Association of macrovascular complications of type 2 diabetes mellitus with serum magnesium levels

Reduced Serum Magnesium Levels Are Associated with the Occurrence of Retinopathy in Patients with Type 2 Diabetes Mellitus: a Retrospective Study

The aim of this study is to explore the relationship between serum magnesium (Mg²⁺) level and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). The clinical data of 2222 patients with T2DM, including 713 patients with DR and 1509 patients without DR, between September 2016 and August 2020 in our hospital, were analyzed retrospectively. Further, the role and predictive value of serum Mg²⁺ on the prevalence of DR were determined through logistic regression and the receiver operating characteristic (ROC) curve respectively. The level of serum Mg²⁺ was lower in DR group than that in non-DR group (0.92 vs 0.88 mmol/L, P < 0.001). Stratified serum Mg²⁺ levels into quartiles (Q1-Q4), the first (Q1, Mg²⁺ ≤ 0.85 mmol/L) and fourth quartile (Q4, ≥ 0.96 mmol/L) represented the lowest and highest quartile, respectively. And the incidence of DR was obviously higher in Q1 and Q2 than that in Q3 and Q4 (50.9% and 30.2% vs 23.5% and 21%, respectively). Logistic regression demonstrated that there remained an independent association between lower serum Mg²⁺ levels and the occurrence of DR (OR were 3.907 and 1.709 in Q1 and Q2, respectively) no matter whether the interference of confounding variables. ROC curve showed the best cut-off value of serum Mg²⁺ level in predicting the occurrence of DR was 0.875 mmol/L. Lower Mg²⁺ levels are related with an increased risk of developing DR. Serum Mg²⁺ level can be a potential clinical indicator to help identify DR in patients with T2DM.

Association of Low Magnesium Level With Duration and Severity of Type 2 Diabetes

Introduction: Type 2 diabetes mellitus can give rise to several complications in the body, including electrolyte imbalance. In this study, we aim to find the association of hypomagnesemia with the duration and severity of diabetes. Understanding the association between magnesium and diabetes may assist in the early detection of hypomagnesemia and help manage the complications associated with electrolyte imbalance.

Methods: This cross-sectional study was conducted in the internal medicine department of a tertiary care hospital in Pakistan from January to March 2021. Three hundred (n = 300) patients with a confirmed diagnosis of type 2 diabetes were enrolled in the study after informed consent via consecutive convenient non-probability sampling. Three hundred (n = 300) patients were included in the study as a reference group. Blood was drawn via phlebotomy and sent to the laboratory to assess glycated hemoglobin (HbA1c) and magnesium levels.

Results: In uncontrolled diabetic patients, mean magnesium level was significantly lower as compared to diabetic patients with good glycemic control (1.34 ± 0.3 mg/dL vs. 1.81 ± 0.5; p-value: <0.0001). Prevalence of hypomagnesemia was significantly more in patients with uncontrolled diabetes, compared to the controlled diabetic group (65.8% vs. 50.8%; p-value: 0.009). In patients with a duration of diabetes of more than 10 years, the mean magnesium level was significantly lower, compared to patients with less than 10 years of diabetes (1.32 ± 0.3 mg/dL vs. 1.78 ± 0.5; p-value: <0.0001). Prevalence of hypomagnesemia was significantly more in patients with diabetes for more than 10 years (64.7% vs. 51.9%; p-value: 0.02).

Conclusion: Hypomagnesemia is prevalent in diabetes and is directly related to the severity and duration of diabetes. It is important to include electrolyte screening as a part of routine screening in diabetic patients for early detection and management of electrolyte imbalance, including hypomagnesemia.

