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Achel DG, Manson EN, Ahiave EK, Nyaaba RA, Amable ASK, Abdul-Wahab D, Agbevanu KT, Ziekah F, Gedel AM, Darfour EK. Nutritional and toxicological assessment of Piliostigma thonnigii leaves and Tubaani food samples: a preliminary investigation. JOURNAL OF FOOD SCIENCE AND TECHNOLOGY 2024; 61:1569-1577. [PMID: 38966792 PMCID: PMC11219655 DOI: 10.1007/s13197-024-05928-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 12/01/2023] [Accepted: 12/16/2023] [Indexed: 07/06/2024]
Abstract
Tubaani is a local delicacy prepared with Piliostigma thonningii leaves. The leaves may contain trace/heavy metals and important phytonutrients that could impact consumers' health. Concerns over the nutritional and toxicological implications of Piliostigma thonningii leaves are critical. Tubaani food and Piliostigma thonningii leaf samples were investigated using Neutron Activation Analysis (NAA) and Spectrophotometry technique. The health risk of Tubaani was also assessed by calculating the target hazard quotient (THQ) and hazard index (HI) of potentially toxic elements. Fifteen trace elements were detected at non-toxicological concentrations in the samples analyzed. No significant difference (p > 0.05) was observed between the samples' mean concentrations. The phenolic content in leaf extracts was higher as compared to the flavonoids. However, the flavonoids in the leaves had an effect on the food samples, unlike the phenols. The THQ and HI of the elements were below 1.0. There is no reason to be concerned about the current dietary intake of the potentially toxic elements in the routine consumption of Tubaani as portrayed in data obtained in this investigation by NAA, THQ, and HI.
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Affiliation(s)
- Daniel Gyingiri Achel
- Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra, Ghana
| | - Eric Naab Manson
- Department of Medical Imaging, University for Development Studies, Tamale, Ghana
| | | | | | - Anthony Selorm Kwesi Amable
- Department of Basic Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Dickson Abdul-Wahab
- Department of Nuclear Science and Applications, School of Nuclear and Allied Sciences, University of Ghana, Accra, Ghana
| | | | - Francis Ziekah
- Department of Applied Chemistry, C.K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Ahmed Mohammed Gedel
- Department of Science Laboratory Technology, Accra Technical University, Accra, Ghana
| | - Emmanuel Kyei Darfour
- Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra, Ghana
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Ansu Baidoo VY, Cara KC, Dickinson SL, Brown AW, Wallace TC, Chung M, Gletsu-Miller N. Systematic Review and Meta-Analysis to Estimate a Reference Range for Circulating Ionized Magnesium Concentrations in Adult Populations. J Nutr 2023; 153:3458-3471. [PMID: 37844840 DOI: 10.1016/j.tjnut.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/14/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND There is a lack of consensus on a reference range for ionized magnesium (iMg2+) in blood as a measure of the status of circulating iMg2+ for the screening of populations. OBJECTIVES We estimated the reference range of iMg2+ levels for healthy adult populations and the ranges for populations with cardiovascular disease (CVD), type 2 diabetes, hypertension, and renal disease. We also estimated 95% ranges for circulating magnesium (Mg) in healthy and those with cardiometabolic diseases. METHODS We searched Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Embase through 24 July, 2020 to identify articles. We included English, peer-reviewed, randomized controlled trials, prospective and retrospective cohort studies, case-control studies, and cross-sectional studies that measured iMg2+ in blood or circulating Mg at baseline. The protocol was registered on PROSPERO (CRD42020216100). Estimated ranges were calculated by employing a frequentist random-effects model using extracted (or calculated) means and SDs from each included study. We determined the 95% confidence interval of the pooled mean. RESULTS A total of 95 articles were included with 53 studies having data for healthy participants and 42 studies having data for participants with cardiometabolic diseases. The estimated reference range for iMg2+ for healthy populations was 0.40-0.68 mmol/L, 0.38-0.64 mmol/L for CVD, 0.34-0.66 mmol/L for type 2 diabetes, 0.39-1.04 mmol/L for hypertension, and 0.40-0.76 mmol/L for renal disease. For circulating Mg, the estimated range was 0.72-1.0 mmol/L for healthy adults, 0.56-1.05 mmol/L for CVD, 0.58-1.14 mmol/L for type 2 diabetes, 0.60-1.08 mmol/L for hypertension, and 0.59-1.26 mmol/L for renal disease. CONCLUSIONS Estimated reference ranges for cardiometabolic disease states for both iMg2+ and circulating Mg were broad and overlapped with the estimated range for healthy populations (0.40-0.68 mmol/L). Further studies should evaluate whether iMg2+ can be used as a biomarker of cardiometabolic disease.
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Affiliation(s)
| | - Kelly C Cara
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Stephanie L Dickinson
- School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
| | - Andrew W Brown
- University of Arkansas for Medical Sciences, Little Rock, AR, United States; Arkansas Children's Research Institute, Little Rock, AR, United States
| | - Taylor C Wallace
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, United States; Think Healthy Group, Inc., Washington, DC, United States; Center for Magnesium Education & Research, Pahoa, HI, United States
| | - Mei Chung
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Nana Gletsu-Miller
- School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States.
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Segev A, Shechter M, Tsur AM, Belkin D, Cohen H, Sharon A, Morag NK, Grossman E, Maor E. Serum Magnesium Is Associated with Long-Term Survival of Non-ST-Elevation Myocardial Infarction Patients. Nutrients 2023; 15:4299. [PMID: 37836583 PMCID: PMC10574643 DOI: 10.3390/nu15194299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Low serum magnesium (sMg) is associated with cardiovascular risk factors and atherosclerotic disease. OBJECTIVE To evaluate the association between sMg levels on admission and clinical outcomes in hospitalized non-ST-elevation myocardial infarction (NSTEMI) patients. METHODS A retrospective analysis of all patients admitted to a single tertiary center with a primary diagnosis of NSTEMI. Patients with advanced chronic kidney disease were excluded. Clinical data were collected and compared between lower sMg quartile patients (Q1; sMg < 1.9 mg/dL) and all other patients (Q2-Q4; sMg ≥ 1.9 mg/dL). RESULTS The study cohort included 4552 patients (70% male, median age 69 [IQR 59-79]) who were followed for a median of 4.4 (IQR 2.4-6.6) years. The median sMg level in the low sMg group was 1.7 (1.6-1.8) and 2.0 (2.0-2.2) mg/dL in the normal/high sMg group. The low sMg group was older (mean of 72 vs. 67 years), less likely to be male (64% vs. 72%), and had higher rates of comorbidities, including diabetes, hypertension, and atrial fibrillation (59% vs. 29%, 92% vs. 85%, and 6% vs. 5%; p < 0.05 for all). Kaplan-Meier survival analysis demonstrated significantly higher cumulative death probability at 4 years in the low sMg group (34% vs. 22%; p log rank <0.001). In a multivariable analysis model adjusted for sex, significant comorbidities, coronary interventions during the hospitalization, and renal function, the low sMg group exhibited an independent 24% increased risk of death during follow up (95% CI 1.11-1.39; p < 0.001). CONCLUSIONS Low sMg is independently associated with higher risk of long-term mortality among patients recovering from an NSTEMI event.
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Affiliation(s)
- Amitai Segev
- The Leviev Cardiothoracic & Vascular Center, Sheba Medical Center, Ramat Gan 5262504, Israel; (M.S.); (E.M.)
- The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel (D.B.); (H.C.); (E.G.)
| | - Michael Shechter
- The Leviev Cardiothoracic & Vascular Center, Sheba Medical Center, Ramat Gan 5262504, Israel; (M.S.); (E.M.)
- The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel (D.B.); (H.C.); (E.G.)
| | - Avishai M. Tsur
- The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel (D.B.); (H.C.); (E.G.)
- Department of Medicine, Sheba Medical Center, Ramat Gan 5262504, Israel
- Israel Defense Forces, Medical Corps, Ramat Gan 5262504, Israel
| | - David Belkin
- The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel (D.B.); (H.C.); (E.G.)
| | - Hofit Cohen
- The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel (D.B.); (H.C.); (E.G.)
- The Bert W. Strassburger Lipid Center, Sheba Medical Center, Ramat Gan 5262504, Israel
| | - Amir Sharon
- The Leviev Cardiothoracic & Vascular Center, Sheba Medical Center, Ramat Gan 5262504, Israel; (M.S.); (E.M.)
- The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel (D.B.); (H.C.); (E.G.)
| | - Nira Koren Morag
- The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel (D.B.); (H.C.); (E.G.)
| | - Ehud Grossman
- The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel (D.B.); (H.C.); (E.G.)
- Department of Medicine, Sheba Medical Center, Ramat Gan 5262504, Israel
| | - Elad Maor
- The Leviev Cardiothoracic & Vascular Center, Sheba Medical Center, Ramat Gan 5262504, Israel; (M.S.); (E.M.)
- The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel (D.B.); (H.C.); (E.G.)
