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Pitliya A, Vasudevan SS, Batra V, Patel MB, Desai A, Nethagani S, Pitliya A. Global prevalence of hypomagnesemia in type 2 diabetes mellitus - a comprehensive systematic review and meta-analysis of observational studies. Endocrine 2024; 84:842-851. [PMID: 38159172 DOI: 10.1007/s12020-023-03670-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE Hypomagnesemia, characterized by low magnesium levels, has been implicated in the pathophysiology of Type 2 Diabetes Mellitus (T2DM). This meta-analysis aims to provide a comprehensive assessment of hypomagnesemia prevalence in individuals with T2DM as well as its potential implications for diabetes management and complications. METHODS We conducted a comprehensive systematic review and meta-analysis using databases like PubMed, Google Scholar, Science Direct, and Research Gate to identify relevant studies between January 2008 and August 2023. We focused on observational studies related to serum magnesium levels and Type 2 Diabetes in individuals aged 19 and older. Newcastle Ottawa tool was used for quality assessment. A random effect meta-analysis was performed to calculate the prevalence of hypomagnesemia in T2DM. RESULTS We identified a total of 671 studies, and after screening 383 abstracts and full texts by two independent reviewers, we identified 19 eligible studies encompassing 4192 patients diagnosed with T2DM. The mean age was 55.4 (SD, 4.39) years with a mean HbA1C level of 8.01. The pooled prevalence of hypomagnesemia in T2DM was 32% (95% CI: 22-36%) out of 4192 cases. On subgroup analysis, the prevalence of hypomagnesemia in male and female were 19.8% and 20.1%, respectively. Geographically, Asia had the highest prevalence of hypomagnesemia with 31.9% (95% CI: 24-41.1%). CONCLUSION This meta-analysis highlights a significant prevalence of hypomagnesemia in individuals with T2DM, emphasizing the need for further investigation due to the intricate nature of the association between serum magnesium levels and T2DM.
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Affiliation(s)
- Aakanksha Pitliya
- Pamnani Hospital and Research Center, (Department of Medicine), Mandsaur, Madhya Pradesh, India
| | | | - Vanshika Batra
- SGT Medical College, (Student), Gurugram, Haryana, India
| | | | - Anjali Desai
- Surat Municipal Institute of Medical Education and Research, (Department of Medicine), Surat, Gujarat, India
| | - Sanjana Nethagani
- Camden Clark Medical Center/University of West Virginia, (Resident Physician, Department of Internal Medicine), Parkersburg, WV, USA
| | - Anmol Pitliya
- Camden Clark Medical Center/University of West Virginia, (Hospitalist, Department of Internal Medicine), Parkersburg, WV, USA
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Kocyigit E, Akturk M, Koksal E. Relationships between serum and dietary magnesium, calcium, and metabolic parameters in women with type 2 diabetes mellitus. Clin Nutr ESPEN 2023; 54:304-310. [PMID: 36963878 DOI: 10.1016/j.clnesp.2023.01.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/18/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND & AIMS Magnesium and calcium are essential minerals in several enzymatic activities that modulate essential biological functions. Hypomagnesemia occurs in patients with type 2 diabetes mellitus (T2DM), especially those with poor metabolic control. Dietary magnesium and calcium intake play a protective role in the development of T2DM. This research aimed to investigate the association of dietary and serum magnesium and calcium with metabolic control parameters in diabetic women. METHODS This case-control study was conducted on 80 women, including 40 patients diagnosed with T2DM and 40 healthy controls aged 35-60 years. Some anthropometric measurements of the individuals were taken, and their body mass index was calculated. In addition, some biochemical parameters, serum magnesium, and calcium were analyzed. A validated 96-item quantitative food frequency questionnaire was used to obtain dietary magnesium and calcium intake data. RESULTS Serum magnesium levels were lower in subjects with diabetes than in controls, and there was a similar incidence of hypomagnesemia in T2DM patients and controls, but not statistically significant (p > 0.05). In T2DM patients, there was a statistically significant inverse association between HbA1c and serum magnesium (p < 0.05). Dietary magnesium intake was inversely associated with HOMA-IR scores (p < 0.05) but had a positive association with serum magnesium levels in patients with T2DM (p < 0.05). There were no significant differences in the calcium/magnesium ratio between T2DM patients and healthy controls (p > 0.05). In a multiple linear regression analysis, dietary magnesium intake and HbA1c were found to be significantly related to altered serum magnesium in T2DM patients. CONCLUSION The present findings suggest that lower serum magnesium levels were associated with higher HbA1c levels in subjects with T2DM. Increased dietary magnesium intake in T2DM may enhance HOMA-IR scores and serum magnesium levels.
