoi T, Saito M, Tamasawa A, Nakayama S, Someya Y, Ishida H, Kanazawa A, Gosho M, Fujitani Y, Watada H. Relationship between dietary patterns and risk factors for cardiovascular disease in patients with type 2 diabetes mellitus: a cross-sectional study. Nutr J 2016; 15:15. [PMID: 26847556 PMCID: PMC4743161 DOI: 10.1186/s12937-016-0132-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 01/21/2016] [Indexed: 12/15/2022] Open
Abstract
Background While some dietary patterns are associated with the incidence of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), the relationship between dietary pattern and risk factors for CVD in patients with T2DM remains to be clarified. The aim of this study was to identify dietary patterns and investigate the relationship between dietary patterns and potential risk factors for CVD in patients with T2DM. Methods The study participants comprised 726 Japanese T2DM outpatients free of history of CVD. Life styles were analyzed using self-reported questionnaires. The relationship between dietary patterns, identified by factor analysis, and potential risk factors for CVD was investigated by linear and logistic regression analyses. Results Six dietary patterns were identified by factor analysis. Especially, three dietary patterns were associated with risk factors for CVD. The “Seaweeds, Vegetables, Soy products and Mushrooms” pattern, characterized by high consumption of seaweeds, soy products and mushrooms, was associated with lower use of diabetes medication and healthier lifestyles. The “Noodle and Soup” pattern, characterized by high consumption of noodle and soup was associated with higher body mass index, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase and triglyceride levels. The “Fruit, Dairy products and Sweets” pattern was associated with lower γ-glutamyl transpeptidase levels, blood pressure, albuminuria and brachial-ankle pulse wave velocity. Conclusions The findings suggested that dietary patterns correlated with risk factors for CVD in T2DM patients.
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Affiliation(s)
- Yusuke Osonoi
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan. .,Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Takeshi Osonoi
- Naka Memorial Clinic, 745-5, Nakadai, Naka, Ibaraki, 311-0113, Japan.
| | - Miyoko Saito
- Naka Memorial Clinic, 745-5, Nakadai, Naka, Ibaraki, 311-0113, Japan.
| | - Atsuko Tamasawa
- Naka Memorial Clinic, 745-5, Nakadai, Naka, Ibaraki, 311-0113, Japan.
| | - Shiho Nakayama
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Yuki Someya
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Hidenori Ishida
- Naka Memorial Clinic, 745-5, Nakadai, Naka, Ibaraki, 311-0113, Japan.
| | - Akio Kanazawa
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan. .,Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Masahiko Gosho
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Yoshio Fujitani
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan.
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan. .,Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Bunkyoku, Tokyo, 113-8421, Japan. .,Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, Bunkyoku, Tokyo, 113-8421, Japan. .,Sportology Center, Juntendo University Graduate School of Medicine, Bunkyoku, Tokyo, 113-8421, Japan.
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Dai Q, Cantwell MM, Murray LJ, Zheng W, Anderson LA, Coleman HG. Dietary magnesium, calcium:magnesium ratio and risk of reflux oesophagitis, Barrett's oesophagus and oesophageal adenocarcinoma: a population-based case-control study. Br J Nutr 2016; 115:342-50. [PMID: 26563986 DOI: 10.1017/s0007114515004444] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Evidence suggests a role of Mg and the ratio of Ca:Mg intakes in the prevention of colonic carcinogenesis. The association between these nutrients and oesophageal adenocarcinoma - a tumour with increasing incidence in developed countries and poor survival rates - has yet to be explored. The aim of this investigation was to explore the association between Mg intake and related nutrients and risk of oesophageal adenocarcinoma and its precursor conditions, Barrett's oesophagus and reflux oesophagitis. This analysis included cases of oesophageal adenocarcinoma (n 218), Barrett's oesophagus (n 212), reflux oesophagitis (n 208) and population-based controls (n 252) recruited between 2002 and 2005 throughout the island of Ireland. All the subjects completed a 101-item FFQ. Unconditional logistic regression analysis was applied to determine odds of disease according to dietary intakes of Mg, Ca and Ca:Mg ratio. After adjustment for potential confounders, individuals consuming the highest amounts of Mg from foods had significant reductions in the odds of reflux oesophagitis (OR 0·31; 95 % CI 0·11, 0·87) and Barrett's oesophagus (OR 0·29; 95 % CI 0·12, 0·71) compared with individuals consuming the lowest amounts of Mg. The protective effect of Mg was more apparent in the context of a low Ca:Mg intake ratio. No significant associations were observed for Mg intake and oesophageal adenocarcinoma risk (OR 0·77; 95 % CI 0·30, 1·99 comparing the highest and the lowest tertiles of consumption). In conclusion, dietary Mg intakes were inversely associated with reflux oesophagitis and Barrett's oesophagus risk in this Irish population.
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Affiliation(s)
- Qi Dai
- 1Vanderbilt Epidemiology Center,Department of Medicine,Vanderbilt-Ingram Cancer Center,Vanderbilt University School of Medicine,Nashville,TN 37203,USA
| | - Marie M Cantwell
- 2Cancer Epidemiology & Health Services Research Group, Centre of Excellence for Public Health Northern Ireland,Centre for Public Health,Queens University Belfast,Belfast,BT12 6BJ,Northern Ireland
| | - Liam J Murray
- 2Cancer Epidemiology & Health Services Research Group, Centre of Excellence for Public Health Northern Ireland,Centre for Public Health,Queens University Belfast,Belfast,BT12 6BJ,Northern Ireland
| | - Wei Zheng
- 1Vanderbilt Epidemiology Center,Department of Medicine,Vanderbilt-Ingram Cancer Center,Vanderbilt University School of Medicine,Nashville,TN 37203,USA
| | - Lesley A Anderson
- 2Cancer Epidemiology & Health Services Research Group, Centre of Excellence for Public Health Northern Ireland,Centre for Public Health,Queens University Belfast,Belfast,BT12 6BJ,Northern Ireland
| | - Helen G Coleman
- 2Cancer Epidemiology & Health Services Research Group, Centre of Excellence for Public Health Northern Ireland,Centre for Public Health,Queens University Belfast,Belfast,BT12 6BJ,Northern Ireland
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67
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Dietary magnesium intake and the risk of diabetes in the Japanese community: results from the Takayama study. Eur J Nutr 2015; 56:767-774. [PMID: 26689794 DOI: 10.1007/s00394-015-1122-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 11/29/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE Several experimental studies showed that magnesium intake improved insulin resistance and glucose uptake in diabetes patients. However, epidemiological studies on the association between magnesium intake and diabetes risk have yielded inconsistent results. We investigated whether magnesium intake is related to the risk of developing diabetes in a population-based cohort study in Japan. METHODS Study subjects were participants in the Takayama study. A total of 13,525 residents in Takayama City, Japan, responded to a self-administered questionnaire in 1992 and to a follow-up questionnaire seeking information about diabetes in 2002. Magnesium and other nutrient intakes were estimated from a validated food frequency questionnaire administered at the baseline. RESULTS During a follow-up of 10 years, 438 subjects reported diabetes newly diagnosed by physician. Compared with women in the low quartile of magnesium intake, women in the high quartile were at a significantly reduced risk of diabetes (HR 0.50; 95 % CI 0.30-0.84; P-trend 0.005) after adjustments for covariates. In men, there was no association between magnesium intake and the risk of diabetes. CONCLUSION These results suggest that diets with a high intake of magnesium may decrease the risk of diabetes in women.
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Dibaba D, Xun P, Yokota K, White E, He K. Magnesium intake and incidence of pancreatic cancer: the VITamins and Lifestyle study. Br J Cancer 2015; 113:1615-21. [PMID: 26554653 PMCID: PMC4705892 DOI: 10.1038/bjc.2015.382] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 09/28/2015] [Accepted: 10/08/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Studies document that magnesium is inversely associated with the risk of diabetes, which is a risk factor of pancreatic cancer. However, studies on the direct association of magnesium with pancreatic cancer are few and findings are inconclusive. In this study, we aimed to investigate the longitudinal association between magnesium intake and pancreatic cancer incidence in a large prospective cohort study. METHOD A cohort of 66,806 men and women aged 50-76 years at baseline who participated in the VITamins And Lifestyle (VITAL) study was followed from 2000 to 2008. Multivariable-adjusted Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of pancreatic cancer incidence by magnesium intake categories. RESULT During an average of 6.8-year follow-up, 151 participants developed pancreatic cancer. Compared with those who met the recommended dietary allowance (RDA) for magnesium intake, the multivariable-adjusted HRs (95% CIs) for pancreatic cancer were 1.42 (0.91, 2.21) for those with magnesium intake in the range of 75-99% RDA and 1.76 (1.04, 2.96) for those with magnesium intake <75% RDA. Every 100 mg per day decrement in magnesium intake was associated with a 24% increase in the incidence of pancreatic cancer (HR: 1.24; 95% CI: 1.02, 1.50; P(trend)=0.03). The observed inverse associations appeared not to be appreciably modified by age, gender, body mass index, and non-steroidal anti-inflammatory drug use but appeared to be limited to those taking magnesium supplementation (from multivitamins or individual supplement). CONCLUSIONS Findings from this prospective cohort study indicate that magnesium intake may be beneficial in terms of primary prevention of pancreatic cancer.
