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Takemoto N, Millman J, Uema T, Yamakawa F, Okamoto S, Mori M, Mori H, Nakamura K, Yamori Y, Masuzaki H. Analysis of spot urine biomarkers and association with body weight in Japanese elementary schoolchildren. Eur J Pediatr 2022; 181:3879-3888. [PMID: 36097199 PMCID: PMC9546969 DOI: 10.1007/s00431-022-04604-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 08/17/2022] [Accepted: 08/29/2022] [Indexed: 11/24/2022]
Abstract
UNLABELLED Childhood obesity is rapidly increasing worldwide and is largely the consequence of adoption of unhealthy diets excessive in calories and salt (NaCl) as well as devoid in pivotal micronutrients such as potassium (K) and magnesium (Mg). Education-based programs aiming to encourage healthy food knowledge and behaviors are crucial at a young age, and for this purpose, convenient ways to assess daily dietary intake are warranted. We therefore attempted to evaluate the dietary intake of Okinawan schoolchildren in Japan by analyzing a series of biomarkers in morning spot urine samples and explore whether these biomarkers correlate with body weight and a series of metabolic parameters. We enrolled 98 third-grade elementary schoolchildren in Okinawa, Japan. Morning spot urine samples were collected and analyzed using high-performance liquid chromatography (HPLC) to assess dietary intake. We found that estimated daily NaCl intake was higher in obese/overweight children as compared to healthy-weight children (p = 0.0001). There was also a significant positive correlation between body mass index (BMI) and NaCl intake (Spearman) (ρ = 0.45, p < 0.0001) and a negative correlation between BMI and Mg/Cr (ρ = -0.27, p = 0.01). Furthermore, Na/K ratio was higher in samples collected on Monday (weekend) as compared to samples collected on Thursday or Friday (weekday) (p < 0.0001). CONCLUSION Via the use of morning spot urine analyses, our results show that NaCl intake was associated with obesity, and Mg excretion negatively correlated with BMI in Japanese schoolchildren, highlighting the potential role of these micronutrients in maintaining a healthy body weight. WHAT IS KNOWN •Overweight and obesity are largely due to excessive consumption of calories and positively correlated with salt (NaCl) intake. •Spot urine methods are convenient for assessing the nutritional needs and targeting prevention programs in children. WHAT IS NEW •Utilizing morning spot urine analyses, estimated NaCl intake is positively correlated and Mg/Cr negatively correlated with BMI in Okinawan schoolchildren. •As estimated via morning spot urine samples, a greater proportion of children likely exceeds the recommended NaCl intake on the weekend as compared to weekday.
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Affiliation(s)
- Nozomi Takemoto
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Jasmine Millman
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
| | - Tsugumi Uema
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
| | - Fusae Yamakawa
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Shiki Okamoto
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Mari Mori
- Department of Health Management, School of Health Studies, Tokai University, Kanagawa, Japan
| | - Hideki Mori
- Institute for World Health Development, Mukogawa Women's University, Hyogo, Japan
| | - Koshi Nakamura
- Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yukio Yamori
- Institute for World Health Development, Mukogawa Women's University, Hyogo, Japan
| | - Hiroaki Masuzaki
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
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Dong Y, Silver SM, Sterns RH. Estimating urine volume from the urine creatinine concentration. Nephrol Dial Transplant 2021; 38:811-818. [PMID: 34850163 DOI: 10.1093/ndt/gfab337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Indexed: 11/12/2022] Open
Abstract
Spot determinations of the urine creatinine concentration are widely used as a substitute for 24-hour urine collections. Expressed as the amount excreted per gram of creatinine, urine concentrations in a single-voided sample are often used to estimate 24-hour excretion rates of protein, sodium, potassium, calcium, magnesium, urea, and uric acid. These estimates are predicated on the assumption that daily creatinine excretion equals 1 gm (and that a urine creatinine concentration of 100 mg/dl reflects a 1 Liter 24-hour urine volume). Such estimates are invalid if the serum creatinine concentration is rising or falling. In addition, because creatinine excretion is determined by muscle mass, the assumption that 24-hour urine creatinine excretion equals 1 gm yields a misleading estimate at the extremes of age and body size. In this review we evaluate seven equations for the accuracy of their estimates of urine volume based on urine creatinine concentrations in actual and idealized patients. None of the equations work well in patients who are morbidly obese or in patients with markedly decreased muscle mass. In other patients, estimates based on a reformulation of the Cockroft-Gault equation are reasonably accurate. A recent study based on this relationship found a high strength of correlation between estimated and measured urine output with chronic kidney disease (CKD) studied in the African American Study of Kidney Disease (AASK) trial and for the patients studied in the CKD Optimal Management with Binders and NictomidE (COMBINE) trial. However, the equation systematically underestimated urine output in the AASK trial. Hence, an intercept was added to account for the bias in estimated output. A more rigorous equation, derived from an ambulatory Swiss population, that includes body mass index and models the non-linear accelerated decline in creatinine excretion with age, could potentially be more accurate in overweight and elderly patients. In addition to extremes of body weight and muscle mass, decreased dietary intake or reduced hepatic synthesis of creatine, a precursor of creatinine, or ingestion of creatine supplements will also result in inaccurate estimates. These limitations must be appreciated to rationally use predictive equations to estimate urine volume. If the baseline urine creatinine concentration is determined in a sample of known volume, subsequent urine creatinine concentrations will reveal actual urine output as well as the change in urine output. Given the constraints of the various estimating equations, a single baseline timed collection may be more useful strategy for monitoring urine volume than entering anthropomorphic data into a calculator.