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Affiliation(s)
- Emine Kocyigit
- Ordu University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Ordu, Turkey.
| | - Mujde Akturk
- Gazi University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Eda Koksal
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara, Turkey
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Eshetu B, Worede A, Fentie A, Chane E, Fetene G, Wondifraw H, Shimelis M, Girma M, Hadgu R, Demeke K, Fasil A. Assessment of Electrolyte Imbalance and Associated Factors Among Adult Diabetic Patients Attending the University of Gondar Comprehensive Specialized Hospital, Ethiopia: A Comparative Cross-Sectional Study. Diabetes Metab Syndr Obes 2023; 16:1207-1220. [PMID: 37131504 PMCID: PMC10149060 DOI: 10.2147/dmso.s404788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/15/2023] [Indexed: 05/04/2023] Open
Abstract
Introduction Electrolyte imbalance refers to altered electrolyte levels that predominantly affect diabetic patients due to hyperglycemia which rise plasma osmolality and impaired renal function, contributing to a change in electrolyte level. Therefore, this study aimed to assess the prevalence of electrolyte imbalance and its associated factors among diabetic patients and healthy control groups attending the University of Gondar Comprehensive Specialized Hospital. Patients and Methods A comparative cross-sectional study was conducted on 130 diabetic patients and 130 diabetes-free controls. Sociodemographic, behavioral and clinical data were collected using a structured questionnaire. After measuring anthropometric parameters, 5mL of the blood sample was collected. Electrolytes were measured based on ion-selective electrode methods. Fasting blood glucose, and creatinine were measured by spectrophotometric enzyme hexokinase, and Jaffe reaction methods, respectively. The data was entered into Epi-data version 4.6 and analyzed using STATA version 14. Mann-Whitney U-tests and independent t-tests were used for comparison. Multiple logistic regression analysis was done to determine the factors associated with electrolyte imbalances. P-value <0.05 was considered statistically significant. Result The overall prevalence of electrolyte imbalance among diabetic patients and controls were 83.07% and 52.31%, respectively. The mean of Na+ and the median level of Mg2+ and Ca2+ were significantly decreased. However, the mean level of Cl- was significantly increased in diabetic patients as compared to control groups. In multivariable logistic regression: alcohol consumption AOR = 3.34 [1.02-10.9], no formal education AOR = 5.38 [1.14-25.4], hyperglycemia AOR = 6.32 [2.04-19.5], and urbanization AOR = 5.6 [1.44-22.3] showed significant association with electrolyte imbalance. Conclusion Diabetic patients have more likely to develop electrolyte imbalance than control groups. Diabetic participants showed significantly reduced Na+, Mg2+, and Ca2+ levels and significantly increasing CI- levels when compared to control groups. Hyperglycemia, alcohol drinking habits, urbanization, and no-formal education were statistically significantly associated with electrolyte imbalance.
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Affiliation(s)
- Bruktawit Eshetu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abebaw Worede
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemie Fentie
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Elias Chane
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getnet Fetene
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habtamu Wondifraw
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mahider Shimelis
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mahider Girma
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Rishan Hadgu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Kassaw Demeke
- University of Gondar Comprehensive Specialized Hospital, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Fasil
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Alebachew Fasil, Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Po Box. 196, Gondar, Ethiopia, Tel +251-918733171, Email ;
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Albaker WI, Al-Hariri MT, Al Elq AH, Alomair NA, Alamoudi AS, Voutchkov N, Ihm S, Namazi MA, Alsayyah AA, AlRubaish FA, Alohli FT, Zainuddin FA, Alobaidi AA, Almuzain FA, Elamin MO, Alamoudi NB, Alamer MA, Alghamdi AA, AlRubaish NA. Beneficial effects of adding magnesium to desalinated drinking water on metabolic and insulin resistance parameters among patients with type 2 diabetes mellitus: a randomized controlled clinical trial. NPJ CLEAN WATER 2022; 5:63. [PMID: 36408199 PMCID: PMC9660218 DOI: 10.1038/s41545-022-00207-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
There is evidence that increasing the consumption of water containing magnesium can improve glucose metabolism and insulin resistance in patients with type 2 diabetes mellitus (T2DM). This trial was undertaken with the objective of evaluating the effect of adding different concentrations of magnesium chloride to the desalinated drinking water on the glycemic, metabolic, and insulin resistance parameters among patients with T2DM. A randomized cross-sectional controlled clinical trial was conducted to evaluate the effects of adding magnesium chloride supplement to desalinated drinking water consumed by patients with T2DM on the glycemic and metabolic parameters and indicators of insulin sensitivity. The total number of patients with T2DM who successfully completed the trial is 102. Patients were randomly allocated into three groups: the first group received bottled water without added magnesium (0 mg/L) (Group A, n = 37); the second group received bottled water with a low level of magnesium (20 mg/L) (Group B, n = 33); and the third group received drinking water with a high level of magnesium (50 mg/L) (Group C, n = 32). The daily consumption of elemental magnesium for a period of 3 months resulted in significant improvement in HbA1C (8.0 vs 8.2%, p = 0.04), insulin level (7.5 vs 9.9 μIU/mL, p = 0.03), and homeostasis model assessment-estimated insulin resistance (HOMA.IR) (2.5 vs 2.9, p = 0.002) in group C. However, there was no significant improvement in fasting blood glucose (FBS) level or lipid profile. The results of this study suggest that oral magnesium supplementation at the given dose of 50 mg/L daily added to drinking water could improve long-term glycemic control indicators and reduce insulin resistance in patients with T2DM.
