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Zhao D, Chen P, Chen M, Chen L, Wang L. Association of Magnesium Depletion Score with Congestive Heart Failure: Results from the NHANES 2007-2016. Biol Trace Elem Res 2024; 202:454-465. [PMID: 37198357 DOI: 10.1007/s12011-023-03697-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/03/2023] [Indexed: 05/19/2023]
Abstract
The magnesium depletion score (MDS) is considered a new valuable and reliable predictor of body magnesium status. This study aimed to explore the association between MDS and congestive heart failure (CHF) among US adults. A total of 19,227 eligible participants from the 2007-2016 National Health and Nutrition Examination Survey were enrolled in this study and then divided into three groups according to the level of MDS (none to low: MDS=0-1, middle: MDS=2, high: MDS=3-5). Sample-weighted logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs) exploring the independent relationship between MDS and CHF. The estimated prevalence of CHF increased with the increasing level of MDS (none to low: 0.86%, middle: 4.06%, high: 13.52%; P < 0.001). Compared to those in the none-to-low group, participants in the middle and high groups were at significantly higher risk of CHF after adjusting for various covariates (model 3: OR=1.55, 95%CI: 1.05-2.30, P < 0.001; OR=3.20, 95%CI: 2.07-4.96, P < 0.001; respectively). Subgroup analyses indicated that adequate dietary magnesium intake could reduce the risk of CHF in participants who did not meet the recommended dietary allowance (RDA) for magnesium. Besides, there was an interaction between coronary artery disease and MDS on CHF (P for interaction < 0.001). These findings indicated that MDS, a novel indicator estimating magnesium deficiency, is associated with the risk of CHF in non-institutionalized US civilians. Participants whose dietary magnesium intake reaches the RDA might be at lower risk.
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Affiliation(s)
- Diming Zhao
- Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Pengfei Chen
- Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Mingjian Chen
- Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Liang Chen
- Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Liqing Wang
- Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China.
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Tian Z, Qu S, Chen Y, Fang J, Song X, He K, Jiang K, Sun X, Shi J, Tao Y, Jin L. Associations of the magnesium depletion score and magnesium intake with diabetes among US adults: an analysis of the National Health and Nutrition Examination Survey 2011-2018. Epidemiol Health 2024; 46:e2024020. [PMID: 38271961 DOI: 10.4178/epih.e2024020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/05/2023] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVES The magnesium depletion score (MDS) is considered more reliable than traditional approaches for predicting magnesium deficiency in humans. We explored the associations of MDS and dietary magnesium intake with diabetes. METHODS We obtained data from 18,853 participants in the National Health and Nutrition Examination Survey 2011-2018. Using multivariate regression and stratified analysis, we investigated the relationships of both MDS and magnesium intake with diabetes. To compute prevalence ratios (PRs), we employed modified Poisson or log-binomial regression. We characterized the non-linear association between magnesium intake and diabetes using restricted cubic spline analysis. RESULTS Participants with MDS ≥2 exhibited a PR of 1.26 (95% confidence interval [CI], 1.19 to 1.34) for diabetes. Per-standard deviation (SD) increase in dietary magnesium intake was associated with a lower prevalence of diabetes (PR, 0.91; 95% CI, 0.87 to 0.96). Subgroup analyses revealed a positive association between MDS ≥2 and diabetes across all levels of dietary magnesium intake, including the lowest (PR, 1.35; 95% CI, 1.18 to 1.55), middle (PR, 1.23; 95% CI, 1.12 to 1.35), and highest tertiles (PR, 1.25; 95% CI, 1.13 to 1.37; pinteraction<0.001). Per-SD increase in magnesium intake was associated with lower diabetes prevalence in participants with MDS <2 (PR, 0.92; 95% CI, 0.87 to 0.98) and those with MDS ≥2 (PR, 0.91; 95% CI, 0.84 to 0.98; pinteraction=0.030). CONCLUSIONS MDS is associated with diabetes, particularly among individuals with low magnesium intake. Adequate dietary magnesium intake may reduce diabetes risk, especially in those with high MDS.
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Affiliation(s)
- Zhong Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Shifang Qu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yana Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Jiaxin Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xingxu Song
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Kai He
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Kexin Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiaoyue Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Jianyang Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yuchun Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
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Wolf FI, Maier JA, Rosanoff A, Barbagallo M, Baniasadi S, Castiglioni S, Cheng FC, Day SC, Costello RB, Dominguez LJ, Elin RJ, Gamboa-Gomez C, Guerrero-Romero F, Kahe K, Kisters K, Kolisek M, Kraus A, Iotti S, Mazur A, Mercado-Atri M, Merolle L, Micke O, Gletsu-Miller N, Nielsen F, O-Uchi J, Piazza O, Plesset M, Pourdowlat G, Rios FJ, Rodriguez-Moran M, Scarpati G, Shechter M, Song Y, Spence LA, Touyz RM, Trapani V, Veronese N, von Ehrlich B, Vormann J, Wallace TC, Cmer Center For Magnesium Education Research, Gesellschaft Für Magnesium-Forschung E V Germany, Sdrm Society International Society For The Development Of Research On Magnesium. [The magnesium global network (MaGNet) to promote research on magnesium in diseases focusing on covid-19]. Magnes Res 2021; 34:90-92. [PMID: 34524085 PMCID: PMC10617598 DOI: 10.1684/mrh.2021.0479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Federica I Wolf
- Dipartimento di Medicina e Chirurgia Traslazionale, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy, SDRM International Society for the Development of Research on Magnesium www.sdrmsociety.org,
| | - Jeanette A Maier
- Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Italy, SDRM International Society for the Development of Research on Magnesium www.sdrmsociety.org,
| | - Andrea Rosanoff
- CMER Center for Magnesium Education & Research, Pahoa, HI 96778, USA www.MagnesiumEducation.com,
| | - Mario Barbagallo
- Geriatric Unit, Department of Medicine, University of Palermo, Italy
| | - Shadi Baniasadi
- Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Sara Castiglioni
- Dipartimento di Scienze Biomediche e Cliniche L. Sacco, Università di Milano, Italy, SDRM International Society for the Development of Research on Magnesium www.sdrmsociety.org,
| | - Fu-Chou Cheng
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Sherrie Colaneri Day
- CMER Center for Magnesium Education & Research, Pahoa, HI 96778, USA www.MagnesiumEducation.com,
| | - Rebecca B Costello
- CMER Center for Magnesium Education & Research, Pahoa, HI 96778, USA www.MagnesiumEducation.com,
| | - Ligia J Dominguez
- Geriatric Unit, Department of Medicine, University of Palermo, Italy
| | - Ronald J Elin
- Department of Pathology and Laboratory Medicine, University of Louisville, KY, USA
| | | | | | - Ka Kahe
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, New York, USA
| | - Klaus Kisters
- Internal Medicine I, St. Anna Hospital, Herne, Germany, Gesellschaft für Magnesium-Forschung e.V., Germany www.magnesium-ges.de,
| | - Martin Kolisek
- Biomedical Center in Martin, Jessenius Medical faculty in Martin, Comenius University, Martin, 03601, Slovakia, Gesellschaft für Magnesium-Forschung e.V., Germany www.magnesium-ges.de,
| | - Anton Kraus
- Gesellschaft für Magnesium-Forschung e.V., Germany www.magnesium-ges.de,
| | - Stefano Iotti
- Department of Pharmacy and Biotechnology (FaBit) Università di Bologna, National Institute of Biostructures and Biosystems, Italy, SDRM International Society for the Development of Research on Magnesium www.sdrmsociety.org,
| | - Andre Mazur
- Université Clermont Auvergne, INRAE, UNH, Unité de Nutrition Humaine, Clermont-Ferrand, France, SDRM International Society for the Development of Research on Magnesium www.sdrmsociety.org,
| | - Moises Mercado-Atri
- Research Unit in Endocrine Diseases, Specialty Hospital, National Medical Center, Century XXI, Mexican Social Security Institute at Mexico City, Mexico
| | - Lucia Merolle
- Transfusion Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Oliver Micke
- Department of Radiotherapy and Radiation Oncology, Franziskus Hospital, Bielefeld, Germany, Gesellschaft für Magnesium-Forschung e.V., Germany www.magnesium-ges.de,
| | - Nana Gletsu-Miller
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202, USA
| | | | - Jin O-Uchi
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ornella Piazza
- Anestesiologia e Rianimazione, Dipartimento di Medicina e Chirurgia, Università degli Studi di Salerno, Italy
| | - Michael Plesset
- CMER Center for Magnesium Education & Research, Pahoa, HI 96778, USA www.MagnesiumEducation.com,
| | - Guitti Pourdowlat
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD) Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Francisco J Rios
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | - Giuliana Scarpati
- Anestesiologia e Rianimazione, Dipartimento di Medicina e Chirurgia, Università degli Studi di Salerno, Italy
| | - Michael Shechter
- Leviev Cardiothoracic and Vascular Center, Chaim Sheba Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Yiqing Song
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Lisa A Spence
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Rhian M Touyz
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK, SDRM International Society for the Development of Research on Magnesium www.sdrmsociety.org,
| | - Valentina Trapani
- Dipartimento di Medicina e Chirurgia Traslazionale, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy, Alleanza Contro il Cancro, Rome, Italy, SDRM International Society for the Development of Research on Magnesium www.sdrmsociety.org,
| | - Nicola Veronese
- Geriatric Unit, Department of Medicine, University of Palermo, Italy
| | - Bodo von Ehrlich
- Internal Medicine Private Practice, Kempten, Germany, Gesellschaft für Magnesium-Forschung e.V., Germany www.magnesium-ges.de,
| | - Juergen Vormann
- Institute for Prevention and Nutrition, Ismaning, Germany, Gesellschaft für Magnesium-Forschung e.V., Germany www.magnesium-ges.de,
| | - Taylor C Wallace
- Think Healthy Group, Department of Nutrition and Food Studies, George Mason University, Washington, USA, CMER Center for Magnesium Education & Research, Pahoa, HI 96778, USA www.MagnesiumEducation.com,
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Tao MH, Fulda KG. Association of Magnesium Intake with Liver Fibrosis among Adults in the United States. Nutrients 2021; 13:E142. [PMID: 33401667 PMCID: PMC7823345 DOI: 10.3390/nu13010142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 12/24/2022] Open
Abstract
Liver fibrosis represents the consequences of chronic liver injury. Individuals with alcoholic or nonalcoholic liver diseases are at high risk of magnesium deficiency. This study aimed to evaluate the association between magnesium and calcium intakes and significant liver fibrosis, and whether the associations differ by alcohol drinking status. Based on the National Health and Nutrition Examination Survey (NHANES) 2017-2018, the study included 4166 participants aged >18 years who completed the transient elastography examination and had data available on magnesium intake. The median liver stiffness of 8.2 kPa was used to identify subjects with significant fibrosis (≥F2). The age-adjusted prevalence of significant fibrosis was 12.81%. Overall total magnesium intake was marginally associated with reduced odds of significant fibrosis (p trend = 0.14). The inverse association of total magnesium intake with significant fibrosis was primarily presented among those who had daily calcium intake <1200 mg. There were no clear associations for significant fibrosis with calcium intake. Findings suggest that high total magnesium alone may reduce risk of significant fibrosis. Further studies are needed to confirm these findings.
