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Demssie YN, Patel L, Kumar M, Syed AA. Hypomagnesaemia: clinical relevance and management. Br J Hosp Med (Lond) 2014; 75:39-43. [DOI: 10.12968/hmed.2014.75.1.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Yared N Demssie
- Consultant Physician, Royal Blackburn Hospital, Blackburn BB2 3HH
| | - Leena Patel
- Foundation Year 2 Trainee, Royal Blackburn Hospital, Blackburn BB2 3HH
| | - Mohit Kumar
- Specialist Trainee in the Department of Endocrinology, Royal Blackburn Hospital, Blackburn BB2 3HH
| | - Akheel A Syed
- Consultant Physician in the Department of Endocrinology, Salford Royal NHS Foundation Trust, Salford and The University of Manchester, Manchester
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102
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Drapkina OM, Gegnava BB. [Magnesium deficiency in cardiology]. TERAPEVT ARKH 2014; 86:104-6. [PMID: 25804050 DOI: 10.17116/terarkh20148612104-106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The paper considers the consequences and causes of magnesium deficiency in patients with cardiovascular diseases. The features of magnesium metabolism in atherosclerosis, hypertension, and heart failure are described. Prospects of magnesium therapy in cardiology practice are discussed.
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103
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Eilat-Adar S, Sinai T, Yosefy C, Henkin Y. Nutritional recommendations for cardiovascular disease prevention. Nutrients 2013; 5:3646-83. [PMID: 24067391 PMCID: PMC3798927 DOI: 10.3390/nu5093646] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 08/26/2013] [Accepted: 08/27/2013] [Indexed: 02/07/2023] Open
Abstract
Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10.
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Affiliation(s)
- Sigal Eilat-Adar
- Zinman College for Physical Education & Sports, Wingate Institute, Netanya 42902, Israel
| | - Tali Sinai
- School of Nutritional Sciences, Institute of Biochemistry, Food Science and Nutrition, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel; E-Mail:
| | - Chaim Yosefy
- Cardiology Department, Barzilai Medical Center Campus, Ashkelon 78000, Israel; E-Mail:
- Ben-Gurion University of the Negev, Beer Sheva 84105, Israel; E-Mail:
| | - Yaakov Henkin
- Ben-Gurion University of the Negev, Beer Sheva 84105, Israel; E-Mail:
- Cardiology Department, Soroka University Medical Center, Beer-Sheva 84101, Israel
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104
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The relationship between hypomagnesemia, metformin therapy and cardiovascular disease complicating type 2 diabetes: the Fremantle Diabetes Study. PLoS One 2013; 8:e74355. [PMID: 24019966 PMCID: PMC3760872 DOI: 10.1371/journal.pone.0074355] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Accepted: 08/02/2013] [Indexed: 12/15/2022] Open
Abstract
Background Low serum magnesium concentrations have been associated with cardiovascular disease risk and outcomes in some general population studies but there are no equivalent studies in diabetes. Metformin may have cardiovascular benefits beyond blood glucose lowering in type 2 diabetes but its association with hypomagnesemia appears paradoxical. The aim of this study was to examine relationships between metformin therapy, magnesium homoeostasis and cardiovascular disease in well-characterized type 2 patients from the community. Methods and Findings We studied 940 non-insulin-treated patients (mean±SD age 63.4±11.6 years, 49.0% males) from the longitudinal observational Fremantle Diabetes Study Phase I (FDS1) who were followed for 12.3±5.3 years. Baseline serum magnesium was measured using stored sera. Multivariate methods were used to determine associates of prevalent and incident coronary heart disease (CHD) and cerebrovascular disease (CVD) as ascertained from self-report and linked morbidity/mortality databases. 19% of patients were hypomagnesemic (serum magnesium <0.70 mmol/L). Patients on metformin, alone or combined with a sulfonylurea, had lower serum magnesium concentrations than those on diet alone (P<0.05). There were no independent associations between serum magnesium or metformin therapy and either CHD or CVD at baseline. Incident CVD, but not CHD, was independently and inversely associated with serum magnesium (hazard ratio (95% CI) 0.28 (0.11–0.74); P = 0.010), but metformin therapy was not a significant variable in these models. Conclusions Since hypomagnesemia appears to be an independent risk factor for CVD complicating type 2 diabetes, the value of replacement therapy should be investigated further, especially in patients at high CVD risk.
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105
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Hypomagnesemia is a significant predictor of cardiovascular and non-cardiovascular mortality in patients undergoing hemodialysis. Kidney Int 2013; 85:174-81. [PMID: 23986148 DOI: 10.1038/ki.2013.327] [Citation(s) in RCA: 214] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 05/12/2013] [Accepted: 05/29/2013] [Indexed: 01/15/2023]
Abstract
Although previous studies in the general population showed that hypomagnesemia is a risk for cardiovascular diseases (CVD), the impact of magnesium on the prognosis of patients on hemodialysis has been poorly investigated. To gain information on this we conducted a nationwide registry-based cohort study of 142,555 hemodialysis patients to determine whether hypomagnesemia is an independent risk for increased mortality in this population. Study outcomes were 1-year all-cause and cause-specific mortality with baseline serum magnesium levels categorized into sextiles. During follow-up, a total of 11,454 deaths occurred, of which 4774 had a CVD cause. In a fully adjusted model, there was a J-shaped association between serum magnesium and the odds ratio of all-cause mortality from the lowest to highest sextile, with significantly higher mortality in sextiles 1-3 and 6. Similar associations were found between magnesium and both CVD and non-CVD mortality. The proportion of patients with a baseline intact parathyroid hormone level under 50 pg/ml was significantly higher in the highest sextile; however, after excluding these patients, the CVD mortality risk in the highest sextile was attenuated. Thus, hypomagnesemia was significantly associated with an increased risk of mortality in hemodialysis patients. Interventional studies are needed to clarify whether magnesium supplementation is beneficial for improving patient prognosis.
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106
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Ochi A, Ishimura E, Tsujimoto Y, Kakiya R, Tabata T, Mori K, Fukumoto S, Tahara H, Shoji T, Yasuda H, Nishizawa Y, Inaba M. Hair magnesium, but not serum magnesium, is associated with left ventricular wall thickness in hemodialysis patients. Circ J 2013; 77:3029-36. [PMID: 23979658 DOI: 10.1253/circj.cj-13-0347] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Extracellular magnesium (Mg) accounts for approximately 1% of the total body Mg. Clinically, serum Mg concentration is measured, but it does not necessarily reflect total body Mg status. Although relationships have been reported between reduced Mg and cardiovascular disease in non-dialysis patients, there have been few such studies in hemodialysis patients. It was hypothesized that reduced Mg, as represented by lower Mg concentration in the hair, would be associated with echocardiographic parameters in chronic hemodialysis patients. METHODS AND RESULTS Hair Mg concentration was measured in 79 male hemodialysis patients using inductively coupled plasma mass spectrometry, and the relationships between hair Mg concentration and echocardiographic parameters were investigated. There was no significant correlation between Mg concentration in the hair and in serum. Hair Mg concentration in the patients with high-left ventricular mass index (LVMI) was significantly lower than that in the low-LVMI patients. Hair Mg concentration correlated significantly and negatively with posterior left ventricular wall thickness, interventricular septum thickness, left ventricular wall thickness (LVWT), and relative wall thickness. Serum Mg concentration, however, did not correlate with any of these echocardiographic parameters. CONCLUSIONS In hemodialysis patients, hair Mg concentration is a biomarker, independent of serum Mg concentration. Hair Mg, but not serum Mg, was significantly and negatively associated with LVWT. Reduced tissue Mg concentration, as measured in the hair, may be associated with left ventricular hypertrophy in hemodialysis patients.
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Affiliation(s)
- Akinobu Ochi
- Metabolism, Endocrinology, Molecular Medicine and Nephrology, Osaka City University Graduate School of Medicine
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107
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Kupetsky-Rincon EA, Uitto J. Magnesium: novel applications in cardiovascular disease--a review of the literature. ANNALS OF NUTRITION AND METABOLISM 2013; 61:102-10. [PMID: 22907037 DOI: 10.1159/000339380] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Accepted: 05/09/2012] [Indexed: 12/15/2022]
Abstract
Magnesium is an ubiquitous element and its formulation determines its efficacy and administration. It is used for gastrointestinal and obstetric disease and recently cardiovascular and neurological indications have also been explored. The role of serum/dietary magnesium intake on cardiovascular disease, carotid intima-media thickness (CIMT), hypertension (HTN) and cholesterol synthesis has been investigated. Despite differences in patient populations, some observational and interventional studies have suggested that low serum/dietary magnesium is associated with higher CIMT and more cardiovascular risk factors. A few clinical and basic science interventional studies have also shown the benefits of magnesium administration in cardiovascular disease prevention and as a neuroprotective agent. Low magnesium levels have been implicated in inflammation and endothelial dysfunction. Hypomagnesemia results in increased C-reactive protein and cytokine exaggeration, increased nuclear factor kappa B and platelet dysfunction, which can lead to thrombosis. Magnesium appears to play a vital function in cardiovascular stability and health, but an optimal dose and formulation has not been defined. Potentially promising avenues include the combination of magnesium with a statin to reduce cholesterol, C-reactive protein and CIMT, and its early use to reduce stroke morbidity and mortality. Understanding the role of magnesium in inflammation and mineralization and how it has the potential for playing a role in modulating cardiovascular and neurological disease can be a new frontier in medicine.