Efficacy of Curcumin Gel on Zinc, Magnesium, Copper, IL-1β, and TNF-α in Chronic Periodontitis Patients

Curcumin exhibits antibacterial, antioxidant, and anti-inflammatory effects and has been suggested as a treatment for inflammatory diseases. The study is aimed at evaluating the effect of curcumin gel on serum levels of micronutrients (zinc, copper, and magnesium) and proinflammatory cytokines (IL-1β and TNF-α) in chronic periodontitis patients. Ninety subjects with an age of 25-54 were included in this study. From the total number, 30 subjects with healthy periodontium (control group) (mean age = 37.30 ± 7.08) were employed for the sole purpose of obtaining the normal mean values of clinical, chemical, and immunological parameters, and 60 with chronic periodontitis (mean age = 36.73 ± 6.22) were divided randomly into 2 groups, of which each group included 30 subjects. Group A received scaling and root planing SRP and curcumin gel injection covered by Coe pack for 7 days, and group B received SRP alone covered by Coe pack. Clinical parameters (plaque index, gingival index, bleeding on probing, pocket depth, and clinical attachment loss measurements) and blood samples were collected before and after 1 month of treatment to measure serum levels of zinc, copper, magnesium, IL-1β, and TNF-α. The results showed significant micronutrient alteration and increase of proinflammatory cytokines in the chronic periodontitis group as compared to healthy control (P ≤ 0.05), and curcumin gel had a significant effect on the reduction of IL-1β, TNF-α, copper, and clinical parameters (P ≤ 0.05) and increase of zinc and magnesium levels after 1 month as compared to baseline (P ≤ 0.05), nearly the same pattern for group B but with nonsignificant differences for Zn (P > 0.05). In conclusion, curcumin gel resulted in a more significant reduction in clinical parameters, inflammatory mediators, and copper and increase of zinc and magnesium levels as compared to SRP alone.

The New Pharmaceutical Compositions of Zinc Oxide Nanoparticles and Triterpenoids for the Burn Treatment

We studied oleogels containing zinc oxide nanoparticles (ZnO NPs) and lupane triterpenoids in sunflower oil for the treatment of burns. The modification of ZnO was carried out by treatment with alcohol solutions of betulin, betulonic acid, betulin diacetate and betulin diphosphate. The properties of modified ZnO NPs were studied by powder XRD (average sizes of 10-20 nm), FTIR (νZnO 450 cm-1), UV-vis (345-360 nm), and blue-violet emission (380-420 nm). The identification and assay of modified ZnO NPs and triterpenoids were estimated. The treatment by oleogels of deep II-degree burns was studied on rats using histological studies, Doppler flowmetry and evaluation of enzymes activity and malonic dialdehyde (MDA) level. After the action of oleogels, burn wound area, and the necrosis decreased twice on the 10th day in comparison with the 1st day after burn. The microcirculation index in the near-wound zone by 20-30% improved compared with the group without treatment. Evaluation of the enzyme activity and the MDA level after treatment by oleogels during the course of 10 days showed them returning to normal. The improvement of antioxidant biochemical indexes, as well as wounds' healing, was mainly determined by the influence of zinc oxide nanoparticles.

Role of Magnesium in Type 2 Diabetes Mellitus

Magnesium (in its ionized and biologically active form, Mg²⁺) is an essential trace element that participates in numerous physiologic processes. Abnormal Mg²⁺ homeostasis can lead to many metabolic disorders, including diabetes mellitus (DM) and its complications. Mg²⁺ participates in energy generation and is required for DNA and RNA synthesis, reproduction, and protein synthesis. Additionally, Mg²⁺ acts as a calcium antagonist and protects vascular endothelial cells from oxidative stress. Imbalances in Mg²⁺ status, more frequently hypomagnesemia, inhibit glucose transporter type 4 translocation, increase insulin resistance, affect lipid metabolism, induce oxidative stress, and impair the antioxidant system of endothelial cells, In these ways, hypomagnesemia contributes to the initiation and progression of DM and its macrovascular and microvascular complications. In this review, we summarize recent advances in knowledge of the mechanisms whereby Mg²⁺ regulates insulin secretion and sensitivity. In addition, we discuss the future prospects for research regarding the mechanisms whereby Mg²⁺ status impacts DM and its complications.

Association between dietary patterns with insulin resistance in an Iranian population

AIM

To assess the association between dietary patterns no single food or group, and risk of insulin resistance (Fasting blood sugar (FBS), Fasting insulin, 2h-glucose, 2h-insulin and HOMA-IR).

METHODS

In a cross-sectional, population-based study in Tehran, Iran, 2016-2017. Adults (n = 1500, 38% men) mean age 43.72 ± 14.9 years. Dietary intake was collected by semi-quantitative food frequency questionnaire and insulin resistance was evaluated by Fasting blood sugar (FBS), Fasting insulin, 2h glucose, 2h insulin and HOMA-IR. Associations were assessed by using correlation and multivariable linear regression.