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Affiliation(s)
- Daniel Dibaba
- Department of Epidemiology and Biostatistics, School of Public Health–Bloomington, Indiana University, Bloomington, IN, USA
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, School of Public Health–Bloomington, Indiana University, Bloomington, IN, USA
| | - Kuninobu Yokota
- Division of Diabetes and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Emily White
- Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA
| | - Ka He
- Department of Epidemiology and Biostatistics, School of Public Health–Bloomington, Indiana University, Bloomington, IN, USA
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Huang JW, Famure O, Li Y, Kim SJ. Hypomagnesemia and the Risk of New-Onset Diabetes Mellitus after Kidney Transplantation. J Am Soc Nephrol 2015; 27:1793-800. [PMID: 26449610 DOI: 10.1681/asn.2015040391] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 08/13/2015] [Indexed: 12/13/2022] Open
Abstract
Several studies suggest a link between post-transplant hypomagnesemia and new-onset diabetes after transplantation (NODAT), but this relationship remains controversial. We conducted a retrospective cohort study of 948 nondiabetic kidney transplant recipients from January 1, 2000, to December 31, 2011, to examine the association between serum magnesium level and NODAT. Multivariable Cox proportional hazards models were fitted to evaluate the risk of NODAT as a function of baseline (at 1 month), time-varying (every 3 months), and rolling-average (i.e., mean for 3 months moving at 3-month intervals) serum magnesium levels while adjusting for potential confounders. A total of 182 NODAT events were observed over 2951.2 person-years of follow-up. Multivariable models showed an inverse relationship between baseline serum magnesium level and NODAT (hazard ratio [HR], 1.24 per 0.1 mmol/L decrease; 95% confidence interval [95% CI], 1.05 to 1.46; P=0.01). The association with the risk of NODAT persisted in conventional time-varying (HR, 1.32; 95% CI, 1.14 to 1.52; P<0.001) and rolling-average models (HR, 1.34; 95% CI, 1.13 to 1.57; P=0.001). Hypomagnesemia (serum magnesium <0.74 mmol/L) also significantly associated with increased risk of NODAT in baseline (HR, 1.58; 95% CI, 1.07 to 2.34; P=0.02), time-varying (HR, 1.78; 95% CI, 1.29 to 2.45; P<0.001), and rolling-average models (HR, 1.83; 95% CI, 1.30 to 2.57; P=0.001). Our results suggest that lower post-transplant serum magnesium level is an independent risk factor for NODAT in kidney transplant recipients. Interventions targeting serum magnesium to reduce the risk of NODAT should be evaluated.
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Affiliation(s)
- Johnny W Huang
- Division of Nephrology and the Kidney Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Olusegun Famure
- Division of Nephrology and the Kidney Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Yanhong Li
- Division of Nephrology and the Kidney Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - S Joseph Kim
- Division of Nephrology and the Kidney Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology and the Renal Transplant Program, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Tam CHT, Wang Y, Lee HM, Luk AOY, Tong PCY, Chan MHM, Ozaki R, Kong APS, So WY, Chan JCN, Ma RCW. Early gene-diet interaction between glucokinase regulatory protein (GCKR) polymorphism, vegetable and fish intakes in modulating triglyceride levels in healthy adolescents. Nutr Metab Cardiovasc Dis 2015; 25:951-958. [PMID: 26234566 DOI: 10.1016/j.numecd.2015.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 06/29/2015] [Accepted: 06/29/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS The benefits of dietary vegetable and fish consumptions on improving glucose and lipid metabolism have been well established. Recently, the T-allele of a common genetic variant rs780094 at glucokinase regulatory protein (GCKR) was reported to be associated with elevated triglyceride (TG) levels but reduced fasting plasma glucose (FPG) and type 2 diabetes risk. However, the dietary modulation on genetic risk is not clearly understood. METHODS AND RESULTS A cohort of 2095 Chinese adolescents (mean age 15.6 ± 2.0 years, 45.3% male) recruited from a population-based school survey for cardiovascular risk factor assessment, with dietary data including weekly vegetable and fish consumptions as well as clinical data were genotyped for the GCKR rs780094 polymorphism. In the linear regression analysis with adjustment for sex, age, body mass index, and socioeconomic status (school banding, paternal and maternal education levels), the frequency of vegetable intake per week was inversely associated with FPG (P = 0.044). Individuals with low fish intake generally had elevated TG levels but reduced TC, HDL-C and LDL-C (0.006 < P < 0.029). We also observed significant associations of the minor T-allele of GCKR rs780094 with decreased FPG (P = 0.013) and increased TG levels (P = 2.7 × 10(-8)). There were significant gene-diet interactions between rs780094 and vegetable consumption (P(interaction) = 0.009), and between rs780094 and fish consumption (P(interaction) = 0.031) in modulating TG levels. The T-allele of GCKR locus was associated with higher TG levels amongst individuals with ≥7 vegetable meals per week (P = 6.4 × 10(-9)), and among individuals with <7 fish meals per week (P = 0.020 and 7.0 × 10(-7) for 4-6 and ≤3 meals per week, respectively). High intake of vegetable exerted a reduction in TG levels only among CC genotype carriers (Ptrend = 0.020), while high intake of fish was associated with reduced TG levels only among TT genotype carriers (Ptrend = 0.026). CONCLUSIONS In summary, our data indicated that the favorable associations of higher vegetable and fish intakes on TG levels are dependent on the genetic background of an individual. In particular, at-risk TT- genotype carriers of the GCKR variant may derive more benefits from a high fish intake, while the CC-genotype carriers may find further benefits from a high consumption of vegetable.
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Affiliation(s)
- C H T Tam
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong (CUHK), Prince of Wales Hospital (PWH), Hong Kong
| | - Y Wang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong (CUHK), Prince of Wales Hospital (PWH), Hong Kong
| | - H M Lee
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong (CUHK), Prince of Wales Hospital (PWH), Hong Kong
| | - A O Y Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong (CUHK), Prince of Wales Hospital (PWH), Hong Kong; CUHK-PWH International Diabetes Federation (IDF) Centre of Education, Hong Kong
| | - P C Y Tong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong (CUHK), Prince of Wales Hospital (PWH), Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong; CUHK-PWH International Diabetes Federation (IDF) Centre of Education, Hong Kong
| | - M H M Chan
- Department of Chemical Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - R Ozaki
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong (CUHK), Prince of Wales Hospital (PWH), Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong; CUHK-PWH International Diabetes Federation (IDF) Centre of Education, Hong Kong
| | - A P S Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong (CUHK), Prince of Wales Hospital (PWH), Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong; CUHK-PWH International Diabetes Federation (IDF) Centre of Education, Hong Kong
| | - W Y So
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong (CUHK), Prince of Wales Hospital (PWH), Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong; CUHK-PWH International Diabetes Federation (IDF) Centre of Education, Hong Kong
| | - J C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong (CUHK), Prince of Wales Hospital (PWH), Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong; CUHK-PWH International Diabetes Federation (IDF) Centre of Education, Hong Kong
| | - R C W Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong (CUHK), Prince of Wales Hospital (PWH), Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong; CUHK-PWH International Diabetes Federation (IDF) Centre of Education, Hong Kong.
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Kalsoom U, Guijt RM, Boyce MC, Townsend AT, Haselberg R, Breadmore MC. Direct electrokinetic injection of inorganic cations from whole fruits and vegetables for capillary electrophoresis analysis. J Chromatogr A 2015; 1428:346-51. [PMID: 26422302 DOI: 10.1016/j.chroma.2015.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/04/2015] [Accepted: 08/06/2015] [Indexed: 12/15/2022]
Abstract
A novel approach for the direct injection from plant tissues without any sample pre-treatment has been developed by simply placing a small piece of the tissue into a capillary electrophoresis vial followed by application of a voltage for electrokinetic injection. Separations of sodium, potassium, calcium and magnesium were achieved using a BGE comprising 10mM imidazole and 2.5mM 18-crown-6-ether at pH 4.5. The addition of 2% (m/v) hydroxypropylmethyl cellulose to the separation buffer allowed for precise and accurate electrokinetic injection of ions from the plant material by halting the movement of tissue fluid into the capillary. This method provides both qualitative and quantitative data of inorganic cations, with quantitation in zucchini, mushroom and apple samples in agreement with Sector Field Inductively Coupled Plasma Mass Spectrometric analysis (r(2)=0.98, n=9). This method provides a new way for rapid, quantitative analysis by eliminating sample preparation procedures, and has great potential for a range of applications in plant science and food chemistry.