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Affiliation(s)
- Waleed I. Albaker
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province Saudi Arabia
| | - Mohammed T. Al-Hariri
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province Saudi Arabia
| | - Abdulmohsen H. Al Elq
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province Saudi Arabia
| | - Nuhad A. Alomair
- Department of Chemistry, Science College, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province Saudi Arabia
| | - Ahmed S. Alamoudi
- Desalination Technologies Research Institute, Saline Water Conversation Corporation, Riyadh, Saudi Arabia
| | - Nikalay Voutchkov
- Desalination Technologies Research Institute, Saline Water Conversation Corporation, Riyadh, Saudi Arabia
| | - Seungwon Ihm
- Desalination Technologies Research Institute, Saline Water Conversation Corporation, Riyadh, Saudi Arabia
| | - Mohammed A. Namazi
- Desalination Technologies Research Institute, Saline Water Conversation Corporation, Riyadh, Saudi Arabia
| | - Ahmed A. Alsayyah
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province Saudi Arabia
| | - Fatima A. AlRubaish
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province Saudi Arabia
| | - Fadwa T. Alohli
- Department of Family Medicine, Armed Forces Hospital, Dhahran, Eastern Province Saudi Arabia
| | - Fatma A. Zainuddin
- Department of Medical Allied Services, Imam Abdulrahman Bin Faisal University -King Fahd Hospital of the University Eastern Province, Dammam, Saudi Arabia
| | - Anwar A. Alobaidi
- Department of Medical Allied Services, Imam Abdulrahman Bin Faisal University -King Fahd Hospital of the University Eastern Province, Dammam, Saudi Arabia
| | - Fatimah A. Almuzain
- Department of Medical Allied Services, Imam Abdulrahman Bin Faisal University -King Fahd Hospital of the University Eastern Province, Dammam, Saudi Arabia
| | - Mohamed O. Elamin
- Department of Biochemistry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province Saudi Arabia
| | - Naela B. Alamoudi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province Saudi Arabia
- Present Address: Emergency Medicine Department, King Fahad Specialist Hospital, Eastern Health Cluster, Dammam, Eastern Province Saudi Arabia
| | - Mashael A. Alamer
- Intern, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province Saudi Arabia
| | - Abdulrahman A. Alghamdi
- Intern, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province Saudi Arabia
| | - Nafie A. AlRubaish
- Intern, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province Saudi Arabia
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Hamarshih M, Hamshari S, Nazzal Z, Snobar F, Mletat R, Abu-Mazen O, Maraqa B. Hypomagnesemia and Poor Glycemic Control among Type 2 Diabetic Patients: A Cross-Sectional Study. Indian J Endocrinol Metab 2022; 26:575-580. [PMID: 39005513 PMCID: PMC11245293 DOI: 10.4103/ijem.ijem_213_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 09/09/2022] [Accepted: 11/20/2022] [Indexed: 02/05/2023] Open
Abstract
Background/Aim Hypomagnesaemia has been shown to have a significant impact on both glycaemic control and diabetes complications in type 2 diabetes mellitus (T2DM) patients. This study aims to assess the prevalence of hypomagnesaemia in T2DM patients and find the association between serum magnesium levels and outcomes relevant to glycaemic control and diabetic complications in primary care unit. Methods A cross-sectional study was conducted and included 373 patients (222 males and 151 females) from primary care unit. Serum magnesium levels were measured by the colorimetric endpoint method using the Cobas C501 system. Hypomagnesaemia was determined to be a serum magnesium level <1.6 mg/dL. In addition, the following data was also obtained: patients' characteristics, anthropometric measurements, smoking status, HbA1c, comorbidities and therapeutic management. Results Patients' mean age was 56.2 ± 10.8 years, 24.6% were smokers, and most were overweight or obese. About 60% have a history of hypertension, and the majority have had diabetes for more than 10 years. Their mean HbA1c level was 8.5 ± 2%. The prevalence of hypomagnesaemia was 11% (95% CI: 8%-14.6%). It was found to be significantly higher among females (adjusted OR: 2.7, 95%CI: 1.2%-5.8%), patients with HbA1c ≥8% (adjusted OR: 2.4, 95%CI: 1.1%-5.5%) and patients with a history of diabetic retinopathy (adjusted OR: 2.7, 95%CI: 1.1%-7.1%). Conclusion The study showed that hypomagnesaemia is more prevalent in females and is associated with diabetic retinopathy and poor glycaemic control. Having a sufficient magnesium level may be associated with better glycaemic control and a reduced occurrence of complications.