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Affiliation(s)
- Erine A Kupetsky-Rincon
- Department of Dermatology and Cutaneous Biology, Jefferson Medical College and Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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108
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Del Gobbo LC, Imamura F, Wu JHY, de Oliveira Otto MC, Chiuve SE, Mozaffarian D. Circulating and dietary magnesium and risk of cardiovascular disease: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr 2013; 98:160-73. [PMID: 23719551 PMCID: PMC3683817 DOI: 10.3945/ajcn.112.053132] [Citation(s) in RCA: 222] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Clinical hypomagnesemia and experimental restriction of dietary magnesium increase cardiac arrhythmias. However, whether or not circulating or dietary magnesium at usual concentrations or intakes influences the risk of cardiovascular disease (CVD), including fatal ischemic heart disease (IHD), is unclear. OBJECTIVE We performed a systematic review and meta-analysis to investigate prospective associations of circulating and dietary magnesium with incidence of CVD, IHD, and fatal IHD. DESIGN Multiple literature databases were systematically searched without language restriction through May 2012. Inclusion decisions and data extraction were performed in duplicate. Linear dose-response associations were assessed by using random-effects meta-regression. Potential nonlinear associations were evaluated by using restricted cubic splines. RESULTS Of 2303 articles, 16 studies met the eligibility criteria; these studies comprised 313,041 individuals and 11,995 CVD, 7534 IHD, and 2686 fatal IHD events. Circulating magnesium (per 0.2 mmol/L increment) was associated with a 30% lower risk of CVD (RR: 0.70; 95% CI: 0.56, 0.88 per 0.2 mmol/L) and trends toward lower risks of IHD (RR: 0.83; 95% CI: 0.75, 1.05) and fatal IHD (RR: 0.61; 95% CI: 0.37, 1.00). Dietary magnesium (per 200-mg/d increment) was not significantly associated with CVD (RR: 0.89; 95% CI: 0.75, 1.05) but was associated with a 22% lower risk of IHD (RR: 0.78; 95% CI: 0.67, 0.92). The association of dietary magnesium with fatal IHD was nonlinear (P < 0.001), with an inverse association observed up to a threshold of ∼250 mg/d (RR: 0.73; 95% CI: 0.62, 0.86), compared with lower intakes. CONCLUSION Circulating and dietary magnesium are inversely associated with CVD risk, which supports the need for clinical trials to evaluate the potential role of magnesium in the prevention of CVD and IHD.
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Affiliation(s)
- Liana C Del Gobbo
- Department of Nutrition, Harvard School of Public Health, Boston MA, USA.
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109
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Ortega O, Rodriguez I, Cobo G, Hinostroza J, Gallar P, Mon C, Ortiz M, Herrero JC, Di Gioia C, Oliet A, Vigil A. Lack of influence of serum magnesium levels on overall mortality and cardiovascular outcomes in patients with advanced chronic kidney disease. ISRN NEPHROLOGY 2013; 2013:191786. [PMID: 24959538 PMCID: PMC4045427 DOI: 10.5402/2013/191786] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 06/06/2013] [Indexed: 11/23/2022]
Abstract
Background. Low serum magnesium has been associated with an increased cardiovascular risk in the general population and in dialysis patients. Our aim was to analyze the influence of serum magnesium on overall mortality and cardiovascular outcomes in patients with advanced CKD not yet on dialysis. Methods. Seventy patients with CKD stages 4 and 5 were included. After a single measurement of s-magnesium, patients were followed a mean of 11 months. Primary end-point was death of any cause, and secondary end-point was the occurrence of fatal or nonfatal CV events. Results. Basal s-magnesium was within normal range (2.1 ± 0.3 mg/dL), was lower in men (P = 0.008) and in diabetic patients (P = 0.02), and was not different (P = 0.2) between patients with and without cardiopathy. Magnesium did not correlate with PTH, calcium, phosphate, albumin, inflammatory parameters (CRP), and cardiac (NT-proBNP) biomarkers but correlated inversely (r = −0.23; P = 0.052) with the daily dose of loop diuretics. In univariate and multivariate Cox proportional hazard models, magnesium was not an independent predictor for overall mortality or CV events. Conclusions. Our results do not support that serum magnesium can be an independent predictor for overall mortality or future cardiovascular events among patients with advanced CKD not yet on dialysis.
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Affiliation(s)
- Olimpia Ortega
- Nephrology Service, Hospital Severo Ochoa, Avenida Orellana s/n, Leganés 28911, Madrid, Spain
| | - Isabel Rodriguez
- Nephrology Service, Hospital Severo Ochoa, Avenida Orellana s/n, Leganés 28911, Madrid, Spain
| | - Gabriela Cobo
- Nephrology Service, Hospital Severo Ochoa, Avenida Orellana s/n, Leganés 28911, Madrid, Spain
| | - Julie Hinostroza
- Nephrology Service, Hospital Severo Ochoa, Avenida Orellana s/n, Leganés 28911, Madrid, Spain
| | - Paloma Gallar
- Nephrology Service, Hospital Severo Ochoa, Avenida Orellana s/n, Leganés 28911, Madrid, Spain
| | - Carmen Mon
- Nephrology Service, Hospital Severo Ochoa, Avenida Orellana s/n, Leganés 28911, Madrid, Spain
| | - Milagros Ortiz
- Nephrology Service, Hospital Severo Ochoa, Avenida Orellana s/n, Leganés 28911, Madrid, Spain
| | - Juan Carlos Herrero
- Nephrology Service, Hospital Severo Ochoa, Avenida Orellana s/n, Leganés 28911, Madrid, Spain
| | - Cristina Di Gioia
- Nephrology Service, Hospital Severo Ochoa, Avenida Orellana s/n, Leganés 28911, Madrid, Spain
| | - Aniana Oliet
- Nephrology Service, Hospital Severo Ochoa, Avenida Orellana s/n, Leganés 28911, Madrid, Spain
| | - Ana Vigil
- Nephrology Service, Hospital Severo Ochoa, Avenida Orellana s/n, Leganés 28911, Madrid, Spain
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Joosten MM, Gansevoort RT, Mukamal KJ, Kootstra-Ros JE, Feskens EJ, Geleijnse JM, Navis G, Bakker SJ. Urinary Magnesium Excretion and Risk of Hypertension. Hypertension 2013; 61:1161-7. [DOI: 10.1161/hypertensionaha.113.01333] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Michel M. Joosten
- From the Top Institute Food and Nutrition, Wageningen, The Netherlands (M.M.J., E.J.M.F., J.M.G., S.J.L.B.); Department of Internal Medicine (M.M.J., R.T.G., G.N., S.J.L.B.) and Department of Laboratory Medicine (J.E.K.-R.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (M.M.J., K.J.M.); and Division of Human Nutrition, Wageningen University, Wageningen, The
| | - Ron T. Gansevoort
- From the Top Institute Food and Nutrition, Wageningen, The Netherlands (M.M.J., E.J.M.F., J.M.G., S.J.L.B.); Department of Internal Medicine (M.M.J., R.T.G., G.N., S.J.L.B.) and Department of Laboratory Medicine (J.E.K.-R.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (M.M.J., K.J.M.); and Division of Human Nutrition, Wageningen University, Wageningen, The
| | - Kenneth J. Mukamal
- From the Top Institute Food and Nutrition, Wageningen, The Netherlands (M.M.J., E.J.M.F., J.M.G., S.J.L.B.); Department of Internal Medicine (M.M.J., R.T.G., G.N., S.J.L.B.) and Department of Laboratory Medicine (J.E.K.-R.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (M.M.J., K.J.M.); and Division of Human Nutrition, Wageningen University, Wageningen, The
| | - Jenny E. Kootstra-Ros
- From the Top Institute Food and Nutrition, Wageningen, The Netherlands (M.M.J., E.J.M.F., J.M.G., S.J.L.B.); Department of Internal Medicine (M.M.J., R.T.G., G.N., S.J.L.B.) and Department of Laboratory Medicine (J.E.K.-R.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (M.M.J., K.J.M.); and Division of Human Nutrition, Wageningen University, Wageningen, The
| | - Edith J.M. Feskens
- From the Top Institute Food and Nutrition, Wageningen, The Netherlands (M.M.J., E.J.M.F., J.M.G., S.J.L.B.); Department of Internal Medicine (M.M.J., R.T.G., G.N., S.J.L.B.) and Department of Laboratory Medicine (J.E.K.-R.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (M.M.J., K.J.M.); and Division of Human Nutrition, Wageningen University, Wageningen, The
| | - Johanna M. Geleijnse
- From the Top Institute Food and Nutrition, Wageningen, The Netherlands (M.M.J., E.J.M.F., J.M.G., S.J.L.B.); Department of Internal Medicine (M.M.J., R.T.G., G.N., S.J.L.B.) and Department of Laboratory Medicine (J.E.K.-R.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (M.M.J., K.J.M.); and Division of Human Nutrition, Wageningen University, Wageningen, The
| | - Gerjan Navis
- From the Top Institute Food and Nutrition, Wageningen, The Netherlands (M.M.J., E.J.M.F., J.M.G., S.J.L.B.); Department of Internal Medicine (M.M.J., R.T.G., G.N., S.J.L.B.) and Department of Laboratory Medicine (J.E.K.-R.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (M.M.J., K.J.M.); and Division of Human Nutrition, Wageningen University, Wageningen, The
| | - Stephan J.L. Bakker