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Affiliation(s)
- Meng-Hua Tao
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Kimberly G. Fulda
- Department of Family Medicine and Osteopathic Manipulative Medicine, NorTex, University of North Texas Health Science Center, Fort Worth, TX 76107, USA;
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Malinowska J, Małecka M, Ciepiela O. Variations in Magnesium Concentration Are Associated with Increased Mortality: Study in an Unselected Population of Hospitalized Patients. Nutrients 2020; 12:nu12061836. [PMID: 32575600 PMCID: PMC7353204 DOI: 10.3390/nu12061836] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 01/10/2023] Open
Abstract
Dysmagnesemia is a serious disturbance of microelement homeostasis. The aim of this study was to analyze the distribution of serum magnesium concentrations in hospitalized patients according to gender, age, and result of hospitalization. The study was conducted from February 2018 to January 2019 at the Central Clinical Hospital in Warsaw. Laboratory test results from 20,438 patients were included in this retrospective analysis. When a lower reference value 0.65 mmol/L was applied, hypermagnesemia occurred in 196 patients (1%), hypomagnesemia in 1505 patients (7%), and normomagnesemia in 18,711 patients (92%). At a lower reference value of 0.75 mmol/L, hypomagnesemia was found in 25% and normomagnesemia in 74% of patients. At a lower reference value of 0.85 mmol/L, hypomagnesemia was found in 60% and normomagnesemia in 39% of patients. Either hypo- or hyper-magnesemia was associated with increased risk of in-hospital mortality. This risk is the highest in patients with hypermagnesemia (40.1% of deaths), but also increases inversely with magnesium concentration below 0.85 mmol/L. Serum magnesium concentration was not gender-dependent, and there was a slight positive correlation with age (p < 0.0001, r = 0.07). Large fluctuations in serum magnesium level were associated with increased mortality (p = 0.0017). The results indicate that dysmagnesemia is associated with severe diseases and generally severe conditions. To avoid misdiagnosis, an increase of a lower cut-off for serum magnesium concentration to at least 0.75 mmol/L is suggested.
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Affiliation(s)
- Justyna Malinowska
- Students Scientific Group of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Milena Małecka
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Olga Ciepiela
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland;
- Correspondence: ; Tel.: +48-22-599-24-05
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Maccioni Romero A, Mena Nannig P. [Hypomagnesemia in newborns with hypoxic ischemic encephalopathy and whole-body hypothermia]. Rev Chil Pediatr 2020; 91:116-121. [PMID: 32730422 DOI: 10.32641/rchped.v91i1.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 11/17/2019] [Indexed: 06/11/2023]
Abstract
INTRODUCTION In newborns with the diagnosis of hypoxic-ischemic encephalopathy (HIE) treated with hypother mia, metabolic alterations are observed, which are associated with neurological prognosis. Hypo magnesemia has been reported frequently in the literature in these patients, but it is not measured or corrected in all neonatal healthcare centers. OBJECTIVE To evaluate the frequency of hypomag nesemia and hypocalcemia in newborns with HIE treated with whole-body hypothermia and to evaluate the response to the magnesium sulfate administration. PATIENTS AND METHOD Prospective, observational and descriptive study in hospitalized newborns with the diagnosis of HIE and trea ted with whole-body hypothermia between the years 2016 and 2017. Serial blood measurement of magnesemia (Mg) and calcemia (Ca) was performed. When presenting an Mg level < 1.8 mg/dl, supplementation with magnesium sulfate was administered to maintain levels between 1.9 and 2.8 mg/dl. The frecuency of hypomagnesemia, hypocalcemia and clinical evolution was registered. A descriptive statistical analysis was performed, with central tendency measures. RESULTS Sixteen ca ses were included, 13 of them presented hypomagnesemia (81.3%), with early-onset (6-36 hours of life), which was normalized with magnesium sulfate treatment, receiving a second dose 4 patients. Six of 16 patients presented hypocalcemia (37.5 %). CONCLUSIONS Hypomagnesemia is frequent (80%), similar to that described in the literature, and should be controlled and corrected early, given its physiological role, in the same way that calcium is controlled.
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Affiliation(s)
- A Catalano
- Department of Clinical and Experimental Medicine; University Hospital of Messina; Via C. Valeria, 98125 Messina, Italy.
| | - F Bellone
- Department of Clinical and Experimental Medicine; University Hospital of Messina; Via C. Valeria, 98125 Messina, Italy
| | - D Chilà
- Department of Clinical and Experimental Medicine; University Hospital of Messina; Via C. Valeria, 98125 Messina, Italy
| | - S Loddo
- Department of Clinical and Experimental Medicine; University Hospital of Messina; Via C. Valeria, 98125 Messina, Italy
| | - F Corica
- Department of Clinical and Experimental Medicine; University Hospital of Messina; Via C. Valeria, 98125 Messina, Italy
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Srinutta T, Chewcharat A, Takkavatakarn K, Praditpornsilpa K, Eiam-Ong S, Jaber BL, Susantitaphong P. Proton pump inhibitors and hypomagnesemia: A meta-analysis of observational studies. Medicine (Baltimore) 2019; 98:e17788. [PMID: 31689852 PMCID: PMC6946416 DOI: 10.1097/md.0000000000017788] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Previous meta-analyses have suggested that there might be an association between the use of proton pump inhibitors (PPIs) and the development of hypomagnesemia, although the conclusions were no definitive. METHODS To provide an update on this topic, we performed a meta-analysis of all observational studies that examined the association between the use of PPIs and the development of hypomagnesemia. A literature search was conducted in MEDLINE, Scopus and Cochrane Central Register of Controlled Trials (January 1970 to June 2018) to identify observational studies that examined the association between the use of PPIs and the incidence and prevalence of hypomagnesemia. STUDY ELIGIBILITY CRITERIA In the absence of randomized controlled trials, we focused primarily on observational studies, including cross-sectional, case-control, retrospective, and prospective cohort studies. There was no limitation on sample size or study duration. Random-effect models meta-analyses were used to compute pooled unadjusted and adjusted odds ratios (ORs) for binary variables. RESULTS Sixteen observational studies were identified, including 13 cross-sectional studies, 2 case-control studies, and 1 cohort study, with a total of 131,507 patients. The pooled percentage of PPI users was 43.6% (95% confidence interval [CI] 25.0%, 64.0%). Among PPI users, 19.4% (95% CI 13.8%, 26.5%) had hypomagnesemia compared to 13.5% (95% CI 7.9%, 22.2%) among nonusers. By meta-analysis, PPI use was significantly associated with hypomagnesemia, with a pooled unadjusted OR of 1.83 (95% CI 1.26, 2.67; P = .002) and a pooled adjusted OR of 1.71 (95% CI 1.33, 2.19; P < .001). In subgroup analyses, high-dose PPI use was associated with higher odds for hypomagnesemia relative to low-dose PPI use (pooled adjusted OR 2.13; 95% CI 1.26, 3.59; P = .005). CONCLUSION Our findings are in support of the results of the previous meta-analyses. Furthermore, we found a dose-response between the PPI use and development of hypomagnesemia.
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Affiliation(s)
- Thawin Srinutta
- Division of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Api Chewcharat
- Division of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kullaya Takkavatakarn
- Division of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kearkiat Praditpornsilpa
- Division of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Bertrand L. Jaber
- Department of Medicine, St. Elizabeth's Medical Center
- Department of Medicine, Tufts University School of Medicine, Boston, MA
| | - Paweena Susantitaphong
- Division of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Research Unit for Metabolic Bone Disease in CKD patients, Chulalongkorn University, Bangkok, Thailand
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Kumssa DB, Penrose B, Bone PA, Lovatt JA, Broadley MR, Kendall NR, Ander EL. A reconnaissance survey of farmers' awareness of hypomagnesaemic tetany in UK cattle and sheep farms. PLoS One 2019; 14:e0223868. [PMID: 31603922 PMCID: PMC6788701 DOI: 10.1371/journal.pone.0223868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 09/30/2019] [Indexed: 12/02/2022] Open
Abstract
Hypomagnesaemic tetany (HypoMgT) in ruminants is a physiological disorder caused by inadequate intake or impaired absorption of magnesium (Mg) in the gut. If it is not detected and treated in time, HypoMgT can cause the death of the affected animal. A semi-structured questionnaire survey was conducted from July 2016–2017 to assess farmers’ awareness of HypoMgT in cattle and sheep in the UK. The questionnaire was distributed to farmers at farm business events and agricultural shows, and through a collaborative group of independent veterinary practices to their clients. Farmers were asked about (i) the incidence of presumed HypoMgT (PHT); (ii) their strategies to treat or prevent HypoMgT; (iii) mineral tests on animals, forage and soil, and (iv) farm enterprise type. A total of 285 responses were received from 82 cattle, 157 mixed cattle and sheep, and 46 sheep farmers, of whom 39% reported HypoMgT in their livestock, affecting 1–30 animals. Treatment and/or prevention against HypoMgT was reported by 96% respondents with PHT and 79% of those without. Mineral tests on animal, forage, and soil was conducted by 24%, 53%, and 66% of the respondents, respectively, regardless of PHT. There was a highly significant association between the use of interventions to tackle HypoMgT and the incidence of PHT (p < 0.01). The top three treatment/prevention strategies used were reported as being free access supplementation (149), in feed supplementation (59) and direct to animal treatments (drenches, boluses and injections) (45) although these did vary by farm type. Although some (9) reported using Mg-lime, no other pasture management interventions were reported (e.g., Mg-fertilisation or sward composition). Generally, the results indicate that UK farmers are aware of the risks of HypoMgT. A more integrated soil-forage-animal assessment may improve the effectiveness of tackling HypoMgT and help highlight the root causes of the problem.
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Affiliation(s)
- Diriba B. Kumssa
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Leicestershire, United Kingdom
- * E-mail:
| | - Beth Penrose
- School of Land & Food, University of Tasmania, Tasmania, Australia
| | - Peter A. Bone
- Livestock and Grassland Mineral Consultancy, Fairford, Gloucestershire, United Kingdom
| | - J. Alan Lovatt
- Institute of Biological, Environmental and Rural Sciences (IBERS), Aberystwyth University, Aberystwyth, United Kingdom
| | - Martin R. Broadley
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Leicestershire, United Kingdom
| | - Nigel R. Kendall
- School of Veterinary Medicine and Science, University of Nottingham, Leicestershire, United Kingdom
| | - E. Louise Ander
- Inorganic Geochemistry, Centre for Environmental Geochemistry, British Geological Survey, Keyworth, Nottinghamshire, United Kingdom
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Noor MM, Nazir Q, Khan TM, Gillani S, Abbasi MA, Rauf A, Qureshi ZU. Association Between Low Serum Magnesium Level And Type 2 Diabetes Mellitus In Abbottabad. J Ayub Med Coll Abbottabad 2019; 31:226-229. [PMID: 31094121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Magnesium serves as a cofactor for various oxidation reactions in the body and helps in glucose transport across cell membrane. Deficiency of magnesium is a common electrolyte abnormality in type 2 diabetic patients and is linked to development of various diabetic complications. This study was conducted to determine the association between low serum magnesium level and type 2 diabetes mellitus presenting at Medical B ward, BBS Hospital Abbottabad. METHODS This descriptive study was conducted over a period of 6 months starting July 1, 2017. One hundred & eighty diagnosed diabetic patients aged at least 40 years, were included in the study. Their serum magnesium level was checked after withdrawing blood under strict aseptic conditions. Fasting & random blood glucose and the level of glycosylated haemoglobin were measured and age, gender, duration of illness were recorded on a proforma. RESULTS Sixty-one patients (33.89%) had hypomagnesemia. There was no significant association between hypomagnesemia and age and sex of patients (p>0.05). However, hypomagnesemia was found to be significantly associated with the duration of diabetes mellitus among study population (p=0.02). CONCLUSIONS Hypomagnesemia is frequently present in patients with diabetes mellitus and it appears that its prevalence increases with the duration of diabetes mellitus.
