Dietary Magnesium Intake Affects the Association Between Serum Vitamin D and Type 2 Diabetes: A Cross-Sectional Study

Exploring the association between type 2 diabetes and fecal incontinence in american adults: insights from a large cross-sectional study

BACKGROUND

The relationship between fecal incontinence (FI) and type 2 diabetes (T2D) has been well recognized, but a comprehensive understanding of this relationship is lacking, taking into account demographic factors and lifestyle variables.

METHODS

Using a cross-sectional approach, 13,510 adults aged 20 years and older were identified from the 2005-2010 National Health and Nutrition Examination Survey. Multivariate logistic regression models were used to calculate the adjusted odds ratios (ORs), and further subgroup analyses and propensity score analysis were performed to ensure stable results.

RESULTS

Among 13,510 adults, 11.2% had T2D, and 8.8% had FI. We found a strong T2D-FI link (OR: 1.30; 95% CI: 1.09-1.54, P < 0.001), even after adjusting for covariates. Age > 45 was a critical factor, with a stronger T2D-FI association. Sedentary behavior (OR: 1.41; 95% CI: 1.15-1.73) in T2D patients were associated with FI.

CONCLUSIONS

Our study highlights the significant T2D-FI link in US adults, especially in older T2D patients. Lifestyle changes may reduce FI risk. More research is needed for causality and mechanisms.

Association between weight-adjusted waist index and risk of diabetes mellitus type 2 in United States adults and the predictive value of obesity indicators

BACKGROUND

The weight-adjusted waist index (WWI) is a quantitative anthropometric index that can be applied to evaluate obesity. This study examined the relationship between adult United States (US) residents' risk of diabetes mellitus type 2 (T2DM) and WWI.

METHODS

The NHANES (National Health and Nutrition Examination Survey) 2001-2018 provided the data for this investigation. This study used multifactorial logistic regression analysis, smoothed curve fitting, subgroup analysis, and interaction tests to assess the association between WWI and T2DM. Additionally, threshold effects were calculated using a two-stage linear regression model. The receiver operating characteristic(ROC) curves evaluated the diagnostic ability of the WWI and commonly used obesity indicators.

RESULTS

20,477 participants were enrolled in the analysis, and patients with greater levels of WWI had a higher prevalence of T2DM. WWI and T2DM have a non-linear relationship, with a positive association found on the left side of the breakpoint (WWI = 12.35) (OR = 1.82, 95%CI:1.64-2.02), whereas, on the right side, no such relationship was found (OR = 0.9, 95%CI:0.61-1.34). For every unit rise in WWI, the probability of having T2DM increased by 67% after controlling for all other variables (OR:1.67,95%CI:1.53-1.83). Based on subgroup analyses, individuals under 40 had a higher correlation between WWI and T2DM (P < 0.001).ROC analyses showed that WWI had the best discrimination and accuracy in predicting T2DM compared to other obesity indicators (WC, BMI, and Weight).

CONCLUSION

Higher WWI values had a higher prevalence of T2DM in US individuals, especially in adults under 40. WWI has the strongest ability to predict T2DM. Therefore, the importance of WWI in the early identification of T2DM in US adults should be emphasized.

Inquiry of the Metabolic Traits in Relationship with Daily Magnesium Intake: Focus on Type 2 Diabetic Population

