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1.
Hosp Pract (1995) ; 48(2): 80-85, 2020 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-32005074

RESUMO

BACKGROUND: The impact of admission serum magnesium on long-term mortality in hospitalized patients was unclear. This study aimed to assess the long-term mortality risk based on admission of serum magnesium in hospitalized patients. METHODS: This was a retrospective cohort study conducted at a tertiary referral hospital. We included all adult patients admitted to Mayo Clinic Hospital, Minnesota, between 1 January 2009 and 31 December 2013, who had available admission serum magnesium. We categorized serum magnesium into ≤1.4, 1.5-1.6, 1.7-1.8, 1.9-2.0, 2.1-2.2, ≥2.3 mg/dL. We estimated the 1-year mortality risk based on various admission serum magnesium levels using Kaplan-Meier plot and assessed the association of admission serum magnesium with 1-year mortality using Cox proportional hazard analysis. We selected serum magnesium of 1.7-1.8 mg/dL as the reference group for mortality comparison. RESULTS: We included a total of 65,974 patients, with a mean admission serum magnesium of 1.9 ± 0.3 mg/dL in this study. The 1-year mortality was 15.7%, 15.8%, 15.5%, 16.7%, 19.0%, and 25.6% in admission serum magnesium of ≤1.4, 1.5-1.6, 1.7-1.8, 1.9-2.0, 2.1-2.2, ≥2.3 mg/dL, respectively (p < 0.001). After adjustment for confounders, admission serum magnesium of 1.9-2.0, 2.1-2.2, and ≥2.3 mg/dL were significantly associated with increased 1-year mortality compared with magnesium of 1.7-1.8 mg/dL with adjusted HR of 1.09 (95% CI 1.02-1.15), 1.22 (95% CI 1.14-1.30), and 1.55 (95% CI 1.45-1.55), respectively. There was no significant difference in 1-year mortality risk between low serum magnesium ≤1.6 mg/dL and magnesium of 1.7-1.8 mg/dL. CONCLUSION: Hypermagnesemia, but not hypomagnesemia, at the time of hospital admission was associated with increased 1-year mortality among hospitalized patients.


Assuntos
Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Deficiência de Magnésio/sangue , Deficiência de Magnésio/complicações , Magnésio/sangue , Admissão do Paciente/estatística & dados numéricos , Valor Preditivo dos Testes , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Centros de Atenção Terciária
2.
Clin Biochem ; 75: 48-52, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31786206

RESUMO

INTRODUCTION: The significance of hypomagnesemia and the need for treatment are under-recognized in clinical practice. Our objective was to design, establish, and test two interventions to screen for patients with hypomagnesemia and increase the rate of treatment of hypomagnesemia in the Emergency Department (ED). MATERIAL AND METHODS: A prospective two-year study was conducted. The Laboratory Information System was set to automatically order plasma magnesium in ED patients with plasma calcium < 7.5 mg/dL (1.9 mmol/L) and/or plasma potassium < 2.5 mEq/L (2.5 mmol/L). We counted the number of identified cases of hypomagnesemia, and calculated the total economic cost per identified patient. The study had three periods "Central lab" "Stat lab" and "Stat lab with comment" according to the availability to measure plasma magnesium levels in the stat laboratory and the inclusion of an automatic comment in the laboratory report in cases of hypomagnesemia. We retrospectively reviewed the medical records of patients with magnesium < 1.5 mg/dL (0.6 mmol/L), to investigate whether they have been appropriately treated. RESULTS: A total of 410 plasma magnesium were measured due to our intervention; 179 due to hypokalemia and 231 due to hypocalcemia. Two hundred thirty (56.1%) of 410 showed hypomagnesemia. Each detected case resulted in reagent cost of 0.7$, when prompted by hypocalcemia, and 0.6$ when prompted by hypokalemia. The rate of patients with hypomagnesemia that were appropriately treated increased from 15% to 75% along the study period. CONCLUSIONS: Our strategies successfully identified patients with hypomagnesemia in the ED at a very affordable cost, and increased the percentage of patients with hypomagnesemia that received treatment.