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Affiliation(s)
| | - Quratulann Nazir
- Department of Gynaecology, Ayub Teaching Hospital, Abbottabad, Pakistan
| | - Tariq Mehmood Khan
- **Department of Pharmacology & Therapeutics, Frontier Medical College, Abbottabad, Pakistan
| | - Saima Gillani
- Department of Paediatrics,Ayub Teaching Hospital, Abbottabad
| | | | - Abdur Rauf
- Department of Surgery, Ayub Teaching Hospital, Abbottabad, Pakistan
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Kooijmans ECM, Bökenkamp A, Tjahjadi NS, Tettero JM, van Dulmen‐den Broeder E, van der Pal HJH, Veening MA. Early and late adverse renal effects after potentially nephrotoxic treatment for childhood cancer. Cochrane Database Syst Rev 2019; 3:CD008944. [PMID: 30855726 PMCID: PMC6410614 DOI: 10.1002/14651858.cd008944.pub3] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Improvements in diagnostics and treatment for paediatric malignancies resulted in a major increase in survival. However, childhood cancer survivors (CCS) are at risk of developing adverse effects caused by multimodal treatment for their malignancy. Nephrotoxicity is a known side effect of several treatments, including cisplatin, carboplatin, ifosfamide, radiotherapy and nephrectomy, and can cause glomerular filtration rate (GFR) impairment, proteinuria, tubulopathy, and hypertension. Evidence about the long-term effects of these treatments on renal function remains inconclusive. It is important to know the risk of, and risk factors for, early and late adverse renal effects, so that ultimately treatment and screening protocols can be adjusted. This review is an update of a previously published Cochrane Review. OBJECTIVES To evaluate existing evidence on the effects of potentially nephrotoxic treatment modalities on the prevalence of renal dysfunction in survivors treated for childhood cancer with a median or mean survival of at least one year after cessation of treatment, where possible in comparison with the general population or CCS treated without potentially nephrotoxic treatment. In addition, to evaluate evidence on associated risk factors, such as follow-up duration, age at time of diagnosis and treatment combinations, as well as the effect of doses. SEARCH METHODS On 31 March 2017 we searched the following electronic databases: CENTRAL, MEDLINE and Embase. In addition, we screened reference lists of relevant studies and we searched the congress proceedings of the International Society of Pediatric Oncology (SIOP) and The American Society of Pediatric Hematology/Oncology (ASPHO) from 2010 to 2016/2017. SELECTION CRITERIA Except for case reports, case series and studies including fewer than 20 participants, we included studies with all study designs that reported on renal function (one year or longer after cessation of treatment), in CCS treated before the age of 21 years with cisplatin, carboplatin, ifosfamide, radiation involving the kidney region, a nephrectomy, or a combination of two or more of these treatments. When not all treatment modalities were described or the study group of interest was unclear, a study was not eligible for the evaluation of prevalence. We still included it for the assessment of risk factors if it had performed a multivariable analysis. DATA COLLECTION AND ANALYSIS Two review authors independently performed study selection, 'Risk of bias' assessment and data extraction using standardised data collection forms. We performed analyses according to the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. MAIN RESULTS Apart from the remaining 37 studies included from the original review, the search resulted in the inclusion of 24 new studies. In total, we included 61 studies; 46 for prevalence, six for both prevalence and risk factors, and nine not meeting the inclusion criteria, but assessing risk factors. The 52 studies evaluating the prevalence of renal dysfunction included 13,327 participants of interest, of whom at least 4499 underwent renal function testing. The prevalence of adverse renal effects ranged from 0% to 84%. This variation may be due to diversity of included malignancies, received treatments, reported outcome measures, follow-up duration and the methodological quality of available evidence.Seven out of 52 studies, including 244 participants, reported the prevalence of chronic kidney disease, which ranged from 2.4% to 32%.Of these 52 studies, 36 studied a decreased (estimated) GFR, including at least 432 CCS, and found it was present in 0% to 73.7% of participants. One eligible study reported an increased risk of glomerular dysfunction after concomitant treatment with aminoglycosides and vancomycin in CCS receiving total body irradiation (TBI). Four non-eligible studies assessing a total cohort of CCS, found nephrectomy and (high-dose (HD)) ifosfamide as risk factors for decreased GFR. The majority also reported cisplatin as a risk factor. In addition, two non-eligible studies showed an association of a longer follow-up period with glomerular dysfunction.Twenty-two out of 52 studies, including 851 participants, studied proteinuria, which was present in 3.5% to 84% of participants. Risk factors, analysed by three non-eligible studies, included HD cisplatin, (HD) ifosfamide, TBI, and a combination of nephrectomy and abdominal radiotherapy. However, studies were contradictory and incomparable.Eleven out of 52 studies assessed hypophosphataemia or tubular phosphate reabsorption (TPR), or both. Prevalence ranged between 0% and 36.8% for hypophosphataemia in 287 participants, and from 0% to 62.5% for impaired TPR in 246 participants. One non-eligible study investigated risk factors for hypophosphataemia, but could not find any association.Four out of 52 studies, including 128 CCS, assessed the prevalence of hypomagnesaemia, which ranged between 13.2% and 28.6%. Both non-eligible studies investigating risk factors identified cisplatin as a risk factor. Carboplatin, nephrectomy and follow-up time were other reported risk factors.The prevalence of hypertension ranged from 0% to 50% in 2464 participants (30/52 studies). Risk factors reported by one eligible study were older age at screening and abdominal radiotherapy. A non-eligible study also found long follow-up time as risk factor. Three non-eligible studies showed that a higher body mass index increased the risk of hypertension. Treatment-related risk factors were abdominal radiotherapy and TBI, but studies were inconsistent.Because of the profound heterogeneity of the studies, it was not possible to perform meta-analyses. Risk of bias was present in all studies. AUTHORS' CONCLUSIONS The prevalence of adverse renal effects after treatment with cisplatin, carboplatin, ifosfamide, radiation therapy involving the kidney region, nephrectomy, or any combination of these, ranged from 0% to 84% depending on the study population, received treatment combination, reported outcome measure, follow-up duration and methodological quality. With currently available evidence, it was not possible to draw solid conclusions regarding the prevalence of, and treatment-related risk factors for, specific adverse renal effects. Future studies should focus on adequate study designs and reporting, including large prospective cohort studies with adequate control groups when possible. In addition, these studies should deploy multivariable risk factor analyses to correct for possible confounding. Next to research concerning known nephrotoxic therapies, exploring nephrotoxicity after new therapeutic agents is advised for future studies. Until more evidence becomes available, CCS should preferably be enrolled into long-term follow-up programmes to monitor their renal function and blood pressure.
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Affiliation(s)
- Esmee CM Kooijmans
- Amsterdam UMC, Vrije Universiteit AmsterdamDepartment of Pediatrics, Division of Oncology/HematologyDe Boelelaan 1117AmsterdamNetherlands1081 HV
| | - Arend Bökenkamp
- Amsterdam UMC, Vrije Universiteit AmsterdamDepartment of Pediatric NephrologyPO Box 7057AmsterdamNetherlands1007 MB
| | - Nic S Tjahjadi
- Amsterdam UMC, Vrije Universiteit AmsterdamDepartment of Pediatrics, Division of Oncology/HematologyDe Boelelaan 1117AmsterdamNetherlands1081 HV
| | - Jesse M Tettero
- Amsterdam UMC, Vrije Universiteit AmsterdamDepartment of Pediatrics, Division of Oncology/HematologyDe Boelelaan 1117AmsterdamNetherlands1081 HV
| | - Eline van Dulmen‐den Broeder
- Amsterdam UMC, Vrije Universiteit AmsterdamDepartment of Pediatrics, Division of Oncology/HematologyDe Boelelaan 1117AmsterdamNetherlands1081 HV
| | - Helena JH van der Pal
- Princess Maxima Center for Pediatric Oncology, KE.01.129.2PO Box 85090UtrechtNetherlands3508 AB
| | - Margreet A Veening
- Amsterdam UMC, Vrije Universiteit AmsterdamDepartment of Pediatrics, Division of Oncology/HematologyDe Boelelaan 1117AmsterdamNetherlands1081 HV
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Abstract
BACKGROUND Proton pump inhibitors (PPIs) are commonly used in the treatment of acid-related diseases; however, the association between the use of PPIs and potential risk of hypomagnesemia is controversial. METHODS In the present study, databases including PubMed, EMBASE, MEDLINE, PsycINFO, CINAHL, the Cochrane Library, and 4 Chinese databases were searched since the inception until April 2018. Previous observational studies on the incidence of hypomagnesemia in individuals exposed to PPIs were included. RESULTS This systematic review involved 15 studies including 129,347 participants, and the sample size varied from 52 to 95,205. Meta-analysis of 14 studies indicated that the use of PPIs increased the risk of hypomagnesemia [RR, 1.44, 95% CI, 1.13-1.76; I, 85.2%]. Subgroup analysis revealed that the use of PPI was not associated with the incidence of hypomagnesemia in outpatients [RR, 1.49; 95% CI, 0.83-2.14; I, 41.4%] and hospitalized patients [RR, 1.05; 95% CI, 0.81-1.29; I, 62.1%], respectively. The use of PPIs was not related to the risk of hypomagnesemia based on the cut-off values of 1.8 mg/dL [RR, 1.73; 95% CI, 0.87-2.58; I, 65.2%], 1.7 mg/dL [RR, 1.48; 95% CI, 0.90-2.06; I, 87.6%], and 1.6 mg/dL [RR, 0.98; 95% CI, 0.69-1.27; I, 67.9%]. CONCLUSION The association between the exposure to PPI and the incidence of hypomagnesemia remained unclear. Due to the remarkable heterogeneity in previous studies, a definitive conclusion could not be drawn. Further research should be conducted to investigate the relationship between the use of individual PPI and potential risk of hypomagnesemia, and a dose-response analysis may be required.
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Affiliation(s)
- Shengtao Liao
- Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Li Gan
- Department of Anatomy, North Sichuan Medical College, Nanchong, Sichuan, P.R. China
| | - Zhechuan Mei
- Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing
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13
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Abstract
Numerous epidemiological, experimental and clinical studies over the last 30 years have consistently shown that chronic magnesium deficiency is associated with and/or exacerbates a number of major disorders (Table 1). Yet chronic magnesium deficiency is not widely recognized and a major reason for this failure is that serum magnesium levels do not accurately reflect body magnesium stores. Specifically, in chronic magnesium deficiency, serum magnesium levels are often within the normal reference range (usually lowest quartile) and may not progress to overt hypomagnesaemia. This raises serious questions namely (i) should chronic magnesium deficiency be considered in high-risk patients irrespective of serum magnesium, even when 'normal'? and (ii) if recognized, should oral magnesium supplement be given to restore body stores? Appreciating the vital role of magnesium for normal cellular function and bone health may help in formulating a well-considered and justifiable approach to these questions. Pragmatic tests for assessing magnesium status in the adult are suggested and discussed.
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Affiliation(s)
- A A A Ismail
- Retired Consultant Clinical Biochemist, Chevet Lane, Wakefield, West Yorkshire, UK
| | - Y Ismail
- Department of Cardiology, Bristol Heart Institute, Bristol, Avon, UK
| | - A A Ismail
- Rheumatology Department, Stockport NHS Foundation Trust, Stockport, UK
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14
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Abstract
Magnesium is a critical mineral in the human body and is involved in ~80% of known metabolic functions. It is currently estimated that 60% of adults do not achieve the average dietary intake (ADI) and 45% of Americans are magnesium deficient, a condition associated with disease states like hypertension, diabetes, and neurological disorders, to name a few. Magnesium deficiency can be attributed to common dietary practices, medications, and farming techniques, along with estimates that the mineral content of vegetables has declined by as much as 80⁻90% in the last 100 years. However, despite this mineral's importance, it is poorly understood from several standpoints, not the least of which is its unique mechanism of absorption and sensitive compartmental handling in the body, making the determination of magnesium status difficult. The reliance on several popular sample assays has contributed to a great deal of confusion in the literature. This review will discuss causes of magnesium deficiency, absorption, handling, and compartmentalization in the body, highlighting the challenges this creates in determining magnesium status in both clinical and research settings.
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Affiliation(s)
- Jayme L Workinger
- Human Nutrition and Pharma, Balchem Corporation, 52 Sunrise Park Road, New Hampton, NY 10958, USA.
| | - Robert P Doyle
- Department of Chemistry, Center for Science and Technology, Syracuse University, 111 College Place, Syracuse, NY 13244, USA.
| | - Jonathan Bortz
- Human Nutrition and Pharma, Balchem Corporation, 52 Sunrise Park Road, New Hampton, NY 10958, USA.