- From the Top Institute Food and Nutrition, Wageningen, The Netherlands (M.M.J., E.J.M.F., J.M.G., S.J.L.B.); Department of Internal Medicine (M.M.J., R.T.G., G.N., S.J.L.B.) and Department of Laboratory Medicine (J.E.K.-R.), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA (M.M.J., K.J.M.); and Division of Human Nutrition, Wageningen University, Wageningen, The
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111
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Joosten MM, Gansevoort RT, Mukamal KJ, van der Harst P, Geleijnse JM, Feskens EJM, Navis G, Bakker SJL. Urinary and plasma magnesium and risk of ischemic heart disease. Am J Clin Nutr 2013; 97:1299-306. [PMID: 23485414 DOI: 10.3945/ajcn.112.054114] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Previous studies on dietary magnesium and risk of ischemic heart disease (IHD) have yielded inconsistent results, in part because of a lack of direct measures of actual magnesium uptake. Urinary excretion of magnesium, an indicator of dietary magnesium uptake, might provide more consistent results. OBJECTIVE The objective was to investigate whether urinary magnesium excretion and plasma magnesium are associated with IHD risk. DESIGN We examined 7664 adult participants free of known cardiovascular disease in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study-a prospective population-based cohort study. Urinary magnesium excretion was measured in 2 baseline 24-h urine collections. RESULTS Mean ± SD urinary magnesium excretion was 4.24 ± 1.65 mmol/24 h for men and 3.54 ± 1.40 mmol/24 h for women. During a median follow-up of 10.5 y (IQR: 9.9-10.8 y), 462 fatal and nonfatal IHD events occurred. After multivariable adjustment, urinary magnesium excretion had a nonlinear relation with IHD risk (P-curvature = 0.01). The lowest sex-specific quintile (men: <2.93 mmol/24 h; women: <2.45 mmol/24 h) had an increased risk of fatal and nonfatal IHD (multivariable HR: 1.60; 95% CI: 1.28, 2.00) compared with the upper 4 quintiles of urinary magnesium excretion. A similar increase in risk of the lowest quintile was observed for mortality related to IHD (HR: 1.70; 95% CI: 1.10, 2.61). No associations were observed between circulating magnesium and risk of IHD. CONCLUSIONS Low urinary magnesium excretion was independently associated with a higher risk of IHD incidence. An increased dietary intake of magnesium, particularly in those with the lowest urinary magnesium, could reduce the risk of IHD.
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112
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Chiuve SE, Sun Q, Curhan GC, Taylor EN, Spiegelman D, Willett WC, Manson JE, Rexrode KM, Albert CM. Dietary and plasma magnesium and risk of coronary heart disease among women. J Am Heart Assoc 2013; 2:e000114. [PMID: 23537810 PMCID: PMC3647257 DOI: 10.1161/jaha.113.000114] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Magnesium is associated with lower risk of sudden cardiac death, possibly through antiarrhythmic mechanisms. Magnesium influences endothelial function, inflammation, blood pressure, and diabetes, but a direct relation with coronary heart disease (CHD) risk has not been established. Methods and Results We prospectively examined the association between dietary and plasma magnesium and risk of CHD among women in the Nurses' Health Study. The association for magnesium intake was examined among 86 323 women free of disease in 1980. Information on magnesium intake and lifestyle factors was ascertained every 2 to 4 years through questionnaires. Through 2008, 3614 cases of CHD (2511 nonfatal/1103 fatal) were documented. For plasma magnesium, we conducted a nested case–control analysis, with 458 cases of incident CHD (400 nonfatal/58 fatal) matched to controls (1:1) on age, smoking, fasting status, and date of blood sampling. Higher magnesium intake was not associated with lower risk of total CHD (P‐linear trend=0.12) or nonfatal CHD (P‐linear trend=0.88) in multivariable models. However, magnesium intake was inversely associated with risk of fatal CHD. The RR comparing quintile 5 to quintile 1 of magnesium intake was 0.61 (95% CI, 0.45 to 0.84; P‐linear trend=0.003). The association between magnesium intake and risk of fatal CHD appeared to be mediated partially by hypertension. Plasma magnesium levels above 2.0 mg/dL were associated with lower risk of CHD, although not independent of other cardiovascular biomarkers (RR, 0.67; 95% CI, 0.44 to 1.04). Conclusions Dietary and plasma magnesium were not associated with total CHD incidence in this population of women. Dietary magnesium intake was inversely associated with fatal CHD, which may be mediated in part by hypertension.
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Affiliation(s)
- Stephanie E Chiuve
- Center for Arrhythmia Prevention, Department of Medicine Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02215, USA.
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113
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Qu X, Jin F, Hao Y, Li H, Tang T, Wang H, Yan W, Dai K. Magnesium and the risk of cardiovascular events: a meta-analysis of prospective cohort studies. PLoS One 2013; 8:e57720. [PMID: 23520480 PMCID: PMC3592895 DOI: 10.1371/journal.pone.0057720] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Accepted: 01/25/2013] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Prospective studies that have examined the association between dietary magnesium intake and serum magnesium concentrations and the risk of cardiovascular disease (CVD) events have reported conflicting findings. We undertook a meta-analysis to evaluate the association between dietary magnesium intake and serum magnesium concentrations and the risk of total CVD events. METHODOLOGY/PRINCIPAL FINDINGS We performed systematic searches on MEDLINE, EMBASE, and OVID up to February 1, 2012 without limits. Categorical, linear, and nonlinear, dose-response, heterogeneity, publication bias, subgroup, and meta-regression analysis were performed. The analysis included 532,979 participants from 19 studies (11 studies on dietary magnesium intake, 6 studies on serum magnesium concentrations, and 2 studies on both) with 19,926 CVD events. The pooled relative risks of total CVD events for the highest vs. lowest category of dietary magnesium intake and serum magnesium concentrations were 0.85 (95% confidence interval 0.78 to 0.92) and 0.77 (0.66 to 0.87), respectively. In linear dose-response analysis, only serum magnesium concentrations ranging from 1.44 to 1.8 mEq/L were significantly associated with total CVD events risk (0.91, 0.85 to 0.97) per 0.1 mEq/L (P(nonlinearity)= 0.465). However, significant inverse associations emerged in nonlinear models for dietary magnesium intake (P(nonlinearity)= 0.024). The greatest risk reduction occurred when intake increased from 150 to 400 mg/d. There was no evidence of publication bias. CONCLUSIONS/SIGNIFICANCE There is a statistically significant nonlinear inverse association between dietary magnesium intake and total CVD events risk. Serum magnesium concentrations are linearly and inversely associated with the risk of total CVD events.
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Affiliation(s)
- Xinhua Qu
- Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fangchun Jin
- Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yongqiang Hao
- Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Huiwu Li
- Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Tingting Tang
- Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hao Wang
- Department of Pharmacology and Biostatistics, Institute of Medical Sciences, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Weili Yan
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Kerong Dai
- Shanghai Key Laboratory of Orthopaedic Implant, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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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: 85] [Impact Index Per Article: 7.1] [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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Abstract
The most common childhood genitourinary cancers are Wilms tumour, rhabdomyosarcoma and germ cell tumour (GCT). Long-term survival rates for patients with these tumours are generally excellent, ranging from 80% to 100%. However, the high cure rates have highlighted the need to minimize the long-term complications of treatments (referred to as 'late effects'), which can be caused by the three treatment modalities used to treat genitourinary tumours: surgery, chemotherapy and radiation therapy. Serious late effects, such as death, second cancers and tumour recurrence, are uncommon but do occur occasionally. Chronic health conditions--such as cardiac, pulmonary and fertility disorders--are more prevalent. Given the high prevalence of late effects, survivors of childhood genitourinary malignancies require regular surveillance and health promotion delivered by health-care providers with specialist knowledge of the long-term complications of treatment.