Assuntos
Sistemas de Informação em Laboratório Clínico , Hipocalcemia/sangue , Hipopotassemia/sangue , Deficiência de Magnésio/diagnóstico , Deficiência de Magnésio/terapia , Magnésio/sangue , Idoso , Idoso de 80 Anos ou mais , Serviço Hospitalar de Emergência , Feminino , Humanos , Deficiência de Magnésio/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
3.
BMC Endocr Disord ; 19(1): 142, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856822

RESUMO

BACKGROUND: Pseudohypoparathyroidism(PHP) is a heterogeneous group of disorders due to impaired activation of c AMP dependant pathways following binding of parathyroid hormone (PTH) to its receptor. In PHP end organ resistance to PTH results in hypocalcaemia, hyperphosphataemia and high PTH levels. CASE PRESENTATION: A 59 year old male presented with a history of progressive impairment of speech and unsteadiness of gait for 1 week and acute onset altered behavior for 1 day and one episode of generalized seizure. His muscle power was grade four according to MRC (medical research council) scale in all limbs and Chovstek's and Trousseau's signs were positive. Urgent non contrast computed tomography scan of the brain revealed extensive bilateral cerebral and cerebellar calcifications. A markedly low ionized calcium level of 0.5 mmol/l, an elevated phosphate level of 9.5 mg/dl (reference range: 2.7-4.5 mg/dl) and an elevated intact PTH of 76.3 pg/l were noted. His renal functions were normal. His hypocalcemia was accentuated by the presence of hypomagnesaemia. His 25 hydroxy vitamin D level was only marginally low which could not account for severe hypocalcaemia. A diagnosis of pseudohypoparathyroidism without phenotypic defects, was made due to hypocalcaemia and increased parathyroid hormone levels with cerebral calcifications. The patient was treated initially with parenteral calcium which was later converted to oral calcium supplements. His coexisting Vitamin D deficiency was corrected with 1αcholecalciferol escalating doses. His hypomagnesaemia was corrected with magnesium sulphate parenteral infusions initially and later with oral preparations. With treatment there was a significant clinical and biochemical response. CONCLUSION: Pseudohypoparathyroidism can present for the first time in elderly resulting in extensive cerebral calcifications. Identification and early correction of the deficit will result in both symptomatic and biochemical response.


Assuntos
Calcinose/etiologia , Pseudo-Hipoparatireoidismo/complicações , Doenças da Coluna Vertebral/etiologia , Calcinose/sangue , Calcinose/diagnóstico , Calcinose/tratamento farmacológico , Cálcio/administração & dosagem , Cálcio/sangue , Humanos , Deficiência de Magnésio/sangue , Deficiência de Magnésio/complicações , Deficiência de Magnésio/diagnóstico , Deficiência de Magnésio/tratamento farmacológico , Sulfato de Magnésio/administração & dosagem , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo/sangue , Pseudo-Hipoparatireoidismo/sangue , Pseudo-Hipoparatireoidismo/diagnóstico , Pseudo-Hipoparatireoidismo/tratamento farmacológico , Doenças da Coluna Vertebral/sangue , Doenças da Coluna Vertebral/diagnóstico , Doenças da Coluna Vertebral/tratamento farmacológico , Vitamina D/administração & dosagem , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/tratamento farmacológico
4.
Saudi J Kidney Dis Transpl ; 30(5): 1032-1037, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31696840

RESUMO

Diabetic nephropathy (DN) is the most common microvascular complication observed in patients with type-2 diabetes mellitus. Furthermore, magnesium (Mg) deficiency is a common problem in diabetic patients. In this study, we estimated the levels of Mg, which is an important trace element and pro-oxidant marker, and then evaluated the association between serum Mg and pro-oxidants in patients with DN. In the present study, 200 patients were enrolled and were divided into two groups. The control and DN groups consisted of 100 healthy individuals and 100 patients with DN, respectively. Serum Mg, total anti-oxidant capacity (TAC), and superoxide dismutase (SOD) levels were estimated using the Calmagite, Koracevic, and Marklund and Marklund methods, respectively. Glutathione (GSH) and malondialdehyde (MDA) levels were estimated using the Tietze F and Jean CD method, respectively. Mg levels were found to be significantly decreased in the DN group in comparison to the control group. Anti-oxidant markers were statistically significantly reduced (P <0.001), whereas MDA levels were statistically significantly elevated (P <0.001) in the DN group compared to the control group. There was a significant positive association of Mg with TAC, SOD, and GSH. A statistically significant negative association of Mg with MDA (r = -0.302, P <0.001, n = 100) was also observed. An apparent relationship was observed between hypomagnesemia and oxidative stress in patients with DN. Lower levels of Mg and oxidative stress were also strongly linked.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/sangue , Deficiência de Magnésio/sangue , Magnésio/sangue , Oxidantes/sangue , Estresse Oxidativo , Idoso , Biomarcadores/sangue , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/etiologia , Feminino , Glutationa/sangue , Humanos , Deficiência de Magnésio/complicações , Deficiência de Magnésio/diagnóstico , Masculino , Malondialdeído/sangue , Pessoa de Meia-Idade , Fatores de Risco , Superóxido Dismutase/sangue
5.
Magnes Res ; 32(1): 1-15, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31503001