RESULTS

After controlling of the confounding factor or possible underlying such as gender, age, menopausal, BMI, physical activity and the amount of daily energy intake, unhealthy dietary pattern had a positive relationship with all indexes of insulin resistance except 2h glucose and HOMA-IR, healthy dietary pattern had negative and significant relationship with indexes of insulin resistance but apart from 2h glucose.

CONCLUSIONS

It can be figured out that receiving diet rich in healthy foods might reduce the risk of creating insulin resistance.

Are Circulating Mg2+ Levels Associated with Glucose Tolerance Profiles and Incident Type 2 Diabetes?

Magnesium (Mg²⁺) is an enzyme co-factor that plays a key role in many biochemical reactions, as well as in glucose metabolism. Clinical evidences have demonstrated that depletion of serum Mg²⁺ increases exponentially with the duration of type 2 diabetes mellitus (T2DM). Diabetes is associated with low Mg²⁺, and hypomagnesemia is associated with insulin resistance, inflammation, and increased risk for cardiovascular disease. In subjects at high risk of inflammation and insulin resistance, supplementation of Mg²⁺ alone ameliorates both phenotypes, slowing the development and progression of hepatic steatosis. We analyze the relationship between serum Mg²⁺ levels and the onset of T2DM in a large cohort of well-characterized adult white individuals participating in the CATAMERI study, who were reexamined after a mean follow-up of 5.6 ± 0.9 years. In our analysis we acquired a significant negative correlation between Mg²⁺ levels, fasting glucose, and 2h-post load glucose in subjects who underwent an OGTT. Moreover, Mg²⁺ levels correlated negatively with fasting insulin levels, and positively with the lipid profile. As for the detrimental effect of lower circulating Mg²⁺ levels, our data revealed a significant reduction of T2DM risk of about 20% for each 1 mg/dL increase of circulating Mg²⁺. The present results are consistent with the theory that Mg²⁺ supplementation could ameliorate insulin sensitivity reducing the risk to develop T2DM.

Low magnesium level as an indicator of poor glycemic control in type 2 diabetic patients with complications

AIM

Alteration in the metabolism of magnesium have an influence on different metabolic and signaling pathways involved in development of diabetes and its progression. Reduced magnesium level was associated with diabetes related complications. The aim of this study is to determine the serum levels of magnesium in diabetic patients having different complications and the association of magnesium with status of glycemic control.

MATERIALS AND METHODS

This study was conducted among 88 type 2 diabetic patients, subdivided into two groups according to diabetic complications (with complications n = 55; without complications n = 33) and biochemical variables were measured.

RESULTS

The serum magnesium level was decreased in diabetic patients having any complications (P = 0.039) or independent complication (nephropathy, P = 0.437; retinopathy, P = 0.038; neuropathy, P = 0.012 and macrovascular complication, P = 0.039), also decrease with increase in number of diabetic complications. Serum magnesium showed an inverse relation with glycemic parameters (HbA1c (r = -0.323; P = 0.002) and fasting blood glucose (r = - 0.321; P = 0.002)).

CONCLUSION

The low levels of magnesium in diabetic complications, indicates the poor glycemic control in diabetic patients. Hence, maintaining the sufficient level of magnesium can control glycemia, thereby prevent the development of diabetic complications.

Estimation of magnesium level in type 2 diabetes mellitus and its correlation with HbA1c level

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a common disease; the total number of diabetes patients is expected to reach 366 million by 2030. Magnesium has received considerable attention for its potential role in improving insulin sensitivity and preventing diabetes and its cardiovascular complications. Hypomagnesaemia is linked to poor control of type 2 diabetes mellitus, and depletion of serum magnesium occurs exponentially with duration of disease. The aim of this study was to measure serum magnesium level and the correlation of magnesium level with HbA1c in type 2 diabetes mellitus.

METHODS

In this cross-sectional study, we included 100 diabetic patients; blood is taken for measurement of both magnesium and HbA1c levels. Patients with risk factors of magnesium deficiency were not included.