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Affiliation(s)
- Karim T Sadak
- Division of Oncology, Children's National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010, USA
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Abstract
INTRODUCTION Hypomagnesemia is reported in type 2 diabetes; magnesium deficiency may play a role in the development of endothelial dysfunction and altered insulin function. OBJECTIVE To assess the incidence of hypomagnesemia among noncritically ill patients of Type 2 diabetes mellitus and to evaluate the relation of hypomagnesemia to glycemic control and various long-term complications of diabetes mellitus. MATERIALS AND METHODS One hundred and fifty, noncritically ill (APACHE score < 10) type 2 diabetes mellitus patients, who were admitted in the Departments of Medicine and Endocrinology, GMCH for uncontrolled hyperglycemia and/or various diabetic complications were studied. Serum magnesium was assessed at admission and rechecked in those found to be deficient. RESULTS Hypomagnesemia (Se magnesium < 1.6 mg/dl) was documented in 17 (11.33%) patients with a female:male ratio of 9:8. Mean HbA1c was 11.9% in the hypomagnesemic patients compared with 9.8% in controls (P =0.0016). Retinopathy, microalbuminuria, macroalbuminuria, foot ulceration, and neuropathy was present in 64%, 47%, 17.64%, 58.8%, and 82.35%, respectively, of the patients with hypomagnesemia as compared with 45.8% (P =0.118), 38.34% (P =0.704),15.03% (P =0.566), 22.55% (P =0.011) and 82.7% (P =0.976) without hypomagnesemia. Coronary artery disease was less common in the hypomagnesemia group (17.6% vs 39%), but comparable in the subgroup < 50 years (27% vs 25%) (P =0.796). CONCLUSION Hypomagnesemia in diabetes was associated with poorer glycemic control, retinopathy, nephropathy, and foot ulcers.
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Affiliation(s)
- Arundhati Dasgupta
- Department of Endocrinology and Metabolism, Gauhati Medical College and Hospital, Guwahati, Assam, India
| | - Dipti Sarma
- Department of Endocrinology and Metabolism, Gauhati Medical College and Hospital, Guwahati, Assam, India
| | - Uma Kaimal Saikia
- Department of Endocrinology and Metabolism, Gauhati Medical College and Hospital, Guwahati, Assam, India
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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: 4.5] [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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118
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Scorza FA, Albuquerque MD, Arida RM, Cysneiros RM. Serum levels of magnesium in sudden cardiac deaths among people with schizophrenia: hit or miss? ARQUIVOS DE NEURO-PSIQUIATRIA 2012; 70:814-6. [DOI: 10.1590/s0004-282x2012001000011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 07/08/2012] [Indexed: 11/22/2022]
Abstract
Schizophrenia is a devastating mental disorder, affecting cognitive, emotional, and behavioral conditions, ability to work, social functioning, family stability and self-esteem of the patient. People with schizophrenia show a two to three-fold increased risk to die prematurely than those without schizophrenia. Understanding the mechanisms behind sudden cardiac death in individuals with schizophrenia is a key to prevention. Although different mechanisms may be related, there are clear indications that cardiac abnormalities play a potential role. Some antipsychotics may be associated with cardiovascular adverse events, e.g., QT interval prolongation, metabolic dysfunction, blood pressure and heart rate alterations. Magnesium (Mg) abnormalities may lead to various morphological and functional dysfunctions of the heart and low levels of serum Mg are considered to be at high risk for sudden cardiac death. As low serum Mg is associated with detrimental effects on the heart and that antipsychotic-treated schizophrenia patients frequently affect the heart rate, possibly, these factors together must change the normal functioning of the heart and consequently being able to culminate in a catastrophic event.
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119
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Wang Q, Xie L, He Z, Di D, Liu J. Biodegradable magnesium nanoparticle-enhanced laser hyperthermia therapy. Int J Nanomedicine 2012; 7:4715-25. [PMID: 22956872 PMCID: PMC3431971 DOI: 10.2147/ijn.s34902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Recently, nanoparticles have been demonstrated to have tremendous merit in terms of improving the treatment specificity and thermal ablation effect on tumors. However, the potential toxicity and long-term side effects caused by the introduced nanoparticles and by expelling them out of the body following surgery remain a significant challenge. Here, we propose for the first time to directly adopt magnesium nanoparticles as the heating enhancer in laser thermal ablation to avoid these problems by making full use of the perfect biodegradable properties of this specific material. Methods To better understand the new nano “green” hyperthermia modality, we evaluated the effects of magnesium nanoparticles on the temperature transients inside the human body subject to laser interstitial heating. Further, we experimentally investigated the heating enhancement effects of magnesium nanoparticles on a group of biological samples: oil, egg white, egg yolk, in vitro pig tissues, and the in vivo hind leg of rabbit when subjected to laser irradiation. Results Both the theoretical simulations and experimental measurements demonstrated that the target tissues injected with magnesium nanoparticles reached much higher temperatures than tissues without magnesium nanoparticles. This revealed the enhancing behavior of the new nanohyperthermia method. Conclusion Given the unique features of magnesium nanoparticles – their complete biological safety and ability to enhance heating – which most other advanced metal nanoparticles do not possess, the use of magnesium nanoparticles in hyperthermia therapy offers an important “green” nanomedicine modality for treating tumors. This method has the potential to be used in clinics in the near future.
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Affiliation(s)
- Qian Wang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, People's Republic of China
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120
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Serum magnesium and sudden unexpected death in epilepsy: A curious clinical sign or a necessity of life. Epilepsy Res 2012; 101:293-4. [DOI: 10.1016/j.eplepsyres.2012.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 04/04/2012] [Accepted: 04/08/2012] [Indexed: 11/19/2022]
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121
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Alves SC, Tomasi CD, Constantino L, Giombelli V, Candal R, Bristot MDL, Topanotti MF, Burdmann EA, Dal-Pizzol F, Fraga CM, Ritter C. Hypomagnesemia as a risk factor for the non-recovery of the renal function in critically ill patients with acute kidney injury. Nephrol Dial Transplant 2012; 28:910-6. [DOI: 10.1093/ndt/gfs268] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Sakaguchi Y, Shoji T, Hayashi T, Suzuki A, Shimizu M, Mitsumoto K, Kawabata H, Niihata K, Okada N, Isaka Y, Rakugi H, Tsubakihara Y. Hypomagnesemia in type 2 diabetic nephropathy: a novel predictor of end-stage renal disease. Diabetes Care 2012; 35:1591-7. [PMID: 22498805 PMCID: PMC3379604 DOI: 10.2337/dc12-0226] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 02/25/2012] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There is now growing evidence that magnesium (Mg) deficiency is implicated in type 2 diabetes and its complications. However, it has not been fully elucidated whether hypomagnesemia is a predictor of end-stage renal disease (ESRD) in type 2 diabetic nephropathy. RESEARCH DESIGN AND METHODS This retrospective cohort study included 455 chronic kidney disease (CKD) patients (144 with type 2 diabetic nephropathy and 311 with nondiabetic CKD) who were hospitalized at Osaka General Medical Center for a CKD educational program between April 2001 and December 2007. The primary outcome was progression to renal replacement therapy. Participants were categorized based on serum Mg level into Low-Mg (serum Mg level ≤1.8 mg/dL) and High-Mg (serum Mg level >1.8 mg/dL) groups with the previously published normal lower limit chosen as the cutoff point. RESULTS Of the subjects with type 2 diabetic nephropathy, 102 progressed to ESRD during follow-up (median, 23 months). A multivariate Cox proportional hazards model showed that after adjustment for various demographic factors and laboratory data, the Low-Mg group had a 2.12-fold higher risk of ESRD than the High-Mg group (95% CI 1.28-3.51; P = 0.004). In contrast, 135 of the nondiabetic CKD subjects progressed to ESRD during follow-up (median, 44 months). No significant difference in outcome was found between the Low- and High-Mg groups of this population (adjusted hazard ratio, 1.15; 95% CI 0.70-1.90; P = 0.57). CONCLUSIONS Hypomagnesemia is a novel predictor of ESRD in patients with type 2 diabetic nephropathy.
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Affiliation(s)
- Yusuke Sakaguchi
- Department of Kidney Disease and Hypertension, Osaka General Medical Center, Osaka, Japan.
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123
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Yuen AW, Sander JW. Can magnesium supplementation reduce seizures in people with epilepsy? A hypothesis. Epilepsy Res 2012; 100:152-6. [DOI: 10.1016/j.eplepsyres.2012.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 01/31/2012] [Accepted: 02/05/2012] [Indexed: 12/15/2022]
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Frisoli TM, Schmieder RE, Grodzicki T, Messerli FH. Beyond salt: lifestyle modifications and blood pressure. Eur Heart J 2011; 32:3081-3087. [PMID: 21990264 DOI: 10.1093/eurheartj/ehr379] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2025] Open
Abstract
Lifestyle changes have been shown to effect significant blood pressure (BP) reductions. Although there are several proposed neurohormonal links between weight loss and BP, body mass index itself appears to be the most powerful mediator of the weight-BP relationship. There appears to be a mostly linear relationship between weight and BP; as weight is regained, the BP benefit is mostly lost. Physical activity, but more so physical fitness (the physiological benefit obtained from physical activity), has a dose-dependent BP benefit but reaches a plateau at which there is no further benefit. However, even just a modest physical activity can have a meaningful BP effect. A diet rich in fruits and vegetables with low-fat dairy products and low in saturated and total fat (DASH) is independently effective in reducing BP. Of the dietary mineral nutrients, the strongest data exist for increased potassium intake, which reduces BP and stroke risk. Vitamin D is associated with BP benefit, but no causal relationship has been established. Flavonoids such as those found in cocoa and berries may have a modest BP benefit. Neither caffeine nor nicotine has any significant, lasting BP effect. Biofeedback therapies such as those obtained with device-guided breathing have a modest and safe BP benefit; more research is needed before such therapies move beyond those having an adjunctive treatment role. There is a strong, linear relationship between alcohol intake and BP; however, the alcohol effects on BP and coronary heart disease are divergent. The greatest BP benefit seems to be obtained with one drink per day for women and with two per day for men. This benefit is lost or attenuated if the drinking occurs in a binge form or without food. Overall, the greatest and most sustained BP benefit is obtained when multiple lifestyle interventions are incorporated simultaneously.