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15
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Gant CM, Soedamah-Muthu SS, Binnenmars SH, Bakker SJL, Navis G, Laverman GD. Higher Dietary Magnesium Intake and Higher Magnesium Status Are Associated with Lower Prevalence of Coronary Heart Disease in Patients with Type 2 Diabetes. Nutrients 2018; 10:E307. [PMID: 29510564 PMCID: PMC5872725 DOI: 10.3390/nu10030307] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/24/2018] [Accepted: 03/01/2018] [Indexed: 02/07/2023] Open
Abstract
In type 2 diabetes mellitus (T2D), the handling of magnesium is disturbed. Magnesium deficiency may be associated with a higher risk of coronary heart disease (CHD). We investigated the associations between (1) dietary magnesium intake; (2) 24 h urinary magnesium excretion; and (3) plasma magnesium concentration with prevalent CHD in T2D patients. This cross-sectional analysis was performed on baseline data from the DIAbetes and LifEstyle Cohort Twente-1 (DIALECT-1, n = 450, age 63 ± 9 years, 57% men, and diabetes duration of 11 (7-18) years). Prevalence ratios (95% CI) of CHD by sex-specific quartiles of magnesium indicators, as well as by magnesium intake per dietary source, were determined using multivariable Cox proportional hazard models. CHD was present in 100 (22%) subjects. Adjusted CHD prevalence ratios for the highest compared to the lowest quartiles were 0.40 (0.20, 0.79) for magnesium intake, 0.63 (0.32, 1.26) for 24 h urinary magnesium excretion, and 0.62 (0.32, 1.20) for plasma magnesium concentration. For every 10 mg increase of magnesium intake from vegetables, the prevalence of CHD was, statistically non-significantly, lower (0.75 (0.52, 1.08)). In this T2D cohort, higher magnesium intake, higher 24 h urinary magnesium excretion, and higher plasma magnesium concentration are associated with a lower prevalence of CHD.
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Affiliation(s)
- Christina M Gant
- Department of Internal Medicine/Nephrology, ZGT Hospital, 7609 PP Almelo, The Netherlands.
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Centre Groningen, 9713EZ Groningen, The Netherlands.
| | - Sabita S Soedamah-Muthu
- Centre of Research on Psychology in Somatic Diseases (CORPS), Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, The Netherlands.
- Institute for Food, Nutrition and Health, University of Reading, Reading RG1 5EX, UK.
| | - S Heleen Binnenmars
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Centre Groningen, 9713EZ Groningen, The Netherlands.
| | - Stephan J L Bakker
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Centre Groningen, 9713EZ Groningen, The Netherlands.
| | - Gerjan Navis
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Centre Groningen, 9713EZ Groningen, The Netherlands.
| | - Gozewijn D Laverman
- Department of Internal Medicine/Nephrology, ZGT Hospital, 7609 PP Almelo, The Netherlands.
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16
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Kılıc H, Kanbay A, Karalezlı A, Babaoglu E, Hasanoglu HC, Erel O, Ates C. The Relationship between Hypomagnesemia and Pulmonary Function Tests in Patients with Chronic Asthma. Med Princ Pract 2018; 27:139-144. [PMID: 29455196 PMCID: PMC5968247 DOI: 10.1159/000487760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 02/16/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To investigate the relationship between serum values of magnesium and the parameters of the pulmonary function tests (PFT) in patients with chronic asthma. SUBJECTS AND METHODS This study recruited 50 patients with chronic stable asthma and 40 healthy individuals as a control group. Data on age, sex, severity of asthma, PFT, and details of drug therapy were obtained from each group. Serum magnesium, potassium, phosphorus, calcium, and sodium levels were also measured. To evaluate differences between groups, the Student t test or Mann-Whitney U test was performed for continuous variables, and the χ2 test for categorical variables. RESULTS In the asthma group, 10% (n = 9) of the patients had hypomagnesemia and 5.5% (n = 5) had hypophosphatemia. Patients with asthma were divided into two groups: the hypomagnesemic group (n = 9) and the normomagnesemic group (n = 41). Forced expiratory volume in 1 s (FEV1), FEV1%, peak expiratory flow (PEF), and PEF% were lower in the hypomagnesemic group than in the normomagnesemic group (p = 0.02). Multiple logistic regression analysis revealed a statistically significant association between hypomagnesemia and PFT in the hypomagnesemic asthmatic group. The correlations of age with FEV1, FEV1%, PEF, and PEF% were as follows: p = 0.00, r = 0.29; p = 0.00, r = 0.43; p = 0.03, r = 0.22; p = 0.00, r = 0.38; and p = 0.03, r = 0.22, respectively. The correlation of serum magnesium levels with PFT (FEV1, FEV1%, PEF, PEF%) were as follows: p = 0.001, r = 0.29; p = 0.001, r = 0.43; p = 0.03, r = 0.22; and p = 0.001, r = 0.38, respectively. The other electrolytes were within the normal range in both groups. CONCLUSION In this study, hypomagnesemia and hypophosphatemia were found to be the most common electrolyte abnormalities in patients with chronic stable asthma. FEV1, FEV1%, PEF, and PEF% were significantly lower in asthmatic patients with hypomagnesemia compared to asthmatic patients with normomagnesemia.
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Affiliation(s)
- Hatice Kılıc
- Department of Pulmonary Medicine, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Asiye Kanbay
- Department of Pulmonary Medicine, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ayşegul Karalezlı
- Department of Pulmonary Medicine, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Elif Babaoglu
- Department of Pulmonary Medicine, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - H. Canan Hasanoglu
- Department of Pulmonary Medicine, Faculty of Medicine, Yıldırım Beyazit University, Ankara, Turkey
| | - Ozcan Erel
- Department of Biochemistry, Faculty of Medicine, Yıldırım Beyazit University, Ankara, Turkey
| | - Can Ates
- Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara, Turkey
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17
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Bertinato J, Wang KC, Hayward S. Serum Magnesium Concentrations in the Canadian Population and Associations with Diabetes, Glycemic Regulation, and Insulin Resistance. Nutrients 2017; 9:nu9030296. [PMID: 28304338 PMCID: PMC5372959 DOI: 10.3390/nu9030296] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 02/24/2017] [Accepted: 03/14/2017] [Indexed: 01/10/2023] Open
Abstract
Total serum magnesium (Mg) concentration (SMC) is commonly used to assess Mg status. This study reports current SMCs of Canadians and their associations with demographic factors, diabetes, and measures of glycemic control and insulin resistance using results from the Canadian Health Measures Survey cycle 3 (2012-2013). Associations were examined in adults aged 20-79 years using linear mixed models. Mean SMCs and percentile distributions for 11 sex-age groups between 3 and 79 years (n = 5561) are reported. SMCs were normally distributed and differences (p < 0.05) among sex and age groups were small. Between 9.5% and 16.6% of adult sex-age groups had a SMC below the lower cut-off of a population-based reference interval (0.75-0.955 mmol·L-1) established in the United States population as part of the NHANES I conducted in 1971-1974. Having diabetes was associated with 0.04 to 0.07 mmol·L-1 lower SMC compared to not having diabetes in the various models. Body mass index, glycated hemoglobin, serum glucose and insulin concentrations, and homeostatic model assessment of insulin resistance were negatively associated with SMC. This is the first study to report SMCs in a nationally representative sample of the Canadian population. A substantial proportion of Canadians are hypomagnesaemic in relation to a population-based reference interval, and SMC was negatively associated with diabetes and indices of glycemic control and insulin resistance.
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Affiliation(s)
- Jesse Bertinato
- Nutrition Research Division, Food Directorate, Health Products and Food Branch, Health Canada, Sir Frederick G. Banting Research Centre, 251 Sir Frederick Banting Driveway, Ottawa, ON K1A 0K9, Canada.
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
| | - Kuan Chiao Wang
- Bureau of Food Surveillance and Science Integration, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, ON K1A 0K9, Canada.
| | - Stephen Hayward
- Bureau of Food Surveillance and Science Integration, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, ON K1A 0K9, Canada.
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18
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Abstract
In the multifactorial pathogenesis of periodontitis, there are still unknown factors influencing the outcome of the disease. An association between magnesium and periodontitis has been suggested by preliminary studies. However, relevant clinical data are lacking. We investigated the association between magnesium status and periodontal health in a population-based analysis. We conducted a cross-sectional epidemiological investigation involving 4290 subjects aged 20–80 yrs. We recorded periodontal risk factors and determined concentrations of serum magnesium and calcium, relating them to periodontal parameters. In a matched-pair study, 60 subjects using oral magnesium-containing drugs and 120 without were compared. In subjects aged 40 yrs and older, increased serum Mg/Ca was significantly associated with reduced probing depth (p < 0.001), less attachment loss (p = 0.006), and a higher number of remaining teeth (p = 0.005). Subjects taking Mg drugs showed less attachment loss (p < 0.01) and more remaining teeth than did their matched counterparts. These results suggest that nutritional magnesium supplementation may improve periodontal health.
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Affiliation(s)
- P Meisel
- Department of Pharmacology, Ernst Moritz Arndt University, F.-Loeffler-Str. 23d, D-17487 Greifswald, Germany.
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Fang X, Han H, Li M, Liang C, Fan Z, Aaseth J, He J, Montgomery S, Cao Y. Dose-Response Relationship between Dietary Magnesium Intake and Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Regression Analysis of Prospective Cohort Studies. Nutrients 2016; 8:nu8110739. [PMID: 27869762 PMCID: PMC5133122 DOI: 10.3390/nu8110739] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 11/09/2016] [Accepted: 11/14/2016] [Indexed: 12/15/2022] Open
Abstract
The epidemiological evidence for a dose-response relationship between magnesium intake and risk of type 2 diabetes mellitus (T2D) is sparse. The aim of the study was to summarize the evidence for the association of dietary magnesium intake with risk of T2D and evaluate the dose-response relationship. We conducted a systematic review and meta-analysis of prospective cohort studies that reported dietary magnesium intake and risk of incident T2D. We identified relevant studies by searching major scientific literature databases and grey literature resources from their inception to February 2016. We included cohort studies that provided risk ratios, i.e., relative risks (RRs), odds ratios (ORs) or hazard ratios (HRs), for T2D. Linear dose-response relationships were assessed using random-effects meta-regression. Potential nonlinear associations were evaluated using restricted cubic splines. A total of 25 studies met the eligibility criteria. These studies comprised 637,922 individuals including 26,828 with a T2D diagnosis. Compared with the lowest magnesium consumption group in the population, the risk of T2D was reduced by 17% across all the studies; 19% in women and 16% in men. A statistically significant linear dose-response relationship was found between incremental magnesium intake and T2D risk. After adjusting for age and body mass index, the risk of T2D incidence was reduced by 8%–13% for per 100 mg/day increment in dietary magnesium intake. There was no evidence to support a nonlinear dose-response relationship between dietary magnesium intake and T2D risk. The combined data supports a role for magnesium in reducing risk of T2D, with a statistically significant linear dose-response pattern within the reference dose range of dietary intake among Asian and US populations. The evidence from Europe and black people is limited and more prospective studies are needed for the two subgroups.
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Affiliation(s)
- Xin Fang
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden.
| | - Hedong Han
- Department of Health Statistics, Second Military Medical University, Shanghai 200433, China.
| | - Mei Li
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
| | - Chun Liang
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
| | - Jan Aaseth
- Faculty of Public Health, Hedmark University of Applied Sciences, Elverum 2411, Norway.
- Innlandet Hospital Trust, Kongsvinger Hospital Division, Kongsvinger 2226, Norway.
| | - Jia He
- Department of Health Statistics, Second Military Medical University, Shanghai 200433, China.
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro 70182, Sweden.
- Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm 17177, Sweden.
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
| | - Yang Cao
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden.
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro 70182, Sweden.