RESULTS

Of the total 100 patients recruited in our study, majority had diabetes for 8.0 years duration. The mean age of the patients was 53.97 ± 10.65 years, most of them were on oral hypoglycaemic agents (84.9%) followed by combination of oral hypoglycaemic agents and insulin (10.5%), and a small percentage were on insulin alone (4.7%). The mean of serum magnesium and HbA1c levels was 1.88 ± 0.25 mg/dL and 8.38% ± 1.53%, respectively. The majority of the patients had a normal level of magnesium (95.0%); however, most of them had uncontrolled blood glucose (82.0%). The study showed that the serum magnesium level and HbA1c are not significantly correlated (P = 0.462).

CONCLUSION

Normal magnesium levels were observed in majority of patients, there is no significant correlation between serum magnesium and HbA1c levels in patients with T2DM, but larger-scale clinical trials are needed in future.

Association between serum magnesium and common complications of diabetes mellitus

BACKGROUND:

Magnesium ion, as important cation in the human body, involved in various enzymatic reactions, glucose transport and insulin release. Now diabetes mellitus and diabetic complications have become important public health problems around the world.

OBJECTIVE:

This paper explores the association between concentration levels of serum magnesium and common complications and comorbidities of diabetes mellitus and other biochemical indexes.

METHODS:

There are 1217 eligible patients selected from 14,317 cases of diabetic hospitalization patients from January 2010 to December 2011. Random forest algorithm was applied to assess the importance of various biochemical indexes and to perform diabetic complications prediction.

RESULTS:

The research results showed that low concentration of serum magnesium and four common diabetic complications – diabetic retinopathy, diabetic nephropathy, diabetic neuropathy and diabetic macroangiopathy – exists association, but no obvious correlation with other comorbidities like hypertension.

CONCLUSIONS:

The specific factors of four common diabetic complications were selected from the biochemical indexes to provide a reference direction for further research.

Association Between Magnesium Status, Dietary Magnesium Intake, and Metabolic Control in Patients with Type 2 Diabetes Mellitus

BACKGROUND

Hypomagnesemia could worsen glycemic control by impairing insulin release and promoting insulin resistance. On the contrary, type 2 diabetes mellitus (T2DM) may induce and/or exacerbate low serum magnesium levels, and this could, in turn, worsen glycemic control of diabetes.

OBJECTIVE

The aim of this study was to investigate the relationship between serum magnesium level, dietary magnesium intake, and metabolic control parameters in patients with T2DM.

METHODS

The study included 119 patients with T2DM (26 male, 93 female; mean age 54.7 ± 8.4 years). Serum magnesium level was measured by spectrophotometric method. Magnesium intake was assessed by food frequency questionnaire. Anthropometric measurements were taken. The General Linear Model procedure was applied to determine the relationship of serum magnesium with quantitative variables.

RESULTS

Of the 119 patients, 23.5% of the patients had inadequate magnesium intake (lower than 67% of the recommended daily allowance), and 18.5% had hypomagnesemia. In patients with hypomagnesemia (< 0.75 mmol/l), serum levels of fasting plasma glucose (FPG), postprandial plasma glucose (PPG), and serum glycosylated hemoglobin (HbA1c) were higher compared to patients with normomagnesemia. FPG levels were significantly higher in patients with hypomagnesemia in Model 1 (179.0 ± 64.9 vs. 148.7 ± 52.0 mg/dl, p = 0.009) but the significance disappeared in other models. PPG levels were significantly higher in patients with hypomagnesemia in all models (287.9 ± 108.4 vs. 226.8 ± 89.4 mg/dl, p = 0.006 for Model 1, p = 0.027 for Model 2, p = 0.016 for Model 3). Serum HbA1c levels were significantly higher in patients with hypomagnesemia, and this significance proceeded (8.0 ± 1.9% vs. 6.5 ± 1.2%, p = 0.000 for all models). Body fat mass was significantly higher in patients with hypomagnesemia as compared to patients with normomagnesemia in model 3 (35.4 ± 9.4 kg, 34.6 ± 10.2 kg; p = 0.034). Dietary magnesium intake was not significantly associated with either metabolic parameters or anthropometric measurements.