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Affiliation(s)
- Mohammad Hamarshih
- Consultant Family Medicine, and Diabetology, Palestine Diabetes Institute, Ramallah, Palestine
| | - Suha Hamshari
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Zaher Nazzal
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Farha Snobar
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Rawa Mletat
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ola Abu-Mazen
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Ranganathan RS, K EV, R S, Manimozhian N. High Fasting Blood Sugar and Increased Waist Circumference as Risk Factors for Diabetic Retinopathy in Type 2 Diabetes Patients Older than 45 Years. Cureus 2022; 14:e28291. [PMID: 36158357 PMCID: PMC9494576 DOI: 10.7759/cureus.28291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Diabetes mellitus (DM) has a long-term impact on retinal micro-blood vessels, culminating in the progression of diabetic retinopathy (DR); however; screening for DR is not widely used due to a lack of accessibility and economic constraints, especially in resource-limited settings. Thus, a longitudinal marker that is associated with the development of DR is required. This study sought to assess the association of DR with fasting blood sugar (FBS) levels and waist circumference. Methodology A cross-sectional study was conducted in a tertiary care hospital for one year. All individuals diagnosed with Type 2 DM (T2DM) and ≥45 years of age were included in the study. Individuals with fasting blood glucose levels of <126 mg/dl and <3 years of diagnosis with T2DM were excluded from the study. Individuals having one or more retinal microaneurysms or retinal blot hemorrhages, with or without any additional abnormalities, were diagnosed with DR. The results were analyzed using SPSS version 21 (IBM Corp., Armonk, NY). Results The prevalence of diabetic retinopathy among the study participants was 67.6 %. There was a significant association between increasing waist circumference (p = 0.009) and High FBS levels (p = 0.032) with the presence of DR. Conclusion Approximately two-thirds of the patients with T2DM aged >45 years and above have diabetic retinopathy. High FBS and waist circumference were associated with DR.
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Kobat SG, Baygin N, Yusufoglu E, Baygin M, Barua PD, Dogan S, Yaman O, Celiker U, Yildirim H, Tan RS, Tuncer T, Islam N, Acharya UR. Automated Diabetic Retinopathy Detection Using Horizontal and Vertical Patch Division-Based Pre-Trained DenseNET with Digital Fundus Images. Diagnostics (Basel) 2022; 12:diagnostics12081975. [PMID: 36010325 PMCID: PMC9406859 DOI: 10.3390/diagnostics12081975] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/08/2022] [Accepted: 08/13/2022] [Indexed: 12/23/2022] Open
Abstract
Diabetic retinopathy (DR) is a common complication of diabetes that can lead to progressive vision loss. Regular surveillance with fundal photography, early diagnosis, and prompt intervention are paramount to reducing the incidence of DR-induced vision loss. However, manual interpretation of fundal photographs is subject to human error. In this study, a new method based on horizontal and vertical patch division was proposed for the automated classification of DR images on fundal photographs. The novel sides of this study are given as follows. We proposed a new non-fixed-size patch division model to obtain high classification results and collected a new fundus image dataset. Moreover, two datasets are used to test the model: a newly collected three-class (normal, non-proliferative DR, and proliferative DR) dataset comprising 2355 DR images and the established open-access five-class Asia Pacific Tele-Ophthalmology Society (APTOS) 2019 dataset comprising 3662 images. Two analysis scenarios, Case 1 and Case 2, with three (normal, non-proliferative DR, and proliferative DR) and five classes (normal, mild DR, moderate DR, severe DR, and proliferative DR), respectively, were derived from the APTOS 2019 dataset. These datasets and these cases have been used to demonstrate the general classification performance of our proposal. By applying transfer learning, the last fully connected and global average pooling layers of the DenseNet201 architecture were used to extract deep features from input DR images and each of the eight subdivided horizontal and vertical patches. The most discriminative features are then selected using neighborhood component analysis. These were fed as input to a standard shallow cubic support vector machine for classification. Our new DR dataset obtained 94.06% and 91.55% accuracy values for three-class classification with 80:20 hold-out validation and 10-fold cross-validation, respectively. As can be seen from steps of the proposed model, a new patch-based deep-feature engineering model has been proposed. The proposed deep-feature engineering model is a cognitive model, since it uses efficient methods in each phase. Similar excellent results were seen for three-class classification with the Case 1 dataset. In addition, the model attained 87.43% and 84.90% five-class classification accuracy rates using 80:20 hold-out validation and 10-fold cross-validation, respectively, on the Case 2 dataset, which outperformed prior DR classification studies based on the five-class APTOS 2019 dataset. Our model attained about >2% classification results compared to others. These findings demonstrate the accuracy and robustness of the proposed model for classification of DR images.