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Affiliation(s)
- Tiberio M Frisoli
- St Luke' s-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 1000 Tenth Avenue, New York, NY 10019, USA
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125
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Chiuve SE, Korngold EC, Januzzi JL, Gantzer ML, Albert CM. Plasma and dietary magnesium and risk of sudden cardiac death in women. Am J Clin Nutr 2011; 93:253-60. [PMID: 21106914 PMCID: PMC3021423 DOI: 10.3945/ajcn.110.002253] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Magnesium has antiarrhythmic properties in cellular and experimental models; however, its relation to sudden cardiac death (SCD) risk is unclear. OBJECTIVE We prospectively examined the association between magnesium, as measured in diet and plasma, and risk of SCD. DESIGN The analysis was conducted within the Nurses' Health Study. The association for magnesium intake was examined prospectively in 88,375 women who were free of disease in 1980. Information on magnesium intake, other nutrients, and lifestyle factors was updated every 2-4 y through questionnaires, and 505 cases of sudden or arrhythmic death were documented over 26 y of follow-up. For plasma magnesium, a nested case-control analysis including 99 SCD cases and 291 controls matched for age, ethnicity, smoking, and presence of cardiovascular disease was performed. RESULTS After multivariable adjustment for confounders and potential intermediaries, the relative risk of SCD was significantly lower in women in the highest quartile compared with those in the lowest quartile of dietary (relative risk: 0.63; 95% CI: 0.44, 0.91) and plasma (relative risk: 0.23; 95% CI: 0.09, 0.60) magnesium. The linear inverse relation with SCD was strongest for plasma magnesium (P for trend = 0.003), in which each 0.25-mg/dL (1 SD) increment in plasma magnesium was associated with a 41% (95% CI: 15%, 58%) lower risk of SCD. CONCLUSIONS In this prospective cohort of women, higher plasma concentrations and dietary magnesium intakes were associated with lower risks of SCD. If the observed association is causal, interventions directed at increasing dietary or plasma magnesium might lower the risk of SCD.
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Affiliation(s)
- Stephanie E Chiuve
- Center for Arrhythmia Prevention, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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Abdulsahib HT. Determination of Magnesium in whole Blood and Serum of Ischemic Heart Disease(IHD) Patients by Flame Atomic Absorption Spectrometry. ACTA ACUST UNITED AC 2011. [DOI: 10.4236/ajac.2011.28117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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127
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Terra VC, Albuquerque MD, Scorza CA, Arida RM, Scorza FA. Serum magnesium: a clinical biomarker for sudden unexpected death in epilepsy? ACTA ACUST UNITED AC 2011. [DOI: 10.1590/s1676-26492011000200008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION: Epilepsy is one of the most common chronic neurological disorder in the world and has a higher mortality rate than would be expected in a healthy population. One of the most related category of death is sudden unexpected death in epilepsy (SUDEP). Many risk factors have been related to SUDEP, but the mechanisms involved in its genesis is still unknown. OBJECTIVE: Here we describe one case of a patient with low serum magnesium levels that suffered of SUDEP. CONCLUSION: we discuss a possible cause-effect relation, suggesting that magnesium may be, in some cases, a biomarker of SUDEP.
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Santos MSB, Seguro AC, Andrade L. Hypomagnesemia is a risk factor for nonrecovery of renal function and mortality in AIDS patients with acute kidney injury. Braz J Med Biol Res 2010; 43:316-23. [PMID: 20401440 DOI: 10.1590/s0100-879x2010007500002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Accepted: 01/07/2010] [Indexed: 11/22/2022] Open
Abstract
The objective of the present study was to determine the prevalence of electrolyte disturbances in AIDS patients developing acute kidney injury in the hospital setting, as well as to determine whether such disturbances constitute a risk factor for nephrotoxic and ischemic injury. A prospective, observational cohort study was carried out. Hospitalized AIDS patients were evaluated for age; gender; coinfection with hepatitis; diabetes mellitus; hypertension; time since HIV seroconversion; CD4 count; HIV viral load; proteinuria; serum levels of creatinine, urea, sodium, potassium and magnesium; antiretroviral use; nephrotoxic drug use; sepsis; intensive care unit (ICU) admission, and the need for dialysis. Each of these characteristics was correlated with the development of acute kidney injury, with recovery of renal function and with survival. Fifty-four patients developed acute kidney injury: 72% were males, 59% had been HIV-infected for >5 years, 72% had CD4 counts <200 cells/mm(3), 87% developed electrolyte disturbances, 33% recovered renal function, and 56% survived. ICU admission, dialysis, sepsis and hypomagnesemia were all significantly associated with nonrecovery of renal function and with mortality. Nonrecovery of renal function was significantly associated with hypomagnesemia, as was mortality in the multivariate analysis. The risks for nonrecovery of renal function and for death were 6.94 and 6.92 times greater, respectively, for patients with hypomagnesemia. In hospitalized AIDS patients, hypomagnesemia is a risk factor for nonrecovery of renal function and for in-hospital mortality. To determine whether hypomagnesemia is a determinant or simply a marker of critical illness, further studies involving magnesium supplementation in AIDS patients are warranted.
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Ulger Z, Ariogul S, Cankurtaran M, Halil M, Yavuz BB, Orhan B, Kavas GO, Aribal P, Canlar S, Dede DS, Ozkayar N, Akyol O. Intra-erythrocyte magnesium levels and their clinical implications in geriatric outpatients. J Nutr Health Aging 2010; 14:810-4. [PMID: 21125197 DOI: 10.1007/s12603-010-0121-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Magnesium deficiency has been implicated as a factor in numerous chronic diseases and previous studies suggest a greater prevalence of occult magnesium deficiency among older adults. Serum is the choice for the assessment of most analyses used in clinical medicine, although serum magnesium concentrations have been shown to be poor predictors of intracellular magnesium concentration. The aim of this study was to compare intracellular and extracellular magnesium concentrations in geriatric outpatients. Moreover, we examined whether a significant correlation between magnesium parameters and clinical outcome existed. DESIGN Cross-sectional study. SETTING Geriatric medicine outpatient clinic of a university hospital. PARTICIPANTS A total of 246 patients with a mean age of 71.9 ± 5.7 years were involved. MEASUREMENTS Intra-erythrocyte magnesium levels were analyzed with atomic absorption spectrophotometry. RESULTS Serum magnesium levels were within normal range in all patients, whereas intra-erythrocyte magnesium measurements were low in 57% of the patients. Increase in serum levels were together with just only a slightly increase in intra-erythrocyte measurements and the relationship was very weak. Intra-erythrocyte Mg levels were not significantly correlated with many laboratory or clinical parameters. CONCLUSION Our results confirm that intra-erythrocyte Mg does not correlate with serum levels and clinical parameters in geriatric outpatients, but further studies are needed to define the correlation.
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Affiliation(s)
- Z Ulger
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
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Magnesium deficiency promotes a pro-atherogenic phenotype in cultured human endothelial cells via activation of NFkB. Biochim Biophys Acta Mol Basis Dis 2010; 1802:952-8. [DOI: 10.1016/j.bbadis.2010.06.016] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 06/11/2010] [Accepted: 06/23/2010] [Indexed: 11/19/2022]
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Khan AM, Sullivan L, McCabe E, Levy D, Vasan RS, Wang TJ. Lack of association between serum magnesium and the risks of hypertension and cardiovascular disease. Am Heart J 2010; 160:715-20. [PMID: 20934566 DOI: 10.1016/j.ahj.2010.06.036] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Accepted: 06/24/2010] [Indexed: 01/13/2023]
Abstract
BACKGROUND Experimental studies have linked hypomagnesemia with the development of vascular dysfunction, hypertension, and atherosclerosis. Prior clinical studies have yielded conflicting results but were limited by the use of self-reported magnesium intake or short follow-up periods. METHODS We examined the relationship between serum magnesium concentration and incident hypertension, cardiovascular disease (CVD), and mortality in 3,531 middle-aged adult participants in the Framingham Heart Study offspring cohort. Analyses were performed using Cox proportional hazards regressions, adjusted for traditional CVD risk factors. RESULTS Follow-up was 8 years for new-onset hypertension (551 events) and 20 years for CVD (554 events). There was no association between baseline serum magnesium and the development of hypertension (multivariable-adjusted hazards ratio per 0.15 mg/dL 1.03, 95% CI 0.92-1.15, P = .61), CVD (0.83, 95% CI 0.49-1.40, P = .49), or all-cause mortality (0.77, 95% CI 0.41-1.45, P = .42). Similar findings were observed in categorical analyses, in which serum magnesium was modeled in categories (<1.5, 1.5-2.2, >2.2 mg/dL) or in quartiles. CONCLUSIONS In conclusion, data from this large, community-based cohort do not support the hypothesis that low serum magnesium is a risk factor for developing hypertension or CVD.
