Magnesium absorption using stable isotope tracers in healthy children and children treated for leukemia

Assessing mineral metabolism in children using stable isotopes

Mineral metabolism may be altered in children with acute or chronic illnesses. The effects may be short term, such as hypomagnesemia associated with chemotherapy, or long-term, such as loss of bone mineral mass after steroid use. Understanding the causes, consequences, and potential therapies for mineral disorders is enhanced by understanding the absorption, body utilization, and turnover of these minerals. These assessments can now be done safely and readily using non-radioactive, stable isotopes which are available for calcium, zinc, magnesium, and iron. The methods for measurement of mineral absorption and kinetics (turnover) are well established, especially for calcium, and have been tested in every age group. Few studies, however, have been performed in children with acute or chronic illnesses such as cancer. Isotope dosing and infusion protocols are minimally invasive and protocols require small blood or urine volumes. Mineral absorption can be assessed without collecting fecal samples. Kinetics are assessed with blood and urine collections, usually over 5-10 days. Increased use of these techniques may be important in medical and nutritional assessment as well as in the management of pediatric oncology patients.

Stable isotopes in studies of intestinal absorption, exchangeable pools and mineral status: the example of magnesium

Magnesium (Mg) is a biologically essential mineral and Mg deficiency is known to lead to severe biochemical and symptomatic disorders. Radioactive isotopes and, more recently, stable isotopes have been used as research tools to determine intestinal Mg absorption in humans and animals under different nutritional and physiological conditions. Mg isotopes are given orally or orally plus intravenously and analysed in faeces and/or in plasma and urine in order to calculate intestinal Mg absorption and possibly endogenous Mg excretion. Mg isotopes have been used to assess exchangeable pools of Mg under nutritional and physiopathological conditions. Mg isotopes are given intravenously and are analysed in plasma and urine to calculate the size and half-life of the various Mg exchangeable pools. More recently, in vitro isotopic tests have been developed to study the need of cells for Mg in different nutritional and genetic conditions. Whole blood is incubated with Mg isotopes and isotopic blood cell enrichment is measured, which reflects the avidity of cells for Mg and thus its initial status. This paper is a report on the use of stable Mg isotopes and their advantages in these different fields of Mg absorption and metabolism. The studies available have clearly demonstrated that stable isotopes provide a useful research tool for determining intestinal Mg absorption, and represent a precious research tool for the study of Mg metabolism and the assessment of Mg status.

Comparison of stable-isotope-tracer methods for the determination of magnesium absorption in humans

BACKGROUND

The double-labeling (DL) method for determining magnesium absorption is less cumbersome than is the fecal monitoring method, which has been used most often, but it has not been validated.

OBJECTIVE

The aim of this study was to compare methods and several sampling protocols for determining magnesium absorption to establish a simple and reliable alternative to the fecal monitoring approach. Fecal monitoring was used as the standard against which the DL methods based on urine data (DLU), plasma data (DLP), and plasma kinetics with the use of a deconvolution analysis (DP) were compared.

DESIGN

Six healthy adult men received 70 mg (26)Mg orally and 30 mg (25)Mg intravenously. Multiple blood samples and complete urine and fecal samples were collected over 12 d. Stable-isotope ratios were determined by inductively coupled plasma mass spectrometry.

RESULTS

Results from DLU were not significantly different from the fecal monitoring reference value (0.48 +/- 0.05; +/- SD) when based on 3-d urine pools from 72 to 144 h (0.54 +/- 0.04) and when based on the 24-h urine pools from 48 to 72 h (0.49 +/- 0.06), 72 to 96 h (0.51 +/- 0.11), and 96 to 120 h (0.50 +/- 0.06). Results with the DLP method 72 h after isotope administration also compared well with those with the fecal monitoring method (0.54 +/- 0.09). Magnesium absorption was 0.47 +/- 0.06 with the DP method, which also agreed with the fecal monitoring value.

CONCLUSIONS

The DL methods are an alternative to fecal monitoring when applied within the appropriate time intervals. Therefore, DLU-the simplest and least invasive approach-is recommended for determining magnesium absorption.