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Affiliation(s)
- Sabiha Gungor Kobat
- Department of Ophthalmology, Firat University Hospital, Firat University, Elazig 23119, Turkey
| | - Nursena Baygin
- Department of Computer Engineering, Faculty of Engineering, Kafkas University, Kars 36000, Turkey
| | - Elif Yusufoglu
- Department of Ophthalmology, Elazig Fethi Sekin City Hospital, Elazig 23280, Turkey
| | - Mehmet Baygin
- Department of Computer Engineering, Faculty of Engineering, Ardahan University, Ardahan 75000, Turkey
| | - Prabal Datta Barua
- School of Management & Enterprise, University of Southern Queensland, Darling Heights, QLD 4350, Australia
- Faculty of Engineering and Information Technology, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Sengul Dogan
- Department of Digital Forensics Engineering, Technology Faculty, Firat University, Elazig 23119, Turkey
- Correspondence: ; Tel.: +90-424-2370000-7634
| | - Orhan Yaman
- Department of Digital Forensics Engineering, Technology Faculty, Firat University, Elazig 23119, Turkey
| | - Ulku Celiker
- Department of Ophthalmology, Firat University Hospital, Firat University, Elazig 23119, Turkey
| | - Hakan Yildirim
- Department of Ophthalmology, Firat University Hospital, Firat University, Elazig 23119, Turkey
| | - Ru-San Tan
- Department of Cardiology, National Heart Centre Singapore, Singapore 169609, Singapore or
- Duke-NUS Medical Centre, Singapore 169857, Singapore
| | - Turker Tuncer
- Department of Digital Forensics Engineering, Technology Faculty, Firat University, Elazig 23119, Turkey
| | - Nazrul Islam
- Glaucoma Faculty, Bangladesh Eye Hospital & Institute, Dhaka 1209, Bangladesh
| | - U. Rajendra Acharya
- Ngee Ann Polytechnic, Department of Electronics and Computer Engineering, Singapore 599489, Singapore
- Department of Biomedical Engineering, School of Science and Technology, SUSS University, Singapore 599494, Singapore
- Department of Biomedical Informatics and Medical Engineering, Asia University, Taichung 41354, Taiwan
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Huang Y, Wang Y, Liu C, Zhou Y, Wang X, Cheng B, Kui C, Wang Y. C-peptide, glycaemic control, and diabetic complications in type 2 diabetes mellitus: A real-world study. Diabetes Metab Res Rev 2022; 38:e3514. [PMID: 34841643 DOI: 10.1002/dmrr.3514] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 11/02/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To explore the relationship between C-peptide and glycaemic control rate and diabetic complications (microvascular complication and cerebral infarction) and provide evidence for stratified treatment of type 2 diabetes mellitus (T2DM)-based C-peptide. METHOD This is a cross-sectional real-world observational study. According to the inclusion and exclusion criteria, we studied 1377 patients with T2DM, grouped by fasting C-peptide and HOMA-IR. Blood samples were collected after fasting overnight. Logistic regression was used to analyse the relationship among fasting C-peptide, HOMA-IR, C2/C0 ratio (the ratio of 2 h postprandial C-peptide to fasting C-peptide), glycaemic control rate, and occurrence of diabetic complications. Restricted cubic spline (RCS) curves based on logistic regression were used to evaluate the relationship between C-peptide, glycaemic control rate, and diabetic kidney disease (DKD). RESULTS Patients were subdivided according to their fasting C-peptide in 4 groups (Q1,Q2,Q3,Q4). Patients of group Q3 (1.71 ≤ C-peptide < 2.51 ng/ml) showed the lowest incidence of DKD, diabetic retinopathy (DR), and rate of insulin absorption as welll as higher glycaemic control rate. Logistic regression shows that the probability of reaching glycemic control increased with higher levels of C-peptide, compared with group Q1, after adjusting for age, gender, duration of diabetes, body mass index, systolic blood pressure, diastolic blood pressure, creatinine, low-density lipoprotein, triglyceride, total cholesterol, and high-density lipoprotein. RCS curve shows that, when C-peptide is ≤2.68 ng/ml, the incidence of not reaching glycaemic control decreases with increasing C-peptide. The possibility of not reaching glycaemic control decreased with increasing C2/C0, when C-peptide is ≥1.71 ng/ml. RCS curve shows that the relationship between C-peptide and DKD follows a U-style curve. When C-peptide is <2.84 ng/ml, the incidence of DKD decreased with increasing C-peptide. With the increase in the C2/C0 ratio, the incidence of DKD, DR, and fatty liver did not decrease. CONCLUSION When C-peptide is ≥ 1.71 and < 2.51 ng/ml, patients with T2DM had a higher glycemic control rate. Excessive C-peptide plays different roles in DKD and DR; C-peptide may promote the incidence of DKD but protects patients from DR. Higher C2/C0 ratio is important for reaching glycaemic control but cannot reduce the risk of DKD, DR, and fatty liver.