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Affiliation(s)
- Umme Kalsoom
- Australian Centre for Research on Separation Science (ACROSS), School of Physical Sciences Chemistry, University of Tasmania, Private Bag 75, Hobart, Tasmania, 7001, Australia; Centre for Ecosystem Management, School of Natural Sciences, Edith Cowan University, Perth, Western Australia, 6027, Australia
| | - Rosanne M Guijt
- School of Medicine and Australian Centre for Research on Separation Science (ACROSS), Private Bag 26, Hobart, Tasmania, 7001, Australia
| | - Mary C Boyce
- Centre for Ecosystem Management, School of Natural Sciences, Edith Cowan University, Perth, Western Australia, 6027, Australia
| | - Ashley T Townsend
- Central Science Laboratory, University of Tasmania, Private Bag 74, Hobart, Tasmania, 7001, Australia
| | - Rob Haselberg
- VU University Amsterdam, Division of BioAnalytical Chemistry, AIMMS research group BioMolecular Analysis, De Boelelaan 1083, 1081 HV, Amsterdam, The Netherlands
| | - Michael C Breadmore
- Australian Centre for Research on Separation Science (ACROSS), School of Physical Sciences Chemistry, University of Tasmania, Private Bag 75, Hobart, Tasmania, 7001, Australia.
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Barbagallo M, Dominguez LJ. Magnesium and type 2 diabetes. World J Diabetes 2015; 6:1152-1157. [PMID: 26322160 PMCID: PMC4549665 DOI: 10.4239/wjd.v6.i10.1152] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 06/29/2015] [Accepted: 08/17/2015] [Indexed: 02/05/2023] Open
Abstract
Type 2 diabetes is frequently associated with both extracellular and intracellular magnesium (Mg) deficits. A chronic latent Mg deficit or an overt clinical hypomagnesemia is common in patients with type 2 diabetes, especially in those with poorly controlled glycemic profiles. Insulin and glucose are important regulators of Mg metabolism. Intracellular Mg plays a key role in regulating insulin action, insulin-mediated-glucose-uptake and vascular tone. Reduced intracellular Mg concentrations result in a defective tyrosine-kinase activity, postreceptorial impairment in insulin action and worsening of insulin resistance in diabetic patients. A low Mg intake and an increased Mg urinary loss appear the most important mechanisms that may favor Mg depletion in patients with type 2 diabetes. Low dietary Mg intake has been related to the development of type 2 diabetes and metabolic syndrome. Benefits of Mg supplementation on metabolic profiles in diabetic patients have been found in most, but not all clinical studies and larger prospective studies are needed to support the potential role of dietary Mg supplementation as a possible public health strategy in diabetes risk. The aim of this review is to revise current evidence on the mechanisms of Mg deficiency in diabetes and on the possible role of Mg supplementation in the prevention and management of the disease.
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Abstract
Although the following text will focus on magnesium in disease, its role in healthy subjects during physical exercise when used as a supplement to enhance performance is also noteworthy. Low serum magnesium levels are associated with metabolic syndrome, Type 2 diabetes mellitus (T2DM) and hypertension; consequently, some individuals benefit from magnesium supplementation: increasing magnesium consumption appears to prevent high blood pressure, and higher serum magnesium levels are associated with a lower risk of developing a metabolic syndrome. There are, however, conflicting study results regarding magnesium administration with myocardial infarction with and without reperfusion therapy. There was a long controversy as to whether or not magnesium should be given as a first-line medication. As the most recent trials have not shown any difference in outcome, intravenous magnesium cannot be recommended in patients with myocardial infarction today. However, magnesium has its indication in patients with torsade de pointes and has been given successfully to patients with digoxin-induced arrhythmia or life-threatening ventricular arrhythmias. Magnesium sulphate as an intravenous infusion also has an important established therapeutic role in pregnant women with pre-eclampsia as it decreases the risk of eclamptic seizures by half compared with placebo.
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Affiliation(s)
- Helmut Geiger
- Klinikum der J.W. Goethe-Universität, Medizinische Klinik III/Nephrologie, Frankfurt/Main, Germany
| | - Christoph Wanner
- Universitätsklinik Würzburg, Medizinische Klinik und Poliklinik I, Würzburg, Germany
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Zeng C, Li H, Wei J, Yang T, Deng ZH, Yang Y, Zhang Y, Yang TB, Lei GH. Association between Dietary Magnesium Intake and Radiographic Knee Osteoarthritis. PLoS One 2015; 10:e0127666. [PMID: 26010333 PMCID: PMC4444049 DOI: 10.1371/journal.pone.0127666] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 03/19/2015] [Indexed: 12/15/2022] Open
Abstract
Objective To examine the cross-sectional associations between dietary magnesium (Mg) intake and radiographic knee osteoarthritis (OA), joint space narrowing (JSN), and osteophytes (OST) respectively. Methods A total of 1626 subjects were included in the study. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. Radiographic knee OA was defined as Kellgren-Lawrence (K-L) Grade 2 in at least one leg. JSN and OST were assessed individually according to the Osteoarthritis Research Society International (OARSI) atlas. A multivariable logistic analysis model was applied to test the various associations after adjusting for potentially confounding factors. Results The relative odds of radiographic knee OA were decreased by 0.53 times in the third quintile of Mg intake [odds ratio (OR) 0.53, 95% confidence interval (CI) 0.28–1.01], 0.40 times in the fourth quintile (OR 0.40, 95% CI 0.17–0.94) and 0.34 times in the fifth quintile (OR 0.34, 95% CI 0.11–1.00) compared with those in the lowest quintile, while P for trend was 0.111. The relative odds of JSN were decreased by 0.49 times in the third quintile of Mg intake (OR 0.49, 95% CI 0.28–0.88) and 0.37 times in the fifth quintile (OR 0.37, 95% CI 0.14–0.98) compared with those in the lowest quintile, while P for trend was 0.088. There was no significant relationship between dietary Mg intake and the presence of OST. Conclusions The findings of this cross-sectional study indicate that Mg intake is inversely associated with radiographic knee OA and JSN. It supports potential role of Mg in the prevention of knee OA. Level of Evidence LevelIII, cross-sectional study.
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Affiliation(s)
- Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Hui Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Jie Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Tuo Yang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Zhen-han Deng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Ye Yang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yi Zhang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Tu-bao Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Guang-hua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- * E-mail:
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de Baaij JHF, Hoenderop JGJ, Bindels RJM. Magnesium in man: implications for health and disease. Physiol Rev 2015; 95:1-46. [PMID: 25540137 DOI: 10.1152/physrev.00012.2014] [Citation(s) in RCA: 886] [Impact Index Per Article: 98.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Magnesium (Mg(2+)) is an essential ion to the human body, playing an instrumental role in supporting and sustaining health and life. As the second most abundant intracellular cation after potassium, it is involved in over 600 enzymatic reactions including energy metabolism and protein synthesis. Although Mg(2+) availability has been proven to be disturbed during several clinical situations, serum Mg(2+) values are not generally determined in patients. This review aims to provide an overview of the function of Mg(2+) in human health and disease. In short, Mg(2+) plays an important physiological role particularly in the brain, heart, and skeletal muscles. Moreover, Mg(2+) supplementation has been shown to be beneficial in treatment of, among others, preeclampsia, migraine, depression, coronary artery disease, and asthma. Over the last decade, several hereditary forms of hypomagnesemia have been deciphered, including mutations in transient receptor potential melastatin type 6 (TRPM6), claudin 16, and cyclin M2 (CNNM2). Recently, mutations in Mg(2+) transporter 1 (MagT1) were linked to T-cell deficiency underlining the important role of Mg(2+) in cell viability. Moreover, hypomagnesemia can be the consequence of the use of certain types of drugs, such as diuretics, epidermal growth factor receptor inhibitors, calcineurin inhibitors, and proton pump inhibitors. This review provides an extensive and comprehensive overview of Mg(2+) research over the last few decades, focusing on the regulation of Mg(2+) homeostasis in the intestine, kidney, and bone and disturbances which may result in hypomagnesemia.
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Affiliation(s)
- Jeroen H F de Baaij
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joost G J Hoenderop
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - René J M Bindels
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Abstract
PURPOSE OF REVIEW The tight control of blood magnesium (Mg) levels is of central importance for numerous physiological processes. A persistent low Mg status (hypomagnesemia) is associated with severe health risks and is involved in the pathogenesis of type 2 diabetes mellitus, osteoporosis, asthma, and heart and vascular diseases. The current view has expanded significantly as a result of the identification of novel genes and regulatory pathways involved in hypomagnesemic disorders. This review aims to give an up-to-date overview of transient receptor potential melastatin 6 (TRPM6) regulation and its role in the maintenance of Mg homeostasis. RECENT FINDINGS The epithelial Mg channel TRPM6 is considered to be the Mg entry pathway in the distal convoluted tubule of the kidney, where it functions as gatekeeper for controlling the body's Mg balance. Various factors and hormones contribute not only to the function, but also to the dysregulation of TRPM6, which has a substantial impact on renal Mg handling. Recent genetic and molecular studies have further elucidated the signaling processes of epithelial Mg transport, including their effect on the expression and function of TRPM6. SUMMARY Knowledge of TRPM6 functioning is of vital importance to decipher its role in Mg handling and will, in particular, provide a molecular basis for achieving a better understanding of Mg mal(re)absorption and hence systemic Mg balance.