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Guerrero-Romero F, Flores-García A, Saldaña-Guerrero S, Simental-Mendía LE, Rodríguez-Morán M. Obesity and hypomagnesemia. Eur J Intern Med 2016; 34:29-33. [PMID: 27353277 DOI: 10.1016/j.ejim.2016.06.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 05/15/2016] [Accepted: 06/15/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Whether low serum magnesium is an epiphenomenon related with obesity or, whether obesity per se is cause of hypomagnesemia, remains to be clarified. OBJECTIVE To examine the relationship between body weight status and hypomagnesemia in apparently healthy subjects. METHODS A total of 681 healthy individuals aged 30 to 65years were enrolled in A cross-sectional study. Extreme exercise, chronic diarrhea, alcohol intake, use of diuretics, smoking, oral magnesium supplementation, diabetes, malnutrition, hypertension, liver disease, thyroid disorders, and renal damage were exclusion criteria. Based in the Body Mass Index (BMI), body weight status was defined as follows: normal weight (BMI <25kg/m2); overweight (BMI ≥25<30 BMIkg/m2); and obesity (BMI ≥30kg/m2). Hypomagnesemia was defined by serum magnesium concentration ≤0.74mmol/L. A multiple logistic regression analysis was used to compute the odds ratio (OR) between body weight status (independent variables) and hypomagnesemia (dependent variable). RESULTS The multivariate logistic regression analysis showed that dietary magnesium intake (OR 2.11; 95%CI 1.4-5.7) but no obesity (OR 1.53; 95%CI 0.9-2.5), overweight (OR 1.40; 95%CI 0.8-2.4), and normal weight (OR 0.78; 95%CI 0.6-2.09) were associated with hypomagnesemia. A subsequent logistic regression analysis adjusted by body mass index, waist circumference, total body fat, systolic and diastolic blood pressure, and triglycerides levels showed that hyperglycemia (2.19; 95%CI 1.1-7.0) and dietary magnesium intake (2.21; 95%CI 1.1-8.9) remained associated with hypomagnesemia. CONCLUSIONS Our results show that body weight status is not associated with hypomagnesemia and that, irrespective of obesity, hyperglycemia is cause of hypomagnesemia in non-diabetic individuals.
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Affiliation(s)
- Fernando Guerrero-Romero
- Biomedical Research Unit, Mexican Social Security Institute, Predio Canoas # 100, Col. Los Angeles, ZC 34067, Durango, Mexico
| | - Araceli Flores-García
- Biomedical Research Unit, Mexican Social Security Institute, Predio Canoas # 100, Col. Los Angeles, ZC 34067, Durango, Mexico
| | - Stephanie Saldaña-Guerrero
- Biomedical Research Unit, Mexican Social Security Institute, Predio Canoas # 100, Col. Los Angeles, ZC 34067, Durango, Mexico
| | - Luis E Simental-Mendía
- Biomedical Research Unit, Mexican Social Security Institute, Predio Canoas # 100, Col. Los Angeles, ZC 34067, Durango, Mexico
| | - Martha Rodríguez-Morán
- Biomedical Research Unit, Mexican Social Security Institute, Predio Canoas # 100, Col. Los Angeles, ZC 34067, Durango, Mexico.
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Cheungpasitporn W, Thongprayoon C, Harindhanavudhi T, Edmonds PJ, Erickson SB. Hypomagnesemia linked to new-onset diabetes mellitus after kidney transplantation: A systematic review and meta-analysis. Endocr Res 2016; 41:142-7. [PMID: 26934195 DOI: 10.3109/07435800.2015.1094088] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND New-onset diabetes after kidney transplantation (NODAT) is associated with both renal allograft failure and increased mortality. The objective of this meta-analysis was to evaluate the risk of NODAT in patients with hypomagnesemia. METHODS A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through May, 2015. Studies that reported relative risks, odd ratios or hazard ratios comparing the risk of NODAT in patients with hypomagnesemia were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. RESULTS Five cohort studies with 1699 patients were included in the analysis to assess the risk of NODAT in patients with hypomagnesemia. The pooled RR of NODAT in patients with hypomagnesemia was 1.25 (95% CI, 1.08-1.45). When meta-analysis was limited only to studies with the post-transplant hypomagnesemia, the pooled RR of NODAT was 1.22 (95% CI, 1.09-1.38). CONCLUSION Our meta-analysis demonstrates a significant association between hypomagnesemia and NODAT in kidney transplant recipients. This finding suggests the need for a large randomized controlled trial-with very careful attention to assess the effects of normalizing Mg levels and the risk of NODAT.
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Affiliation(s)
| | - Charat Thongprayoon
- a Division of Nephrology and Hypertension , Mayo Clinic , Rochester , MN , USA
| | - Tasma Harindhanavudhi
- b Division of Diabetes, Endocrinology and Metabolism , University of Minnesota , Minneapolis , MN , USA
| | | | - Stephen B Erickson
- a Division of Nephrology and Hypertension , Mayo Clinic , Rochester , MN , USA
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Abstract
Hypomagnesaemia in housed and grazing suckler cows. Coronavirus infection in cows. Suspected nitrite toxicity in lambs associated with feeding broccoli. Maedi visna in ewes. Mycotic pneumonia in a wildcat. These are among matters discussed in the disease surveillance report for November 2015 from SAC Consulting: Veterinary Services (SAC C VS).
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Fujii H, Iihara H, Ishihara M, Matsuhashi N, Takahashi T, Yoshida K, Itoh Y. [Relationship between the Incidence of Hypomagnesemia and Acneiform Rash and the Therapeutic Effect of Anti-EGFR Monoclonal Antibody in Patients with Metastatic Colorectal Cancer]. Gan To Kagaku Ryoho 2016; 43:229-233. [PMID: 27067688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Although anti-EGFR monoclonal antibodies, including cetuximab and panitumumab, are highly effective in KRAS wild-type advanced colorectal cancer, these drugs frequently cause several adverse events. These events include hypomagnesemia and acneiform rash, which may lead to the dose reduction or discontinuation of therapy. In the present study, we retrospectively investigated the incidence of hypomagnesemia and acneiform rash in patients with metastatic colorectal cancer (mCRC). We examined the relationship between the incidence of such adverse events and the therapeutic effect. METHODS Thirty-four mCRC patients receiving anti -EGFR monoclonal antibody as a first-line therapy during April 2012 to March 2015 were the subjects of the present study. The symptoms of hypomagnesemia and acneiform rash were graded in accordance with the Common Terminology Criteria for Adverse Events, v4.0. RESULTS The incidence rates of hypomagnesemia (all grades) and the acneiform rash (≥grade 2) were 29%and 50%, respectively. Eight patients (24%) exhibited both of these adverse events. The tumor response rate was notable, as it was significantly higher in patients who experienced both of these adverse events compared to those who did not(88% vs 38% for complete response plus partial response, p=0.039). However, the tumor response rate tended to be higher, although not significantly, in patients with either of these adverse events compared to those without it. CONCLUSION Concurrent onset of hypomagnesemia and acneiform rash may become a reliable factor capable of predicting the therapeutic effect of anti-EGFR monoclonal antibody.
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Ragupathi L, Fonseka N, Sendecki JA, McCarey MM, Breecker SW, Whellan DJ. Proton pump inhibitors and hypomagnesemia in patients with arrhythmias. Int J Clin Pract 2015; 69:1525-6. [PMID: 26647010 DOI: 10.1111/ijcp.12710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- L Ragupathi
- Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - N Fonseka
- Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - J A Sendecki
- Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - M M McCarey
- Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - S W Breecker
- Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - D J Whellan
- Thomas Jefferson University Hospital, Philadelphia, PA, USA.
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Abstract
Magnesium is the fourth most abundant mineral in the body. It has been recognized as a cofactor for more than 300 enzymatic reactions, where it is crucial for adenosine triphosphate (ATP) metabolism. Magnesium is required for DNA and RNA synthesis, reproduction, and protein synthesis. Moreover, magnesium is essential for the regulation of muscular contraction, blood pressure, insulin metabolism, cardiac excitability, vasomotor tone, nerve transmission and neuromuscular conduction. Imbalances in magnesium status—primarily hypomagnesemia as it is seen more common than hypermagnesemia—might result in unwanted neuromuscular, cardiac or nervous disorders. Based on magnesium’s many functions within the human body, it plays an important role in prevention and treatment of many diseases. Low levels of magnesium have been associated with a number of chronic diseases, such as Alzheimer’s disease, insulin resistance and type-2 diabetes mellitus, hypertension, cardiovascular disease (e.g., stroke), migraine headaches, and attention deficit hyperactivity disorder (ADHD).
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Affiliation(s)
- Uwe Gröber
- Academy of Micronutrient Medicine, Essen 45130, Germany.
| | | | - Klaus Kisters
- Academy of Micronutrient Medicine, Essen 45130, Germany.
- Department of Internal Medicine I, St. Anna-Hospital, Herne 44649, Germany.
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Haider DG, Lindner G, Ahmad SS, Sauter T, Wolzt M, Leichtle AB, Fiedler GM, Exadaktylos AK, Fuhrmann V. Hypermagnesemia is a strong independent risk factor for mortality in critically ill patients: results from a cross-sectional study. Eur J Intern Med 2015; 26:504-7. [PMID: 26049918 DOI: 10.1016/j.ejim.2015.05.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 05/17/2015] [Accepted: 05/20/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Patients with electrolyte imbalances or disorders have a high risk of mortality. It is unknown if this finding from sodium or potassium disorders extends to alterations of magnesium levels. METHODS AND PATIENTS In this cross-sectional analysis, all emergency room patients between 2010 and 2011 at the Inselspital Bern, Switzerland, were included. A multivariable logistic regression model was performed to assess the association between magnesium levels and in-hospital mortality up to 28days. RESULTS A total of 22,239 subjects were screened for the study. A total of 5339 patients had plasma magnesium concentrations measured at hospital admission and were included into the analysis. A total of 6.3% of the 352 patients with hypomagnesemia and 36.9% of the 151 patients with hypermagnesemia died. In a multivariate Cox regression model hypermagnesemia (HR 11.6, p<0.001) was a strong independent risk factor for mortality. In these patients diuretic therapy revealed to be protective (HR 0.5, p=0.007). Hypomagnesemia was not associated with mortality (p>0.05). Age was an independent risk factor for mortality (both p<0.001). CONCLUSION The study does demonstrate a possible association between hypermagnesemia measured upon admission in the emergency department, and early in-hospital mortality.
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Affiliation(s)
- Dominik G Haider
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland.
| | - Gregor Lindner
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland
| | - Sufian S Ahmad
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland
| | - Thomas Sauter
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland
| | - Michael Wolzt
- Department of Clinical Pharmacology, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria
| | | | - Georg-Martin Fiedler
- Center of Laboratory Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Aristomenis K Exadaktylos
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, Bern, 3010, Switzerland
| | - Valentin Fuhrmann
- Department of Intensive Care Medicine, University Hospital Hamburg-Eppendorf, Martinistraße 5220246 Hamburg, Germany
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Affiliation(s)
- Luca Pasina
- IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Italy.
| | - Danilo Zanotta
- Internal Medicine II, Ospedale di Circolo, Busto Arsizio, Italy
| | | | | | - Guido Bonoldi
- Internal Medicine II, Ospedale di Circolo, Busto Arsizio, Italy
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Affiliation(s)
- Stephen B Walsh
- UCL Centre for Nephrology, University College London, London, UK
| | - Anselm A Zdebik
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Robert J Unwin
- UCL Centre for Nephrology and Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK.