Magnesium (Mg), an essential nutrient with a wide area of physiological roles, stands as a cofactor in over 600 enzymatic reactions involved in the synthesis of proteins and nucleic acids, DNA repair, neuromuscular functions, neuronal transmission, cardiac rhythm regulation, and the modulation of metabolic pathways, as well as acting as a natural blocker for the calcium channels. Our objective was to highlight the most recent clinical data with respect to daily Mg intake (DMI) and metabolic traits, particularly type 2 diabetes mellitus (DM). This was a PubMed-based review of the English-language medical papers across different key terms of search; the time frame was from January 2019 until April 2024. We included (clinically relevant) original studies and excluded cases reports, series, reviews, editorials, opinion, experimental studies, and non-human data as well as studies that did not specifically assessed DMI and only provided assays of serum Mg, studies on patients diagnosed with type 1 or secondary DM. A total of 30 studies were included and we organized the key findings into several sections as follows. Studies investigating DMI in relationship with the adherence to local recommendations in diabetic subjects (n = 2, one transversal and another retrospective cohort; N = 2823) found that most of them had lower DMI. Deficient DMI was correlated with the risk of developing/having DM across five studies (n = 5, one prospective and four of cross-sectional design; N = 47,166). An inverse correlation between DMI and DM prevalence was identified, but these data are presented amid a rather heterogeneous spectrum. Four novel studies (N = 7279) analysed the relationship between DMI and DM control according to various methods (HbA1c, fasting and postprandial glycaemia, and insulin); the association may be linear in diabetic subjects only at certain levels of DMI; additionally, the multifactorial influence on HBA1c should take into consideration this dietary determinant, as well, but there are no homogenous results. Three studies concerning DMI and diabetic complications (one cross-sectional, one prospective, and another case-control study) in terms of retinopathy (n = 1, N = 3794) and nephropathy (n = 2, N = 4805) suggested a lower DMI was associated with a higher risk of such complications. Additionally, two other studies (one prospective and one retrospective cohort) focused on mortality (N = 6744), which, taking only certain mortality indicators into consideration, might be decreased in the subgroups with a higher DMI. Seven studies (N = 30,610) analysed the perspective of DMI in the general population with the endpoint of different features amid glucose profile, particularly, insulin resistance. Concerning HOMA-IR, there were three confirmatory studies and one non-confirmatory, while fasting plasma glucose was highlighted as inversely correlated with a DMI (n = 1). The highest level of evidence regarding Mg supplementation effects on glucose metabolism stands on seven randomised controlled trials (N = 350). However, the sample size was reduced (from 14 to 86 individuals per study, either diabetic or pre-diabetic) and outcomes were rather discordant. These clinical aspects are essential from a multidisciplinary perspective and further trials are mandatory to address the current areas of discordant results.

Charting Wellness in India: Piloting the iTHRIVE's Functional Nutrition Approach to Improve Glycaemic and Inflammatory Parameters in Prediabetes and Type 2 Diabetes Mellitus

Introduction Type 2 diabetes mellitus (T2DM) is characterized by elevation of blood glucose levels due to underlying insulin resistance and inflammation. Multiple modifiable risk factors such as unhealthy dietary habits, physical inactivity, obesity, smoking and psychological stress contribute to T2DM. We investigated the efficacy of a comprehensive functional nutrition approach aimed at mitigating T2DM using the iTHRIVE approach which encompassed anti-inflammatory and elimination diets, micronutrient supplements, physical activity, stress management and environmental modifications through a pre-post study design. The research assessed changes in blood glucose and inflammatory markers following the implementation of the functional nutrition program. Methods A prospective pre-post intervention pilot study was conducted at ThriveTribe Wellness Solutions Pvt Ltd. (iTHRIVE), where 50 study participants from urban areas of Pune city, India (n=25 each group) were recruited voluntarily in the age group of 20-60 years. The participants were subjected to 90 days of the iTHRIVE functional nutrition approach which consisted of eliminating certain inflammatory foods and adding a combination of nutritious organic foods, adding dietary supplements like magnesium, vitamin D, alpha lipoic acid, chromium picolinate, berberine and biogymnema, physical activities like resistance training, stress reduction techniques like meditation and deep breathing exercises along with environmental changes. The blood parameters like fasting blood glucose, postprandial blood glucose, glycated haemoglobin (HbA1C), fasting serum insulin, post-prandial serum insulin, high sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), vitamin D, body weight and waist circumference were measured before and after the intervention. The changes were statistically analyzed using a paired t-test. Results The mean age of the participants was found to be 43.76±10.58 years. Around 68% of the participants were prediabetic (HbA1c: 5.7-6.4%) and 32% had T2DM (HbA1c ≥6.5%). A significant reduction was observed in the average HbA1c (13.75% reduction, p<0.0001), average post-prandial blood glucose levels (14.51% reduction, p<0.048), average post-prandial serum insulin (34.31% reduction, p<0.017) and average ESR levels (34.51% reduction, p<0.006). The hs-CRP levels were reduced by 6.6%, but not statistically significant. The average body weight of the participants dropped from 78.59±15.18 kg to 75.20±14.20 kg with a mean loss of 2.91 kg (p<0.05) whereas the waist circumference decreased from 37.54±5.09 to 35.97±4.74 inches with an average loss of 1.19 inches (p<0.0004). Conclusions Following the intervention, several health indicators indicated significant improvements. Particularly, there was a significant drop in HbA1c levels, suggesting better long-term blood glucose control. Blood glucose and serum insulin levels after a meal dropped significantly, indicating enhanced insulin sensitivity. There was a decrease in systemic inflammation as evidenced by the decrease in ESR levels. These results imply that the iTHRIVE functional nutrition approach used in this investigation might be beneficial for enhancing glycemic control and insulin sensitivity, along with reducing inflammatory markers in people with prediabetes and T2DM. Larger sample sizes and longer periods of monitoring would be useful in subsequent research to validate and build on these encouraging findings.