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79
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Yamori Y, Sagara M, Mizushima S, Liu L, Ikeda K, Nara Y. An inverse association between magnesium in 24-h urine and cardiovascular risk factors in middle-aged subjects in 50 CARDIAC Study populations. Hypertens Res 2014; 38:219-25. [PMID: 25354778 DOI: 10.1038/hr.2014.158] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 08/28/2014] [Accepted: 09/03/2014] [Indexed: 12/15/2022]
Abstract
Serum, plasma and dietary magnesium (Mg) have been reported to be inversely associated with cardiovascular disease risk factors. We examined the associations between the 24-h urinary Mg/creatinine (Cre) ratio and cardiovascular disease risk factors, such as body mass index (BMI), blood pressure (BP), serum total cholesterol (TC) and prevalence of obesity, hypertension and hypercholesterolemia. A cross-sectional analysis was conducted among 4211 participants (49.7% women) aged 48-56 years in 50 population samples from 22 countries in the World Health Organization-coordinated Cardiovascular Diseases and Alimentary Comparison (CARDIAC) Study (1985-1994). In linear regression analyses, Mg/Cre ratio was inversely associated with BMI, systolic BP (SBP), diastolic BP (DBP) and TC (P for linear trend <0.001 for each). These associations were not markedly altered by adjustment for traditional risk factors, urinary markers or cohort effects. Multivariate-adjusted mean values for the subjects in the highest Mg/Cre ratio quintile were 6.3, 3.4, 5.3 and 4.6% lower than those for the subjects in the lowest quintile for BMI, SBP, DBP and TC (P < 0.001, respectively). The prevalence of obesity, hypertension and hypercholesterolemia was 2.10 (95% confidence interval: 1.50, 2.95), 1.55 (1.25, 1.92) and 2.06 (1.63, 2.62) times higher (P < 0.001, respectively) among the subjects in the lowest Mg/Cre ratio quintile than in the subjects in the highest quintile. These associations were not appreciably altered by adjustment for potential confounding variables. In conclusion, higher 24-h urinary Mg/Cre ratio was associated with lower cardiovascular disease risk factors, including BMI, BP, TC, obesity, hypertension and hypercholesterolemia.
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Affiliation(s)
- Yukio Yamori
- 1] Institute for World Health Development, Mukogawa Women's University, Nishinomiya, Japan [2] Laboratory of Preventive Nutritional Medicine, Research Institute for Production Development, Kyoto, Japan [3] International (Former WHO-Collaborating) Center for Research on Primary Prevention of Cardiovascular Diseases, Kyoto, Japan
| | - Miki Sagara
- 1] Laboratory of Preventive Nutritional Medicine, Research Institute for Production Development, Kyoto, Japan [2] International (Former WHO-Collaborating) Center for Research on Primary Prevention of Cardiovascular Diseases, Kyoto, Japan
| | - Shunsaku Mizushima
- 1] International (Former WHO-Collaborating) Center for Research on Primary Prevention of Cardiovascular Diseases, Kyoto, Japan [2] Department of Epidemiology and Public Health, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Longjian Liu
- 1] International (Former WHO-Collaborating) Center for Research on Primary Prevention of Cardiovascular Diseases, Kyoto, Japan [2] Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA
| | - Katsumi Ikeda
- 1] International (Former WHO-Collaborating) Center for Research on Primary Prevention of Cardiovascular Diseases, Kyoto, Japan [2] School of Pharmacy and Pharmaceutical Sciences, Mukogawa Women's University, Nishinomiya, Japan
| | - Yasuo Nara
- International (Former WHO-Collaborating) Center for Research on Primary Prevention of Cardiovascular Diseases, Kyoto, Japan
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80
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Das UN. Magnesium Supplementation Reduces Metabolic Syndrome—How and Why? Arch Med Res 2014; 45:604-6. [DOI: 10.1016/j.arcmed.2014.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 10/01/2014] [Indexed: 12/15/2022]
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Rodríguez-Moran M, Guerrero-Romero F. Oral Magnesium Supplementation Improves the Metabolic Profile of Metabolically Obese, Normal-weight Individuals: A Randomized Double-blind Placebo-controlled Trial. Arch Med Res 2014; 45:388-93. [DOI: 10.1016/j.arcmed.2014.05.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 04/30/2014] [Indexed: 02/08/2023]
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Kaur B, Henry J. Micronutrient status in type 2 diabetes: a review. ADVANCES IN FOOD AND NUTRITION RESEARCH 2014; 71:55-100. [PMID: 24484939 DOI: 10.1016/b978-0-12-800270-4.00002-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Type 2 diabetes is characterized by significant losses of important micronutrients due to metabolic basis of the disease and its complications. Evidence of changes in trace mineral and vitamin metabolism as a consequence of type 2 diabetes is reviewed in this chapter. This review is not a meta-analysis but an overview of the micronutrient status, metabolic needs, and potential micronutrient requirements in type 2 diabetics. This chapter will not concentrate on vitamin D and type 2 diabetes as this is a topic that has been extensively reviewed before. The less well-known micronutrients notably zinc, magnesium, chromium, copper, manganese, iron, selenium, vanadium, B-group vitamins, and certain antioxidants are assessed. While some evidence is available to demonstrate the positive influence of micronutrient supplementation on glycemic control, much remains to be investigated. Additional research is necessary to characterize better biomarkers of micronutrient status and requirements in type 2 diabetics. The optimal level of micronutrient supplementation to achieve glucose homeostasis in type 2 diabetics remains a challenge.
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Affiliation(s)
- Bhupinder Kaur
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Singapore, Singapore.
| | - Jeyakumar Henry
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Singapore, Singapore
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83
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Barbagallo M, Di Bella G, Brucato V, D'Angelo D, Damiani P, Monteverde A, Belvedere M, Dominguez LJ. Serum ionized magnesium in diabetic older persons. Metabolism 2014; 63:502-9. [PMID: 24462317 DOI: 10.1016/j.metabol.2013.12.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 12/05/2013] [Accepted: 12/09/2013] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Several alterations of magnesium metabolism have been associated with type 2 diabetes pathophysiology, a condition particularly frequent in older persons. We aimed to evaluate serum total (Mg-tot) and serum ionized magnesium (Mg-ion) in older persons with type 2 diabetes in order to explore clinically applicable methods for the detection of magnesium deficit. MATERIAL/METHODS Mg-tot and Mg-ion were measured in 105 fasting subjects with type 2 diabetes (mean age: 71.1±0.8 years; M/F: 45/60) and in 100 age-matched non-diabetic control persons (mean age: 72.2±0.8 years; M/F: 42/58). RESULTS Mg-ion concentrations were significantly lower in diabetic persons compared with controls (0.49±0.05 mmol/L vs. 0.55±0.05 mmol/L; p<0.001). Mg-tot was also slightly but significantly lower in diabetic patients (0.82±0.007 mmol/L vs. 0.84±0.006 mmol/L; p<0.05). There was an almost complete overlap in the values of Mg-tot in older diabetic patients and controls; conversely, 44.8% of diabetic patients had Mg-ion values below 0.47 mmol/L, while none of the controls did. After adjustment for age, sex, BMI, and triglycerides, Mg-tot was significantly associated with FBG in all the participants (p<0.05) and Mg-ion was significantly associated with FBG in all the participants (p<0.01) and with HbA1c in diabetic participants (p<0.001). CONCLUSIONS Alterations of magnesium serum concentrations are common in type 2 diabetic older adults; Mg-ion evaluation may help to identify subclinical magnesium depletion (i.e. in patients with normal Mg-tot); the close independent associations of Mg-tot and Mg-ion with FBG and with HbA1c reinforce the possible link between magnesium homeostasis and altered glucose metabolism.