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Cheungpasitporn W, Thongprayoon C, Qian Q. Dysmagnesemia in Hospitalized Patients: Prevalence and Prognostic Importance. Mayo Clin Proc 2015; 90:1001-10. [PMID: 26250725 DOI: 10.1016/j.mayocp.2015.04.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/12/2015] [Accepted: 04/29/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To examine the prevalence of serum magnesium (Mg) alterations and outcomes in hospitalized patients. PATIENTS AND METHODS All admissions to Mayo Clinic in Rochester, Minnesota, from January 1, 2009, through December 31, 2013 (288,120 patients), were screened. Admission Mg from each unique patient and relevant clinical data were extracted from the institutional electronic database. RESULTS After excluding patients aged less than 18 years, those without Mg measurement, and readmission episodes, a total of 65,974 patients were studied. Magnesium levels of 2.1 mg/dL or higher were found in 20,777 patients (31.5%), and levels less than 1.7 mg/dL were noted in 13,320 (20.2%). Hypomagnesemia was common in patients with hematologic/oncological disorders, and hypermagnesemia was common in those with cardiovascular disease. The lowest hospital mortality, assessed by restricted cubic spline and percentage death, occurred in patients with Mg levels between 1.7 and 1.89 mg/dL. An Mg level of less than 1.7 mg/dL was independently associated with an increased risk of hospital mortality after adjusting for all variables except the admission diagnosis; risk for longer hospital stay and being discharged to a care facility were increased in the fully adjusted model. An elevated Mg level of 2.3 mg/dL or higher was a predictor for all adverse outcomes. The magnitude of Mg elevations in patients with levels of 2.3 mg/dL or higher (N=7908) was associated with worse hospital mortality in a dose-response manner. In patients with cardiovascular diseases, Mg levels of 1.5 to 1.69 mg/dL and 2.3 mg/dL or higher both independently predicted poor outcomes including hospital mortality. CONCLUSION Dysmagnesemia in hospitalized patients is common, with hypermagnesemia being most prevalent. Compared with hypomagnesemia, hypermagnesemia is a stronger predictor for poor outcomes. Magnesium supplementation for patients without Mg deficiency should be avoided in the absence of randomized controlled trials documenting a benefit.
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Affiliation(s)
| | - Charat Thongprayoon
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN; Department of Anesthesiology, Mayo Clinic, Rochester, MN
| | - Qi Qian
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
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Uras Y, Uysal Y, Arikan TA, Kop A, Caliskan M. Hydrogeochemistry of the drinking water sources of Derebogazi Village (Kahramanmaras) and their effects on human health. Environ Geochem Health 2015; 37:475-490. [PMID: 25446040 DOI: 10.1007/s10653-014-9659-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 11/09/2014] [Indexed: 06/04/2023]
Abstract
The aim of this study was to investigate the sources of drinking water for Derebogazi Village, Kahramanmaras Province, Turkey, in terms of hydrogeochemistry, isotope geochemistry, and medical geology. Water samples were obtained from seven different water sources in the area, all of which are located within quartzite units of Paleozoic age, and isotopic analyses of (18)O and (2)H (deuterium) were conducted on the samples. Samples were collected from the region for 1 year. Water quality of the samples was assessed in terms of various water quality parameters, such as temperature, pH, conductivity, alkalinity, trace element concentrations, anion-cation measurements, and metal concentrations, using ion chromatography, inductively coupled plasma (ICP) mass spectrometry, ICP-optical emission spectrometry techniques. Regional health surveys had revealed that the heights of local people are significantly below the average for the country. In terms of medical geology, the sampled drinking water from the seven sources was deficient in calcium and magnesium ions, which promote bone development. Bone mineral density screening tests were conducted on ten females using dual energy X-ray absorptiometry to investigate possible developmental disorder(s) and potential for mineral loss in the region. Of these ten women, three had T-scores close to the osteoporosis range (T-score < -2.5).
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Affiliation(s)
- Yusuf Uras
- Geology Engineering Department, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey,
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Abstract
CONTEXT Magnesium deficiency is commonly associated with endocrine and metabolic disorders, especially with Diabetes Mellitus type 2 though the mechanism of hypomagnesemia in Diabetes Mellitus is not completely known. There is a close association between metabolic control of Diabetes Mellitus and impaired magnesium balance. AIMS To estimate the serum levels of magnesium in patients of with Diabetes Mellitus type 2 and to find a correlation if any, with the duration and control (by estimating HbA1c) of Diabetes Mellitus type 2. MATERIALS AND METHODS Fifty patients of Diabetes Mellitus type 2 were included in the study. Blood samples were analyzed for fasting and post prandial glucose, HbA1c and magnesium. The patients were grouped into three categories based upon their HbA1c levels into those with good control, need intervention and poor control. The three groups were compared with reference to their mean levels of blood glucose and magnesium. Association of serum magnesium levels with HbA1c, Fasting and postprandial blood glucose and duration of Diabetes Mellitus was also done. RESULTS Serum magnesium levels were found to decline with rise in HbA1c levels and with duration of Diabetes Mellitus type 2. CONCLUSION Hypomagnesemia is linked to poor control of Diabetes Mellitus type 2 and depletion of serum magnesium occurs exponentially with duration of disease.
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Affiliation(s)
- S Ramadass
- Department of Physiology, Indira Gandhi Medical College and Research Institute, Pondicherry, India.
| | - Sharbari Basu
- Department of Biochemistry, Indira Gandhi Medical College and Research Institute, Pondicherry, India.
| | - A R Srinivasan
- Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India.
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Guerrero-Romero F, Rodríguez-Morán M. [Oral magnesium supplementation: an adjuvant alternative to facing the worldwide challenge of type 2 diabetes?]. CIR CIR 2014; 82:282-289. [PMID: 25238470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND In the search for answers that contribute to the metabolic control of patients with diabetes and the primary prevention of the disease, we performed a review of the evidence from cohort studies on the relationship between serum and/or magnesium intake with the risk of developing type 2 diabetes as well as of clinical trials on the efficacy of oral magnesium salts on reducing glycemia. METHODS An electronic search using the databases MEDLINE, EMBASE, and Cochrane Controlled Trials Register, updated to September 30, 2013, was performed. RESULTS A total of seven cohort studies (24,388 persons/year) show unequivocally that magnesium intake is associated with decreased risk of developing type 2 diabetes; two studies (13,076 persons/year) indicate that low magnesium intake is not associated with the risk of diabetes; one study (8,735 persons/year) shows that hypomagnesemia is associated with the development of impaired glucose metabolism. A total of 11 randomized controlled trials were identified; five show the effectiveness of oral magnesium salts in reducing glycemia in high-risk subjects and six studies carried out in patients with type 2 diabetes show inconsistent results. CONCLUSIONS Magnesium intake in the customary diet of subjects of the general population and the high-risk groups and/or oral magnesium supplementation is recommended for the prevention of diabetes. The efficacy of oral magnesium supplementation in the reduction of glucose levels in type 2 diabetic patients is inconsistent.
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Affiliation(s)
- Fernando Guerrero-Romero
- Unidad de Investigación Biomédica, Instituto Mexicano del Seguro Social, Delagación Durango, Durango, Mexico.
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Selvaraj T, Syed AA. Serum magnesium in postoperative patients admitted to the intensive care unit. Eur J Intern Med 2014; 25:e48-9. [PMID: 24484621 DOI: 10.1016/j.ejim.2014.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 01/10/2014] [Accepted: 01/14/2014] [Indexed: 11/18/2022]
Affiliation(s)
- Thomas Selvaraj
- Department of Anaesthesia and Intensive Care, Warwick Hospital, Lakin Road, Warwick CV34 5BW, UK.
| | - Akheel A Syed
- Faculty of Medical and Human Sciences, The University of Manchester, Manchester, UK
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Luk CP, Parsons R, Lee YP, Hughes JD. Response to "Proton pump inhibitor-associated hypomagnesemia: what do FDA data tell us?". Ann Pharmacother 2014; 48:432. [PMID: 24586075 DOI: 10.1177/1060028013512832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Knijnenburg SL, Mulder RL, Schouten-Van Meeteren AYN, Bökenkamp A, Blufpand H, van Dulmen-den Broeder E, Veening MA, Kremer LCM, Jaspers MWM. Early and late renal adverse effects after potentially nephrotoxic treatment for childhood cancer. Cochrane Database Syst Rev 2013:CD008944. [PMID: 24101439 DOI: 10.1002/14651858.cd008944.pub2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Great improvements in diagnostics and treatment for malignant disease in childhood have led to a major increase in survival. However, childhood cancer survivors (CCS) are at great risk for developing adverse effects caused by multimodal treatment for their malignancy. Nephrotoxicity is one of these known (acute) side effects of several treatments, including cisplatin, carboplatin, ifosfamide, radiotherapy and nephrectomy, and can cause glomerular filtration rate impairment, proteinuria, tubulopathy and hypertension. However, evidence about the long-term effects of these treatments on renal function remains inconclusive. To reduce the number of (long-term) nephrotoxic events in CCS, it is important to know the risk of, and risk factors for, early and late renal adverse effects, so that ultimately treatment and screening protocols can be adjusted. OBJECTIVES To evaluate existing evidence on the effects of potentially nephrotoxic treatment modalities on the prevalence of and associated risk factors for renal dysfunction in survivors treated for childhood cancer with a median or mean survival of at least one year after cessation of treatment, where possible in comparison with healthy controls or CCS treated without potentially nephrotoxic treatment. SEARCH METHODS We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 4, 2011), MEDLINE/PubMed (from 1945 to December 2011) and EMBASE/Ovid (from 1980 to December 2011). SELECTION CRITERIA With the exception of case reports, case series and studies including fewer than 20 participants, we included studies with all study designs that reported on renal function (one year or longer after cessation of treatment) in children and adults who were treated for a paediatric malignancy (aged 18 years or younger at diagnosis) with cisplatin, carboplatin, ifosfamide, radiation including the kidney region and/or a nephrectomy. DATA COLLECTION AND ANALYSIS Two review authors independently performed study selection, risk of bias assessment and data extraction using standardised data collection forms. Analyses were performed according to the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. MAIN RESULTS The search strategy identified 5504 studies, of which 5138 were excluded on the basis of title and/or abstract. The full-text screening of the remaining 366 articles resulted in the inclusion of 57 studies investigating the prevalence of and sometimes also risk factors for early and late renal adverse effects of treatment for childhood cancer. The 57 studies included at least 13,338 participants of interest for this study, of whom at least 6516 underwent renal function testing. The prevalence of renal adverse effects ranged from 0% to 84%. This variation may be due to diversity in included malignancies, prescribed treatments, reported outcome measurements and the methodological quality of available evidence.Chronic kidney disease/renal insufficiency (as defined by the authors of the original studies) was reported in 10 of 57 studies. The prevalence of chronic kidney disease ranged between 0.5% and 70.4% in the 10 studies and between 0.5% and 18.8% in the six studies that specifically investigated Wilms' tumour survivors treated with a unilateral nephrectomy.A decreased (estimated) glomerular filtration rate was present in 0% to 50% of all assessed survivors (32/57 studies). Total body irradiation; concomitant treatment with aminoglycosides, vancomycin, amphotericin B or cyclosporin A; older age at treatment and longer interval from therapy to follow-up were significant risk factors reported in multivariate analyses. Proteinuria was present in 0% to 84% of all survivors (17/57 studies). No study performed multivariate analysis to assess risk factors for proteinuria.Hypophosphataemia was assessed in seven studies. Reported prevalences ranged between 0% and 47.6%, but four of seven studies found a prevalence of 0%. No studies assessed risk factors for hypophosphataemia using multivariate analysis. The prevalence of impairment of tubular phosphate reabsorption was mostly higher (range 0% to 62.5%; 11/57 studies). Higher cumulative ifosfamide dose, concomitant cisplatin treatment, nephrectomy and longer follow-up duration were significant risk factors for impaired tubular phosphate reabsorption in multivariate analyses.Treatment with cisplatin and carboplatin was associated with a significantly lower serum magnesium level in multivariate analysis, and the prevalence of hypomagnesaemia ranged between 0% and 37.5% in the eight studies investigating serum magnesium.Hypertension was investigated in 24 of the 57 studies. Reported prevalences ranged from 0% to 18.2%. A higher body mass index was the only significant risk factor noted in more than one multivariate analysis. Other reported factors that significantly increased the risk of hypertension were use of total body irradiation, abdominal irradiation, acute kidney injury, unrelated or autologous stem cell donor type, growth hormone therapy and older age at screening. Previous infection with hepatitis C significantly decreased the risk of hypertension.Because of the profound heterogeneity of the studies, it was not possible to perform any meta-analysis. AUTHORS' CONCLUSIONS The prevalence of renal adverse events after treatment with cisplatin, carboplatin, ifosfamide, radiation therapy involving the kidney region and/or nephrectomy ranged from 0% to 84%. With currently available evidence, it was not possible to draw any conclusions with regard to prevalence of and risk factors for renal adverse effects. Future studies should focus on adequate study design and reporting and should deploy multivariate risk factor analysis to correct for possible confounding. Until more evidence becomes available, CCS should be enrolled into long-term follow-up programmes to monitor their renal function and blood pressure.