Association between dietary carbohydrate intake percentage and epilepsy prevalence in the NHANES 2013-2018: a cross-sectional study

BACKGROUND

Epilepsy is a neurological disorder characterized by recurrent seizures. We aimed to investigate the association between the percentage of dietary carbohydrate intake (DCI) and epilepsy prevalence among American adults.

METHODS

We analyzed the data from 9,584 adults aged 20-80 years who participated in the National Health and Nutrition Examination Survey from 2013 to 2018. Logistic regression was applied to explore the association between the percentage of DCI and epilepsy prevalence.

RESULTS

A total of 146 (1.5%) individuals with epilepsy were enrolled in this study. The average age of the participants was 56.4 years, and 5,454 (56.9%) individuals were female. A high DCI was associated with an increased prevalence of epilepsy (odds ratio [OR], 4.56; 95% confidence interval [CI], 1.11-18.69; P = 0.035) after adjusting for age, sex, marital status, race/ethnicity, educational level, family income, body mass index, smoking status, drinking status, hypertension, diabetes, and cardiovascular disease. Stratified analyses indicated a positive correlation between DCI and epilepsy prevalence in adults with different characteristics. Compared with individuals in quartile 1 of DCI (<40.5%), those in quartile 4 (>55.4%) had an adjusted OR for epilepsy of 1.72 (95% CI, 1.09-2.73, P = 0.02, P for trend = 0.012).

CONCLUSIONS

A high percentage of DCI was associated with an increased prevalence of epilepsy. The risk of epilepsy increased 3.5-fold with a 1% increase in DCI. These results suggest an important role of DCI in the dietary management of epilepsy.

Associations between dietary magnesium intake and hypertension, diabetes, and hyperlipidemia

Hypertension, diabetes, and hyperlipidemia significantly impact chronic diseases and mortality. Magnesium is an essential nutrient for maintaining critical physiological functions, and magnesium deficiency is often associated with adverse health outcomes. In a cross-sectional study of US adults, we aimed to explore dietary magnesium intake and its association with the prevalence of hypertension, diabetes, and hyperlipidemia in US adults over 20 years of age in NHANES 2007-2018. We obtained data on 24,171 samples of hypertension, 9950 samples of diabetes, and 12,149 samples of hyperlipidemia. We used multivariable logistic regression models adjusted for multiple sociodemographic, anthropometric, and lifestyle factors, with participants subdivided into five groups based on quintiles of daily dietary magnesium. After adjusting for the major lifestyle and dietary variables, an independent and significant inverse relationship between dietary magnesium and hypertension, diabetes, and hyperlipidemia was observed. Compared with the lowest quintile of magnesium intake, the prevalence of hypertension, diabetes, and hyperlipidemia was significantly reduced in the highest magnesium quintile. The OR of hypertension in the highest quintile was 0.66 (95% CI: 0.51-0.87; P trend < 0.001), the OR of diabetes was 0.56 (95% CI: 0.39-0.81; P trend < 0.001), and the OR of hyperlipidemia was 0.68 (95% confidence interval: 0.53-0.86; P trend = 0.007). In the subgroup analysis, most of the inverse relationships persisted. Our findings highlight the potential of magnesium-rich foods to prevent hypertension, diabetes, and hyperlipidemia in US adults. This article summarizes and discuss recent findings on: 1) A high dietary magnesium intake was associated with a lower prevalence of hypertension; 2) An inverse relationship between dietary magnesium with diabetes hyperlipidemia; 3) Monitoring and management of magnesium was important.