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Liu M, Dudley SC. Beyond Ion Homeostasis: Hypomagnesemia, Transient Receptor Potential Melastatin Channel 7, Mitochondrial Function, and Inflammation. Nutrients 2023; 15:3920. [PMID: 37764704 PMCID: PMC10536927 DOI: 10.3390/nu15183920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/02/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
As the second most abundant intracellular divalent cation, magnesium (Mg2+) is essential for cell functions, such as ATP production, protein/DNA synthesis, protein activity, and mitochondrial function. Mg2+ plays a critical role in heart rhythm, muscle contraction, and blood pressure. A significant decline in Mg2+ intake has been reported in developed countries because of the increased consumption of processed food and filtered/deionized water, which can lead to hypomagnesemia (HypoMg). HypoMg is commonly observed in cardiovascular diseases, such as heart failure, hypertension, arrhythmias, and diabetic cardiomyopathy, and HypoMg is a predictor for cardiovascular and all-cause mortality. On the other hand, Mg2+ supplementation has shown significant therapeutic effects in cardiovascular diseases. Some of the effects of HypoMg have been ascribed to changes in Mg2+ participation in enzyme activity, ATP stabilization, enzyme kinetics, and alterations in Ca2+, Na+, and other cations. In this manuscript, we discuss new insights into the pathogenic mechanisms of HypoMg that surpass previously described effects. HypoMg causes mitochondrial dysfunction, oxidative stress, and inflammation. Many of these effects can be attributed to the HypoMg-induced upregulation of a Mg2+ transporter transient receptor potential melastatin 7 channel (TRMP7) that is also a kinase. An increase in kinase signaling mediated by HypoMg-induced TRPM7 transcriptional upregulation, independently of any change in Mg2+ transport function, likely seems responsible for many of the effects of HypoMg. Therefore, Mg2+ supplementation and TRPM7 kinase inhibition may work to treat the sequelae of HypoMg by preventing increased TRPM7 kinase activity rather than just altering ion homeostasis. Since many diseases are characterized by oxidative stress or inflammation, Mg2+ supplementation and TRPM7 kinase inhibition may have wider implications for other diseases by acting to reduce oxidative stress and inflammation.
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Affiliation(s)
- Man Liu
- Cardiovascular Division, Department of Medicine, The Lillehei Heart Institute, University of Minnesota at Twin Cities, Minneapolis, MN 55455, USA;
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Theisen CF, Wodschow K, Hansen B, Schullehner J, Gislason G, Ersbøll BK, Ersbøll AK. Drinking water magnesium and cardiovascular mortality: A cohort study in Denmark, 2005-2016. ENVIRONMENT INTERNATIONAL 2022; 164:107277. [PMID: 35551005 DOI: 10.1016/j.envint.2022.107277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 04/28/2022] [Accepted: 05/01/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Cardiovascular diseases are globally a major cause of death. Magnesium deficiency is associated with several diseases including cardiovascular diseases. OBJECTIVE To examine if a low concentration of magnesium in drinking water is associated with increased cardiovascular mortality and mortality due to acute myocardial infarction and stroke. METHODS A nationwide population-based cohort study using national health registries was used. A total of 4,274,132 individuals aged 30 years or more were included. Magnesium concentration in drinking water was estimated by linkage of residential addresses in the period 2005-2016 with the national drinking water quality monitoring database. The association between magnesium concentration in drinking water and cardiovascular mortality and mortality due to acute myocardial infarction and stroke was examined using a Poisson regression of number of deaths and logarithmic transformation of follow-up time as offset. The incidence rate ratio (IRR) was adjusted for differences in age, sex, calendar year, cohabitation, country of origin, and socioeconomic status. RESULTS Median magnesium concentration in drinking water at inclusion was 12.4 mg/L (range: 1.37-54.2 mg/L). The adjusted IRR for cardiovascular mortality was 0.96 (95% CI: 0.94; 0.97) for the lowest magnesium quintile (<6.5 mg/L) as compared to the highest magnesium quintile (>21.9 mg/L). The adjusted IRR for mortality due to acute myocardial infarction and stroke was 1.22 (1.17; 1.27) and 0.96 (0.93; 0.99), respectively, for the lowest magnesium quintile as compared to the highest quintile A decreasing mortality due to acute myocardial infarction was seen with an increasing magnesium concentration in a dose-response manner. CONCLUSION Low concentrations of magnesium in drinking water were associated with an increased mortality due to acute myocardial infarction. Low concentrations of magnesium in drinking water were associated with decreased cardiovascular mortality, and mortality due to stroke.
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Affiliation(s)
- C F Theisen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; DTU Compute, Technical University of Denmark, Kgs Lyngby, Denmark
| | - K Wodschow
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - B Hansen
- Geological Survey of Denmark and Greenland, GEUS, Aarhus, Denmark
| | - J Schullehner
- Geological Survey of Denmark and Greenland, GEUS, Aarhus, Denmark; Department of Public Health, Research Unit for Environment, Work and Health, Aarhus University, Aarhus, Denmark
| | - G Gislason
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; Department of Cardiology, The Cardiovascular Research Centre, Copenhagen University Hospital Herlev and Gentofte, Gentofte, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; The Danish Heart Foundation, Copenhagen, Denmark
| | - B K Ersbøll
- DTU Compute, Technical University of Denmark, Kgs Lyngby, Denmark
| | - A K Ersbøll
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
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Arancibia-Hernández YL, Aranda-Rivera AK, Cruz-Gregorio A, Pedraza-Chaverri J. Antioxidant/anti-inflammatory effect of Mg 2+ in coronavirus disease 2019 (COVID-19). Rev Med Virol 2022; 32:e2348. [PMID: 35357063 PMCID: PMC9111052 DOI: 10.1002/rmv.2348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/09/2022] [Accepted: 03/17/2022] [Indexed: 12/26/2022]
Abstract
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), characterised by high levels of inflammation and oxidative stress (OS). Oxidative stress induces oxidative damage to lipids, proteins, and DNA, causing tissue damage. Both inflammation and OS contribute to multi-organ failure in severe cases. Magnesium (Mg2+ ) regulates many processes, including antioxidant and anti-inflammatory responses, as well as the proper functioning of other micronutrients such as vitamin D. In addition, Mg2+ participates as a second signalling messenger in the activation of T cells. Therefore, Mg2+ deficiency can cause immunodeficiency, exaggerated acute inflammatory response, decreased antioxidant response, and OS. Supplementation with Mg2+ has an anti-inflammatory response by reducing the levels of nuclear factor kappa B (NF-κB), interleukin (IL) -6, and tumor necrosis factor alpha. Furthermore, Mg2+ supplementation improves mitochondrial function and increases the antioxidant glutathione (GSH) content, reducing OS. Therefore, Mg2+ supplementation is a potential way to reduce inflammation and OS, strengthening the immune system to manage COVID-19. This narrative review will address Mg2+ deficiency associated with a worse disease prognosis, Mg2+ supplementation as a potent antioxidant and anti-inflammatory therapy during and after COVID-19 disease, and suggest that randomised controlled trials are indicated.
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Affiliation(s)
| | - Ana Karina Aranda-Rivera
- Facultad de Química, Departamento de Biología, Laboratorio F-315, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Alfredo Cruz-Gregorio
- Facultad de Química, Departamento de Biología, Laboratorio F-315, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - José Pedraza-Chaverri
- Facultad de Química, Departamento de Biología, Laboratorio F-315, Universidad Nacional Autónoma de México, Mexico City, Mexico
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The Effect of Magnesium Supplementation on Endothelial Function: A Randomised Cross-Over Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158169. [PMID: 34360460 PMCID: PMC8346147 DOI: 10.3390/ijerph18158169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022]
Abstract
Evidence supports an association between low magnesium (Mg) intake and coronary heart disease and between Mg intake and endothelial function. The aim of this study was to assess the effect of one week of Mg supplementation on endothelial function, assessed by flow mediated dilatation (FMD). Nineteen healthy men and women completed this cross-over pilot study in which participants were randomised to take an over-the-counter magnesium supplement for one week or to follow their usual diet. Weight, FMD and blood pressure (BP) were taken on completion of each intervention and 24 h urine collections and blood samples were taken to assess compliance. Baseline serum Mg was within normal range for all participants. Urinary Mg and urinary magnesium-creatinine ratio (Mg/Cr) significantly increased between interventions, (p = 0.03, p = 0.005, respectively). No significant differences in FMD or BP were found between the interventions. A significant negative correlation was seen between age and FMD (r = −0.496, p = 0.031). When adjusted for age, saturated fat was negatively associated with FMD (p = 0.045). One week of Mg supplementation did not improve FMD in a healthy population.
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Wang KM, Li J, Bhalla V, Jardine MJ, Neal B, de Zeeuw D, Fulcher G, Perkovic V, Mahaffey KW, Chang TI. Canagliflozin, serum magnesium and cardiovascular outcomes-Analysis from the CANVAS Program. Endocrinol Diabetes Metab 2021; 4:e00247. [PMID: 34277971 PMCID: PMC8279612 DOI: 10.1002/edm2.247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/09/2021] [Accepted: 02/13/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Patients with type 2 diabetes (T2D) are predisposed to derangements in serum Magnesium (Mg), which may have implications for cardiometabolic events and outcomes. In clinical trials, participants with T2D randomized to sodium-glucose co-transporter 2 (SGLT2) inhibitors have shown mild to moderate increases in serum Mg from baseline levels. This post hoc analysis assesses the relation between serum Mg with cardiovascular outcomes in 10,140 participants of the Canagliflozin Cardiovascular Assessment Study (CANVAS) Program. METHODS We evaluated the association of baseline serum Mg with the primary composite end point of death from cardiovascular causes, non-fatal myocardial infarction, and non-fatal stroke, and tested whether this association is modified by baseline serum Mg. Using mediation analysis, we determined whether change in serum Mg post-randomization mediates the beneficial effect of canagliflozin on cardiovascular outcomes. RESULTS Mean serum Mg levels at baseline were 0.77 ± 0.09 mmol/L in both canagliflozin group and placebo groups. The canagliflozin group experienced an average increase in serum Mg by 0.07 mmol/L (95% CI, 0.065-0.072 mmol/L; p < .001) for the duration of the trial. We found no association between baseline serum Mg levels and the primary composite end point, and no evidence of effect modification by baseline Mg levels. Change in serum Mg post-randomization was not a mediator of the effects of canagliflozin on cardiovascular outcomes. CONCLUSIONS In participants of the CANVAS Program, baseline and post-randomization serum Mg levels are not associated with cardiovascular outcomes.