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Affiliation(s)
- Yishan Dong
- Rochester General Hospital, Rochester, New York, USA
| | | | - Richard H Sterns
- Rochester General Hospital, Rochester, New York, USA.,University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
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Vall-Palomar M, Madariaga L, Ariceta G. Familial hypomagnesemia with hypercalciuria and nephrocalcinosis. Pediatr Nephrol 2021; 36:3045-3055. [PMID: 33595712 DOI: 10.1007/s00467-021-04968-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 10/22/2022]
Abstract
Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC; OMIM 248250) is a rare autosomal recessive kidney disease caused by mutations in the CLDN16 or CLDN19 genes encoding the proteins claudin-16 and claudin-19, respectively. These are involved in paracellular magnesium and calcium transport in the thick ascending limb of Henle's loop and account for most of the magnesium reabsorption in the tubules. FHHNC is characterized by hypomagnesaemia, hypercalciuria, and nephrocalcinosis, and progresses to kidney failure, requiring dialysis and kidney transplantation mainly during the second to third decades of life. Patients carrying CLDN19 mutations frequently exhibit associated congenital ocular defects leading to variable visual impairment. Despite this severe clinical course, phenotype variability even among siblings has been described in this disease, suggesting unidentified epigenetic mechanisms or other genetic or environmental modifiers. Currently, there is no specific therapy for FHHNC. Supportive treatment with high fluid intake and dietary restrictions, as well as magnesium salts, thiazides, and citrate, are commonly used in an attempt to retard the progression of kidney failure. A kidney transplant remains the only curative option for kidney failure in these patients. In this review, we summarize the current knowledge about FHHNC and discuss the remaining open questions about this disorder.
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Affiliation(s)
- Mònica Vall-Palomar
- Fisiopatologia Renal, Centro de Investigaciones en Bioquímica y Biología Molecular (CIBBIM), Vall d'Hebron. Institut de Recerca (VHIR), Barcelona, Spain
| | - Leire Madariaga
- Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain.,Pediatric Nephrology Department, Cruces University Hospital, UPV/EHU, Barakaldo, Spain
| | - Gema Ariceta
- Fisiopatologia Renal, Centro de Investigaciones en Bioquímica y Biología Molecular (CIBBIM), Vall d'Hebron. Institut de Recerca (VHIR), Barcelona, Spain. .,Pediatric Nephrology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. .,Servei Nefrología Pediátrica, Hospital Vall d' Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
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Tang NLS, Hui J, Huang D, Tang MF, Wang X, Wu J, Chan IHS, Leung TF. Reference intervals of spot urine copper excretion in preschool children and potential application in pre-symptomatic screening of Wilson disease. Pathology 2020; 52:439-446. [PMID: 32276787 DOI: 10.1016/j.pathol.2020.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/31/2020] [Accepted: 02/07/2020] [Indexed: 12/30/2022]
Abstract
The objectives were to determine the reference intervals of spot urine copper excretion indexes in pre-school children and to evaluate their utility in screening for Wilson disease (WD). With spot urine collected from a control sample of preschool children (aged 3-7 years, n=153), the reference intervals of spot urine copper excretion indexes and their biological variation were defined. In order to investigate their utility performance in screening for WD in this age group, multiple spot urine samples from six WD patients who were diagnosed at presymptomatic stage were also analysed and compared. Cut-off values useful for detection of WD were defined by receiver operator curve (ROC) analysis. Biological (inter-individual) variation of spot urine copper indexes expressed as coefficient of variation (CVg) were around 60% at this age group, which was moderate and similar to other clinically useful urine tests, such as urine albumin excretion ratio. Spot urine copper excretion strongly correlated with both urine creatinine and osmolality. Linear regression against both creatinine and osmolality showed that ∼94% of data points in healthy preschool children fell within the prediction interval, suggesting that both were useful normalisation factors. ROC showed that copper to osmolality ratio was the best index with an area under curve (AUC) greater than 0.98. Cut-off values of 0.5 μmol/L, 0.1 μmol/mmol and 0.00085 μmol/mOsmol (32 μg/L, 56 μg/g creatinine and 0.054 μg/mOsmol, respectively, in conventional units) for spot urine copper concentration, copper to creatinine ratio and copper to osmolality ratio, respectively, have potential application in the differentiation of WD patients. Based on the data, a new WD screening strategy targeting preschool children is proposed. Application of a bivariate screening strategy using spot urine copper concentration and urine osmolality may be useful in a population-wide screening program for WD among preschool children.