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Affiliation(s)
- Yajing Huang
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yahao Wang
- Medicine College, Qingdao University, Qingdao, China
| | - Chuanfeng Liu
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yue Zhou
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiang Wang
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Bingfei Cheng
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Che Kui
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yangang Wang
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Scapaticci S, Neri CR, Marseglia GL, Staiano A, Chiarelli F, Verduci E. The impact of the COVID-19 pandemic on lifestyle behaviors in children and adolescents: an international overview. Ital J Pediatr 2022; 48:22. [PMID: 35120570 PMCID: PMC8815717 DOI: 10.1186/s13052-022-01211-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/11/2022] [Indexed: 12/24/2022] Open
Abstract
The adverse effects of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) are not limited to the related infectious disease. In children and adolescents, serious risks due to the coronavirus disease 2019 (COVID-19) pandemic are also related to its indirect effects. These include an unbalanced diet with an increased risk of weight excess or nutritional deficiencies, increased sedentary lifestyle, lack of schooling, social isolation, and impaired mental health.Pediatricians should be aware of the side effects of the COVID-19 pandemic on children's diet, physical mental health and advise the families according to their nutritional needs and financial resources. Moreover, the lack of a targeted therapy able to offer protection against the deleterious effects of SARS-CoV-2 infection should require a greater effort by scientific societies to find a more effective prevention strategy. In this context, much interest should be given to nutritional support, able to contrast malnutrition and to stimulate the immune system.
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Affiliation(s)
- S Scapaticci
- Department of Paediatrics, University of Chieti-Pescara, Chieti, Italy
| | - C R Neri
- Department of Paediatrics, University of Chieti-Pescara, Chieti, Italy
| | - G L Marseglia
- Department of Paediatrics, University of Pavia IRCCS San Matteo foundation, Pavia, Italy
| | - A Staiano
- Department of Paediatrics, University of Naples "Federico II", Naples, Italy
| | - F Chiarelli
- Department of Paediatrics, University of Chieti-Pescara, Chieti, Italy.
| | - E Verduci
- Department of Paediatrics, Children's Hospital "Vittore Buzzi", University of Milan, Milan, Italy
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10
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Association between magnesium concentrations and prediabetes: a systematic review and meta-analysis. Sci Rep 2021; 11:24388. [PMID: 34937856 PMCID: PMC8695575 DOI: 10.1038/s41598-021-03915-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/13/2021] [Indexed: 01/10/2023] Open
Abstract
Studies on the association between serum magnesium level and prediabetes yielded inconsistent results. Therefore, the present meta-analysis was designed to examine the association between serum magnesium levels and prediabetes. Online databases including PubMed, Embase, Scopus and Google Scholar were searched up to October, 2020. A total of 10 studies that reported mean and standard deviation (SD) of magnesium levels in prediabetes and healthy control group were identified. Random effects models were used to pool weighted mean differences (WMDs) of serum magnesium levels. Pooled-analysis showed that subjects with prediabetes had significantly lower serum magnesium levels compared with healthy controls (WMD = - 0.07 mmol/L; 95% CI - 0.09, - 0.05 mmol/L, P < 0.001). A significant heterogeneity observed across included studies (I2 = 95.6%, P < 0.001). However, different subgroup analysis did not detect the potential source of observed heterogeneity. Withdrawal of each individual study had no effect on the overall results. The present meta-analysis showed that circulating magnesium levels in people with prediabetes were significantly lower than healthy controls, confirming that magnesium deficiency may play a role in development and progression of prediabetes. Further studies with larger sample size and robust design are warranted to confirm present results.