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Affiliation(s)
- Katherine M. Wang
- Division of NephrologyStanford University School of MedicineStanfordCAUSA
| | - JingWei Li
- The George Institute for Global HealthUniversity of New South WalesSydneyNSWAustralia
- Department of CardiologyXinqiao HospitalArmy Military Medical UniversityChongqingChina
| | - Vivek Bhalla
- Division of NephrologyStanford University School of MedicineStanfordCAUSA
| | - Meg J. Jardine
- The George Institute for Global HealthUniversity of New South WalesSydneyNSWAustralia
- Department of Renal MedicineConcord Repatriation General HospitalSydneyNSWAustralia
- Kidney Health ResearchNHMRC Clinical Trials CentreUniversity of SydneySydneyNSWAustralia
| | - Bruce Neal
- The George Institute for Global HealthUniversity of New South WalesSydneyNSWAustralia
- Charles Perkins CentreUniversity of SydneySydneyNSWAustralia
- Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonLondonUK
| | - Dick de Zeeuw
- Department of Clinical Pharmacy and PharmacologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Greg Fulcher
- Kolling InstituteRoyal North Shore Hospital and University of SydneySydneyNSWAustralia
| | - Vlado Perkovic
- The George Institute for Global HealthUniversity of New South WalesSydneyNSWAustralia
- Department of Renal MedicineRoyal North Shore HospitalSydneyNSWAustralia
| | - Kenneth W. Mahaffey
- Stanford Center for Clinical ResearchStanford University School of MedicineStanfordCAUSA
- Division of Cardiovascular MedicineStanford University School of MedicineStanford CAUSA
| | - Tara I. Chang
- Division of NephrologyStanford University School of MedicineStanfordCAUSA
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Yang AM, Lo K, Zheng TZ, Yang JL, Bai YN, Feng YQ, Cheng N, Liu SM. Environmental heavy metals and cardiovascular diseases: Status and future direction. Chronic Dis Transl Med 2020; 6:251-259. [PMID: 33336170 PMCID: PMC7729107 DOI: 10.1016/j.cdtm.2020.02.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Indexed: 12/19/2022] Open
Abstract
Cardiovascular disease (CVD) and environmental degradation are leading global health problems of our time. Recent studies have linked exposure to heavy metals to the risks of CVD and diabetes, particularly in populations from low- and middle-income countries, where concomitant rapid development occurs. In this review, we 1) assessed the totality, quantity, and consistency of the available epidemiological studies, linking heavy metal exposures to the risk of CVD (including stroke and coronary heart disease); 2) discussed the potential biological mechanisms underlying some tantalizing observations in humans; and 3) identified gaps in our knowledge base that must be investigated in future work. An accumulating body of evidence from both experimental and observational studies implicates exposure to heavy metals, in a dose-response manner, in the increased risk of CVD. The limitations of most existing studies include insufficient statistical power, lack of comprehensive assessment of exposure, and cross-sectional design. Given the widespread exposure to heavy metals, an urgent need has emerged to investigate these putative associations of environmental exposures, either independently or jointly, with incident CVD outcomes prospectively in well-characterized cohorts of diverse populations, and to determine potential strategies to prevent and control the impacts of heavy metal exposure on the cardiometabolic health outcomes of individuals and populations.
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Affiliation(s)
- Ai-Min Yang
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China.,Centre for Global Cardiometabolic Health, Department of Epidemiology, Surgery, and Medicine, Brown University, Providence, RI 02903, USA.,Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02903, USA
| | - Kenneth Lo
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Surgery, and Medicine, Brown University, Providence, RI 02903, USA.,Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02903, USA
| | - Tong-Zhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02903, USA
| | - Jing-Li Yang
- Department of Epidemiology, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Ya-Na Bai
- Department of Epidemiology, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Ying-Qing Feng
- Department of Cardiology and Endocrinology, Guangdong Provincial People's Hospital, Guandong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China
| | - Ning Cheng
- Department of Epidemiology, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Si-Min Liu
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China.,Centre for Global Cardiometabolic Health, Department of Epidemiology, Surgery, and Medicine, Brown University, Providence, RI 02903, USA
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Arkhipov M, Bozhko Y, Beloconova N, Kochmasheva V, Chromtsova O. Optimization of hypomagnesemia diagnostics as an integral element in paroxysmal atrial fibrillation management strategy. BIO WEB OF CONFERENCES 2020. [DOI: 10.1051/bioconf/20202202023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Purpose. To study magnesium status of patients having paroxysmal atrial fibrillation (AF) based on the use of an integrated clinical and laboratory approach. Methods. A prospective cohort study included 58 patients of the cardiology department of New Hospital Medical Association. The main group consisted of 32 patients having frequently recurring paroxysmal AF, the control group consisted of 26 patients without paroxysmal rhythm disturbance. The clinical status, Holter ECG monitoring data, the test results for magnesium deficiency (MD) clinical evidence, laboratory evidence of calcium, magnesium in blood plasma and formed elements, magnesium in whole blood, free fatty acids (FFA) and osmolality in blood plasma were assessed. Results. The score obtained when assessing MD clinical evidence was significantly higher in the main group patients compared with the control group (16.5 (11÷21) vs. 13 (8÷15), p<0.001). A statistically significant magnesium decrease in whole blood was revealed in patients having paroxysmal AF (0.54 (0.46÷0.60) vs. 0.61 (0.59÷0.64), p<0.001) and inside formed elements (0.68 (0.53÷1.07) vs. 1.31 (1.07÷1.44), p<0.001), which reflected changes in their magnesium status to a greater extent than the measured plasma cation concentrations. A close correlation between magnesium content in formed elements (intracellularly) and AF paroxysms frequency (Spearman’s rank correlation -0.51, p<0.001) was established. A violation of calcium to magnesium ratio in blood plasma (2.6 (2.5÷2.9) vs. 3.0 (2.8÷3.1), p=0.004) and intracellularly (4.85 (2.62÷9.3) vs. 1.85 (1.57÷2.07), p<0.001) was revealed in patients having AF. It has been shown that complex forming interactions with free fatty acids may affect intracellular calcium and magnesium content.
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Liotta EM, Karmarkar A, Batra A, Kim M, Prabhakaran S, Naidech AM, Maas MB. Magnesium and Hemorrhage Volume in Patients With Aneurysmal Subarachnoid Hemorrhage. Crit Care Med 2020; 48:104-110. [PMID: 31688193 PMCID: PMC7008932 DOI: 10.1097/ccm.0000000000004079] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES We tested the hypothesis that admission serum magnesium levels are associated with extent of hemorrhage in patients with aneurysmal subarachnoid hemorrhage. DESIGN Single-center prospective observational study. SETTING Tertiary hospital neurologic ICU. PATIENTS Patients with aneurysmal subarachnoid hemorrhage. INTERVENTIONS Clinically indicated CT scans and serum laboratory studies. MEASUREMENTS AND MAIN RESULTS Demographic, clinical, laboratory, and radiographic data were analyzed. Extent of initial hemorrhage was graded semi-quantitatively on admission CT scans using the modified Fisher scale (grades: 0, no radiographic hemorrhage; 1, thin [< 1 mm in depth] subarachnoid hemorrhage; 2, thin subarachnoid hemorrhage with intraventricular hemorrhage; 3, thick [≥ 1 mm] subarachnoid hemorrhage; 4, thick subarachnoid hemorrhage with intraventricular hemorrhage). We used both ordinal (modified Fisher scale) and dichotomized (thick vs thin subarachnoid hemorrhage) univariate and adjusted logistic regression models to assess associations between serum magnesium and radiographic subarachnoid hemorrhage severity. Data from 354 patients (mean age 55 ± 14 yr, 28.5% male, median admission Glasgow Coma Scale 14 [10-15]) were analyzed. Mean magnesium was lower in patients with thick versus thin subarachnoid hemorrhage (1.92 vs 1.99 mg/dL; p = 0.022). A monotonic trend across categories of modified Fisher scale was found using analysis of variance and Spearman rank correlation (p = 0.015 and p = 0.008, respectively). In adjusted ordinal and binary regression models, lower magnesium levels were associated with higher modified Fisher scale (odds ratio 0.33 per 1 mg/dL increase; 95% CI, 0.14-0.77; p = 0.011) and with thick subarachnoid hemorrhage (odds ratio 0.29 per 1 mg/dL increase; 95% CI, 0.10-0.78; p = 0.015). CONCLUSIONS These data support the hypothesis that magnesium influences hemorrhage severity in patients with aneurysmal subarachnoid hemorrhage, potentially through a hemostatic mechanism.
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Affiliation(s)
- Eric M. Liotta
- Department of Neurology, Northwestern University, Chicago, IL
| | | | - Ayush Batra
- Department of Neurology, Northwestern University, Chicago, IL
| | - Minjee Kim
- Department of Neurology, Northwestern University, Chicago, IL
| | | | | | - Matthew B. Maas
- Department of Neurology, Northwestern University, Chicago, IL
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12
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The association between serum and dietary magnesium with cardiovascular disease risk factors in Iranian adults with metabolic syndrome. TRANSLATIONAL METABOLIC SYNDROME RESEARCH 2020. [DOI: 10.1016/j.tmsr.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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13
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Effects of Oral Magnesium Supplementation on Vascular Function: A Systematic Review and Meta-analysis of Randomized Controlled Trials. High Blood Press Cardiovasc Prev 2019; 27:19-28. [PMID: 31845310 DOI: 10.1007/s40292-019-00355-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 12/04/2019] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION The effects of magnesium (Mg) supplementation on vascular function have been evaluated in some randomized controlled trials (RCT) but their results are conflicting. AIM A systematic review and meta-analysis were conducted to summarize the effects of oral Mg supplementation on vascular function in RCT. METHODS The databases MEDLINE (PubMed), Embase, Web of Science and Cochrane Library were accessed from inception to May 27, 2019. Intergroup differences (treatment vs. control group) related to changes in flow-mediated dilation (FMD) and pulse wave velocity (PWV), expressed as mean and standard deviation, were used to evaluate the effect of Mg supplementation on these outcomes. The results of the meta-analysis were expressed using a random-effects model. The heterogeneity between studies was evaluated using the I2 statistic. RESULTS The oral supplementation of Mg had no significant effect on FMD (mean difference 2.13; 95% CI - 0.56, 4.82; p = 0.12) and PWV (mean difference - 0.54, 95% CI - 1.45, 0.36, p = 0.24). Heterogeneity for both outcomes (FMD and PWV) was high (I2 = 99%, p < 0.001). However, in subgroup analyses, oral Mg significantly improved FMD in studies longer than 6 months, in unhealthy subjects, in individuals older than 50 years, or in those with body mass index (BMI) ≥ 25 kg/m2. The reduced number of RCT and the heterogeneity among them were the main limitations. CONCLUSIONS This meta-analysis suggest that oral Mg supplementation may improve endothelial function when conducted at least for 6 months and in unhealthy, overweight or older individuals. Registration number: PROSPERO CRD42019111462.