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Affiliation(s)
- Nelson Leung-Sang Tang
- Department of Chemical Pathology, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
| | - Joannie Hui
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong
| | - Dan Huang
- Department of Anaesthesia and Intensive Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Man Fung Tang
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Xingyan Wang
- Department of Chemical Pathology, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Junyi Wu
- Department of Chemical Pathology, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Iris H S Chan
- Department of Chemical Pathology, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Ting Fan Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
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Schneider I, Greupner T, Hahn A. Magnesium bioavailability from mineral waters with different mineralization levels in comparison to bread and a supplement. Food Nutr Res 2017; 61:1384686. [PMID: 29056894 PMCID: PMC5642192 DOI: 10.1080/16546628.2017.1384686] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/21/2017] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to compare the magnesium bioavailability from four mineral waters with different types of mineralization (e.g. SO42-, HCO3−, calcium) with the magnesium bioavailability from bread and from a magnesium supplement. A single-center, randomized, controlled trial with a crossover design with 22 healthy men and women was conducted at the Institute of Food Science and Human Nutrition, Leibniz University Hannover, Germany. The participants consumed the six test products providing 100 mg of magnesium each on six examination days with a one-week washout phase in between. The primary outcome variables were the 24 h urinary magnesium excretion, the 24 h urinary magnesium/creatinine ratio, and the area under the curve of serum magnesium levels for 10 h (AUC0-10h). No significant differences among groups were observed for either 24 h urinary magnesium excretion or 24 h urinary magnesium/creatinine ratio. Likewise, statistical group comparisons of AUC0-10h for serum magnesium levels revealed no significant differences among the treatment groups. Accordingly, given equivalent magnesium availability from all test products, neither SO42- content nor the content of HCO3− or of calcium influenced the bioavailability of magnesium. Thus, mineral water with higher concentrations of magnesium constitutes a calorie-free magnesium source that contributes to optimal magnesium supply.