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Peacock JM, Ohira T, Post W, Sotoodehnia N, Rosamond W, Folsom AR. Serum magnesium and risk of sudden cardiac death in the Atherosclerosis Risk in Communities (ARIC) Study. Am Heart J 2010; 160:464-70. [PMID: 20826254 DOI: 10.1016/j.ahj.2010.06.012] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Accepted: 06/04/2010] [Indexed: 12/13/2022]
Abstract
BACKGROUND We hypothesized that serum magnesium (Mg) is associated with increased risk of sudden cardiac death (SCD). METHODS The Atherosclerosis Risk in Communities Study assessed risk factors and levels of serum Mg in a cohort of 45- to 64-year-old subjects in 1987-1989 (n = 14,232). After an average of 12 years of follow-up, we observed 264 cases of SCD, as determined by physician review of all suspected cases. We used proportional hazards regression to evaluate the association of serum Mg with risk of SCD. RESULTS Individuals in the highest quartile of serum Mg were at significantly lower risk of SCD in all models. This association persisted after adjustment for potential confounding variables, with an almost 40% reduced risk of SCD (hazard ratio 0.62, 95% CI 0.42-0.93) in quartile 4 versus 1 of serum Mg observed in the fully adjusted model. CONCLUSIONS This study suggests that low levels of serum Mg may be an important predictor of SCD. Further research into the effectiveness of Mg supplementation for those considered to be at high risk for SCD is warranted.
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Dennehy C, Tsourounis C. A review of select vitamins and minerals used by postmenopausal women. Maturitas 2010; 66:370-80. [PMID: 20580500 DOI: 10.1016/j.maturitas.2010.06.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 06/01/2010] [Accepted: 06/02/2010] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The purpose of this review is to summarize the effectiveness of select vitamins, minerals and trace elements in postmenopausal women for their effects on bone health, cardiovascular health, breast cancer, cognition and vasomotor symptoms. METHODS Review of the relevant literature and results from recent clinical studies, as well as critical analyses of published systematic reviews and meta-analyses were obtained from PubMed and Cochrane Library of Reviews. Vitamin A, the B vitamins, vitamin C, calcium, vitamin D, vitamin E, vitamin K, magnesium, selenium and zinc were selected for review. In circumstances where the vitamin, mineral or trace element has not been studied for a given condition, no information was provided. RESULTS AND DISCUSSION All vitamins, minerals and trace elements play an important role in maintaining health and wellbeing among menopausal women. Adequate dietary intake is essential and supplementation should be considered in women with documented malabsorption syndromes or deficiencies. Based on a review of the literature, supplementation with vitamin C, D, K and calcium can also be recommended for proper maintenance of bone health. The only supplement studied for vasomotor symptoms was vitamin E and this vitamin lacked clinical support. Supplementation in healthy postmenopausal women with vitamins and minerals in diet or pill forms cannot be recommended currently for any other indications.
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Affiliation(s)
- Cathi Dennehy
- Department of Clinical Pharmacy, UCSF School of Pharmacy, San Francisco, CA 94143, USA.
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New hypotheses for the health-protective mechanisms of whole-grain cereals: what is beyond fibre? Nutr Res Rev 2010; 23:65-134. [PMID: 20565994 DOI: 10.1017/s0954422410000041] [Citation(s) in RCA: 609] [Impact Index Per Article: 40.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Epidemiological studies have clearly shown that whole-grain cereals can protect against obesity, diabetes, CVD and cancers. The specific effects of food structure (increased satiety, reduced transit time and glycaemic response), fibre (improved faecal bulking and satiety, viscosity and SCFA production, and/or reduced glycaemic response) and Mg (better glycaemic homeostasis through increased insulin secretion), together with the antioxidant and anti-carcinogenic properties of numerous bioactive compounds, especially those in the bran and germ (minerals, trace elements, vitamins, carotenoids, polyphenols and alkylresorcinols), are today well-recognised mechanisms in this protection. Recent findings, the exhaustive listing of bioactive compounds found in whole-grain wheat, their content in whole-grain, bran and germ fractions and their estimated bioavailability, have led to new hypotheses. The involvement of polyphenols in cell signalling and gene regulation, and of sulfur compounds, lignin and phytic acid should be considered in antioxidant protection. Whole-grain wheat is also a rich source of methyl donors and lipotropes (methionine, betaine, choline, inositol and folates) that may be involved in cardiovascular and/or hepatic protection, lipid metabolism and DNA methylation. Potential protective effects of bound phenolic acids within the colon, of the B-complex vitamins on the nervous system and mental health, of oligosaccharides as prebiotics, of compounds associated with skeleton health, and of other compounds such as alpha-linolenic acid, policosanol, melatonin, phytosterols and para-aminobenzoic acid also deserve to be studied in more depth. Finally, benefits of nutrigenomics to study complex physiological effects of the 'whole-grain package', and the most promising ways for improving the nutritional quality of cereal products are discussed.
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Ishikawa M, Shimoda S, Nakamura Y. Histological Study of the Periodontal Ligament and Alveolar Bone in Magnesium-deficient Rats. J Oral Biosci 2010. [DOI: 10.1016/s1349-0079(10)80047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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136
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Boylan S, Welch A, Pikhart H, Malyutina S, Pajak A, Kubinova R, Bragina O, Simonova G, Stepaniak U, Gilis-Januszewska A, Milla L, Peasey A, Marmot M, Bobak M. Dietary habits in three Central and Eastern European countries: the HAPIEE study. BMC Public Health 2009; 9:439. [PMID: 19951409 PMCID: PMC2791768 DOI: 10.1186/1471-2458-9-439] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Accepted: 12/01/2009] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The high cardiovascular mortality in Eastern Europe has often been attributed to poor diet, but individual-level data on nutrition in the region are generally not available. This paper describes the methods of dietary assessment and presents preliminary findings on food and nutrient intakes in large general population samples in Russia, Poland and the Czech Republic. METHODS The HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study examined random samples of men and women aged 45-69 years at baseline in Novosibirsk (Russia), Krakow (Poland) and six Czech urban centres in 2002-2005. Diet was assessed using a food frequency questionnaire (at least 136 items); complete dietary information was available for 26,870 persons. RESULTS Total energy intakes among men ranged between 8.7 MJ in the Czech sample and 11.7 MJ in the Russian sample, while among women, energy intakes ranged between 8.2 MJ in the Czech sample and 9.8 MJ in the Russian sample. A Healthy Diet Indicator (HDI), ranging from a score of 0 (lowest) to 7 (highest), was developed using the World Health Organisation's (WHO) guidelines for the prevention of chronic diseases. The mean HDI scores were low, ranging from 1.0 (SD = 0.7) among the Polish subjects to 1.7 (SD = 0.8) among the Czech females. Very few subjects met the WHO recommended intakes for complex carbohydrates, pulses or nuts; intakes of saturated fatty acids, sugar and protein were too high. Only 16% of Polish subjects met the WHO recommendation for polyunsaturated fat intake. Consumption of fruits and vegetables was lower than recommended, especially among those Russian subjects who were assessed during the low intake season. Fewer than 65% of subjects consumed adequate amounts of calcium, magnesium and potassium, when compared with the United Kingdom's Reference Nutrient Intake. CONCLUSION This first large scale study of individual-based dietary intakes in the general population in Eastern Europe implies that intakes of saturated fat, sugar and complex carbohydrates are a cause for concern. The development of country-specific nutritional tools must be encouraged and nutritional campaigns must undergo continuing development.
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Affiliation(s)
- Sinéad Boylan
- Department of Epidemiology and Public Health, University College London, London, UK.
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Mathers TW, Beckstrand RL. Oral magnesium supplementation in adults with coronary heart disease or coronary heart disease risk. ACTA ACUST UNITED AC 2009; 21:651-7. [DOI: 10.1111/j.1745-7599.2009.00460.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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138
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Hong BZ, Park SA, Kim HN, Ma TZ, Kim HG, Kang HS, Kim HG, Kwak YG. Basic fibroblast growth factor increases intracellular magnesium concentration through the specific signaling pathways. Mol Cells 2009; 28:13-7. [PMID: 19711039 DOI: 10.1007/s10059-009-0103-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 05/22/2009] [Accepted: 06/08/2009] [Indexed: 01/25/2023] Open
Abstract
Basic fibroblast growth factor (bFGF) plays an important role in angiogenesis. However, the underlying mechanisms are not clear. Mg(2+) is the most abundant intracellular divalent cation in the body and plays critical roles in many cell functions. We investigated the effect of bFGF on the intracellular Mg(2+) concentration ([Mg(2+)](i)) in human umbilical vein endothelial cells (HUVECs). bFGF increased [Mg(2+)](i) in a dose-dependent manner, independent of extracellular Mg(2+). This bFGF-induced [Mg(2+)](i) increase was blocked by tyrosine kinase inhibitors (tyrphostin A-23 and genistein), phosphatidylinositol 3-kinase (PI3K) inhibitors (wortmannin and LY294002) and a phospholipase Cgamma (PLCgamma) inhibitor (U73122). In contrast, mitogen-activated protein kinase inhibitors (SB202190 and PD98059) did not affect the bFGF-induced [Mg(2+)](i) increase. These results suggest that bFGF increases the [Mg(2+)](i) from the intracellular Mg(2+) stores through the tyrosine kinase/PI3K/PLCgamma-dependent signaling pathways.