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Levy J, Miranda AAM, De Carli E, Bittencourt MS, Benseñor IJ, Lotufo PA, Marchioni DM. Ingestion of magnesium was not associated with coronary calcium score in a cross-sectional study. INT J VITAM NUTR RES 2019; 91:217-223. [PMID: 31711405 DOI: 10.1024/0300-9831/a000618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background and aims: Magnesium plays a key role in glucose metabolism, vascular tone, and inflammation. Therefore, it might be a dietary risk factor for cardiovascular diseases. In vitro and animal studies have suggested a decrease in vascular calcification with an increase in the magnesium intake. The objective of the present study was to investigate the association between magnesium intake and coronary artery calcium (CAC) score among participants of the ELSA-Brasil. Methods: This is an observational, cross-sectional study undertaken with a sub-sample from the ELSA-Brasil baseline data. In this sub-sample, only participants with CAC examination data were included (n = 4,306). Dietary intake was assessed by a validated food frequency questionnaire. The association between magnesium intake and presence of CAC (0 versus > 0) was investigated using multiple logistic regression models. Results: The participants were predominantly female (54.4 %), with self-reported white skin color (59.1 %), no smoking habit (53.7 %) and undergraduate or postgraduate education (44.4 %). The range of magnesium consumption was 37.24 - 1266.31 mg/day. CAC prevalence was 28.4 %. No significant association was found between magnesium intake and CAC after adjustments for diet, lifestyle, and clinical characteristics. In a first univariate model, the fifth quintile of magnesium intake, in comparison to the first quintile (lowest intake), resulted in an OR = 1.25, 95 % CI: 1.01 - 1.54 (P-linear trend = 0.005). However, in the last fully adjusted model, the fifth quintile of magnesium intake resulted in OR = 0.86, 95 % CI: 0.64 - 1.17 (P-linear trend = 0.239). Conclusions: In ELSA-Brasil, the intake of magnesium was not associated with the presence of coronary artery calcification.
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Affiliation(s)
- Jéssica Levy
- School of Public Health/University of São Paulo, Brazil
| | | | | | - Marcio Sommer Bittencourt
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil
| | - Isabela Judith Benseñor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil
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15
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Ferrè S, Li X, Adams-Huet B, Maalouf NM, Sakhaee K, Toto RD, Moe OW, Neyra JA. Association of serum magnesium with all-cause mortality in patients with and without chronic kidney disease in the Dallas Heart Study. Nephrol Dial Transplant 2019; 33:1389-1396. [PMID: 29077944 DOI: 10.1093/ndt/gfx275] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 08/08/2017] [Indexed: 01/08/2023] Open
Abstract
Background Low serum magnesium (SMg) has been linked to increased mortality and cardiovascular disease (CVD) in the general population. We examined whether this association is similar in participants with versus without prevalent chronic kidney disease (CKD) in the multiethnic Dallas Heart Study (DHS) cohort. Methods SMg was analyzed as a continuous variable and divided into tertiles. Study outcomes were all-cause death, cardiovascular (CV) death or event, and CVD surrogate markers, evaluated using multivariable Cox regression models adjusted for demographics, comorbidity, anthropometric and biochemical parameters including albumin, phosphorus and parathyroid hormone, and diuretic use. Median follow-up was 12.3 years (11.9-12.8, 25th percentile-75th percentile). Results Among 3551 participants, 306 (8.6%) had prevalent CKD. Mean SMg was 2.08 ± 0.19 mg/dL (0.85 ± 0.08 mM, mean ± SD) in the CKD and 2.07 ± 0.18 mg/dL (0.85 ± 0.07 mM) in the non-CKD subgroups. During the follow-up period, 329 all-cause deaths and 306 CV deaths or events occurred. In a fully adjusted model, every 0.2 mg/dL decrease in SMg was associated with ∼20-40% increased hazard for all-cause death in both CKD and non-CKD subgroups. In CKD participants, the lowest SMg tertile was also independently associated with all-cause death (adjusted hazard ratio 2.31; 95% confidence interval 1.23-4.36 versus 1.15; 0.55-2.41; for low versus high tertile, respectively). Conclusions Low SMg levels (1.4-1.9 mg/dL; 0.58-0.78 mM) were independently associated with all-cause death in patients with prevalent CKD in the DHS cohort. Randomized clinical trials are important to determine whether Mg supplementation affects survival in CKD patients.
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Affiliation(s)
- Silvia Ferrè
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Division of Mineral Metabolism, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Xilong Li
- Division of Biostatistics, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Beverley Adams-Huet
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Division of Mineral Metabolism, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Division of Biostatistics, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Naim M Maalouf
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Division of Mineral Metabolism, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Khashayar Sakhaee
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Division of Mineral Metabolism, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Robert D Toto
- Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Orson W Moe
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Division of Mineral Metabolism, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Javier A Neyra
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Division of Nephrology, Bone and Mineral Metabolism, Department of Internal Medicine, University of Kentucky, Lexington, KY, USA
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Tambo Tene S, Mathilde Klang J, Ndomou Houketchang SC, Kohole Foffe HA, Womeni HM. Application of amylase rich flours of corn and sweet potato to the reduction of consistency of cassava and corn gruels. J FOOD PROCESS PRES 2019. [DOI: 10.1111/jfpp.14058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Stephano Tambo Tene
- Research Unit of Biochemistry, Food Sciences and Nutrition, Faculty of Sciences, Department of Biochemistry University of Dschang Dschang Cameroon
| | - Julie Mathilde Klang
- Research Unit of Biochemistry, Food Sciences and Nutrition, Faculty of Sciences, Department of Biochemistry University of Dschang Dschang Cameroon
| | - Serge Cyrille Ndomou Houketchang
- Research Unit of Biochemistry, Food Sciences and Nutrition, Faculty of Sciences, Department of Biochemistry University of Dschang Dschang Cameroon
| | - Hermann Arantes Kohole Foffe
- Research Unit of Biochemistry, Food Sciences and Nutrition, Faculty of Sciences, Department of Biochemistry University of Dschang Dschang Cameroon
| | - Hilaire Macaire Womeni
- Research Unit of Biochemistry, Food Sciences and Nutrition, Faculty of Sciences, Department of Biochemistry University of Dschang Dschang Cameroon
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17
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Shahi A, Aslani S, Ataollahi M, Mahmoudi M. The role of magnesium in different inflammatory diseases. Inflammopharmacology 2019; 27:649-661. [PMID: 31172335 DOI: 10.1007/s10787-019-00603-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 05/11/2019] [Indexed: 12/26/2022]
Abstract
Magnesium deficiency (MgD) can cause inflammation in human body. The known mechanisms of inflammation caused by MgD include activation of phagocytic cells, opening of calcium channels, activation of the N-methyl-D-aspartate (NMDA) receptor, and activation of nuclear factor (NF)-κB. In addition, MgD causes systemic stress response through neuroendocrinological pathways. The inflammation caused by MgD can result in pro-atherogenic changes in the metabolism of lipoproteins, endothelial dysfunction, and high blood pressure. Studies suggest that magnesium may play an important role in the pathophysiology of some inflammatory diseases. Several clinical trials and laboratory studies have been done on the functional role of magnesium. In this study, we review some inflammatory diseases, in which the magnesium has a role in their pathophysiology. Among these diseases, diabetes, asthma, preeclampsia, atherosclerosis, heart damage, and rheumatoid arthritis have been highlighted.
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Affiliation(s)
- Abbas Shahi
- Rheumatology Research Center, Tehran University of Medical Sciences, P.O.Box: 14117-13137, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Aslani
- Rheumatology Research Center, Tehran University of Medical Sciences, P.O.Box: 14117-13137, Tehran, Iran
| | - MohammadReza Ataollahi
- Department of Medical Immunology, School of Medicine, Fasa University of Medical Sciences, P.O. Box: 74616-86688, Fasa, Iran.
| | - Mahdi Mahmoudi
- Rheumatology Research Center, Tehran University of Medical Sciences, P.O.Box: 14117-13137, Tehran, Iran.