CONCLUSION

Hypomagnesemia in T2DM is directly associated with poor metabolic control. Clinical assessment should, therefore, focus on augmentation of magnesium status and adequate magnesium intake in patients with T2DM.

Effect of magnesium supplementation on type 2 diabetes associated cardiovascular risk factors: a systematic review and meta-analysis

BACKGROUND

Cardiovascular disorders remain the leading cause of death in type 2 diabetic patients. In the present study, a systematic review and a meta-analysis of randomised controlled trials (RCTs) were conducted aiming to evaluate the effect of magnesium supplementation on type 2 diabetes (T2D) associated cardiovascular risk factors in both diabetic and nondiabetic individuals.

METHODS

PubMed, Scopus, Cochrane, Web of Science and Google Scholar databases were searched from inception to 30 June 2016 aiming to identify RCTs evaluating the effect of magnesium supplementation on T2D associated cardiovascular risk factors. The data were analysed using a random effect model with inverse variance methodology. Sensitivity analysis, risk of bias analysis, subgroup analysis, meta-regression and publication bias analysis were also conducted for the included studies using standard methods.

RESULTS

Following magnesium supplementation, a significant improvement was observed in fasting plasma glucose (FPG) [weighted mean difference (WMD) = -4.641 mg dL-1 , 95% confidence interval (CI) = -7.602, -1.680, P = 0.002], high-density lipoprotein (HDL) (WMD = 3.197 mg dL-1 , 95% CI = 1.455, 4.938, P < 0.001), low-density lipoprotein (LDL) (WMD = -10.668 mg dL-1 , 95% CI = -19.108, -2.228, P = 0.013), plasma triglycerides (TG) (WMD = -15.323 mg dL-1 , 95% CI = -28.821, -1.826, P = 0.026) and systolic blood pressure (SBP) (WMD = -3.056 mmHg, 95% CI = -5.509, -0.603, P = 0.015). During subgroup analysis, a more beneficial effect of magnesium supplementation was observed in diabetic subjects with hypomagnesaemia.

CONCLUSIONS

Magnesium supplementation can produce a favourable effect on FPG, HDL, LDL, TG and SBP. Therefore, magnesium supplementation may decrease the risk T2D associated cardiovascular diseases, although future large RCTs are needed for making robust guidelines for clinical practice.

Oral magnesium supplementation improves glycemic control and lipid profile in children with type 1 diabetes and hypomagnesaemia

Dietary supplementation with magnesium (Mg) in addition to classical therapies for diabetes may help in prevention or delaying of diabetic complications.We aimed to evaluate the status of serum Mg in children with type 1 diabetes and assessing its relationship to glycemic control and lipid profile. Then evaluating the effect of oral Mg supplementation on glycemic control and lipid parameters.We included 71 children at Pediatric Endocrinology Outpatient Clinic, Zagazig University, Egypt with type 1 diabetes and assessed HBA1c, lipid profile, and serum Mg at the start of study. Patients with serum Mg level < 1.7 mg/dL were given 300 mg Mg oxide for 3 months. After that we reevaluated HBA1c, lipid profile, and serum Mg in all patients.The study included 71 patients with type 1 diabetes (32 males and 39 females); their mean age was 9.68 ± 3.99 years. The mean serum Mg level was 1.83 ± .27 mg/dL. Hypomagnesemia was detected in 28.2% study patients. Serum Mg was found to be positively correlated with high density lipoprotein, mean corpuscular volume and platelet count (P < 0.001), and negatively correlated with age, HbA1c, triglycerides, total cholesterol, low density lipoprotein, and duration of diabetes (P < 0.001). There was significant reduction in HBA1c in group given Mg supplementation. HBA1c was initially 10.11% ± 0.87%. After 3 months of oral Mg supplementation it is reduced to 7.88% ± 0.42% (P < 0.001). There was statistically significant difference in lipid parameters in hypomagnesemic diabetic patients before and after Mg supplementation with significant reduction in serum triglycerides, LDL, and total cholesterol following Mg supplementation with P < 0.001. Although HDL shows a significant increase after Mg supplementation in hypomagnesemic diabetic children with P < 0.001.Correction of hypomagnesemia in type 1 diabetic children with oral Mg supplements is associated with optimization of glycemic control and reduction of atherogenic lipid fraction as well as increase in protective lipid fraction.