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[Colorectal cancer -- cetuximab: will the hypomagnesemia treatment have future success]. Z Gastroenterol 2013; 51:712. [PMID: 24298625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Rasheed H, Elahi S, Ajaz H. Serum magnesium and atherogenic lipid fractions in type II diabetic patients of Lahore, Pakistan. Biol Trace Elem Res 2012; 148:165-9. [PMID: 22351157 DOI: 10.1007/s12011-012-9361-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Accepted: 02/08/2012] [Indexed: 12/15/2022]
Abstract
This study was conducted to determine the prevalence of hypomagnesemia and its effect on the lipid profile of local type II diabetic patients. For this purpose, 219 diabetic patients and 100 age-matched control subjects were enrolled. Blood samples of the subjects were analyzed for fasting glucose, Mg, triglyceride, total cholesterol, HDL-cholesterol, and LDL-cholesterol. Results showed that mean serum values of these parameters were differing in diabetic patients as compared to control subjects. The reference range of serum magnesium in healthy controls was 1.2-4.4 mg/dl. Mean serum magnesium in diabetic patients was significantly lower as compared to healthy subjects (1.6 ± 0.23 mg/dl vs. 2.8 ± 0.8 mg/dl). Among diabetic patients, 143 (65.3%) had serum magnesium level below 1.7 mg/dl (hypomagnesemia). The corresponding figure for control subjects was 11 (11%). The difference was significant (p < 0.01). Diabetes mellitus patients with current hyperglycemic status had significantly lower serum Mg as compared to euglycemic patients (p = 0.05). Serum Mg in diabetic patients was correlated with all lipid parameters. Among them, HDL-cholesterol was significantly (p < 0.05) positively correlated (r = 0.34), while total cholesterol and LDL-cholesterol was negatively correlated, albeit non-significantly, with serum Mg. These results demonstrate that hypomagnesemia is accompanied by atherogenic alterations in the lipid profiles of type II diabetic patients of Lahore, Pakistan.
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Affiliation(s)
- Humaira Rasheed
- Department of Chemistry, University of Engineering & Technology, Lahore 54890, Pakistan.
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Sharkey J, Johnson CM, Dean WR. Physical limitations in meal preparation and consumption are associated with lower musculoskeletal nutrient (calcium, vitamin D, magnesium, and phosphorus) intakes in homebound older adults. J Nutr Health Aging 2012; 16:675-7. [PMID: 23076508 DOI: 10.1007/s12603-012-0035-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Although homebound older adults are at increased risk for poor nutritional health and adverse nutrition-related outcomes, little attention has focused on the tasks involved in meal preparation and consumption and the influence of those tasks on dietary intake. METHODS We examined the self-reported dietary intake from 3, 24-h dietary recalls and physical limitations in meal preparation and consumption (LMPC) activities from a randomly recruited sample of 345 homebound older men and women. Ordered logistic regression was used to examine the correlation of demographic characteristics and 6 activities with relative intakes of key musculoskeletal nutrients (calcium, vitamin D, magnesium, and phosphorus). RESULTS At least 70% reported not meeting ⅔ recommended intakes for calcium and vitamin D; 12.5% failed to achieve ⅔ recommended intakes in at least three of the four nutrients. More than 12% of the sample reported it was very difficult or they were unable to perform at least 3 LMPC tasks. Regression results indicated that reporting the greatest LMPC increased the odds for lower intake of musculoskeletal nutrients. CONCLUSION Independent of sociodemographic characteristics, self-reported difficulty in meal preparation and consumption was associated with lower dietary intakes of musculoskeletal nutrients. These results suggest the need to assess difficulty in meal preparation and consumption for the growing population of homebound older adults who participate in supplemental nutrition programs. This brief, 6-item measure may help identify older adults at risk of poor nutritional health and declining function.
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Affiliation(s)
- J Sharkey
- Texas Healthy Aging Research Network Collaborating Center, TX, USA.
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Rasic-Milutinovic Z, Perunicic-Pekovic G, Jovanovic D, Gluvic Z, Cankovic-Kadijevic M. Association of blood pressure and metabolic syndrome components with magnesium levels in drinking water in some Serbian municipalities. J Water Health 2012; 10:161-9. [PMID: 22361711 DOI: 10.2166/wh.2012.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Chronic exposure to insufficient levels of magnesium (Mg) in drinking water increases the risk of magnesium deficiency and its association with hypertension, dyslipidemia and type 2 diabetes mellitus. The aim of the study was to assess the potential association of mineral contents in drinking water with blood pressure and other components of metabolic syndrome (MetS) (BMI as measure of obesity, triglycerides, glucose, and insulin resistance, index-HOMA IR), in a healthy population. This study was conducted in three randomly selected municipalities (Pozarevac, Grocka and Banovci), and recruited 90 healthy blood donors, aged 20-50 years. The Pozarevac area had a four times higher mean Mg level in drinking water (42 mg L(-1)) than Grocka (11 mg L(-1)). Diastolic blood pressure was lowest in subjects from Pozarevac. Serum Mg (sMg) was highest, and serum Ca(2+)/Mg (sCa/Mg) lowest in subjects from Pozarevac, and after adjustment for confounders (age, gender, BMI), only total cholesterol and sMg levels were independent predictors of diastolic blood pressure, sMg levels were independent predictors of triglycerides, and sCa/Mg predicted glucose levels. These results suggest that Mg supplementation in areas of lower magnesium levels in drinking water may be an important measure in the prevention of hypertension and MetS in general.
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Lecube A, Baena-Fustegueras JA, Fort JM, Pelegrí D, Hernández C, Simó R. Diabetes is the main factor accounting for hypomagnesemia in obese subjects. PLoS One 2012; 7:e30599. [PMID: 22291997 PMCID: PMC3265490 DOI: 10.1371/journal.pone.0030599] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Accepted: 12/22/2011] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Type 2 diabetes (T2DM) and obesity are associated with magnesium deficiency. We aimed to determine whether the presence of type 2 diabetes and the degree of metabolic control are related to low serum magnesium levels in obese individuals. METHODS A) Case-control study: 200 obese subjects [50 with T2DM (cases) and 150 without diabetes (controls)] prospectively recruited. B) Interventional study: the effect of bariatric surgery on serum magnesium levels was examined in a subset of 120 obese subjects (40 with type 2 diabetes and 80 without diabetes). RESULTS Type 2 diabetic patients showed lower serum magnesium levels [0.75±0.07 vs. 0.81±0.06 mmol/L; mean difference -0.06 (95% CI -0.09 to -0.04); p<0.001] than non-diabetic patients. Forty-eight percent of diabetic subjects, but only 15% of non-diabetic subjects showed a serum magnesium concentration lower than 0.75 mmol/L. Significant negative correlations between magnesium and fasting plasma glucose, HbA1c, HOMA-IR, and BMI were detected. Multiple linear regression analysis showed that fasting plasma glucose and HbA1c independently predicted serum magnesium. After bariatric surgery serum magnesium increased only in those patients in whom diabetes was resolved, but remain unchanged in those who not, without difference in loss weight between groups. Changes in serum magnesium negatively correlated with changes in fasting plasma glucose and HbA1c. Absolute changes in HbA1c independently predicted magnesium changes in the multiple linear regression analysis. CONCLUSIONS Our results provide evidence that the presence of diabetes and the degree of metabolic control are essential in accounting for the lower levels of magnesium that exist in obese subjects.
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Affiliation(s)
- Albert Lecube
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Diabetes and Metabolism Research Unit, Endocrinology Department, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Uteva AG, Pimenov LT. [Magnesium deficiency and anxiety-depressive syndrome in elderly patients with chronic heart failure]. Adv Gerontol 2012; 25:427-432. [PMID: 23289218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The combination of a magnesium deficiency, heart failure and anxiety-depressive disorders are accompanied by the imposition of symptoms, differential diagnosis difficulties and requires special attention in treating elderly and senile patients. The study of 74 patients with chronic heart failure of 60 to 95 years in urban medical district revealed that the majority of people had depressive disorders, disturbances of electrical stability of the heart in the form of increasing the duration of the QT interval and magnesium deficiency. Frequency and severity of the latter increase with age, increase of a functional class of heart failure, worsening the severity of anxiety-depressive syndrome and prolongation QT.
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Talebi M, Savadi-Oskouei D, Farhoudi M, Mohammadzade S, Ghaemmaghamihezaveh S, Hasani A, Hamdi A. Relation between serum magnesium level and migraine attacks. Neurosciences (Riyadh) 2011; 16:320-323. [PMID: 21983373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE The determination of serum magnesium levels in migraine. METHODS In a case control study performed between January 2007 and December 2007 at Tabriz University of Medical Sciences, Tabriz, Iran, 140 migraine patients were enrolled and their level of serum magnesium was determined and the results were compared with 140 healthy people who did not have any headache, kidney, or gastrointestinal disorders, and no consumption of magnesium complements. RESULTS Migraine patients (22 male, 118 female) with a mean age of 33.82+/-10.31 and 140 healthy people (26 male, 114 female) with a mean age of (34.19+/-9.95) were enrolled. Forty patients had aura and 100 patients did not have aura. The average serum magnesium level in the patient group (26.14+/-4.3) was significantly lower than the control (31.09+/-4.32) group (p=0.000). There was no significant difference between the mean level of serum magnesium in patients with migraine with aura and without aura, however, there was a significant linear relationship between the amount of serum magnesium and the frequency of headache. CONCLUSION Serum magnesium in migraine patients was significantly lower than the normal population and related to the frequency of migraine attacks, supporting the use of magnesium in prevention and treatment of migraine.
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Affiliation(s)
- Mahnaz Talebi
- Department of Neurology, Tabriz University of Medical Sciences, Tabriz, Iran
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Ulger Z, Ariogul S, Cankurtaran M, Halil M, Yavuz BB, Orhan B, Kavas GO, Aribal P, Canlar S, Dede DS, Ozkayar N, Akyol O. Intra-erythrocyte magnesium levels and their clinical implications in geriatric outpatients. J Nutr Health Aging 2010; 14:810-4. [PMID: 21125197 DOI: 10.1007/s12603-010-0121-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Magnesium deficiency has been implicated as a factor in numerous chronic diseases and previous studies suggest a greater prevalence of occult magnesium deficiency among older adults. Serum is the choice for the assessment of most analyses used in clinical medicine, although serum magnesium concentrations have been shown to be poor predictors of intracellular magnesium concentration. The aim of this study was to compare intracellular and extracellular magnesium concentrations in geriatric outpatients. Moreover, we examined whether a significant correlation between magnesium parameters and clinical outcome existed. DESIGN Cross-sectional study. SETTING Geriatric medicine outpatient clinic of a university hospital. PARTICIPANTS A total of 246 patients with a mean age of 71.9 ± 5.7 years were involved. MEASUREMENTS Intra-erythrocyte magnesium levels were analyzed with atomic absorption spectrophotometry. RESULTS Serum magnesium levels were within normal range in all patients, whereas intra-erythrocyte magnesium measurements were low in 57% of the patients. Increase in serum levels were together with just only a slightly increase in intra-erythrocyte measurements and the relationship was very weak. Intra-erythrocyte Mg levels were not significantly correlated with many laboratory or clinical parameters. CONCLUSION Our results confirm that intra-erythrocyte Mg does not correlate with serum levels and clinical parameters in geriatric outpatients, but further studies are needed to define the correlation.