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18
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Serum Magnesium is associated with Carotid Atherosclerosis in patients with high cardiovascular risk (CORDIOPREV Study). Sci Rep 2019; 9:8013. [PMID: 31142774 PMCID: PMC6541600 DOI: 10.1038/s41598-019-44322-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 05/13/2019] [Indexed: 01/05/2023] Open
Abstract
This study aimed to ascertain whether there is an independent association between serum magnesium (Mg) and the Carotid Intima-Media Thickness (IMT-CC), a well-accepted atherosclerotic-biomarker surrogate of cardiovascular disease (CVD), in a population with high cardiovascular risk. Serum Mg and traditional atherosclerotic risk factors were recorded in 939 patients (mean age, 59.6 ± 0.3 years, 83.2% men) with coronary heart disease (CHD) enrolled in the CORDIOPREV trial. Serum Mg strongly associated with IMT-CC. Before adjusting for potential confounding factors, IMT-CC decreased by 0.111 ± 0.011 mm per mg/dl increase in serum Mg (p < 0.001). After adjustment, the effect of Mg did not appear mediated through factors related to glucose metabolism, the lipid profile or the mineral metabolism and renal function. Multivariate models showed the lower Mg levels (quartile 1) as a strong independent factor contributing to IMT-CC along with age, sex, SBP, HDL-C, and diuretic use. Logistic regression analysis confirmed the predictive ability of serum Mg to differentiate patients at higher atherosclerotic risk as defined by an IMT-CC ≥ 1.0 mm, yielding a OR for the lower quartile of 10.623 (95%CI 2.311–48.845; P = 0.002) and a ROC-derived cutoff of 1.61 mg/dl. Therefore, our findings outline low serum magnesium as a possible independent risk factor for carotid atherosclerosis.
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19
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Tangvoraphonkchai K, Davenport A. Magnesium and Cardiovascular Disease. Adv Chronic Kidney Dis 2018; 25:251-260. [PMID: 29793664 DOI: 10.1053/j.ackd.2018.02.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 02/12/2018] [Accepted: 02/13/2018] [Indexed: 12/21/2022]
Abstract
Magnesium is the most abundant intracellular divalent cation and essential for maintaining normal cellular physiology and metabolism, acting as a cofactor of numerous enzymes, regulating ion channels and energy generation. In the heart, magnesium plays a key role in modulating neuronal excitation, intracardiac conduction, and myocardial contraction by regulating a number of ion transporters, including potassium and calcium channels. Magnesium also has a role in regulating vascular tone, atherogenesis and thrombosis, vascular calcification, and proliferation and migration of endothelial and vascular smooth muscle cells. As such, magnesium potentially has a major influence on the pathogenesis of cardiovascular disease. As the kidney is a major regulator of magnesium homeostasis, kidney disorders can potentially lead to both magnesium depletion and overload, and as such increase the risk of cardiovascular disease. Observational data have shown an association between low serum magnesium concentrations or magnesium intake and increased atherosclerosis, coronary artery disease, arrhythmias, and heart failure. However, major trials of supplementation with magnesium have reported inconsistent benefits and also raised potential adverse effects of magnesium overload. As such, there is currently no firm recommendation for routine magnesium supplementation except when hypomagnesemia has been proven or suspected as a cause for cardiac arrhythmias.
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20
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Rosique-Esteban N, Guasch-Ferré M, Hernández-Alonso P, Salas-Salvadó J. Dietary Magnesium and Cardiovascular Disease: A Review with Emphasis in Epidemiological Studies. Nutrients 2018; 10:nu10020168. [PMID: 29389872 PMCID: PMC5852744 DOI: 10.3390/nu10020168] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 01/24/2018] [Accepted: 01/24/2018] [Indexed: 12/15/2022] Open
Abstract
Magnesium (Mg) is an essential dietary element for humans involved in key biological processes. A growing body of evidence from epidemiological studies, randomized controlled trials (RCTs) and meta-analyses have indicated inverse associations between Mg intake and cardiovascular diseases (CVD). The present review aims to summarize recent scientific evidence on the topic, with a focus on data from epidemiological studies assessing the associations between Mg intake and major cardiovascular (CV) risk factors and CVD. We also aimed to review current literature on circulating Mg and CVD, as well as potential biological processes underlying these observations. We concluded that high Mg intake is associated with lower risk of major CV risk factors (mainly metabolic syndrome, diabetes and hypertension), stroke and total CVD. Higher levels of circulating Mg are associated with lower risk of CVD, mainly ischemic heart disease and coronary heart disease. Further, RCTs and prospective studies would help to clarify whether Mg intake and Mg circulating levels may also protect against other CVDs and CVD death.
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Affiliation(s)
- Nuria Rosique-Esteban
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, University Hospital of Sant Joan de Reus, Pere Virgili Institute for Health Research, Rovira i Virgili University, St/Sant Llorenç 21, 43201 Reus, Spain.
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain.
| | - Marta Guasch-Ferré
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, University Hospital of Sant Joan de Reus, Pere Virgili Institute for Health Research, Rovira i Virgili University, St/Sant Llorenç 21, 43201 Reus, Spain.
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Pablo Hernández-Alonso
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, University Hospital of Sant Joan de Reus, Pere Virgili Institute for Health Research, Rovira i Virgili University, St/Sant Llorenç 21, 43201 Reus, Spain.
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain.
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, University Hospital of Sant Joan de Reus, Pere Virgili Institute for Health Research, Rovira i Virgili University, St/Sant Llorenç 21, 43201 Reus, Spain.
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain.
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Kokubo Y, Saito I, Iso H, Yamagishi K, Yatsuya H, Ishihara J, Maruyama K, Inoue M, Sawada N, Tsugane S. Dietary magnesium intake and risk of incident coronary heart disease in men: A prospective cohort study. Clin Nutr 2017; 37:1602-1608. [PMID: 28843443 DOI: 10.1016/j.clnu.2017.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/04/2017] [Accepted: 08/07/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND & AIMS The associations between dietary magnesium intake and stroke and coronary heart disease (CHD) incidences are inconsistent and not established in Asian. We aimed to determine the association between dietary magnesium intake and the risk of stroke and CHD in a Japanese population. SUBJECTS/METHODS We studied 85,293 Japanese subjects by questionnaire at baseline (age 45-74 years, without cardiovascular disease or cancer in 1995 and 1998 for Cohorts I and II, respectively). The participants were followed until the end of 2009 and 2010 in Cohorts I and II, respectively. Dietary magnesium intake was estimated from a self-administered 138-item food-frequency questionnaire. RESULTS After 1,305,738 person-years of follow-up, 4110 strokes and 1283 cases of CHD were documented. The multivariable-adjusted hazard ratios (HRs, 95% confidence intervals, 95%CIs) of CHD for the fourth and fifth quintiles of dietary magnesium intake were 0.70 (0.50-0.99) and 0.66 (0.44-0.97) in men (P for trend = 0.036), respectively, and third quintile of dietary magnesium intake was 0.61 (0.39-0.96) in women (P for trend = 0.241), compared with the lowest quintile in men and women. We observed no decreased risks of incident stroke in men or women with higher dietary magnesium intakes. CONCLUSIONS Higher dietary magnesium intake was associated with a reduced risk of CHD in Japanese men.
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Affiliation(s)
- Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan.
| | - Isao Saito
- Department of Public Health, Ehime University Graduate School of Medicine, Toon, Japan
| | - Hiroyasu Iso
- Department of Public Health, Social Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroshi Yatsuya
- Department of Public Health, School of Medicine, Fujita Health University, Nagoya, Japan
| | - Junko Ishihara
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan; Department of Food and Life Science, School of Life and Environmental Science, Azabu University, Sagamihara City, Japan
| | - Koutatsu Maruyama
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Manami Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Norie Sawada
- Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Shoichiro Tsugane
- Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Serum magnesium level is not associated with inflammation in patients with knee osteoarthritis. Turk J Phys Med Rehabil 2017; 63:249-252. [PMID: 31453461 DOI: 10.5606/tftrd.2017.511] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 07/20/2016] [Indexed: 01/18/2023] Open
Abstract
Objectives In this study, we aimed to evaluate the relationship of serum magnesium (Mg) with the radiological severity and inflammation in the patients with knee osteoarthritis (OA). Patients and methods A total of 75 patients (61 females, 14 males; mean age 67.5±9.9 years; range 44 to 92 years) with the Kellgren-Lawrence Grade 1-4 knee OA were included in the study. Serum Mg levels (mg/dL) and inflammatory markers including erythrocyte sedimentation rate (ESR; mm/h) and C-reactive protein (CRP; mg/dL) were recorded. Serum Mg levels of the patients with mild OA (Grade 1-2) and severe OA (Grade 3-4) were compared. The correlation between Mg and both inflammatory markers was analyzed. Results Severe OA group had significantly lower Mg levels than the mild OA group (p=0.044). Serum Mg level was not found to be correlated with either inflammatory biomarkers. Conclusion Although serum Mg is associated with the radiological severity of knee OA, it is not associated with inflammatory biomarkers including ESR and CRP.
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Fang X, Liang C, Li M, Montgomery S, Fall K, Aaseth J, Cao Y. Dose-response relationship between dietary magnesium intake and cardiovascular mortality: A systematic review and dose-based meta-regression analysis of prospective studies. J Trace Elem Med Biol 2016; 38:64-73. [PMID: 27053099 DOI: 10.1016/j.jtemb.2016.03.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/11/2016] [Accepted: 03/29/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although epidemiology studies have reported the relationship, including a dose-response relationship, between dietary magnesium intake and risk of cardiovascular disease (CVD), the risk for CVD mortality is inconclusive and the evidence for a dose-response relationship has not been summarized. OBJECTIVE We conducted a systematic review and meta-analysis of prospective studies to summarize the evidence regarding the association of dietary magnesium intake with risk of CVD mortality and describe their dose-response relationship. DESIGN We identified relevant studies by searching major scientific literature databases and grey literature resources from their inception to August 2015, and reviewed references lists of retrieved articles. We included population-based studies that reported mortality risks, i.e. relative risks (RRs), odds ratios (ORs) or hazard ratios (HRs) of CVD mortality or cause-specific CVD death. Linear dose-response relationships were assessed using random-effects meta-regression. Potential nonlinear associations were evaluated using restricted cubic splines. RESULTS Out of 3002 articles, 9 articles from 8 independent studies met the eligibility criteria. These studies comprised 449,748 individuals and 10,313 CVD deaths. Compared with the lowest dietary magnesium consumption group in the population, the risk of CVD mortality was reduced by 16% in women and 8% in men. No significant linear dose-response relationship was found between increment in dietary magnesium intake and CVD mortality across all the studies. After adjusting for age and BMI, the risk of CVD mortality was reduced by 24-25% per 100mg/d increment in dietary magnesium intake in women of all the participants and in all the US participants. CONCLUSION Although the combined data confirm the role of dietary magnesium intake in reducing CVD mortality, the dose-response relationship was only found among women and in US population.