Hypomagnesaemia: a modifiable risk factor of diabetic nephropathy

Background:

Diabetes mellitus (DM) is a heterogeneous disease characterised by an absolute or relative deficiency of insulin and insulin resistance. Diabetes is occurring at younger age in India. It is estimated that 20% of the type 2 DM patients reach end-stage renal disease (ESRD) during their lifetime. Recently, it has been proposed that hypomagnesaemia is a novel factor implicated in the pathogenesis of diabetic complications. Considering this, a study was designed to estimate the prevalence and association of hypomagnesaemia with diabetic nephropathy in North Indian population.

Materials and methods:

The investigated clinical group composed of 100 type 2 diabetics, grouped into two, on the basis of presence or absence of diabetic nephropathy with n=50 each. Biochemical investigations including fasting blood sugar (BS-F), blood urea, creatinine, magnesium (Mg), urinary albumin-creatinine ratio (U-A/C ratio) were carried out. Descriptive statistics was applied to described frequency and means. χ

Results:

We observed that 37% of diabetic patients had hypomagnesaemia (mean=1.40±0.16 mg/dL). There was also a significantly higher prevalence of hypomagnesaemia (52%) in DM nephropathy patients (mean=1.62±0.31 mg/dL) compared to without nephropathy patients (22%, mean=1.86±0.28 mg/dL). Serum magnesium levels were significantly inversely correlated with serum creatinine (r=–0.222, p=0.026) and U-A/C ratio (r=–0.352, p=0.000), and positively correlated with glomerular filtration rate (GFR) (r=0.304, p=0.002).

Conclusion:

We concluded that hypomagnesaemia was significantly associated with higher prevalence of diabetic nephropathy and can be used as a marker for the risk of development of diabetic nephropathy.

Status of serum magnesium in Egyptian children with type 1 diabetes and its correlation to glycemic control and lipid profile

Diabetes mellitus has been suggested to be the most common metabolic disorder associated with magnesium deficiency, having 25% to 39% prevalence. This deficit could be associated with the development of late diabetic complications, especially macroangiopathy.We aimed to evaluate the status of serum Mg in children with type 1 diabetes and assess its relation to glycemic control and lipid profile.We included 71 Egyptian children with type 1diabetes having their follow-up at Pediatric Endocrinology outpatient clinic, Zagazig University Hospital and 71 age- and sex-matched control. We measured Serum magnesium, HbA1c, and lipid profile in all study subjects.Diabetic children had significantly lower serum magnesium level compared to control children (1.83 ± .27 mg/dL in diabetic children versus 2.00 ± .16 mg/dL in control children). Taking cut-off level of serum magnesium <1.7 mg/dL for definition of hypomagnesemia, hypomagnesemia was detected in 28.2% of diabetic children compared to 9.9% of control children. In diabetic patients, there was statistically significant difference in HbA1c between hypomagnesemic and normomagnesemic group being higher in the low magnesium group, as it is mean ± SD was 11.93 ± 3.17 mg/dL in group I versus 8.92 ± 0.93 mg/dL in the normomagnesemic group. Serum magnesium was found to be positively correlated with HDL (P < 0.001), and negatively correlated with age, HbA1c, triglycerides, total cholesterol, LDL, and duration of diabetes (P < 0.001).We concluded that total serum magnesium was frequently low in Egyptian children with type 1 diabetes and it is correlated with HbA1c and with lipid profile. Hypomagnesemia was more evident in patients with poor diabetic control and those with higher atherogenic lipid parameters. We suggest that low serum magnesium may be included in pathogenesis of poor glycemic control and abnormal lipid profile in children with type 1 diabetes. We need to perform further studies on giving magnesium supplements in diabetic children with hypomagnesemia to observe the effect of correction of serum magnesium on glycemic control, lipid profile, and the risk of diabetic complications.

Essential Nutrient Interactions: Does Low or Suboptimal Magnesium Status Interact with Vitamin D and/or Calcium Status?