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11
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Mirghani HO. Dates fruits effects on blood glucose among patients with diabetes mellitus: A review and meta-analysis. Pak J Med Sci 2021; 37:1230-1236. [PMID: 34290813 PMCID: PMC8281151 DOI: 10.12669/pjms.37.4.4112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 01/27/2021] [Accepted: 03/28/2021] [Indexed: 11/15/2022] Open
Abstract
Background & Objective: Dates fruit is known for its great nutritional value and two to three servings of dates fruit/day are beneficial for patients with diabetes. However, some may advice against this cheap and widely available fruit consumption. Besides, 12% of the population Worldwide are either suffering or are at risk of developing diabetes, but no previous meta-analysis has assessed this important issue. Thus, the study aimed to investigate the effects of date’s fruit on glycemia among patients with diabetes. Methods: A systematic literature search was conducted in PubMed, Medline, EBSCO, Cochrane, and Google Scholar databases for trials published in English from the first published article up to December 2020. The following keywords were used: “dates fruit and glycemic control”, “dates fruit and blood glucose”, “dates fruit and HbA1c” without limitations regarding the date of publication. Results: Out of the 942 references identified, only 10 cohorts from five full texts were included, a reduction of Fasting plasma glucose (FPG), odd ratio, -24.79, 95% CI=-34.75, -14.83 P =0.002. I2 for heterogeneity=79%, P <0.00001 and postprandial plasma glucose (PPPG), odd ratio -28.19, 95% CI=-60.66-4.29, P =<0.0001. I2 for heterogeneity=92%, P=0.09) was observed. While the effect on HbA1c was neutral, odd ratio, -.20, 95% CI=-.46 -.06, P=0.13. I2 for heterogeneity=0. %, P=0.55. Conclusion: Dates fruit was beneficial regarding glycemic control among patients with diabetes, physician may not need to restrict its use among patients with diabetes. The small number of the included studies and the heterogeneity observed in PPPG and FPG sub-analysis limited the current results. Further trials assessing the glycemic indices of various types of dates fruit are needed.
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Affiliation(s)
- Hyder Osman Mirghani
- Hyder Osman Mirghani, MD. Associate Professor, Department of Internal Medicine, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
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12
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Shivakumar K, Rajalakshmi A, Jha KN, Nagarajan S, Srinivasan A, Lokesh Maran A. Serum magnesium in diabetic retinopathy: the association needs investigation. Ther Adv Ophthalmol 2021; 13:25158414211056385. [PMID: 34901747 PMCID: PMC8655827 DOI: 10.1177/25158414211056385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/08/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Magnesium has an essential role in glucose metabolism, and hypomagnesaemia is common in diabetes mellitus. However, the relationship between serum magnesium and diabetic retinopathy is poorly understood. AIM To determine the association between serum magnesium levels and retinopathy in type 2 diabetic patients with normal renal function and to correlate it with severity of retinopathy. METHODS This cross-sectional observational study was conducted in a semi-urban tertiary-care teaching hospital. Clinicodemographic profile and serum magnesium levels were determined in patients with type 2 diabetes mellitus (DM) with (group 1) and without (group 2) retinopathy. Serum magnesium levels were correlated with the presence and severity of retinopathy. RESULTS Of 104 type 2 DM patients, 50 had retinopathy. Younger age, longer duration of disease and poorer glycaemic control (p < 0.05) were found to be associated with retinopathy. The mean serum magnesium levels in patients with retinopathy and those without retinopathy were 1.63 ± 0.30 mg/dL and 1.76 ± 0.22 mg/dL, respectively (p = 0.029). Reduced serum magnesium was associated with elevated fasting sugars (p = 0.019) and female gender (p = 0.037). On comparative analysis of patients with sight-threatening diabetic retinopathy (STDR), non-STDR and no retinopathy by ANOVA test, patients with STDR had significantly lower serum magnesium (1.55 ± 0.33 mg/dL) (p = 0.031). CONCLUSION Serum magnesium levels were lower in patients with diabetic retinopathy. Patients with STDR had lower serum magnesium compared with those without STDR. SUMMARY Serum magnesium, studied extensively for its role in glucose metabolism, was found to be lower in patients with diabetic retinopathy compared with those without retinopathy. Sight-threatening diabetic retinopathy had significantly lower levels of serum magnesium.
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Affiliation(s)
- Koushik Shivakumar
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
| | - A.R. Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry UT 607402, India
| | - Kirti Nath Jha
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
| | - Swathi Nagarajan
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
| | - A.R. Srinivasan
- Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
| | - A. Lokesh Maran
- Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
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13
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Muley A, Moradiya K. A study of serum magnesium level in type 2 diabetes mellitus and its association with glycemic control and its complications. INTERNATIONAL JOURNAL OF NONCOMMUNICABLE DISEASES 2021. [DOI: 10.4103/jncd.jncd_53_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Mathew AA, Panonnummal R. 'Magnesium'-the master cation-as a drug-possibilities and evidences. Biometals 2021; 34:955-986. [PMID: 34213669 PMCID: PMC8249833 DOI: 10.1007/s10534-021-00328-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 06/19/2021] [Indexed: 02/06/2023]
Abstract
Magnesium (Mg2+) is the 2nd most abundant intracellular cation, which participates in various enzymatic reactions; there by regulating vital biological functions. Magnesium (Mg2+) can regulate several cations, including sodium, potassium, and calcium; it consequently maintains physiological functions like impulse conduction, blood pressure, heart rhythm, and muscle contraction. But, it doesn't get much attention in account with its functions, making it a "Forgotten cation". Like other cations, maintenance of the normal physiological level of Mg2+ is important. Its deficiency is associated with various diseases, which point out to the importance of Mg2+ as a drug. The roles of Mg2+ such as natural calcium antagonist, glutamate NMDA receptor blocker, vasodilator, antioxidant and anti-inflammatory agent are responsible for its therapeutic benefits. Various salts of Mg2+ are currently in clinical use, but their application is limited. This review collates all the possible mechanisms behind the behavior of magnesium as a drug at different disease conditions with clinical shreds of evidence.