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Affiliation(s)
- Xin Fang
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Chun Liang
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, 200003 Shanghai, China
| | - Mei Li
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, 200003 Shanghai, China
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden; Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, 17177 Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, WC1E 6BT, UK
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden; Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Jan Aaseth
- Faculty of Public Health, Hedmark University College, 2411 Elverum, Norway; Innlandet Hospital Trust, Kongsvinger Hospital Division, 2226 Kongsvinger, Norway
| | - Yang Cao
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden.
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Meisel P, Schwahn C, Luedemann J, John U, Kroemer HK, Kocher T. Magnesium Deficiency is Associated with Periodontal Disease. J Dent Res 2016; 84:937-41. [PMID: 16183794 DOI: 10.1177/154405910508401012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In the multifactorial pathogenesis of periodontitis, there are still unknown factors influencing the outcome of the disease. An association between magnesium and periodontitis has been suggested by preliminary studies. However, relevant clinical data are lacking. We investigated the association between magnesium status and periodontal health in a population-based analysis. We conducted a cross-sectional epidemiological investigation involving 4290 subjects aged 20–80 yrs. We recorded periodontal risk factors and determined concentrations of serum magnesium and calcium, relating them to periodontal parameters. In a matched-pair study, 60 subjects using oral magnesium-containing drugs and 120 without were compared. In subjects aged 40 yrs and older, increased serum Mg/Ca was significantly associated with reduced probing depth (p < 0.001), less attachment loss (p = 0.006), and a higher number of remaining teeth (p = 0.005). Subjects taking Mg drugs showed less attachment loss (p < 0.01) and more remaining teeth than did their matched counterparts. These results suggest that nutritional magnesium supplementation may improve periodontal health.
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Affiliation(s)
- P Meisel
- Department of Pharmacology, Ernst Moritz Arndt University, F.-Loeffler-Str. 23d, D-17487 Greifswald, Germany.
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Hosseini B, Saedisomeolia A, Skilton MR. Association between Micronutrients Intake/Status and Carotid Intima Media Thickness: A Systematic Review. J Acad Nutr Diet 2016; 117:69-82. [PMID: 27863993 DOI: 10.1016/j.jand.2016.09.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 09/26/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Carotid intima media thickness (IMT) is a noninvasive marker of the extent and severity of subclinical atherosclerosis. Micronutrient intake may affect atherosclerosis and play a major role in the development of cardiovascular diseases (CVDs). OBJECTIVE The primary aim of this review was to synthesize the evidence regarding the association between carotid IMT and selected micronutrients. METHOD The authors searched PubMed, Cochrane, and EMBASE databases from inception to June 2016 for selected micronutrients, CVD, carotid IMT, and antioxidants. Thirty-five original studies met the inclusion criteria and were reviewed following preferred reporting items for systematic review and meta-analysis guidelines. RESULTS Although not all studies found consistent results, the weight of the evidence suggests that high intakes and/or circulatory levels of magnesium, as well as vitamin D and the vitamin B group, may be associated with lower carotid IMT or reduced progression of carotid IMT. The majority of studies did not find any significant association between vitamin E and C and carotid IMT. Less evidence was available for associations of retinol, zinc, and iron with carotid IMT. CONCLUSIONS In general, the current evidence concerning micronutrient intake and carotid IMT is largely inconclusive. Pragmatic clinical trials are required to determine whether dietary or supplemental intake of specific micronutrients alters carotid IMT, which is a surrogate measure of cardiovascular risk.
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Monarca S, Donato F, Zerbini I, Calderon RL, Craun GF. Review of epidemiological studies on drinking water hardness and cardiovascular diseases. ACTA ACUST UNITED AC 2016; 13:495-506. [PMID: 16874137 DOI: 10.1097/01.hjr.0000214608.99113.5c] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Major risk factors do not entirely explain the worldwide variability of morbidity and mortality due to cardiovascular disease. Environmental exposures, including drinking water minerals may affect cardiovascular disease risks. METHOD We conducted a qualitative review of the epidemiological studies of cardiovascular disease and drinking water hardness and calcium and magnesium levels. RESULTS Many but not all ecological studies found an inverse (i.e., protective) association between cardiovascular disease mortality and water hardness, calcium, or magnesium levels; but results are not consistent. Some case-control studies and one cohort study found either a reduced cardiovascular disease mortality risk with increased drinking water magnesium levels or an increased risk with low magnesium levels. However, the analytical studies provide little evidence that cardiovascular risks are associated with drinking water hardness or calcium levels. CONCLUSION Information from epidemiological and other studies supports the hypothesis that a low intake of magnesium may increase the risk of dying from, and possibly developing, cardiovascular disease or stroke. Thus, not removing magnesium from drinking water, or in certain situations increasing the magnesium intake from water, may be beneficial, especially for populations with an insufficient dietary intake of the mineral.
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Affiliation(s)
- Silvano Monarca
- Department of Hygiene and Public Health, University of Perugia, Perugia, Italy.
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Sarrafzadegan N, Khosravi-Boroujeni H, Lotfizadeh M, Pourmogaddas A, Salehi-Abargouei A. Magnesium status and the metabolic syndrome: A systematic review and meta-analysis. Nutrition 2016; 32:409-17. [DOI: 10.1016/j.nut.2015.09.014] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 09/19/2015] [Accepted: 09/21/2015] [Indexed: 12/18/2022]
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Taveira TH, Ouellette D, Gulum A, Choudhary G, Eaton CB, Liu S, Wu WC. Relation of Magnesium Intake With Cardiac Function and Heart Failure Hospitalizations in Black Adults: The Jackson Heart Study. Circ Heart Fail 2016; 9:e002698. [PMID: 27056880 PMCID: PMC4826717 DOI: 10.1161/circheartfailure.115.002698] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 03/07/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Little is known about magnesium intake and risk of heart failure (HF) hospitalizations, particularly in blacks. We hypothesize that magnesium intake relates to HF hospitalization in blacks. METHODS AND RESULTS From the Jackson Heart Study cohort (n=5301), we studied 4916 blacks recruited during 2000 to 2004 in Jackson (Mississippi), who completed an 158-item Food-Frequency Questionnaire that included dietary supplements. Daily magnesium intake derived from the questionnaire was divided by the body weight to account for body storage and stratified by quartiles (0.522-2.308, 2.309-3.147, 3.148-4.226, and ≥4.227 mg magnesium intake/kg). Cox proportional hazards modeling assessed the association between quartiles of magnesium intake/kg and hospitalizations for HF adjusting for HF risk, energy intake, and dietary factors. The cohort had a mean age=55.3 (SD=12.7 years) and composed of 63.4% women, 21.6% diabetes mellitus, 62.7% hypertension, 7.1% coronary disease, and 2.8% with known HF. When compared with participants in the first quartile of magnesium intake/kg, those with higher magnesium intake (>2.308 mg/kg) had decreased risk of HF admission, with adjusted hazard ratios of 0. 66(95% confidence interval, 0.47-0.94) in the second quartile to 0.47 (95% confidence interval, 0.27-0.82) in the highest quartile. Results were similar when individuals with previously diagnosed HF (2.8%) were excluded or when the analysis was repeated using quartiles of magnesium intake without accounting for body weight. CONCLUSIONS Magnesium intake <2.3 mg/kg was related to increased risk of subsequent HF hospitalizations. Future studies are needed to test whether serum magnesium levels predict risk of HF.
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Affiliation(s)
- Tracey H Taveira
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles
| | - Danielle Ouellette
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles
| | - Alev Gulum
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles
| | - Gaurav Choudhary
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles
| | - Charles B Eaton
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles
| | - Simin Liu
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles
| | - Wen-Chih Wu
- From the Department of Medicine, Veterans Affairs Medical Center, Center of Innovation for Long Term Services and Support, Providence, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Pharmacy Practice, University of Rhode Island, College of Pharmacy, Kingston, RI (T.H.T., D.O., A.G., G.C., W.-C.W.); Department of Medicine, Warren Alpert School of Medicine of Brown University, Providence, RI (T.H.T., G.C., W.-C.W.); Center for Primary Care and Prevention (C.B.E.) and the Department of Family Medicine (C.B.E.), Memorial Hospital of Rhode Island, Pawtucket, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI (C.B.E., S.L., W.-C.W.); and The Program on Genomics and Nutrition, Center for Metabolic Disease Prevention, Departments of Epidemiology (S.L.), Medicine (S.L.), and Obstetrics and Gynecology (S.L.), University of California, Los Angeles.
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de Baaij JHF, Hoenderop JGJ, Bindels RJM. Magnesium in man: implications for health and disease. Physiol Rev 2015; 95:1-46. [PMID: 25540137 DOI: 10.1152/physrev.00012.2014] [Citation(s) in RCA: 870] [Impact Index Per Article: 96.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Magnesium (Mg(2+)) is an essential ion to the human body, playing an instrumental role in supporting and sustaining health and life. As the second most abundant intracellular cation after potassium, it is involved in over 600 enzymatic reactions including energy metabolism and protein synthesis. Although Mg(2+) availability has been proven to be disturbed during several clinical situations, serum Mg(2+) values are not generally determined in patients. This review aims to provide an overview of the function of Mg(2+) in human health and disease. In short, Mg(2+) plays an important physiological role particularly in the brain, heart, and skeletal muscles. Moreover, Mg(2+) supplementation has been shown to be beneficial in treatment of, among others, preeclampsia, migraine, depression, coronary artery disease, and asthma. Over the last decade, several hereditary forms of hypomagnesemia have been deciphered, including mutations in transient receptor potential melastatin type 6 (TRPM6), claudin 16, and cyclin M2 (CNNM2). Recently, mutations in Mg(2+) transporter 1 (MagT1) were linked to T-cell deficiency underlining the important role of Mg(2+) in cell viability. Moreover, hypomagnesemia can be the consequence of the use of certain types of drugs, such as diuretics, epidermal growth factor receptor inhibitors, calcineurin inhibitors, and proton pump inhibitors. This review provides an extensive and comprehensive overview of Mg(2+) research over the last few decades, focusing on the regulation of Mg(2+) homeostasis in the intestine, kidney, and bone and disturbances which may result in hypomagnesemia.