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Affiliation(s)
- Mario Barbagallo
- Geriatric Unit, Dept. of Internal Medicine and Specialties, University of Palermo, Italy.
| | - Giovanna Di Bella
- Geriatric Unit, Dept. of Internal Medicine and Specialties, University of Palermo, Italy
| | - Virna Brucato
- Geriatric Unit, Dept. of Internal Medicine and Specialties, University of Palermo, Italy
| | - Daniela D'Angelo
- Geriatric Unit, Dept. of Internal Medicine and Specialties, University of Palermo, Italy
| | - Provvidenza Damiani
- Geriatric Unit, Dept. of Internal Medicine and Specialties, University of Palermo, Italy
| | - Alfredo Monteverde
- Geriatric Unit, Dept. of Internal Medicine and Specialties, University of Palermo, Italy
| | - Mario Belvedere
- Geriatric Unit, Dept. of Internal Medicine and Specialties, University of Palermo, Italy
| | - Ligia J Dominguez
- Geriatric Unit, Dept. of Internal Medicine and Specialties, University of Palermo, Italy
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Garg N, Weinberg J, Ghai S, Bradauskaite G, Nuhn M, Gautam A, Kumar N, Francis J, Chen JLT. Lower magnesium level associated with new-onset diabetes and pre-diabetes after kidney transplantation. J Nephrol 2014; 27:339-44. [PMID: 24609888 DOI: 10.1007/s40620-014-0072-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 02/16/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hypomagnesemia is associated with increased peripheral insulin resistance in the general population. It is frequently seen after renal transplantation. We examined its role as a risk factor for new-onset diabetes after transplantation (NODAT) and new-onset pre-diabetes after transplantation (NOPDAT). METHODS A retrospective analysis of 138 previously non-diabetic renal transplant recipients was conducted. Cox and logistic regression analyses were performed to examine the associations between 1-month post-transplant serum magnesium level and subsequent diagnoses of NODAT/NOPDAT. RESULTS NODAT was diagnosed in 34 (24.6 %) and NOPDAT in 12 (8.7 %) patients. Median time to diagnosis of NODAT/NOPDAT was 20.4 months (interquartile range [IQR] 6.8-34.8). Median follow up for the entire group was 3.5 years (IQR 2.3-5.6). Mean magnesium level at 1 month after transplantation was significantly lower in patients subsequently diagnosed with NODAT/NOPDAT (1.60 ± 0.27 vs. 1.76 ± 0.29 mg/dl, p = 0.002). Cox regression analysis identified a trend towards developing NODAT/NOPDAT with lower baseline magnesium levels (hazard ratio 0.89 per 0.1 mg/dl increment in magnesium level, 95 % confidence interval [CI] = 0.78-1.01, p = 0.07); a stronger relationship between the two variables was seen at logistic regression analysis (odds ratio 0.81 per 0.1 mg/dl increment in serum magnesium (95 % CI 0.67-0.98, p = 0.03). CONCLUSIONS A lower magnesium level at 1 month after transplantation may be predictive of a subsequent diagnosis of glucose intolerance or diabetes in renal transplant recipients. Whether replenishing magnesium stores can prevent development of these disorders requires further investigation.
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Affiliation(s)
- Neetika Garg
- Department of Internal Medicine, Boston University Medical Center, Boston, MA, 02118, USA,
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85
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Dibaba DT, Xun P, He K. Dietary magnesium intake is inversely associated with serum C-reactive protein levels: meta-analysis and systematic review. Eur J Clin Nutr 2014; 68:510-6. [PMID: 24518747 PMCID: PMC3975661 DOI: 10.1038/ejcn.2014.7] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 09/11/2013] [Accepted: 09/13/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND/OBJECTIVES The aim of this study was to quantitatively summarize the association of dietary magnesium (Mg) intake with serum C-reactive protein (CRP) levels in the general population. SUBJECTS/METHODS Observational and experimental studies through February 2013 were reviewed in PubMed and EMBASE. Additional information was retrieved through Google or hand search of related reference lists. The main outcome is either adjusted geometric mean of CRP or odds ratio (OR) of having serum CRP ≥ 3 mg/l. Meta-regression was used to determine the linear association of dietary Mg intake and adjusted geometric means of CRP levels. A fixed-effects model was used to pool ORs of interest, comparing those in the lowest with those in the highest group of dietary Mg intake. RESULTS A data set derived from seven cross-sectional studies including 32,918 participants was quantitatively assessed. A weighted inverse association between Mg intake and serum CRP levels was observed (β-coefficient: -0.0028; 95% confidence interval (CI), -0.0043 to -0.0013; P(trend) = 0.001) from four cross-sectional studies. The pooled OR (95% CI) of having CRP ≥ 3 mg/l was 1.49 (1.18-1.89) on comparing the lowest to the highest group of Mg intake from three studies with the data available. Qualitative assessment among five intervention studies also showed a potential beneficial effect of Mg intake on serum CRP levels. CONCLUSIONS This meta-analysis and systematic review indicates that dietary Mg intake is significantly and inversely associated with serum CRP levels. The potential beneficial effect of Mg intake on chronic diseases may be, at least in part, explained by inhibiting inflammation.
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Affiliation(s)
- D T Dibaba
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA
| | - P Xun
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA
| | - K He
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA
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Hruby A, Meigs JB, O'Donnell CJ, Jacques PF, McKeown NM. Higher magnesium intake reduces risk of impaired glucose and insulin metabolism and progression from prediabetes to diabetes in middle-aged americans. Diabetes Care 2014; 37:419-27. [PMID: 24089547 PMCID: PMC3898748 DOI: 10.2337/dc13-1397] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess 7-year associations between magnesium intake and incident prediabetes and/or insulin resistance (IR), and progression from these states to type 2 diabetes. RESEARCH DESIGN AND METHODS In 2,582 community-dwelling participants 26-81 years old at baseline, magnesium intake and risk of incident "metabolic impairment," defined as impaired fasting glucose (FG) (≥5.6 to <7.0 mmol/L), impaired glucose tolerance (2-h postload glucose ≥7.8 to <11.1 mmol/L), IR, or hyperinsulinemia (≥90th percentile of homeostasis model assessment of IR or fasting insulin, respectively), was estimated among those with normal baseline status, and risk of incident diabetes was estimated among those with baseline metabolic impairment. In participants without incident diabetes, we examined magnesium intake in relation to 7-year changes in fasting and postload glucose and insulin, IR, and insulin sensitivity. RESULTS After adjusting for age, sex, and energy intake, compared with those with the lowest magnesium intake, those with the highest intake had 37% lower risk of incident metabolic impairment (P trend = 0.02), and in those with baseline metabolic impairment, higher intake was associated with 32% lower risk of incident diabetes (P trend = 0.05). In the combined population, the risk in those with the highest intake was 53% (P trend = 0.0004) of those with the lowest intake. Adjusting for risk factors and dietary fiber attenuated associations in the baseline normal population but did not substantially affect associations in the metabolically impaired. Higher magnesium intake tended to associate with lower follow-up FG and IR, but not fasting insulin, postload values, or insulin sensitivity. CONCLUSIONS Magnesium intake may be particularly beneficial in offsetting risk of developing diabetes among those at high risk. Magnesium's long-term associations with non-steady-state (dynamic) measures deserve further research.
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87
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Yang SJ, Hwang SY, Baik SH, Lee KW, Nam MS, Park YS, Woo JT, Kim YS, Park S, Park SY, Yim CH, Yoon HK, Kim SH. Serum magnesium level is associated with type 2 diabetes in women with a history of gestational diabetes mellitus: the Korea National Diabetes Program study. J Korean Med Sci 2014; 29:84-9. [PMID: 24431910 PMCID: PMC3890481 DOI: 10.3346/jkms.2014.29.1.84] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 10/22/2013] [Indexed: 12/15/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is a strong predictor of postpartum prediabetes and transition to overt type 2 diabetes (T2DM). Although many reports indicate that low magnesium is correlated with deteriorated glucose tolerance, the association between postpartum serum magnesium level and the risk for T2DM in women with a history of GDM has not been evaluated. We analyzed postpartum serum magnesium levels and development of prediabetes and T2DM in women with prior GDM according to American Diabetes Association (ADA) criteria using the Korean National Diabetes Program (KNDP) GDM cohort. During a mean follow-up of 15.6 ± 2.0 months after screening, 116 women were divided into three groups according to glucose tolerance status. Ultimately, eight patients (6.9%) were diagnosed with T2DM, 59 patients (50.9%) with prediabetes, and 49 patients (42.2%) with normal glucose tolerance (NGT) after follow-up. The T2DM group had the lowest serum magnesium level (0.65 [0.63-0.68] mM/L) in the postpartum period, but there was no significant difference between the prediabetes group (0.70 [0.65-0.70] mM/L) and the NGT group (0.70 [0.65-0.70] mM/L) (P=0.073) Multiple logistic regression analysis showed that postpartum HOMA-IR was a significant predictor of both prediabetes and T2DM. Moreover, we found that postpartum serum magnesium level was also a possible predictor for T2DM development. Serum magnesium level in the postpartum period may be a possible predictor for T2DM development in women with a history of GDM.