Although much is known about magnesium, its interactions with calcium and vitamin D are less well studied. Magnesium intake is low in populations who consume modern processed-food diets. Low magnesium intake is associated with chronic diseases of global concern [e.g., cardiovascular disease (CVD), type 2 diabetes, metabolic syndrome, and skeletal disorders], as is low vitamin D status. No simple, reliable biomarker for whole-body magnesium status is currently available, which makes clinical assessment and interpretation of human magnesium research difficult. Between 1977 and 2012, US calcium intakes increased at a rate 2-2.5 times that of magnesium intakes, resulting in a dietary calcium to magnesium intake ratio of >3.0. Calcium to magnesium ratios <1.7 and >2.8 can be detrimental, and optimal ratios may be ∼2.0. Background calcium to magnesium ratios can affect studies of either mineral alone. For example, US studies (background Ca:Mg >3.0) showed benefits of high dietary or supplemental magnesium for CVD, whereas similar Chinese studies (background Ca:Mg <1.7) showed increased risks of CVD. Oral vitamin D is widely recommended in US age-sex groups with low dietary magnesium. Magnesium is a cofactor for vitamin D biosynthesis, transport, and activation; and vitamin D and magnesium studies both showed associations with several of the same chronic diseases. Research on possible magnesium and vitamin D interactions in these human diseases is currently rare. Increasing calcium to magnesium intake ratios, coupled with calcium and vitamin D supplementation coincident with suboptimal magnesium intakes, may have unknown health implications. Interactions of low magnesium status with calcium and vitamin D, especially during supplementation, require further study.

Surface modification of biodegradable magnesium and its alloys for biomedical applications

Magnesium and its alloys are being paid much attention recently as temporary implants, such as orthopedic implants and cardiovascular stents. However, the rapid degradation of them in physiological environment is a major obstacle preventing their wide applications to date, which will result in rapid mechanical integrity loss or even collapse of magnesium-based implants before injured tissues heal. Moreover, rapid degradation of the magnesium-based implants will also cause some adverse effects to their surrounding environment, such as local gas cavity around the implant, local alkalization and magnesium ion enrichment, which will reduce the integration between implant and tissue. So, in order to obtain better performance of magnesium-based implants in clinical trials, special alloy designs and surface modifications are prerequisite. Actually, when a magnesium-based implant is inserted in vivo, corrosion firstly happens at the implant-tissue interface and the biological response to implant is also determined by the interaction at this interface. So the surface properties, such as corrosion resistance, hemocompatibility and cytocompatibility of the implant, are critical for their in vivo performance. Compared with alloy designs, surface modification is less costly, flexible to construct multi-functional surface and can prevent addition of toxic alloying elements. In this review, we would like to summarize the current investigations of surface modifications of magnesium and its alloys for biomedical application. The advantages/disadvantages of different surface modification methods are also discussed as a suggestion for their utilization.

Associations of serum and urinary magnesium with the pre-diabetes, diabetes and diabetic complications in the Chinese Northeast population

The effect of magnesium (Mg) deficiency on the prevalence of diabetes and diabetic complications has received a great attention. The present study investigated the association of Mg level in the serum or urine of the patients, lived in the Northeast areas of China, with either pre-diabetes or diabetes with and without complications. From January 2010 to October 2011, patients with type 1 diabetes (T1D, n = 25), type 2 diabetes (T2D, n = 137), impaired fasting glucose (IFG, n = 12) or impaired glucose tolerance (IGT, n = 15), and age/gender matched control (n = 50) were enrolled in the First Hospital of Jilin University. In T2D group, there were 24, 34, and 50 patients with nephropathy, retinopathy or peripheral neuropathy. Serum Mg levels in the patients with IGT, IFG, T2D, and T1D were significantly lower than that of control. The urinary Mg levels were significantly increased only in T2D and T1D patients compared to control. There was no difference for these two changes among T2D with and without complications; In addition, there was a significantly positive correlation of serum Mg levels with serum Ca levels only in T2D patients, and also a significantly positive correlation of urinary Mg levels with urinary Ca levels in control, IGT patients, and T2D patients. Simvastatin treatment in T2D patients selectively reduced serum Ca levels and urinary Mg levels. These results suggest that the potential impact of Mg deficiency on metabolic syndrome, diabetes and diabetic complications needs to be received special attention.