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Affiliation(s)
- Jeroen H F de Baaij
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joost G J Hoenderop
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - René J M Bindels
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Floege J. Magnesium in CKD: more than a calcification inhibitor? J Nephrol 2014; 28:269-77. [PMID: 25227765 PMCID: PMC4439441 DOI: 10.1007/s40620-014-0140-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 09/02/2014] [Indexed: 01/30/2023]
Abstract
Magnesium fulfils important roles in multiple physiological processes. Accordingly, a tight regulation of magnesium homeostasis is essential. Dysregulated magnesium serum levels, in particular hypomagnesaemia, are common in patients with chronic kidney disease (CKD) and have been associated with poor clinical outcomes. In cell culture studies as well as in clinical situations magnesium levels were associated with vascular calcification, cardiovascular disease and altered bone-mineral metabolism. Magnesium has also been linked to diseases such as metabolic syndrome, diabetes, hypertension, fatigue and depression, all of which are common in CKD. The present review summarizes and discusses the latest clinical data on the impact of magnesium and possible effects of higher levels on the health status of patients with CKD, including an outlook on the use of magnesium-based phosphate-binding agents in this context.
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Affiliation(s)
- Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Pauwelsstr. 30, 52057, Aachen, Germany,
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31
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Dibaba DT, Xun P, He K. Dietary magnesium intake is inversely associated with serum C-reactive protein levels: meta-analysis and systematic review. Eur J Clin Nutr 2014; 68:510-6. [PMID: 24518747 PMCID: PMC3975661 DOI: 10.1038/ejcn.2014.7] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 09/11/2013] [Accepted: 09/13/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND/OBJECTIVES The aim of this study was to quantitatively summarize the association of dietary magnesium (Mg) intake with serum C-reactive protein (CRP) levels in the general population. SUBJECTS/METHODS Observational and experimental studies through February 2013 were reviewed in PubMed and EMBASE. Additional information was retrieved through Google or hand search of related reference lists. The main outcome is either adjusted geometric mean of CRP or odds ratio (OR) of having serum CRP ≥ 3 mg/l. Meta-regression was used to determine the linear association of dietary Mg intake and adjusted geometric means of CRP levels. A fixed-effects model was used to pool ORs of interest, comparing those in the lowest with those in the highest group of dietary Mg intake. RESULTS A data set derived from seven cross-sectional studies including 32,918 participants was quantitatively assessed. A weighted inverse association between Mg intake and serum CRP levels was observed (β-coefficient: -0.0028; 95% confidence interval (CI), -0.0043 to -0.0013; P(trend) = 0.001) from four cross-sectional studies. The pooled OR (95% CI) of having CRP ≥ 3 mg/l was 1.49 (1.18-1.89) on comparing the lowest to the highest group of Mg intake from three studies with the data available. Qualitative assessment among five intervention studies also showed a potential beneficial effect of Mg intake on serum CRP levels. CONCLUSIONS This meta-analysis and systematic review indicates that dietary Mg intake is significantly and inversely associated with serum CRP levels. The potential beneficial effect of Mg intake on chronic diseases may be, at least in part, explained by inhibiting inflammation.
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Affiliation(s)
- D T Dibaba
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA
| | - P Xun
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA
| | - K He
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, USA
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Stanisławska M, Szkup-Jabłońska M, Jurczak A, Wieder-Huszla S, Samochowiec A, Jasiewicz A, Noceń I, Augustyniuk K, Brodowska A, Karakiewicz B, Chlubek D, Grochans E. The severity of depressive symptoms vs. serum Mg and Zn levels in postmenopausal women. Biol Trace Elem Res 2014; 157:30-5. [PMID: 24271492 PMCID: PMC3895221 DOI: 10.1007/s12011-013-9866-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 11/13/2013] [Indexed: 12/01/2022]
Abstract
The aim of this study was to assess the severity of depressive symptoms in postmenopausal women, depending on serum Mg and Zn levels. The study involved 171 postmenopausal women from Poland, who were not using menopausal hormone therapy (MHT). The intensity of depressive symptoms was evaluated using a standard research technique, the Beck Depression Inventory (BDI). The plasma Mg and Zn concentrations were measured. Depressive symptoms of different severity levels were diagnosed in 36.8 % of the women. The mean serum Mg level was 1.53 ± 0.28 mg/dL, and Zn level was 72 ±14 μg/dL. The women with higher serum Mg and Zn levels had less depressive symptoms, and this observation is a precious information which can be used when planning depressive disorder prevention programmes.
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Affiliation(s)
- M. Stanisławska
- Nursing Department, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - M. Szkup-Jabłońska
- Nursing Department, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - A. Jurczak
- Nursing Department, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - S. Wieder-Huszla
- Nursing Department, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - A. Samochowiec
- Department of Clinical Psychology, Institute of Psychology, Szczecin University, Krakowska 71-79, 71-017 Szczecin, Poland
| | - A. Jasiewicz
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland
| | - I. Noceń
- Department of Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - K. Augustyniuk
- Nursing Department, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - A. Brodowska
- Department of Gynecology and Urogynecology, Pomeranian Medical University in Szczecin, Siedlecka 2, 72-010 Police, Poland
| | - B. Karakiewicz
- Public Health Department, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - D. Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University of Szczecin, 70-111 Szczecin, al. Powstańców Wlkp. 72, Szczecin, Poland
| | - E. Grochans
- Nursing Department, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
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Pivotal role of mediterranean dietary regimen in the increase of serum magnesium concentration in patients with coronary artery disease. J Nutr Metab 2013; 2013:431070. [PMID: 24307942 PMCID: PMC3838832 DOI: 10.1155/2013/431070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Accepted: 09/23/2013] [Indexed: 11/21/2022] Open
Abstract
Background. Recent studies confirmed cardioprotective role of intravenous magnesium for the prevention of cardiac events, but effect of dietary intake of this mineral via recommended dietary regimens on control and inhibition of coronary artery disease (CAD) risk factors has been questioned. The aim of the present study was to determine effect of Mediterranean dietary approach on serum magnesium concentration among Iranian patients with CAD. Method. Baseline characteristics and clinical data of 102 consecutive patients with the diagnosis of CAD and candidates for isolated coronary artery bypass surgery were entered into the study. Laboratory parameters especially serum magnesium concentration were measured after 12–14 h of overnight fasting and before operation. Nutritional status was assessed by food frequency questionnaire and the diet score was calculated on the basis of Mediterranean diet quality index (Med-DQI). Results. No significant differences were found in the concentrations of albumin, last fasting blood sugar, last creatinine, and lipid profiles between the groups with Mediterranean dietary score < 5 and the group with higher dietary score; however, serum magnesium concentration in the first group was higher than that in the group with higher dietary score. Linear multivariate regression analysis showed that the lower Mediterranean dietary score was a predictor for serum magnesium concentration after adjusting for confounders. Conclusion. Taking Mediterranean dietary regimen can be associated with increased level of serum magnesium concentration, and thus this regimen can be cardioprotective because of its effects on serum magnesium.
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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: 0.9] [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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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: 2.6] [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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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: 225] [Impact Index Per Article: 20.5] [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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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: 7.4] [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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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: 5.3] [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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Mortazavi M, Moeinzadeh F, Saadatnia M, Shahidi S, McGee JC, Minagar A. Effect of magnesium supplementation on carotid intima-media thickness and flow-mediated dilatation among hemodialysis patients: a double-blind, randomized, placebo-controlled trial. Eur Neurol 2013; 69:309-16. [PMID: 23548855 DOI: 10.1159/000346427] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Accepted: 12/05/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of the present study was to determine the efficacy of oral magnesium (Mg) supplementation on endothelial function through evaluation of carotid intima-media thickness (cIMT), brachial artery flow-mediated dilatation (FMD), and C-reactive protein (CRP) among hemodialysis (HD) patients. METHODS This randomized, controlled, double-blind clinical trial consisted of 54 patients on HD. One group was treated orally with 440 mg of Mg oxide 3 times per week for 6 months (n = 29). The control group (n = 25) was given placebo using the same administration protocol. cIMT, FMD, serum calcium levels, phosphorus, lipid, CRP, and bicarbonate were measured at baseline and at 6 months in both groups. RESULTS At 6 months, cIMT was significantly decreased in the Mg group (0.84 ± 0.13 mm at baseline and 0.76 ± 0.13 mm at 6 months, p = 0.001). However, in the placebo group, cIMT was significantly increased (0.73 ± 0.13 and 0.79 ± 0.12 mm, respectively, p = 0.003). When hypertension, diabetes mellitus, smoking, hyperlipidemia, and systemic lupus erythematosus were controlled for in the analysis, the effect of Mg remained significant in both groups (p = 0.000). CONCLUSION Our results indicate that Mg might not improve endothelial function (CRP level and FMD) and that a decreased cIMT as a marker of atherosclerosis may be due to the inhibition of calcification through the regulation parathormone, calcium, and phosphorus.