U-shaped association between serum 25-hydroxyvitamin D concentrations and urinary leakage among adult females aged 45 years and over in the United States: a cross-sectional study

BACKGROUND

The relationship between serum vitamin D status and urinary leakage (UL) among middle-aged females needs to be further studied. The aim of this study was to evaluate the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with UL among American females ages 45 years and over.

METHODS

Seven cycles of the National Health and Nutrition Examination Survey (NHANES) with self-report UL data, were used. A total of 9525 women aged 45 years and older were enrolled in this study. Univariate and multivariate logistic regression models and the smooth curve fitting were utilized to analyze the association between clinical UL and serum 25-hydroxyvitamin D [25(OH)D] concentrations.

RESULTS

A non-linear relationship between serum 25(OH)D concentrations and clinical ULwas observed. When serum 25(OH)D concentration was higher than the inflection point 63.5 nmol/L, a positive correlation was observed between serum 25(OH)D concentrations and clinical UL ([OR]: 1.007, 95%CI: 1.005-1.009, P < 0.01). However, when serum 25(OH)D concentration was below the inflection point 63.5 nmol/L, a negative correlation was observed between serum 25(OH)D concentrations and clinical UL ([OR]: 0.993, 95%CI: 0.989-0.996, P < 0.01).

CONCLUSIONS

The association between serum vitamin D and the risk of UL exhibited a U-shaped pattern among US middle-aged females, with an inflection point occurring at a serum 25(OH)D concentration of 63.5 nmol/L.

Dietary protein intake affects the association between urinary iodine and clinically relevant depression: Evidence from NHANES 2007-2018

Both iodine concentration and protein intake are important nutritional factors that may influence the development of depressive symptoms. However, there are no studies on the effect of protein intake on the relationship between iodine concentration and the risk of depression. The study aimed to explore the relationship between iodine and the risk of clinically relevant depression (CRD) according to protein intake. This study analyzed the adults (≥18 years) who participated in the 2007-2018 National Health and Nutrition Cross-sectional Survey (N = 10,462). CRD was assessed using the Patient Health Questionnaire (PHQ-9). Protein intake was assessed using two 24-h dietary recalls and urinary iodine concentration (UIC) was measured using inductively coupled plasma dynamic response cell mass spectrometry. Weighted multivariate logistic regression and restrictive cubic splines were performed to assess the relationship between UIC and CRD according to protein category (low protein intake <0.8 g/kg/day; high protein intake: ≥0.8 g/kg/day). After controlling for sociodemographic, behavioral, chronic diseases, and dietary factors, a positive correlation was observed between UIC (log10) and CRD (OR: 1.36, 95% CI: 1.026, 1.795). Low UIC (<100 μg/L) was associated with a lower prevalence of CRD (OR: 0.73, 95% CI: 0.533, 0.995) in high protein intake individuals, whereas this relationship did not exist in those with low protein intake. Moreover, restrictive cubic splines confirmed a near L-shaped relationship between UIC and CRD in the low-protein group (nonlinear p = .042) and a linear relationship between them in the high-protein group (nonlinear p = .392). This study illustrates that protein intake affects the relationship between UIC and CRD. Combining lower UIC and high protein intake may help reduce the prevalence of CRD, which would have significant implications for managing patients with depressive CRD in the clinical setting.