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Affiliation(s)
- Sae Jeong Yang
- Department of Internal Medicine, Daerim St. Mary's Hospital, Seoul, Korea
| | - Soon Young Hwang
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Sei Hyun Baik
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kwan Woo Lee
- Department of Internal Medicine, Ajou University College of Medicine, Suwon, Korea
| | - Moon Suk Nam
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Yong Soo Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jeong Taek Woo
- Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Young Seol Kim
- Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sunmin Park
- Department of Food & Nutrition, Hoseo University, Asan, Korea
| | - So-Young Park
- Department of Medicine, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
| | - Chang Hoon Yim
- Department of Medicine, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
| | - Hyun Koo Yoon
- Department of Medicine, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
| | - Sung-Hoon Kim
- Department of Medicine, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
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88
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Hruby A, McKeown NM, Song Y, Djoussé L. Dietary magnesium and genetic interactions in diabetes and related risk factors: a brief overview of current knowledge. Nutrients 2013; 5:4990-5011. [PMID: 24322525 PMCID: PMC3875916 DOI: 10.3390/nu5124990] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 11/18/2013] [Accepted: 11/27/2013] [Indexed: 12/15/2022] Open
Abstract
Nutritional genomics has exploded in the last decade, yielding insights—both nutrigenomic and nutrigenetic—into the physiology of dietary interactions and our genes. Among these are insights into the regulation of magnesium transport and homeostasis and mechanisms underlying magnesium’s role in insulin and glucose handling. Recent observational evidence has attempted to examine some promising research avenues on interaction between genetics and dietary magnesium in relation to diabetes and diabetes risk factors. This brief review summarizes the recent evidence on dietary magnesium’s role in diabetes and related traits in the presence of underlying genetic risk, and discusses future potential research directions.
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Affiliation(s)
- Adela Hruby
- Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Building 2, Boston, MA 02115, USA; E-Mail:
| | - Nicola M. McKeown
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, 9th Floor, Boston, MA 02111, USA; E-Mail:
| | - Yiqing Song
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, 714 N. Senate Avenue, Indianapolis, IN 46202, USA; E-Mail:
| | - Luc Djoussé
- Division of Aging, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 1620 Tremont Street, 3rd Floor, Boston, MA 02120, USA
- Boston Veterans Affairs Healthcare System, Boston, MA 02130, USA
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-617-525-7591; Fax: +1-617-525-7739
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89
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Derom ML, Sayón-Orea C, Martínez-Ortega JM, Martínez-González MA. Magnesium and depression: a systematic review. Nutr Neurosci 2013; 16:191-206. [DOI: 10.1179/1476830512y.0000000044] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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90
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Carneiro G, Laferrère B, Zanella MT. Vitamin and mineral deficiency and glucose metabolism – A review. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.clnme.2013.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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91
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Parker ED, Liu S, Van Horn L, Tinker LF, Shikany JM, Eaton CB, Margolis KL. The association of whole grain consumption with incident type 2 diabetes: the Women's Health Initiative Observational Study. Ann Epidemiol 2013; 23:321-7. [PMID: 23608304 PMCID: PMC3662533 DOI: 10.1016/j.annepidem.2013.03.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 03/19/2013] [Accepted: 03/22/2013] [Indexed: 12/15/2022]
Abstract
PURPOSE Whole grains may offer protection from diabetes by decreasing energy intake, preventing weight gain, and direct effects on insulin resistance. This study examined associations of whole and refined grains with incident type 2 diabetes (T2D) ascertained by self-reported medication use in a cohort of postmenopausal women. METHODS We included 72,215 women free of diabetes at baseline from the Women's Health Initiative Observational Study. Whole grain consumption was categorized as 0, less than 0.5, 0.5 to 1.0, 1.0 to less than 1.5, 1.5 to less than 2.0, and 2.0 or more servings per day. Proportional hazards regression was performed to estimate hazard ratios (HR) and 95% confidence intervals adjusting for potential confounders. RESULTS There were 3465 cases of incident T2D over median follow-up of 7.9 years. Adjusted for age and energy intake per day, successively increasing categories of whole grain consumption were associated with statistically significant reduced risk of incident T2D (HRs, 1.00, 0.83, 0.73, 0.69, 0.61, and 0.57; P for trend < 0.0001). Results were attenuated after adjustment for confounders and other dietary components. The reduction in risk of T2D was greater among nonsmokers and those who maintained their weight within 5 pounds with higher consumption of whole grains than smokers and women who gained more weight. CONCLUSIONS This large, prospective study found an inverse dose-response relationship between whole grain consumption and incident T2D in postmenopausal women.
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Affiliation(s)
- Emily D Parker
- HealthPartners Institute for Education and Research, 33rd Avenue S., Bloomington, MN 55440, USA.
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92
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Lillioja S, Neal AL, Tapsell L, Jacobs DR. Whole grains, type 2 diabetes, coronary heart disease, and hypertension: links to the aleurone preferred over indigestible fiber. Biofactors 2013; 39:242-58. [PMID: 23355358 PMCID: PMC3640698 DOI: 10.1002/biof.1077] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 11/26/2012] [Indexed: 12/13/2022]
Abstract
Higher whole grain cereal intakes are associated with substantially lower risks of type 2 diabetes, coronary heart disease, and hypertension. These reduced risks have been established in large prospective studies that now include millions of person-years of follow-up. We analyze the results of 11 major prospective studies to provide recommendations about whole grain consumption. The following review establishes the amount of whole grains that should ideally be consumed based on prospective evidence; defines the nature of whole grains; identifies that the whole grain evidence is robust and not due to confounding; and provides a detailed assessment of several potential mechanisms for the effect of whole grains on health. We draw the following conclusions. Firstly, to maintain health, 40 grams or more of whole grains should be consumed daily. This is about a bowl of whole grain breakfast cereal daily, but 80% of the population does not achieve this. Secondly, aleurone in bran is a critical grain component generally overlooked in favor of indigestible fiber. Live aleurone cells constitute 50% of millers' bran. They store minerals, protein, and the antioxidant ferulic acid, and are clearly more than just indigestible fiber. Finally, we suggest potential roles for magnesium, zinc, and ferulic acid in the development of chronic disease. If the results of prospective studies were applied to the life-style practices of modern societies there exists the potential for enormous personal health and public financial benefits.
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Affiliation(s)
- Stephen Lillioja
- Illawarra Health and Medical Research Institute, University of Wollongong, Northfields Avenue, NSW 2522, Australia.
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93
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High dietary magnesium intake is associated with low insulin resistance in the Newfoundland population. PLoS One 2013; 8:e58278. [PMID: 23472169 PMCID: PMC3589265 DOI: 10.1371/journal.pone.0058278] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 02/01/2013] [Indexed: 12/15/2022] Open
Abstract
Background Magnesium plays a role in glucose and insulin homeostasis and evidence suggests that magnesium intake is associated with insulin resistance (IR). However, data is inconsistent and most studies have not adequately controlled for critical confounding factors. Objective The study investigated the association between magnesium intake and IR in normal-weight (NW), overweight (OW) and obese (OB) along with pre- and post- menopausal women. Design A total of 2295 subjects (590 men and 1705 women) were recruited from the CODING study. Dietary magnesium intake was computed from the Willett Food Frequency Questionnaire (FFQ). Adiposity (NW, OW and OB) was classified by body fat percentage (%BF) measured by Dual-energy X-ray absorptiometry according to the Bray criteria. Multiple regression analyses were used to test adiposity-specific associations of dietary magnesium intake on insulin resistance adjusting for caloric intake, physical activity, medication use and menopausal status. Results Subjects with the highest intakes of dietary magnesium had the lowest levels of circulating insulin, HOMA-IR, and HOMA-ß and subjects with the lowest intake of dietary magnesium had the highest levels of these measures, suggesting a dose effect. Multiple regression analysis revealed a strong inverse association between dietary magnesium with IR. In addition, adiposity and menopausal status were found to be critical factors revealing that the association between dietary magnesium and IR was stronger in OW and OB along with Pre-menopausal women. Conclusion The results of this study indicate that higher dietary magnesium intake is strongly associated with the attenuation of insulin resistance and is more beneficial for overweight and obese individuals in the general population and pre-menopausal women. Moreover, the inverse correlation between insulin resistance and dietary magnesium intake is stronger when adjusting for %BF than BMI.