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Affiliation(s)
- Bing-Zhe Hong
- Department of Pharmacology, Chonbuk National University Medical School, Jeonju 560-182, Korea
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139
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Ohira T, Peacock JM, Iso H, Chambless LE, Rosamond WD, Folsom AR. Serum and dietary magnesium and risk of ischemic stroke: the Atherosclerosis Risk in Communities Study. Am J Epidemiol 2009; 169:1437-44. [PMID: 19372211 DOI: 10.1093/aje/kwp071] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The authors sought to examine the relation between serum or dietary magnesium and the incidence of ischemic stroke among blacks and whites. Between 1987 and 1989, 14,221 men and women aged 45-64 years took part in the first examination of the Atherosclerosis Risk in Communities Study cohort. The incidence of stroke was ascertained from hospital records. Higher serum magnesium levels were associated with lower prevalence of hypertension and diabetes mellitus at baseline. During the 15-year follow-up, 577 ischemic strokes occurred. Serum magnesium was inversely associated with ischemic stroke incidence. The age-, sex-, and race-adjusted rate ratios of ischemic stroke for those with serum magnesium levels of <or=1.5, 1.6, 1.7, and >or=1.8 mEq/L were 1.0, 0.78 (95% confidence interval (CI): 0.62, 0.96), 0.70 (95% CI: 0.56, 0.88), and 0.75 (95% CI: 0.59, 0.95) (P(trend) = 0.005). After adjustment for hypertension and diabetes, the rate ratios were attenuated to nonsignificant levels. Dietary magnesium intake was marginally inversely associated with the incidence of ischemic stroke (P(trend) = 0.09). Low serum magnesium levels could be associated with increased risk of ischemic stroke, in part, via effects on hypertension and diabetes.
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Affiliation(s)
- Tetsuya Ohira
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota 55454-1015, USA
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140
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Bergman C, Gray-Scott D, Chen JJ, Meacham S. What is next for the Dietary Reference Intakes for bone metabolism related nutrients beyond calcium: phosphorus, magnesium, vitamin D, and fluoride? Crit Rev Food Sci Nutr 2009; 49:136-44. [PMID: 18989832 DOI: 10.1080/10408390701764468] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The science supporting the Dietary Reference Intakes (DRI) for phosphorus, magnesium, vitamin D, and fluoride was examined in this review. Along with the previous article on calcium in this series both of these reviews represent all the DRI for nutrients considered essential for bone metabolism and health, as reported in the Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride (Institute of Medicine, Food and Nutrition Board (FNB), 1997). The Recomended Dietary Allowances (RDA) or adequate intake (AI), and the tolerable upper intake level (UL) were recommended for each of these essential nutrients. For adults and in the case of fluoride, for infants as well, UL were calculated since all of these nutrients have the potential for mild to detrimental side effects. Dietary intake data and controversies regarding the role these nutrients may play in other chronic diseases have also been discussed. Advances and controversies reported since the publication of the DRI for these nutrients were also addressed in this review. A recent Dietary Reference Intake Research Synthesis Workshop report identified an extensive range of suggested future research directions needed to improve our understanding of these bone-related nutrients and their contributions to human health.
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Affiliation(s)
- Christine Bergman
- Department of Food and Beverage Management, University of Nevada, Las Vegas, NV, USA
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141
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Magnesium supplementation helps to improve carotid intima media thickness in patients on hemodialysis. Int Urol Nephrol 2008; 40:1075-82. [PMID: 18568412 DOI: 10.1007/s11255-008-9410-3] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Accepted: 05/28/2008] [Indexed: 12/12/2022]
Abstract
BACKGROUND The atherosclerotic process progresses more dynamically in hemodialysis (HD) patients than in the general population. In HD patients, lower magnesium levels were reported to be associated with increased atherosclerosis of the common carotid artery. We tested the hypotheses that magnesium supplementation helps to improve carotid intima media thickness (IMT) in HD patients. MATERIALS AND METHODS A total of 47 patients on HD were included in the study. Patients were randomly divided into two groups: group A (Mg group), in which patients were given magnesium citrate orally at a dosage of 610 mg every other day for 2 months and group B (control group), in which patients received only calcium acetate therapy as a phosphate binder. At baseline and 2 months later, all patients underwent a carotid artery ultrasound scan to measure carotid IMT. RESULTS At the end of 2 months, mean serum calcium, phosphorus, and calcium x phosphorus product were not changed in both groups. As expected, mean serum Mg level significantly increased in the Mg group at the end of 2 months. In addition, serum parathyroid hormone (PTH) level significantly decreased in the Mg group at the end of 2 months (P = 0.003). Baseline carotid IMT was similar between the groups. Bilateral carotid IMT was significantly improved in patients treated with magnesium citrate compared to initial values (P = 0.001 for left, P = 0.002 for right). CONCLUSION Based on the present data, magnesium may play an important protective role in the progression of atherosclerosis in patients on dialysis. Further studies are needed to assess more accurately the role of magnesium in atherosclerotic regression in dialysis patients.
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142
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Champagne CM. Magnesium in Hypertension, Cardiovascular Disease, Metabolic Syndrome, and Other Conditions: A Review. Nutr Clin Pract 2008; 23:142-51. [DOI: 10.1177/0884533608314533] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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143
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Randell EW, Mathews M, Gadag V, Zhang H, Sun G. Relationship between serum magnesium values, lipids and anthropometric risk factors. Atherosclerosis 2008; 196:413-419. [PMID: 17161404 DOI: 10.1016/j.atherosclerosis.2006.11.024] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2006] [Revised: 10/10/2006] [Accepted: 11/17/2006] [Indexed: 11/24/2022]
Abstract
UNLABELLED Serum magnesium (SMg) has been reported to negatively correlate with an atherogenic lipid profile in individuals with diabetes mellitus (DM) and metabolic syndrome. This study examines whether the relationships between SMg levels and biochemical and anthropometric risk factors for these conditions are also present in the general adult population. DESIGN AND METHODS Biochemical parameters and anthropometric variables were assessed in 1318 healthy adult subjects recruited from the Newfoundland population. RESULTS SMg positively correlated with age, and serum phosphate, calcium, albumin, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglyceride levels. SMg negatively correlated with HOMA-beta and percent body fat measured by DEXA. On sub-grouping subjects according to sex, menopausal status or after excluding subjects with DM, only a significant correlation of SMg with albumin, calcium, phosphate, and total cholesterol was common to all. Stepwise linear regression analysis revealed albumin, phosphate, age, total cholesterol, glucose, and body mass index as independent predictors of SMg levels. CONCLUSIONS These results indicate that SMg levels positively correlate with total cholesterol and possibly all lipoproteins in a large adult study population which suggests that variation of SMg with serum lipid levels may be different in healthy individuals compared with those with DM. We speculate on a possible binding interaction.
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Affiliation(s)
- Edward W Randell
- Division of Laboratory Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Nfld A1B 3V6, Canada; Division of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Nfld A1B 3V6, Canada; Health Care Corporation of St. John's, St. John's, Nfld A1B 3V6, Canada.
| | - Maria Mathews
- Division of Community Health, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Nfld A1B 3V6, Canada
| | - Veeresh Gadag
- Division of Community Health, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Nfld A1B 3V6, Canada
| | - Hongwei Zhang
- Division of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Nfld A1B 3V6, Canada
| | - Guang Sun
- Division of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Nfld A1B 3V6, Canada
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Karaszewski B, Kozera G, Dorosz A, Łukasiak J, Szczyrba S, Łysiak-Szydłowska W, Nyka WM. High magnesium or potassium hair accumulation is not associated with ischemic stroke risk reduction: A pilot study. Clin Neurol Neurosurg 2007; 109:676-9. [PMID: 17624662 DOI: 10.1016/j.clineuro.2007.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 05/25/2007] [Accepted: 05/26/2007] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Various studies suggest that deficiency of magnesium and potassium may be associated with increased risk of ischemic stroke. However, single time-point serum measurements may not be suitable for assessing long-term tissue levels. PATIENTS AND METHODS We investigated Mg and K levels in hair of patients with acute ischemic stroke. The elements hair accumulation analysis might provide historical information on their concentrations over a longer period of time and probably reflects the corresponding nutritional condition. The concentrations of Mg and K in hair of 48 men with acute ischemic stroke and a control group were measured using spectroscopic methods. RESULTS The mean Mg and K concentrations in hair of patients were significantly higher than in the controls. CONCLUSIONS This analysis does not seem to confirm the results of the previous studies suggesting that Mg or K high levels (or their diet supplementation) might protect humans against ischemic stroke.
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Affiliation(s)
- Bartosz Karaszewski
- Department of Neurology of Adults, Medical University of Gdansk, Ul. Debinki 7, 80-211 Gdansk, Poland.