Association between dietary niacin intake and cognitive function in the elderly: Evidence from NHANES 2011-2014

Recent studies have shown an inconsistent association between dietary niacin and cognitive function. And this remains unclear in the American outpatient population. The aim of this study was to assess whether there is an association between dietary niacin and cognitive performance in an older American population aged ≥60 years. A total of 2523 participants from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 were enrolled. Cognitive function was assessed by the CERAD Word Learning (CERAD-WL) test, the CERAD Delayed Recall (CERAD-DR) test, the Animal Fluency test (AFT), and the Digit Symbol Substitution test (DSST). Cognitive impairment that meets one of the four scoring conditions listed above is defined as low cognitive function. Dietary niacin intake was obtained from 2 days of a 24-h recall questionnaire. Based on the quartiles of dietary niacin intake, they were divided into four groups: Q1 (<15.51 mg), Q2 (15.51-20.68 mg), Q3 (20.69-26.90 mg), and Q4 (>26.91 mg). The stability of the results was assessed using multifactorial logistic regression, restricted cubic spline (RCS) models, and sensitivity stratified analysis. More than half of the participants had cognitive impairment (52.52%). In the fully adjusted model, niacin was associated with a significantly reduced risk of cognitive impairment in Q3 and Q4 compared with the Q1 group (OR: 0.610, 95% CI: 0.403, 0.921, p = .022; OR: 0.592, 95% CI: 0.367, 0.954, p = .034). Meanwhile, niacin was negatively associated with poor cognition as assessed by the CERAD-WL test, CERAD test, AFT, and DSST. An L-shaped dose-response relationship between dietary niacin and cognitive function was observed in all participants (nonlinear p < .001). There were also interactions that existed in populations with different carbohydrate intakes and cholesterol intakes (p for interaction = .031, p for interaction = .005). These findings provide new evidence for the potential role of dietary niacin intake on cognitive function in the elderly.

Association of vitamin D and magnesium with insulin sensitivity and their influence on glycemic control

Insulin resistance increases the risk of developing diabetes, and the degree of resistance influences the glycemic control of patients with diabetes. Numerous researchers have focused on improving insulin sensitivity in order to prevent diabetes-related complications and other chronic diseases. Several studies have also linked vitamin D levels to insulin secretion and resistance, given that both vitamin D and its receptor complex play important roles in regulating pancreatic β-cells. It has been suggested that vitamin D supplementation improves vitamin D levels, but further research is needed to confirm this as neither insulin function nor glycemic control improves when vitamin D levels increase. Magnesium is a cofactor for many enzymes. Although the role of magnesium in the management of diabetes has long been evaluated, it has not yet been determined whether magnesium supplements improve insulin function. However, several researchers have found that patients with good glycemic control have high magnesium levels. Magnesium is closely related to vitamin D and is necessary for the transport and activation of vitamin D in humans. Combined supplementation with vitamin D and magnesium improves glycemic control in patients with diabetes.

Dietary zinc intake and migraine in adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey 1999-2004

OBJECTIVE

The study examined the relationship between dietary zinc intake and migraine.

BACKGROUND

Neuroinflammatory and oxidative stress are involved in the pathogenesis of migraine. Little is known about the effects of zinc, an anti-inflammatory and antioxidant trace element, on migraine.

METHODS

The US National Health and Nutrition Examination Survey data from 1999 to 2004 were analyzed for this cross-sectional study. Participants who had severe headache or migraine were classified as having migraine. Dietary zinc intake was evaluated using the 24 h dietary recall system.