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Affiliation(s)
- Mojgan Mortazavi
- Isfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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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: 10.8] [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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Yary T, Aazami S, Soleimannejad K. Dietary intake of magnesium may modulate depression. Biol Trace Elem Res 2013; 151:324-9. [PMID: 23238611 DOI: 10.1007/s12011-012-9568-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Accepted: 11/29/2012] [Indexed: 10/27/2022]
Abstract
Depressive symptoms are frequent in students and may lead to countless problems. Several hypotheses associate magnesium with depression because of the presence of this mineral in several enzymes, hormones, and neurotransmitters, which may play a key role in the pathological pathways of depression. The aim of this study was to assess whether magnesium intake could modulate depressive symptoms. A cross-sectional study was conducted on a convenience sample of 402 Iranian postgraduate students studying in Malaysia to assess the relationship between magnesium intake and depressive symptoms. The mean age of the participants was 32.54 ± 6.22 years. The results of the study demonstrated an inverse relationship between magnesium intake and depressive symptoms, which persisted even after adjustments for sex, age, body mass index, monthly expenses, close friends, living on campus, smoking (current and former), education, physical activity, and marital status.
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Affiliation(s)
- Teymoor Yary
- Department of Cardiology, Faculty of Medicine and Health Sciences, Ilam University of Medical Sciences, 7134-69391, Banganjab, Ilam, Iran.
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Mahalle N, Kulkarni MV, Naik SS. Is hypomagnesaemia a coronary risk factor among Indians with coronary artery disease? J Cardiovasc Dis Res 2012; 3:280-6. [PMID: 23233771 PMCID: PMC3516007 DOI: 10.4103/0975-3583.102698] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Introduction: Magnesium is an essential element that has numerous biological functions in the cardiovascular system. Hence, three hundred patients with known cardiovascular disease above the age of 25 years were studied to evaluate association between dietary and serum magnesium with cardiovascular risk factors. Materials and Methods: Patients were divided into three groups according to serum magnesium levels; ≤1.6 (Group 1), >1.6-2.6 (Group 2) and: >2.6 mg/dl (Group 3), and into two groups according to dietary magnesium intake; ≤350 mg/day (Group 1) and >350 mg/day (Group 2), respectively. Results: Mean age of patients was 60.97 ± 12.5 years. Total cholesterol, triglycerides, VLDL, and LDL were significantly higher and HDL cholesterol significantly lower in group 1 when compared with group 2 and group 3. Diabetes, dyslipidemia, and hypertension were negatively correlated with serum magnesium levels; which were maintained even after adjustment with age, sex, and anthropometric parameters in multiple regression analysis. Similar observations were observed in dietary magnesium intake except LDL and total cholesterol. Dietary magnesium was positively correlated with serum magnesium. Conclusions: Hypomagnesaemia and low dietary intake of magnesium are strongly related to cardiovascular risk factors among known subjects with coronary artery disease. Hence, magnesium supplementation may help in reducing cardiovascular disease.
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Affiliation(s)
- Namita Mahalle
- Department of Pathology, Biochemistry Section, Deenanath Mangeshkar Hospital and Research Center, Erandawane, Pune, India
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Kim YH, Jung KI, Song CH. Effects of serum calcium and magnesium on heart rate variability in adult women. Biol Trace Elem Res 2012; 150:116-22. [PMID: 23054869 DOI: 10.1007/s12011-012-9518-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 10/01/2012] [Indexed: 02/05/2023]
Abstract
The present study was designed to evaluate the association of serum calcium (Ca) and magnesium (Mg) levels with heart rate variability (HRV). One hundred and sixteen adult women were recruited in this cross-sectional study. Serum Ca and Mg levels were measured, and HRV in each time and frequency domain was recorded for 5 min. Mean heart rate and standard deviation of the normal to normal interval (SDNN) and root mean square of differences of successive RR interval (RMSSD) in time domain and total power (TP), low-frequency power (LF), high-frequency power (HF), and LF/HF ratio in frequency domain were compared according to the tertiles of serum Ca and Mg levels and Ca/Mg ratio. The associations between serum Ca and Mg levels and Ca/Mg ratio with HRV were evaluated using regression analyses. Mean heart rate tended to increase from the lowest to the highest tertile of Ca levels (p = 0.081), whereas it decreased significantly with higher Mg levels (p = 0.026). Increasing SDNN value was observed from the lowest to the highest tertile of Mg levels (p = 0.009). SDNN value decreased significantly from the lowest to the highest tertile of Ca/Mg ratio (p = 0.030). Participants in the lowest tertile of Ca/Mg ratio had significantly higher TP and LF values compared to those in the middle and highest tertiles (p < 0.05). Decreasing SDNN, TP, and LF values were significantly associated with higher Ca/Mg ratios (p < 0.05). Associations of serum Mg level and Ca/Mg ratio with HRV could be one of the mechanisms involved in cardiovascular diseases.
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Affiliation(s)
- Yeong-Hoon Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Differences in nutrition status by body mass index in patients with peripheral artery disease. JOURNAL OF VASCULAR NURSING 2012; 30:77-87. [PMID: 22901446 DOI: 10.1016/j.jvn.2012.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 04/05/2012] [Indexed: 12/31/2022]
Abstract
Peripheral Arterial Disease (PAD) is most prevalent in the elderly and associated with increased cardio vascular disease (CVD) morbidity and mortality. Treatment focuses on improving functional capacity and reducing CVD risk factors. To date, little is understood about dietary habits and weight in this patient population. Nutritional and weight recommendations are based on heart health, and little is known about the unique needs of elderly PAD patients with multiple comorbidities. This prospective study compared 1) the dietary intake of nonobese PAD patients in comparison with those who were obese and; 2) dietary intake of those patients with the Estimated Average Requirement (EAR) based on age, gender and BMI. Nutritional intake was assessed with the Block 98 Food Frequency Questionnaire. Body mass index (BMI) was calculated in accordance with the National Heart, Lung, and Blood Institute (NHLBI) guidelines.The study population was divided into obese (BMI ≥ 30) and nonobese (NO) groups. Comparisons between groups were performed using the Mann-Whitney U test for continuous variables and the Chi-square test for ordinal variables. All tests were two-tailed and P < 0.05 was considered significant. The Estimated Average Requirement (EAR) cut-point method was used to compare nutritional variables with Dietary Reference Intakes (DRI). The study population included 189 NO (BMI < 30) and 111 obese (BMI > 30) individuals. Obese participants reported greater intake of foods containing cholesterol and trans-fatty acids and more frequent intake of B vitamins in comparison with the NO BMI group. Additionally, the nutrient intake of all participants by age, gender and BMI was lower than the EAR for magnesium, folate, and Vitamin E. These results suggest that the nutritional intake of PAD patients differs based on gender and BMI. Additionally, EAR was lower for specific nutrients than recommended. Further investigation is needed to examine the association between nutritional intake and nutrition-related deficits.
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Zhang W, Iso H, Ohira T, Date C, Tamakoshi A. Associations of dietary magnesium intake with mortality from cardiovascular disease: The JACC study. Atherosclerosis 2012; 221:587-95. [DOI: 10.1016/j.atherosclerosis.2012.01.034] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Revised: 01/16/2012] [Accepted: 01/23/2012] [Indexed: 01/10/2023]
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Endothelial cells and magnesium: implications in atherosclerosis. Clin Sci (Lond) 2012; 122:397-407. [PMID: 22248353 DOI: 10.1042/cs20110506] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is no doubt that the functional and structural integrity of the endothelium is critical in maintaining vascular homoeostasis and in preventing atherosclerosis. In the light of epidemiological and experimental studies, magnesium deficiency is emerging as an inducer of endothelial dysfunction. In particular, data on the effects of low extracellular magnesium on cultured endothelial cells reinforce the idea that correcting magnesium homoeostasis might be a helpful and inexpensive intervention to prevent and treat endothelial dysfunction and, consequently, atherosclerosis.
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Magnesium intake and prevalence of metabolic syndrome in adults: Tehran Lipid and Glucose Study. Public Health Nutr 2012; 15:693-701. [DOI: 10.1017/s1368980011002941] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AbstractObjectiveWe examined the association of metabolic syndrome (MetS) and its components with dietary intakes of Mg in Tehran adults.DesignIn a cross-sectional study, dietary intakes were assessed using a valid and reliable FFQ. MetS was defined according to the modified guidelines of the National Cholesterol Education Program Adult Treatment Panel III. Waist circumference (WC) was coded according to the newly introduced cut-off points for Iranian adults (≥95 cm for both genders).SettingParticipants of the Tehran Lipid and Glucose Study (2006–2008).SubjectsAdults (n2504; 1120 men and 1384 women) aged 18–74 years.ResultsThe mean age of participants was 40·8 (sd14·6) years and 38·2 (sd13·5) years for men and women, respectively. The reported mean intake of Mg was 349 (sd109) mg/d. After adjustment for confounding factors, dietary Mg intake was inversely associated with fasting blood glucose (β= −0·08,P= 0·006), TAG (β= −0·058,P= 0·009) and WC (β= −0·013,P= 0·006); however, there were no associations between dietary Mg and diastolic blood pressure, systolic blood pressure or HDL cholesterol. An association was observed between MetSZ-score and Mg intake (crudeβ= −0·017,P= 0·001), independent of age, gender, smoking, physical activity and BMI; this association was attenuated following further adjustment for dietary factors and menopausal status (β= −0·034,P= 0·061).ConclusionsOur findings suggest a significant inverse association between dietary Mg, MetS and its components.
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Beckstrand RL, Pickens JS. Beneficial Effects of Magnesium Supplementation. J Evid Based Complementary Altern Med 2011. [DOI: 10.1177/2156587211401746] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Magnesium is an essential mineral necessary for optimal cellular health and well-being. Many adults in the United States fail to get recommended amounts of magnesium from their diets. Even so, symptoms of magnesium deficiency are rarely seen; however, maintaining normal body stores could be preventative against common diseases.
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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: 6.6] [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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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: 3.4] [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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