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Affiliation(s)
- Inga Schneider
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, Germany
| | - Theresa Greupner
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, Germany
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, Germany
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El Mallah C, Ghattas H, Shatila D, Francis S, Merhi K, Hlais S, Toufeili I, Obeid O. Urinary Magnesium, Calcium, and Phosphorus to Creatinine Ratios of Healthy Elementary School Lebanese Children. Biol Trace Elem Res 2016; 170:264-70. [PMID: 26306589 DOI: 10.1007/s12011-015-0484-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 08/17/2015] [Indexed: 10/23/2022]
Abstract
Urinary magnesium (Mg), calcium (Ca), and phosphorus (P) excretions are known to vary greatly between populations due to dietary habits, physical activity, mineral content of water, climate, genetics, and race. Thus, it is essential to determine the normal values in each population in order to assess the status as well as to diagnose any possible abnormality of metabolisms especially hypercalciuria. A study was conducted to determine urinary Mg/creatinine (Cr), Ca/Cr, and P/Cr ratios of healthy Lebanese elementary schoolchildren. Using a multi-stage cluster sampling at district, school, and class levels, a sample of 1403 children (781 boys and 622 girls), from 26 different schools, was selected. Non-fasting morning urine samples and anthropometric data were collected and analyzed. The mean Mg/Cr, Ca/Cr, and P/Cr ratios were 0.122 ± 0.075 mg/mg (0.568 ± 0.348 mM/mM), 0.084 ± 0.101 mg/mg (0.237 ± 0.286 mM/mM), and 0.692 ± 0.417 mg/mg (2.527 ± 1.524 mM/mM), respectively, with no significant difference between boys and girls (P = 0.706, 0.161, and 0.604; respectively). The 95th percentile of Mg/Cr, Ca/Cr, and P/Cr ratios fluctuated with age, showing a sharp decrease in Ca/Cr and P/Cr at the age of 10. The mean Mg/Cr, Ca/Cr, and P/Cr ratios were comparable to those of similar age groups in other populations. The 95th percentiles of Mg/Cr, Ca/Cr, and P/Cr ratios were 0.26 mg/mg (1.23 mM/mM), 0.27 mg/mg (0.76 mM/mM), and 1.48 mg/mg (5.40 mM/mM), respectively. These values can be used as cutoffs to detect abnormalities in these three minerals' metabolisms among healthy Lebanese children.
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Affiliation(s)
- Carla El Mallah
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| | - Hala Ghattas
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Dareen Shatila
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| | - Sirine Francis
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| | - Karina Merhi
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| | - Sani Hlais
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Imad Toufeili
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| | - Omar Obeid
- Department of Nutrition and Food Science, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon.
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Cao Y, Wang C, Guan K, Xu Y, Su YX, Chen YM. Association of magnesium in serum and urine with carotid intima-media thickness and serum lipids in middle-aged and elderly Chinese: a community-based cross-sectional study. Eur J Nutr 2015; 55:219-26. [PMID: 25750058 DOI: 10.1007/s00394-015-0839-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 01/16/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Previous studies suggested that magnesium (Mg) might protect against atherosclerosis, but data were scarce in an Asian population. We examined the association of Mg levels in serum and urine with carotid intima-media thickness (cIMT) and serum lipids in Chinese adults. METHODS This community-based cross-sectional study recruited 2,837 participants aged 40-75 years in Guangzhou, China. General information, lifestyle factors, serum and urinary concentrations of Mg and cardiometabolic factors were determined. The cIMTs of the common carotid artery (CCA) and the carotid bifurcation (BIF) were measured ultrasonographically. RESULTS The mean (SD) concentration of serum Mg was 0.85 (0.07) mmol/L and median (IQR) for urinary Mg excretion was 2.29 (1.56-3.51) mmol/L. After adjustment for potential covariates, both serum and the urinary concentrations of Mg were inversely associated with CCA-IMT, but not with BIF-IMT. The regression coefficients (standard errors) were -100 (29) µm (total), -86 (34) µm (women) and -117 (52) µm (men) CCA-IMT per 1 mmol/L of serum Mg, and -41 (8) µm (total), -41 (10) µm (women) and -44 (15) µm (men) CCA-IMT per 1 unit of urinary Mg/creatinine (log mmol/mmol) (all p < 0.05), respectively. Higher serum Mg levels were associated with higher total cholesterol, HDLc, LDLc and triglyceride, but lower non-HDLc/HDLc in total population (all p < 0.05). Similar relationships of urinary Mg with lipoproteins were also found in total population (all p < 0.05). CONCLUSION Higher levels of serum and urinary Mg are associated with lower CCA-IMTs, and the role of Mg in lipid metabolism needs further investigation.
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Affiliation(s)
- Yi Cao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Cheng Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Ke Guan
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Ying Xu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Yi-xiang Su
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. .,Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
| | - Yu-ming Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. .,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
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Hamada A, Taguchi T, Mori H, Thorpe M, Yamori Y, Mori M. Possible association of high urinary magnesium and taurine to creatinine ratios with metabolic syndrome risk reduction in Australian aboriginals. Cardiol Res Pract 2011; 2011:235653. [PMID: 21738855 PMCID: PMC3123833 DOI: 10.4061/2011/235653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 01/31/2011] [Indexed: 12/15/2022] Open
Abstract
Background. Because of the epidemic of metabolic syndrome (MS) in Australian Aboriginals known for their higher cardiovascular mortality and shorter life expectancy, we analyzed the possible relationship of their MS risks with the current dietary custom. Methods. The subjects were 84 people aged 16–79 years. The health examination was conducted according to the basic protocol of WHO-CARDIAC (Cardiovascular Diseases and Alimentary Comparison) Study. Results. The highest prevalence among MS risks was abdominal obesity (over 60%). After controlling for age and sex, the odds of obesity decreased significantly with high level of urinary magnesium/creatinine ratio (Mg/cre) (OR, 0.11; 95% CI, 0.02–0.57; P < .05). The significant inverse associations of fat intake with Mg/cre and of fast food intake with urinary taurine/creatinine ratio were revealed. Conclusions. The high prevalence of obesity in the Aboriginal people of this area may partly be due to the reduction of beneficial nutrients intake including Mg and taurine.