RESULTS

A total of 11,088 participants were included, of whom, 20.2% (2236/11,088) reported having migraine disease. Compared to the lowest dietary zinc intake quintile (Q1, ≤5.9 mg/day), the adjusted odds ratios for migraine in Q2 (6.0-8.4 mg/day), Q3 (8.5-11.2 mg/day), Q4 (11.3-15.7 mg/day), and Q5 (≥15.8 mg/day) were 0.73 (95% confidence interval [CI]: 0.61-0.88, p = 0.004), 0.71 (95% CI: 0.56-0.91, p = 0.013), 0.71 (95% CI: 0.57-0.90, p = 0.008), and 0.70 (95% CI: 0.52-0.94, p = 0.029), respectively. Sensitivity analysis of zinc supplementation survey participants also showed an association between dietary zinc intake and migraine. Compared to the lowest total zinc intake quintile (Q1: 0.5-9.6 mg/day), the adjusted odds ratios for migraine in Q3 (19.3-24.3 mg/day) and Q4 (24.4-32.5 mg/day) were 0.62 (95% CI: 0.46-0.83, p = 0.019) and 0.67 (95% CI: 0.49-0.91, p = 0.045), respectively.

CONCLUSIONS

Our findings indicate an inverse association between dietary zinc intake and migraine in adult Americans.

Associations between urea nitrogen and risk of depression among subjects with and without type 2 diabetes: A nationwide population-based study

Background

Depression and type 2 diabetes (T2D) are serious public health problems with irreversible health consequences and a significant economic burden on the healthcare system. Previous studies have suggested that blood urea nitrogen (BUN) was inversely longitudinally associated with incidence of diabetes and depression in adults, but few well-designed studies have examined the effects of status of T2D on the full range of relationship between BUN and depression.

Methods

The analysis sample consisted of adults aged≥20 years from the 2007-2014 National Health and Nutrition Examination Survey (NHANES) who completed the Patient Health Questionnaire-9 (PHQ-9), involving 19,005 participants. By stratifying participants according to T2D status, we further assessed the difference between BUN and risk of depression in participants with and without T2D using multivariate logistic regression (interaction test).

Results

In this cross-sectional study, the association between BUN and depression prevalence appeared to differ between the T2D and non-T2D groups (OR: 1.00, 95% Cl: 0.95-1.05 vs. OR: 0.89, 95% Cl: 0.85-0.93). In addition, there was evidence of an interaction between BUN levels and T2D status in reducing the risk of depression (P value for interaction = 0.032.) The relationship between BUN and depressive symptoms was significant in non-T2D subjects (P < 0.001), but not in T2D (P = 0.940).

Conclusions

Our findings suggest that there is a significant relationship between BUN and depression, and T2D status may influence the association between BUN and the risk of depression. Such findings require further prospective studies to provide more evidence.

Associations between dietary magnesium intake and handgrip strength were modified by serum vitamin D level among the US elderly

Objective

The present study aimed to evaluate the associations between dietary magnesium intake and handgrip strength, and whether these associations were affected by serum vitamin D status.

Methods

A total of 2,127 participants aged 60 and above from the National Health and Nutrition Examination Survey (NHANES) of the 2011-2014 cycles were included in the analyses. Magnesium intake was obtained by 24-h dietary recalls and 30-day dietary supplement. Participants in the lowest sex-specific tertile of magnesium intake were defined as having low magnesium intake. Serum 25-hydroxyvitamin D [25(OH)D)] concentrations were examined by using ultra-high performance liquid chromatography tandem mass spectrometry and categorized into three levels: deficient, suboptimal, and sufficient. Handgrip strength was determined by using a dynamometer. Multivariable linear regression models were used to investigate the associations between dietary magnesium intake and handgrip strength.

Results

Low magnesium intake was not associated with handgrip strength, but interactions between low magnesium intake and serum 25(OH)D level existed on handgrip strength. The stratified analyses found that only in participants with deficient serum 25(OH)D, low magnesium intake was associated with reduced handgrip strength. The combined analyses shown that participants with both low magnesium intake and deficient serum 25(OH)D had highest decrease of handgrip strength.

Conclusion

Findings suggested that low magnesium intake was associated with reduced handgrip strength only in participants with deficient serum 25(OH)D. Increased magnesium intake was recommended for participants with deficient serum 25(OH)D in maintaining muscle strength.