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145
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He K, Song Y, Belin RJ, Chen Y. Magnesium intake and the metabolic syndrome: epidemiologic evidence to date. ACTA ACUST UNITED AC 2007; 1:351-5. [PMID: 17679786 DOI: 10.1111/j.1559-4564.2006.05702.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The importance of magnesium intake in relation to the metabolic syndrome has been increasingly recognized. Magnesium is an essential mineral, critical for a number of metabolic functions in the human body. The major dietary sources of magnesium intake include whole grains, legumes, nuts, and green leafy vegetables. Animal studies indicate a pivotal role of magnesium in glucose homeostasis and insulin secretion and action. Experimental and clinical studies suggest that magnesium intake may be inversely related to the risk of hypertension and type 2 diabetes mellitus, and may decrease blood triglyceride and increase high-density lipoprotein cholesterol levels. The purpose of this brief review is to summarize the epidemiologic data relating magnesium to the metabolic syndrome and to discuss the potential mechanisms.
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Affiliation(s)
- Ka He
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
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146
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Pham PCT, Pham PMT, Pham SV, Miller JM, Pham PTT. Hypomagnesemia in patients with type 2 diabetes. Clin J Am Soc Nephrol 2007; 2:366-73. [PMID: 17699436 DOI: 10.2215/cjn.02960906] [Citation(s) in RCA: 229] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Hypomagnesemia has been reported to occur at an increased frequency among patients with type 2 diabetes compared with their counterparts without diabetes. Despite numerous reports linking hypomagnesemia to chronic diabetic complications, attention to this issue is poor among clinicians. This article reviews the literature on the metabolism of magnesium, incidence of hypomagnesemia in patients with type 2 diabetes, implicated contributing factors, and associated complications. Hypomagnesemia occurs at an incidence of 13.5 to 47.7% among patients with type 2 diabetes. Poor dietary intake, autonomic dysfunction, altered insulin metabolism, glomerular hyperfiltration, osmotic diuresis, recurrent metabolic acidosis, hypophosphatemia, and hypokalemia may be contributory. Hypomagnesemia has been linked to poor glycemic control, coronary artery diseases, hypertension, diabetic retinopathy, nephropathy, neuropathy, and foot ulcerations. The increased incidence of hypomagnesemia among patients with type 2 diabetes presumably is multifactorial. Because current data suggest adverse outcomes in association with hypomagnesemia, it is prudent to monitor magnesium routinely in this patient population and treat the condition whenever possible.
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Affiliation(s)
- Phuong-Chi T Pham
- Olive View-UCLA Medical Center, 14445 Olive View Drive, Department of Medicine, 2B-182, Nephrology Division, Sylmar, CA 91342, USA.
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147
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Corica F, Corsonello A, Ientile R, Cucinotta D, Di Benedetto A, Perticone F, Dominguez LJ, Barbagallo M. Serum ionized magnesium levels in relation to metabolic syndrome in type 2 diabetic patients. J Am Coll Nutr 2006; 25:210-5. [PMID: 16766779 DOI: 10.1080/07315724.2006.10719534] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate circulating serum ionized magnesium (i-Mg) concentrations in patients with type 2 diabetes mellitus, and to investigate its relationship with the components of the metabolic syndrome. DESIGN cross-sectional study. SETTING Outpatients' service for diabetic patients at the University Hospital of Messina, Italy. SUBJECTS 290 patients with type 2 diabetes mellitus. MEASURES OF OUTCOME Serum i-Mg was measured by ion selective electrode. Age, gender, body mass index (BMI), waist circumference, blood pressure, fasting glucose, HbA1c, HDL cholesterol, triglycerides, and urinary albumin excretion rate (UAER) were considered in the analyses. Patients with hypomagnesemia, defined as serum i-Mg <0.46 mmol/l, were compared with those having normal serum i-Mg levels, and variables proven to be associated with low i-Mg levels in the univariate analysis were entered in a multivariable logistic regression model to obtain a deconfounded estimate of the association between metabolic parameters and hypomagnesemia. RESULTS In univariate analysis, serum i-Mg levels were significantly reduced in patients with low HDL cholesterol, high triglycerides values, high waist circumference, high blood pressure, microalbuminuria and clinical proteinuria. Hypomagnesemia was highly prevalent in our study population (N = 143, 49.3%). After adjusting for potential confounders, plasma triglycerides (OR = 4.71; 95% CI = 2.56-8.67), waist circumference (OR = 2.21; 95% CI = 1.21-4.04), microalbuminuria (OR = 2.43; 95% CI = 1.16-5.08) and clinical proteinuria (OR = 2.04; 95% CI = 1.02-5.68) were independently associated with hypomagnesemia. CONCLUSIONS Hypomagnesemia is highly prevalent in diabetic outpatients. High plasma triglycerides, waist circumference and albuminuria are independent correlates of hypomagnesemia.
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Affiliation(s)
- Francesco Corica
- Department of Internal Medicine, University of Messina, Messina, Italy
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Lin J, Cook NR, Lee IM, Manson JE, Buring JE, Zhang SM. Total Magnesium Intake and Colorectal Cancer Incidence in Women. Cancer Epidemiol Biomarkers Prev 2006; 15:2006-9. [PMID: 17035414 DOI: 10.1158/1055-9965.epi-06-0454] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jennifer Lin
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue East, Boston, MA 02215, USA.
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149
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Leone N, Courbon D, Ducimetiere P, Zureik M. Zinc, copper, and magnesium and risks for all-cause, cancer, and cardiovascular mortality. Epidemiology 2006; 17:308-14. [PMID: 16570028 DOI: 10.1097/01.ede.0000209454.41466.b7] [Citation(s) in RCA: 199] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Experimental data suggest that zinc, copper, and magnesium are involved in carcinogenesis and atherogenesis. Few longitudinal studies have related these minerals to cancer or cardiovascular disease mortality in a population. METHODS Data from the Paris Prospective Study 2, a cohort of 4035 men age 30-60 years at baseline, were used to assess the association between serum zinc, copper, and magnesium and all-cause, cancer, and cardiovascular disease mortality. Serum mineral values measured at baseline were divided into quartiles and classified into low (1st quartile, referent group), medium (2nd-3rd quartiles), and high (4th quartile) values. During 18-year follow up, 339 deaths occurred, 176 as a result of cancer and 56 of cardiovascular origin. Relative risks (RRs) for each element were inferred using Cox's proportional hazard model after controlling for various potential confounders. RESULTS High copper values (4th quartile) were associated with a 50% increase in RRs for all-cause deaths (RR = 1.5; 95% confidence interval = 1.1-2.1), a 40% increase for cancer mortality (1.4; 0.9-2.2), and a 30% increase for cardiovascular mortality (1.3; 0.6-2.8) compared with low values (1st quartile). High magnesium values were negatively related to mortality with a 40% decrease in RR for all-cause (0.6; 0.4-0.8) and cardiovascular deaths (0.6; 0.2-1.2) and by 50% for cancer deaths (0.5; 0.3-0.8). Additionally, subjects with a combination of low zinc and high copper values had synergistically increased all-cause (2.6; 1.4-5.0) and cancer (2.7; 1.0-7.3) mortality risks. Similarly, combined low zinc and high magnesium values were associated with decreased all-cause (0.2; 0.1-0.5) and cancer (0.2; 0.1-0.8) mortality risks. CONCLUSIONS High serum copper, low serum magnesium, and concomitance of low serum zinc with high serum copper or low serum magnesium contribute to an increased mortality risk in middle-aged men.
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Affiliation(s)
- Nathalie Leone
- Unit 744 National Institute of Health and Medical Research (INSERM), Lille Pasteur Institute, Lille, France
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Hong BZ, Kang HS, So JN, Kim HN, Park SA, Kim SJ, Kim KR, Kwak YG. Vascular endothelial growth factor increases the intracellular magnesium. Biochem Biophys Res Commun 2006; 347:496-501. [PMID: 16828056 DOI: 10.1016/j.bbrc.2006.06.125] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2006] [Accepted: 06/21/2006] [Indexed: 11/17/2022]
Abstract
Vascular endothelial growth factor (VEGF) is one of the key players in the process of angiogenesis. However, its underlying mechanism remains unclear. Mg2+ is the most abundant intracellular divalent cation in the body and plays critical roles in many cell functions. We investigated the effect of VEGF on intracellular Mg2+ in human umbilical vein endothelial cells (HUVECs). VEGF-A165 increased the intracellular Mg2+ concentration ([Mg2+]i) in a dose-dependent manner, with or without extracellular Mg2+, and the increase of [Mg2+]i was blocked by pretreatment with SU1498, tyrosine kinase inhibitors (tyrphostin A-23 and genistein), phosphatidylinositol 3-kinase (PI3K) inhibitors (wortmannin and LY294002) or phospholipase Cgamma (PLCgamma) inhibitor (U73122). In contrast, mitogen-activated protein kinase inhibitors (SB202190 and PD98059) had no effect on the VEGF-induced [Mg2+]i increase. These results suggest that VEGF-A165 increases the [Mg2+]i from the intracellular Mg2+ stores through the tyrosine kinase/PI3K/PLCgamma-dependent signaling pathways.
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Affiliation(s)
- Bing-Zhe Hong
- Department of Pharmacology, Chonbuk National University Medical School, Jeonju, Jeonbuk 560-182, Republic of Korea
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