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94
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Hruby A, Ngwa JS, Renström F, Wojczynski MK, Ganna A, Hallmans G, Houston DK, Jacques PF, Kanoni S, Lehtimäki T, Lemaitre RN, Manichaikul A, North KE, Ntalla I, Sonestedt E, Tanaka T, van Rooij FJA, Bandinelli S, Djoussé L, Grigoriou E, Johansson I, Lohman KK, Pankow JS, Raitakari OT, Riserus U, Yannakoulia M, Zillikens MC, Hassanali N, Liu Y, Mozaffarian D, Papoutsakis C, Syvänen AC, Uitterlinden AG, Viikari J, Groves CJ, Hofman A, Lind L, McCarthy MI, Mikkilä V, Mukamal K, Franco OH, Borecki IB, Cupples LA, Dedoussis GV, Ferrucci L, Hu FB, Ingelsson E, Kähönen M, Kao WHL, Kritchevsky SB, Orho-Melander M, Prokopenko I, Rotter JI, Siscovick DS, Witteman JCM, Franks PW, Meigs JB, McKeown NM, Nettleton JA. Higher magnesium intake is associated with lower fasting glucose and insulin, with no evidence of interaction with select genetic loci, in a meta-analysis of 15 CHARGE Consortium Studies. J Nutr 2013; 143:345-53. [PMID: 23343670 PMCID: PMC3713023 DOI: 10.3945/jn.112.172049] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Favorable associations between magnesium intake and glycemic traits, such as fasting glucose and insulin, are observed in observational and clinical studies, but whether genetic variation affects these associations is largely unknown. We hypothesized that single nucleotide polymorphisms (SNPs) associated with either glycemic traits or magnesium metabolism affect the association between magnesium intake and fasting glucose and insulin. Fifteen studies from the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium provided data from up to 52,684 participants of European descent without known diabetes. In fixed-effects meta-analyses, we quantified 1) cross-sectional associations of dietary magnesium intake with fasting glucose (mmol/L) and insulin (ln-pmol/L) and 2) interactions between magnesium intake and SNPs related to fasting glucose (16 SNPs), insulin (2 SNPs), or magnesium (8 SNPs) on fasting glucose and insulin. After adjustment for age, sex, energy intake, BMI, and behavioral risk factors, magnesium (per 50-mg/d increment) was inversely associated with fasting glucose [β = -0.009 mmol/L (95% CI: -0.013, -0.005), P < 0.0001] and insulin [-0.020 ln-pmol/L (95% CI: -0.024, -0.017), P < 0.0001]. No magnesium-related SNP or interaction between any SNP and magnesium reached significance after correction for multiple testing. However, rs2274924 in magnesium transporter-encoding TRPM6 showed a nominal association (uncorrected P = 0.03) with glucose, and rs11558471 in SLC30A8 and rs3740393 near CNNM2 showed a nominal interaction (uncorrected, both P = 0.02) with magnesium on glucose. Consistent with other studies, a higher magnesium intake was associated with lower fasting glucose and insulin. Nominal evidence of TRPM6 influence and magnesium interaction with select loci suggests that further investigation is warranted.
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Affiliation(s)
- Adela Hruby
- Tufts University Friedman School of Nutrition Science and Policy, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Julius S. Ngwa
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Frida Renström
- Department of Nutrition, Harvard School of Public Health, Boston, MA,Department of Clinical Sciences, Lund University, Malmö, Sweden,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Mary K. Wojczynski
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Andrea Ganna
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Göran Hallmans
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | - Denise K. Houston
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Paul F. Jacques
- Tufts University Friedman School of Nutrition Science and Policy, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Stavroula Kanoni
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK,Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Terho Lehtimäki
- Fimlab Laboratories and University of Tampere, School of Medicine, and Tampere University Hospital, Tampere, Finland
| | - Rozenn N. Lemaitre
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA
| | - Ani Manichaikul
- Center for Public Health Genomics, and Division of Biostatistics and Epidemiology, Department of Public Health Sciences, University of Virginia, Charlottesville, VA
| | - Kari E. North
- Department of Epidemiology and Carolina Center for Genome Sciences, University of North Carolina, Chapel Hill, NC
| | - Ioanna Ntalla
- Clinical Research Branch, National Institute on Aging, Baltimore, MD
| | - Emily Sonestedt
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Toshiko Tanaka
- Clinical Research Branch, National Institute on Aging, Baltimore, MD
| | - Frank J. A. van Rooij
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
| | | | - Luc Djoussé
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research, Education, and Clinical Center, Boston Veterans Affairs Healthcare System, Boston, MA
| | - Efi Grigoriou
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | | | - Kurt K. Lohman
- Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - James S. Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Olli T. Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, and Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Ulf Riserus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - M. Carola Zillikens
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands,Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Neelam Hassanali
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Yongmei Liu
- Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | - Dariush Mozaffarian
- Department of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA; Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | - Ann-Christine Syvänen
- Department of Medical Sciences, Molecular Medicine and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - André G. Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands,Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jorma Viikari
- Department of Medicine, University of Turku, and Turku University Hospital, Turku, Finland
| | - Christopher J. Groves
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Mark I. McCarthy
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK,Oxford NIHR Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Vera Mikkilä
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Kenneth Mukamal
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA
| | - Oscar H. Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
| | - Ingrid B. Borecki
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - L. Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, MA,Framingham Heart Study, Framingham, MA
| | - George V. Dedoussis
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Luigi Ferrucci
- Clinical Research Branch, National Institute on Aging, Baltimore, MD
| | - Frank B. Hu
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Erik Ingelsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, and University of Tampere, Tampere, Finland
| | - W. H. Linda Kao
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | | | | | - Inga Prokopenko
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK,Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Jerome I. Rotter
- Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - David S. Siscovick
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA,Department of Epidemiology, University of Washington, Seattle, WA
| | - Jacqueline C. M. Witteman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Netherlands Genomics Initiative-sponsored Netherlands Consortium for Healthy Aging, Leiden, The Netherlands
| | - Paul W. Franks
- Department of Nutrition, Harvard School of Public Health, Boston, MA,Department of Clinical Sciences, Lund University, Malmö, Sweden,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - James B. Meigs
- Harvard Medical School and General Medicine Division, Clinical Epidemiology and Diabetes Research Units, Massachusetts General Hospital, Boston, MA; and
| | - Nicola M. McKeown
- Tufts University Friedman School of Nutrition Science and Policy, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA,To whom correspondence should be addressed. E-mail:
| | - Jennifer A. Nettleton
- Division of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health at The University of Texas Health Science Center–Houston, Houston, TX
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Ren H, Qin L, Wang W, Ma J, Zhang W, Shen PY, Shi H, Li X, Chen N. Abnormal glucose metabolism and insulin sensitivity in Chinese patients with Gitelman syndrome. Am J Nephrol 2013; 37:152-7. [PMID: 23392128 DOI: 10.1159/000346708] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 12/26/2012] [Indexed: 12/15/2022]
Abstract
BACKGROUND Gitelman syndrome (GS) is an autosomal recessive disease of renal tubulopathy, primarily characterized by hypokalemic metabolic alkalosis with significant hypomagnesemia, low urinary calcium, secondary aldosteronism and normal blood pressure. Both hypokalemia and hypomagnesemia were reported to cause impaired glucose tolerance and/or insulin resistance, but it is unclear whether impaired glucose tolerance and/or insulin resistance are common in GS patients. METHODS An oral glucose tolerance test was performed among 16 GS patients and 12 healthy adults as control subjects. Fasting glucose and serum insulin levels were measured and the values of glucose and serum insulin after 30, 60, 120 and 180 min were also measured after an oral glucose load. The area under curve (AUC) of glucose and insulin was calculated. RESULTS One patient had isolated impaired fasting glucose, 2 had isolated impaired glucose tolerance, and 1 had combined impaired fasting glucose and glucose tolerance. Six patients were diagnosed with type 2 diabetes mellitus. Compared with a healthy normal control group, GS patients showed a higher AUC glucose level [16.1 (IQR 12.5-25.4 mEq · h/l) vs. 13.0 (IQR 11.9-13.7 mEq · h/l); p < 0.05] and AUC insulin level [81.0 (IQR 58.9-138 µU · h/ml) vs. 46.4 (IQR 35.6-63.3 µU · h/ml); p < 0.01]. GS patients showed a delay of insulin secretion peak which was observed 120 min after a glucose load. Homeostasis model assessment of insulin resistance in GS patients was significantly higher than in control volunteers. Quantitative insulin sensitivity check index and insulin sensitivity index composite in the GS group were significantly lower than in the control group. CONCLUSION Abnormal glucose metabolism and insulin secretion is common in GS patients. It is speculated that hypokalemia and hypomagnesemia may be the main cause.
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Affiliation(s)
- Hong Ren
- Department of Nephrology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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96
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Wang H, Livingston KA, Fox CS, Meigs JB, Jacques PF. Yogurt consumption is associated with better diet quality and metabolic profile in American men and women. Nutr Res 2013; 33:18-26. [PMID: 23351406 PMCID: PMC3606818 DOI: 10.1016/j.nutres.2012.11.009] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 11/08/2012] [Accepted: 11/14/2012] [Indexed: 12/15/2022]
Abstract
The evidence-based Dietary Guidelines for Americans recommends increasing the intake of fat-free or low-fat milk and milk products. However, yogurt, a nutrient-dense milk product, has been understudied. This cross-sectional study examined whether yogurt consumption was associated with better diet quality and metabolic profile among adults (n = 6526) participating in the Framingham Heart Study Offspring (1998-2001) and Third Generation (2002-2005) cohorts. A validated food frequency questionnaire was used to assess dietary intake, and the Dietary Guidelines Adherence Index (DGAI) was used to measure overall diet quality. Standardized clinical examinations and laboratory tests were conducted. Generalized estimating equations examined the associations of yogurt consumption with diet quality and levels of metabolic factors. Approximately 64% of women (vs 41% of men) were yogurt consumers (ie, consumed >0 servings/week). Yogurt consumers had a higher DGAI score (ie, better diet quality) than nonconsumers. Adjusted for demographic and lifestyle factors and DGAI, yogurt consumers, compared with nonconsumers, had higher potassium intakes (difference, 0.12 g/d) and were 47%, 55%, 48%, 38%, and 34% less likely to have inadequate intakes (based on Dietary Reference Intake) of vitamins B2 and B12, calcium, magnesium, and zinc, respectively (all P ≤ .001). In addition, yogurt consumption was associated with lower levels of circulating triglycerides, glucose, and lower systolic blood pressure and insulin resistance (all P < .05). Yogurt is a good source of several micronutrients and may help to improve diet quality and maintain metabolic well-being as part of a healthy, energy-balanced dietary pattern.