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Affiliation(s)
- Atsumi Hamada
- Institute for World Health Development, Mukogawa Women's University, Nishinomiya, Hyogo 663 8143, Japan
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Schlingmann KP, Konrad M, Seyberth HW. Genetics of hereditary disorders of magnesium homeostasis. Pediatr Nephrol 2004; 19:13-25. [PMID: 14634861 DOI: 10.1007/s00467-003-1293-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2003] [Revised: 07/25/2003] [Accepted: 07/28/2003] [Indexed: 10/26/2022]
Abstract
Magnesium plays an essential role in many biochemical and physiological processes. Homeostasis of magnesium is tightly regulated and depends on the balance between intestinal absorption and renal excretion. During the last decades, various hereditary disorders of magnesium handling have been clinically characterized and genetic studies in affected individuals have led to the identification of some molecular components of cellular magnesium transport. In addition to these hereditary forms of magnesium deficiency, recent studies have revealed a high prevalence of latent hypomagnesemia in the general population. This finding is of special interest in view of the association between hypomagnesemia and common chronic diseases such as diabetes, coronary heart disease, hypertension, and asthma. However, valuable methods for the diagnosis of body and tissue magnesium deficiency are still lacking. This review focuses on clinical and genetic aspects of hereditary disorders of magnesium homeostasis. We will review primary defects of epithelial magnesium transport, disorders associated with defects in Ca(2+)/ Mg(2+) sensing, as well as diseases characterized by renal salt wasting and hypokalemic alkalosis, with special emphasis on disturbed magnesium homeostasis.
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Affiliation(s)
- Karl P Schlingmann
- Department of Pediatrics, Philipps University, Deutschhausstrasse 12, 35037 Marburg, Germany
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Cohen JS. High-dose oral magnesium treatment of chronic, intractable erythromelalgia. Ann Pharmacother 2002; 36:255-60. [PMID: 11847944 DOI: 10.1345/aph.1a186] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Previous studies with magnesium have shown beneficial effects in pain syndromes and in vascular disorders (hypertension, migraines, Raynaud's phenomenon). However, results have been variable, possibly because of the limited oral doses achievable due to frequent diarrhea. OBJECTIVE To describe the case of a 53-year-old white man (the author) with disabling erythromelalgia (EM) who achieved modest improvement limited by adverse effects with calcium antagonists and then obtained remission with the use of magnesium. Intolerant of several standard magnesium products, he attained high doses of magnesium by taking intravenous-grade magnesium sulfate diluted in water orally (up to 24 mL/d of MgSO4 50% = 1166 mg/d of magnesium). METHODS After 12 months of continued improvement, patient 1, a board member of The Erythromelalgia Association, notified other members of the success of this therapy via an Internet communication channel. He encouraged those interested in high-dose magnesium therapy to consult their physicians and to report their results to the Association. Twelve patients responded to this request, describing several standard oral magnesium products. RESULTS Overall, 8 of 13 patients (61.5%) reported improvement (1, remission; 3, major improvement; 2, moderate improvement; 2, mild improvement). Four patients (30.8%) reported no response to magnesium therapy, and 1 patient's symptoms worsened. Two patients' magnesium dose was limited because of diarrhea. CONCLUSIONS Despite recent progress in understanding and treating EM, this vascular disorder remains painful and life-altering for many patients. In this informal survey, the use of high oral doses of magnesium produced good and sometimes dramatic results in 8 of 13 patients who had been unresponsive to many other treatments. These results suggest a possible role for high-dose oral magnesium in the treatment of EM and, perhaps, other vascular disorders.
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Affiliation(s)
- Jay S Cohen
- Department of Family and Preventive Medicine, University of California-San Diego, La Jolla, CA, USA.
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