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Affiliation(s)
- Aparna Ann Mathew
- Amrita School of Pharmacy, Amrita Institute of Medical Science & Research Centre, Amrita VishwaVidyapeetham, Kochi, 682041, India
| | - Rajitha Panonnummal
- Amrita School of Pharmacy, Amrita Institute of Medical Science & Research Centre, Amrita VishwaVidyapeetham, Kochi, 682041, India.
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15
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Tang CF, Ding H, Jiao RQ, Wu XX, Kong LD. Possibility of magnesium supplementation for supportive treatment in patients with COVID-19. Eur J Pharmacol 2020; 886:173546. [PMID: 32931782 PMCID: PMC7486870 DOI: 10.1016/j.ejphar.2020.173546] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/30/2020] [Accepted: 09/08/2020] [Indexed: 12/16/2022]
Abstract
Magnesium as an enzymatic activator is essential for various physiological functions such as cell cycle, metabolic regulation, muscle contraction, and vasomotor tone. A growing body of evidence supports that magnesium supplementation (mainly magnesium sulfate and magnesium oxide) prevents or treats various types of disorders or diseases related to respiratory system, reproductive system, nervous system, digestive system, and cardiovascular system as well as kidney injury, diabetes and cancer. The ongoing pandemic coronavirus disease 19 (COVID-19) characterized by respiratory tract symptoms with different degrees of important organ and tissue damages has attracted global attention. Particularly, effective drugs are still lacking in the COVID-19 therapy. In this review, we find and summarize the effectiveness of magnesium supplementation on the disorders or diseases, and provide a reference to the possibility of magnesium supplementation for supportive treatment in patients with COVID-19.
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Affiliation(s)
- Chuan-Feng Tang
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, 210023, People's Republic of China
| | - Hong Ding
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, 210023, People's Republic of China
| | - Rui-Qing Jiao
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, 210023, People's Republic of China
| | - Xing-Xin Wu
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, 210023, People's Republic of China
| | - Ling-Dong Kong
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, 210023, People's Republic of China.
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16
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Gile J, Ruan G, Abeykoon J, McMahon MM, Witzig T. Magnesium: The overlooked electrolyte in blood cancers? Blood Rev 2020; 44:100676. [PMID: 32229066 DOI: 10.1016/j.blre.2020.100676] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/22/2020] [Accepted: 02/11/2020] [Indexed: 12/14/2022]
Abstract
Magnesium is an important element that has essential roles in the regulation of cell growth, division, and differentiation. Mounting evidence in the literature suggests an association between hypomagnesemia and all-cause mortality. In addition, epidemiologic studies have demonstrated that a diet poor in magnesium increases the risk of developing cancer, highlighting its importance in the field of hematology and oncology. In solid malignancies, hypomagnesemia at diagnosis portends a worse prognosis. However, little is known about prognosis in patients with hypomagnesemia and blood cancers in general; lymphoma more specifically. Hypomagnesemia has been associated with a higher viral load of the Epstein Barr virus, a virus associated with a multitude of hematologic malignancies. The role of magnesium in the immune system has been further elucidated in studies of patients with a rare primary immunodeficiency known as XMEN disease (X-linked immunodeficiency with Magnesium defect, Epstein-Barr virus (EBV) infection, and Neoplasia disease). These patients have a mutation in the MAGT1 gene, which codes for a magnesium transporter. The mutation leads to impaired T cell activation and an increased risk of developing hematologic malignancies. In this review we discuss the relevance of magnesium as an electrolyte, current measurement techniques, and the known data related to cause and prognosis of blood cancers. The goal is to use these data to stimulate additional high-quality and well powered studies to further investigate the role of magnesium in preventing cancer and improving outcomes of patients with malignancy and concomitant magnesium deficiency.
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Affiliation(s)
- Jennifer Gile
- Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Gordon Ruan
- Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | | | | | - Thomas Witzig
- Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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