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Affiliation(s)
- Huifen Wang
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111
| | - Kara A. Livingston
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111
| | - Caroline S. Fox
- National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA 01702
| | - James B. Meigs
- Department of Medicine, Massachusetts General Hospital, General Internal Medicine Unit, Boston, MA 02114
| | - Paul F. Jacques
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111
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97
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Dai Q, Shu XO, Deng X, Xiang YB, Li H, Yang G, Shrubsole MJ, Ji B, Cai H, Chow WH, Gao YT, Zheng W. Modifying effect of calcium/magnesium intake ratio and mortality: a population-based cohort study. BMJ Open 2013; 3:bmjopen-2012-002111. [PMID: 23430595 PMCID: PMC3585973 DOI: 10.1136/bmjopen-2012-002111] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Magnesium (Mg) and calcium (Ca) antagonise each other in (re)absorption, inflammation and many other physiological activities. Based on mathematical estimation, the absorbed number of Ca or Mg depends on the dietary ratio of Ca to Mg intake. We hypothesise that the dietary Ca/Mg ratio modifies the effects of Ca and Mg on mortality due to gastrointestinal tract cancer and, perhaps, mortality due to diseases occurring in other organs or systems. DESIGN Prospective studies. SETTING Population-based cohort studies (The Shanghai Women's Health Study and the Shanghai Men's Health Study) conducted in Shanghai, China. PARTICIPANTS 74 942 Chinese women aged 40-70 years and 61 500 Chinese men aged 40-74 years participated in the study. PRIMARY OUTCOME MEASURES All-cause mortality and disease-specific mortality. RESULTS In this Chinese population with a low Ca/Mg intake ratio (a median of 1.7 vs around 3.0 in US populations), intakes of Mg greater than US Recommended Daily Allowance (RDA) levels (320 mg/day among women and 420 mg/day among men) were related to increased risks of total mortality for both women and men. Consistent with our hypothesis, the Ca/Mg intake ratio significantly modified the associations of intakes of Ca and Mg with mortality risk, whereas no significant interactions between Ca and Mg in relation to outcome were found. The associations differed by gender. Among men with a Ca/Mg ratio >1.7, increased intakes of Ca and Mg were associated with reduced risks of total mortality, and mortality due to coronary heart diseases. In the same group, intake of Ca was associated with a reduced risk of mortality due to cancer. Among women with a Ca/Mg ratio ≤1.7, intake of Mg was associated with increased risks of total mortality, and mortality due to cardiovascular diseases and colorectal cancer. CONCLUSIONS These results, if confirmed, may help to understand the optimal balance between Ca and Mg in the aetiology and prevention of these common diseases and reduction in mortality.
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Affiliation(s)
- Qi Dai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Xinqing Deng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Yong-Bing Xiang
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Honglan Li
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Martha J Shrubsole
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Butian Ji
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Wong-Ho Chow
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
- Division of Cancer Prevention and Population Sciences, Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, Tennessee, USA
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98
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Calcium, magnesium and potassium intake and mortality in women with heart failure: the Women's Health Initiative. Br J Nutr 2012. [PMID: 23199414 DOI: 10.1017/s0007114512004667] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Although diet is thought to affect the natural history of heart failure (HF), nutrient intake in HF patients has not been well studied. Based on prior research linking high intake of Ca, Mg and K to improved cardiovascular health, we hypothesised that these nutrients would be inversely associated with mortality in people with HF. Of the 161 808 participants in the Women's Health Initiative (WHI), we studied 3340 who experienced a HF hospitalisation. These participants were followed for post-hospitalisation all-cause mortality. Intake was assessed using questionnaires on food and supplement intake. Hazard ratios (HR) and 95 % CI were calculated using Cox proportional hazards models adjusted for demographics, physical function, co-morbidities and dietary covariates. Over a median of 4·6 years of follow-up, 1433 (42·9 %) of the women died. HR across quartiles of dietary Ca intake were 1·00 (referent), 0·86 (95 % CI 0·73, 1·00), 0·88 (95 % CI 0·75, 1·04) and 0·92 (95 % CI 0·76, 1·11) (P for trend = 0·63). Corresponding HR were 1·00 (referent), 0·86 (95 % CI 0·71, 1·04), 0·88 (95 % CI 0·69, 1·11) and 0·84 (95 % CI 0·63, 1·12) (P for trend = 0·29), across quartiles of dietary Mg intake, and 1·00 (referent), 1·20 (95 % CI 1·01, 1·43), 1·06 (95 % CI 0·86, 1·32) and 1·16 (95 % CI 0·90, 1·51) (P for trend = 0·35), across quartiles of dietary K intake. Results were similar when total (dietary plus supplemental) nutrient intakes were examined. In summary, among WHI participants with incident HF hospitalisation, intakes of Ca, Mg and K were not significantly associated with subsequent mortality.
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99
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Misialek JR, Lopez FL, Lutsey PL, Huxley RR, Peacock JM, Chen LY, Soliman EZ, Agarwal SK, Alonso A. Serum and dietary magnesium and incidence of atrial fibrillation in whites and in African Americans--Atherosclerosis Risk in Communities (ARIC) study. Circ J 2012; 77:323-9. [PMID: 23047297 PMCID: PMC4228988 DOI: 10.1253/circj.cj-12-0886] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Low serum magnesium (Mg) has been associated with an increased risk of cardiovascular disease (CVD), including ventricular arrhythmias, but the association between serum or dietary Mg and atrial fibrillation (AF) has not been investigated. METHODS AND RESULTS A total of 14,290 men and women (75% white; 53% female; mean age, 54 years) free of AF at baseline participating in the Atherosclerosis Risk in Communities study in the United States, were studied. Incident AF cases through 2009 were ascertained from electrocardiograms, hospital discharge codes, and death certificates. Multivariate Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for AF associated with serum and dietary Mg quintiles. Over a median follow-up time of 20.6 years, 1,755 incident AF cases were identified. In multivariate models, lower serum Mg was associated with higher AF risk: compared to individuals in the middle quintile (≥ 0.80-0.83 mmol/L), the HR (95% CI) of AF in quintiles 1, 2, 4, and 5 were 1.34 (1.16-1.54), 0.99 (0.85-1.16), 1.04 (0.90-1.22), and 1.06 (0.91-1.23), respectively. There was no evidence of significant interactions between serum Mg and sex or race. No association between dietary Mg and AF risk was observed. CONCLUSIONS Lower serum Mg was associated with a higher AF risk, and this association was not different between whites and African Americans. Dietary Mg was not associated with AF risk.
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Affiliation(s)
- Jeffrey R Misialek
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454,
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100
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Hu G, Lakka TA, Lakka HM, Tuomilehto J. Lifestyle management in the metabolic syndrome. Metab Syndr Relat Disord 2012; 4:270-86. [PMID: 18370746 DOI: 10.1089/met.2006.4.270] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Type 2 diabetes and metabolic syndrome are two of the fastest growing public health problems in both developed and developing countries. Cardiovascular disease is the most prevalent complication of type 2 diabetes and the metabolic syndrome. Overweight, obesity, or weight gain has been shown to be an important risk factor for the development of type 2 diabetes and an important component of the metabolic syndrome. Physical inactivity is another important risk factor for the development of type 2 diabetes. Data from prospective studies have shown that at least 30 min/day of moderate to vigorous physical activity can prevent type 2 diabetes. Moderate or high levels of physical fitness are effective in preventing type 2 diabetes. Results from clinical trials have indicated that lifestyle changes, including dietary modification and increase in physical activity, can prevent type 2 diabetes. Analyses from prospective studies have confirmed that healthy diets are effective and safe ways to prevent type 2 diabetes and the metabolic syndrome. Public health messages, health care professionals, and the health care system should aggressively promote physical activity and responsible nutritional habits during occupation, leisure time, and daily life and prevent overweight and obesity.
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Affiliation(s)
- Gang Hu
- Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland., Department of Public Health, University of Helsinki, Helsinki, Finland
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