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Affiliation(s)
- Z Ulger
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Ankara, Turkey.
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Simmons D, Joshi S, Shaw J. Hypomagnesaemia is associated with diabetes: Not pre-diabetes, obesity or the metabolic syndrome. Diabetes Res Clin Pract 2010; 87:261-6. [PMID: 20004036 DOI: 10.1016/j.diabres.2009.11.003] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 10/29/2009] [Accepted: 11/02/2009] [Indexed: 12/15/2022]
Abstract
AIMS The mechanism for the association between diabetes and hypomagnesaemia remains uncertain. This study aimed to test whether hypomagnesaemia is present in pre-diabetes, obesity and the metabolic syndrome. METHODS 1453 adults from randomly selected households from rural Victoria, Australia, attended for biomedical assessment. Serum magnesium concentrations, hypomagnesaemia defined using local laboratory criteria (<0.70mmol/l), and defined by the bottom quintile of serum magnesium concentrations, were compared in different diabetes pre-cursor states including metabolic syndrome using ATP III criteria. RESULTS The mean serum magnesium was 0.84+/-0.06mmol/l and 25 (1.7%) had a low magnesium. Mean magnesium was lower among those with known diabetes than those with new diabetes, impaired glucose tolerance (IGT), impaired fasting glucose (IFG) and normal subjects (0.79 (0.78-0.81) vs 0.83 (0.81-0.86); 0.84 (0.82-0.85); 0.84 (0.82-0.86); 0.85 (0.84-0.85)mmol/l). After adjusting for confounders, and compared with those without diabetes, hypomagnesaemia was 10.51 (1.37-80.60)-fold more common with new diabetes, 8.63 (2.20-33.90)-fold more common with known diabetes, 6.77 (1.75-26.17)-fold more common among those taking anti-hypertensive medication but with no difference to those with IGT/IFG (0.90 (0.10-8.10)). CONCLUSION Diabetes is associated with hypomagnesaemia, but not its pre-cursor states.
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Affiliation(s)
- David Simmons
- Institute of Metabolic Science, Cambridge University Hospitals NHS Foundation Trust, UK.
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Al-Osali ME, Al-Qassabi SS, ElSayed MK. Hypomagnesemia in type 2 diabetic Omani patients. Saudi Med J 2009; 30:897-901. [PMID: 19618003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVE To study serum total magnesium (Mg) levels in type 2 diabetic Omani patients, and to find the relation between Mg levels and glycosylated hemoglobin (HbA1c), body mass index (BMI), and age of the patient. METHODS This work was carried out at the Bousher Polyclinic, Muscat, Oman from January to October 2008. We compared 34 type 2 diabetic patients with non-diabetic subjects as regards serum total Mg. We assessed diabetic patients in terms of age, gender, HbA1c, BMI, and their medications. Subjects at risk for apparent causes of hypomagnesemia or hypermagnesemia were excluded. RESULTS The mean serum total Mg level was 0.92 mmol/L (SD 0.06) in the control subjects, and 0.81 mmol/L (SD 0.08) in the diabetic group, and although almost all our diabetic patients have no hypomagnesemia, their levels of serum total Mg were significantly reduced compared with control subjects. T-test shows that our diabetics have significantly lower total Mg levels with a difference of 0.12 mmol/L (p=0.000) irrespective of age and gender. The Mg levels are positively correlated with age, but no correlation with HbA1c and BMI. CONCLUSION Although ionized and intracellular Mg levels are more reliable than total serum Mg in assessing Mg deficiency, low total serum levels of Mg are frequently seen in individuals with type 2 diabetes. Further studies on the role of Mg supplementation in the prevention of type 2 diabetes mellitus and its complications and similar studies in type 1 diabetes mellitus are recommended.
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Affiliation(s)
- Magdi E Al-Osali
- Department of Internal Medicie, Bousher Polyclinic, Post Code 118, Muscat, Oman.
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Lima MDL, Cruz T, Rodrigues LE, Bomfim O, Melo J, Correia R, Porto M, Cedro A, Vicente E. Serum and intracellular magnesium deficiency in patients with metabolic syndrome--evidences for its relation to insulin resistance. Diabetes Res Clin Pract 2009; 83:257-62. [PMID: 19124169 DOI: 10.1016/j.diabres.2008.11.019] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Revised: 11/09/2008] [Accepted: 11/13/2008] [Indexed: 12/15/2022]
Abstract
This cross sectional study evaluated serum (SMg) and intramononuclear (MMg) magnesium in patients with metabolic syndrome without diabetes and correlated them with cardiovascular risk factors. 72 patients and 57 controls (blood donors) were studied. Hypomagnesemia (SMg<1.7 mg/dL) was seen in 23.2% and intracellular depletion in 36.1% of the patients. SMg and MMg means were significantly lower in patients than in controls: 1.80+/-0.18 mg/dL vs. 2.43+/-0.43 mg/dL and 0.98+/-0.55 microg/mg vs. 1.67+/-0.64 microg/mg of protein (P<0.001). Inverse correlation was observed between, SMg and MMg with BMI; SMg with systolic blood pressure and waist circumference in women. Patients with acanthosis nigricans had lower SMg (1.75+/-0.18 mg/dL vs. 1.85+/- 0.18 mg/dL, P<0.05). Non-white people had lower SMg (1.78+/-0.16 mg/dL vs. 1.92+/-0.24 mg/dL, P=0.007) and MMg (0.95+/-0.59 microg/mg vs. 1.13+/-0.42 microg/mg, P=0.03). Patients with IR showed lower MgM means (0.84+/-0.33 microg/mg vs. 1.14+/-0.69 microg/mg, P<0.05). The same occurred in patients with low HDL-c levels (0.92+/-0.46 microg/mg vs. 1.20+/-0.70 microg/mg, P=0.03), and those with moderate and severe hepatic steatosis (0.77+/-0.29 microg/mg vs. 1.21+/-0.80 microg/mg, P<0.05). In conclusion, magnesium depletion in serum and mononuclear cells is common in obese people with metabolic syndrome, and it is more evident in non-white people with insulin resistance. This depletion may contribute to a post-receptor insulin resistance.
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Sheybani A, Geraci SA. When should serum magnesium be measured prior to non-cardiac surgery? J Miss State Med Assoc 2008; 49:295-298. [PMID: 19297917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
While prospective data is scant, the advisability of magnesium measurement appears to be convincing in selected circumstances. Electrolyte abnormalities, mainly hypokalemia and hypomagnesemia, are associated with an increased risk for developing cardiac arrhythmias, however, conflicting opinions remain. If performed on all patients undergoing non-cardiac surgery, magnesium measurement would add considerably to health care costs; however, if limited to patients identified as high risk by the above parameters, the additional cost per patient is in keeping with other standard tests. Given the low cost of testing and replacement, preoperative magnesium measurement appears reasonable in patients with structural heart disease, diabetes, chronic alcoholism, and chronic (loop) diuretic use. When high risk patients are undergoing high risk operations, the low cost of measurement and replacement appears particularly cost-effective, whether it reduces morbidity and prolonged hospitalization from atrial fibrillation or mortality from sustained ventricular arrhythmias. Until additional data becomes available, use of this simple test in patients likely to manifest hypomagnesemia who are at elevated risk of cardiac tachyarrhythmias and cardiac complications following non-cardiac surgery seems prudent.
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Affiliation(s)
- Ali Sheybani
- GV (Sonny) Montgomery VA Medical Center, Jackson, USA
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Lee WTK, Ip KS, Chan JSH, Lui NWM, Young BWY. Increased prevalence of constipation in pre-school children is attributable to under-consumption of plant foods: A community-based study. J Paediatr Child Health 2008; 44:170-5. [PMID: 17854410 DOI: 10.1111/j.1440-1754.2007.01212.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIM To evaluate consumption of foods rich in dietary fibre and its relation to the prevalence of constipation in pre-school children. METHODS In total, 368 children aged 3-5 years were randomly selected from kindergartens in Hong Kong. Constipation was confirmed by Rome-criteria. Children with normal bowel habits served as non-constipated controls. Consumption of vegetables, fruits, whole-grain cereals and fluid were determined using a 3-day food record. RESULTS A total of 28.8% children were reported to have constipation. Median dietary fibre intake of constipated children was significantly lower than non-constipated children (3.4 g/d (inter-quartile range (IQR): 2.3-4.6 g/d) vs. 3.8 g/d (IQR: 2.7-4.9 g/d); P = 0.044) corresponding to 40% reference dietary fibre intake. Constipated children also had significantly lower intakes of vitamin C (P = 0.041), folate (P = 0.043) and magnesium (P = 0.002). Fruit intake and total plant foods intake were significantly lower in the constipated than non-constipated children: (61 g/d (IQR: 23.8-115 g/d) vs. 78 g/d (IQR: 41.7-144.6 g/d); P = 0.047) and (142.5 g/d (IQR: 73.7-214.7 g/d) vs. 161.1 g/d (IQR: 98.3-233.3 g/d); P = 0.034), respectively. Total fluid intake did not differ between groups but milk intake among the constipated children was marginally higher than the non-constipated children (P = 0.055) CONCLUSION Insufficient dietary fibre intake is common in Hong Kong pre-school children. Constipated children had significantly lower intakes of dietary fibre and micronutrients including vitamin C, folate and magnesium than non-constipated counterparts which was attributable to under-consumption of plant foods. However, milk intake was marginally higher in the constipated children. More public education is necessary for parents to help develop healthy dietary habit and bowel habit in early life in order to prevent childhood constipation.
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Affiliation(s)
- Warren T K Lee
- Division of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK.
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Seyoum B, Siraj ES, Saenz C, Abdulkadir J. Hypomagnesemia in Ethiopians with diabetes mellitus. Ethn Dis 2008; 18:147-151. [PMID: 18507265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Magnesium, the second most abundant intracellular cation, plays a key role in cellular metabolism. Even though hypomagnesemia has been demonstrated in patients with both type 1 and type 2 diabetes elsewhere, limited information exists from African patients with diabetes mellitus. METHODS This was a cross-sectional study to assess the prevalence of hypomagnesemia in Ethiopian patients with type 1 and type 2 diabetes. A total of 159 subjects were included in the study (44 patients had type 1 diabetes, 69 patients had type 2, and 46 were nondiabetic controls). RESULTS The mean age (+/-standard error of the mean) of the subjects with type 1 diabetes, type 2 diabetes, and controls was 30.6+/-1.6, 51.3+/-1.3, and 29.0+/-1.7 years, respectively (P<.001). Patients with type 2 diabetes were significantly older than those with type 1 diabetes and controls. Basal C-peptide level and body mass index were also significantly higher in patients with type 2 diabetes (P<.001). The mean magnesium level was significantly lower in patients with diabetes than in controls (.84+/-.12 mmol/L vs 1.02+/-.17 mmol/L, P<.001). Hypomagnesemia was seen in 65% of the patients with diabetes. CONCLUSION The study showed that patients with diabetes mellitus have lower levels of magnesium and are therefore at increased risk of complications related to magnesium. In light of these potential complications, we recommend periodic determination of magnesium levels and appropriate magnesium replacements.
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Affiliation(s)
- Berhane Seyoum
- Division of Endocrinology, Diabetes and Metabolism, Wayne State University School of Medicine, Detroit, Michigan, USA.
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Tereshchenko IV. [Magnesium deficiency in an endocrinologist's practice]. Klin Med (Mosk) 2008; 86:47-51. [PMID: 18756748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The review concerning a value of magnesium in an organism in healthy persons and cases with endocrine disorders is presented. The causes of magnesium-deficient conditions in cases with type 1 and type 2 diabetes, thyrotoxic goiter, hypothyroidism and obesity were analyzed. Participation of magnesium in secretion of parathormone and a control of calcium exchange is shown. The clinical semiology of hypomagnesemia seems to be nonspecific and manifold, and, therefore, as a rule, in most of endocrine patients magnesium deficiency remains to be undiagnosed. Questions on preventive measures and management of treatment magnesium-deficient conditions are considered.
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