Association Between Dietary Fiber Intake and Risk of Depression in Patients With or Without Type 2 Diabetes

BACKGROUND

Depression and type 2 diabetes (T2D) are both serious public health problems, with morbidity and mortality in people increasing year by year, resulting in a heavy economic burden. A correlation between dietary fiber and both has been reported. Nevertheless, few data are available concerning dietary fiber and the risk of depression with or without T2D, which deserve further attention.

MATERIALS AND METHODS

We assessed the relationship between dietary fiber intake and risk of depression with or without T2D in the 2007-2014 National Health and Nutrition Examination Survey (NHANES) population. A 24-h dietary review was used to assess fiber intake. The Patient Health Questionnaire-9 was used to assess depression. Stability of the results was assessed using restricted cubic spline models and logistic regression, as well as sensitivity analyses.

RESULTS

A total of 17,866 adults aged 20 years and older with a mean age of 49.3 ± 17.7 years were included in this study, of whom 49.5% were male. After adjusting for covariates, the association of dietary fiber intake with the risk of depression appeared to differ between non-T2D group and T2D group (OR, 0.987; 95% CI, 0.979-0.995 vs. OR, 1.003; 95% CI, 0.988-1.017). Furthermore, when dietary fiber was converted to a categorical variable, there was evidence of interaction between T2D status and fiber intake on decreasing the prevalence of depression (P-value for interaction = 0.015). Sensitivity analysis showed stable results.

CONCLUSION

Our findings indicated that whether a patient has T2D may affect the relationship between dietary fiber intake and the risk of depression, which still needs to be confirmed by further randomized controlled trials.

Dietary Magnesium Intake Ameliorates the Association Between Household Pesticide Exposure and Type 2 Diabetes: Data From NHANES, 2007–2018

Aims/Hypothesis

This study aimed to explore whether household pesticide exposure in the general population increased the risk of developing type 2 diabetes and whether intake of dietary magnesium could lower type 2 diabetes from household pesticide exposure.

Methods

For this cross-sectional study, we obtained the data of 9,187 United States adults from the National Health and Nutrition Examination Surveys, 2007–2018. Participants were subdivided into two groups based on the amount of daily dietary magnesium in the population: low group: <175 mg/day and high group: ≥175 mg/day. Using multivariable logistic regression analysis, we evaluated the relationship between pesticide exposure in the home and type 2 diabetes.

Results

Compared to those unexposed at home, individuals who were exposed to pesticides in their households had a relatively higher odds ratio for type 2 diabetes (OR = 1.22, 95% CI: 1.04–1.44). The association of pesticide exposure in the home with the incidence of type 2 diabetes was different for low and high dietary magnesium groups, OR = 1.66, 95% Cl: 1.19-2.33 vs. OR = 1.1, 95% Cl: 0.92–1.32, respectively. An interaction (P = 0.035) between household pesticide exposure and magnesium intake, suggested that high dietary magnesium intake may reduce the risk of developing type 2 diabetes from pesticide exposure.

Conclusions

Household pesticide exposure in the general population is associated with an elevated risk of type 2 diabetes. We report for the first time possible clinical relevance in that high magnesium intake may ameliorate the increased risk of type 2 diabetes from pesticide exposure.

Association of monocyte-lymphocyte ratio and proliferative diabetic retinopathy in the U.S. population with type 2 diabetes

OBJECTIVE

Diabetic retinopathy (DR), especially proliferative diabetic retinopathy (PDR) is a common cause of blindness and visual impairment. Early prediction of its occurrence and progression is important to improved patient outcomes. Inflammation-related markers may play important roles, and the monocyte-lymphocyte ratio (MLR) can act as a novel inflammatory marker. However, the association between MLR and PDR remains unclear. The aim of the present study was to investigate the association between MLR and PDR in the U.S. population with type 2 diabetes (T2D) based on DR data from NHANES in 2005-2008.

METHODS

This cross-sectional study was conducted in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008. DR was defined by the criteria of the Early Treatment for Diabetic Retinopathy Study based on nonmydriatic fundus photography. The MLR is the monocyte count/lymphocyte count. The lymphocyte count and monocyte count can be obtained directly from laboratory data files. Logistic regression was used to explore the association between MLR and PDR. Stratified analyses were also conducted according to age, sex, hemoglobin, and glycated hemoglobin categories. We applied the duration of diabetes with multiple imputations of missing data.

RESULTS

A total of 367 participants were included, among whom the PDR prevalence was 7% (27/367). Multivariate regression models revealed that PDR was significantly associated with 0.1 unit increase in MLR (adjusted OR = 1.46, 95% CI: 1.08-1.96) after all covariates were adjusted. In the subgroup analysis, effect size of MLR on the presence of PDR in subgroups were stable (all P values > 0.05).

CONCLUSIONS

MLR was significantly associated with PDR in participants with T2D. Assessing the MLR might be a valuable part of follow-up visits for patients with T2D.

The Role of Magnesium in the Pathogenesis of Metabolic Disorders

Magnesium (Mg) is an essential nutrient for maintaining vital physiological functions. It is involved in many fundamental processes, and Mg deficiency is often correlated with negative health outcomes. On the one hand, most western civilizations consume less than the recommended daily allowance of Mg. On the other hand, a growing body of evidence has indicated that chronic hypomagnesemia may be implicated in the pathogenesis of various metabolic disorders such as overweight and obesity, insulin resistance (IR) and type 2 diabetes mellitus (T2DM), hypertension (HTN), changes in lipid metabolism, and low-grade inflammation. High Mg intake with diet and/or supplementation seems to prevent chronic metabolic complications. The protective action of Mg may include limiting the adipose tissue accumulation, improving glucose and insulin metabolism, enhancing endothelium-dependent vasodilation, normalizing lipid profile, and attenuating inflammatory processes. Thus, it currently seems that Mg plays an important role in developing metabolic disorders associated with obesity, although more randomized controlled trials (RCTs) evaluating Mg supplementation strategies are needed. This work represents a review and synthesis of recent data on the role of Mg in the pathogenesis of metabolic disorders.

Dietary Magnesium Intake Affects the Vitamin D Effects on HOMA-β and Risk of Pancreatic β-Cell Dysfunction: A Cross-Sectional Study

Background

Some studies have shown that, the circulating vitamin D (Vit D) concentration in the body exerts a crucial role in regulating the pancreatic β-cell function. Meanwhile, the role of magnesium is important in the synthesis of Vit D, since it is an essential element for activating Vit D. Nevertheless, there remains insufficient studies concerning whether dietary Magnesium intake influences the association between Vit D and risk of pancreatic β-cell dysfunction. Hence, this cross-sectional study aimed to assess the effect of Magnesium intake alterations on the association between serum Vit D levels and the risk of pancreatic β-cell dysfunction.

Methods

This large-scale cross-sectional study involves four cycles of National Health and Nutrition Examination Survey (NHANES) (2007–2014), with totally 4,878 participants. Groups were divided depending on the median daily intake of Magnesium, namely, the low intake group (Magnesium intake <267 Magnesium/d) and the high intake group (Magnesium intake ≥ 267 Magnesium/d). By constructing multiple multivariate linear and logistics regression models, the associations between serum Vit D levels and HOMA-β, as well as between serum Vit D levels and the risk of pancreatic β-cell dysfunction were explored at different Magnesium intakes.

Results

In this cross-sectional study, the serum Vit D level is independently correlated with the HOMA-β index [β: 0.65 (0.40–0.90)] and the risk of pancreatic β-cell dysfunction [OR: 0.95 (0.92–0.98)]. Moreover, such correlations are affected by different dietary Magnesium intakes (P for interaction < 0.001).

Conclusion

According to the results of this study, the dietary Magnesium intake influences the associations of serum Vit D levels with HOMA-β index and pancreatic β-cell dysfunction. Besides, the finding requires validation through more RCT or cohort studies.