RESUMO

Magnesium is an essential bivalent cation. Its fine balance in human organism is extremely important and is involved in a wide range of functions. We need to maintain its amount in human organism within range considered as physiological. This is particularly true for elderly people, and especially for "frail" elderly people, whose systems and apparatuses are in a state of serious homeostatic precariousness. In fact, hypomagnesemia is involved in a very large range of pathological conditions (requiring multiple therapies) that could compromise elderly's autonomy. The aim of this review has been to go through the most important trials, in order to understand the direction taken by research during the last years and to detect the room for improvement in this field. We have tried to understand when magnesium content is truly physiological or pathological, and how we could prevent an inappropriately low magnesium intake in elderly people. First of all, we have remarked the absolute need of an adequate evaluation method for magnesium content in human organism. Current literature appropriately encourages the use of a synoptic assessment of magnesium serum concentration, urinary excretion, and dietary intake. We have also discussed the most important trials relating hypomagnesaemia with human pathology. Specific studies conducted on elderly patients have extensively demonstrated its decisive role in maintaining bone health, adequate glyco-metabolic compensation, a correct cardiac and vascular functional profile, and probably also a physiological psycho-cognitive profile. From the implications discussed above, therefore, it is essential to ensure physiological levels of magnesium in body, particularly in geriatric patient, itself more prone to a reduction in the level of cation. We have concluded, according to the literature, that the best way to prevent hypomagnesemia and its clinical implications in elderly subjects is represented by a proper diet (more fiber and complex carbohydrates, more vegetable proteins, less sugars and fats), which ensures an adequate supply of cation. If with diet alone (due to comorbidity or other concomitant factors) it has not been possible to guarantee suitable serum levels of cation, or in the case of a patient defined as "frail elderly", a reintegration therapy (per os) will be undertaken, after a careful analysis of renal function.


Assuntos
Envelhecimento/sangue , Dieta , Deficiência de Magnésio/prevenção & controle , Magnésio , Idoso , Idoso de 80 Anos ou mais , Suplementos Nutricionais , Humanos , Magnésio/administração & dosagem , Magnésio/sangue , Deficiência de Magnésio/sangue
6.
Magnes Res ; 32(1): 25-36, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31503003

RESUMO

INTRODUCTION: Magnesium (Mg) deficiency is associated with numerous non-communicable diseases. The aim of the study was to estimate the prevalence of hypomagnesemia in the general adult population of Northern Serbia (NS), and to determine the level of Mg in drinking water. METHODS: This is a cross-sectional study with 5,122 adults from the general population. Serum level of Mg was determined by spectrophotometry, while the level of Mg in the drinking water was done by atomic absorption spectrophotometry. Standard laboratory methods were used to determine individual's blood lipid status and complete blood count. RESULTS: The prevalence of hypomagnesemia (Mg < 0.75 mmol/L) in the general population was 2.7%, while the prevalence of the subjects with high risk for the Mg deficiency (Mg 0.75-0.85 mmol/L) was 20.1%. The public water supply showed variable values between 17.3-35.3 mg/L. Age, systolic blood pressure, duration of diabetes mellitus, and glycemia increase with the decrease of Mg level. In addition, increased level of Mg was associated with higher red blood cell count and hemoglobin levels. CONCLUSIONS: The prevalence of hypomagnesemia in Northern Serbia is low (2.7%) and level of Mg in drinking water is not satisfactory. Serum level of Mg in the range 0.75-0.85 mmol/L is present in about 1/5 of the population. Glycemia, advanced age, gender, and smoking have a predictive role in hypomagnesemia occurrence. There is a significant correlation between serum level of Mg and lifestyle and dietary habits.


Assuntos
Água Potável/química , Comportamento Alimentar , Estilo de Vida , Deficiência de Magnésio/sangue , Magnésio/análise , Adulto , Estudos Transversais , Feminino , Humanos , Magnésio/sangue , Deficiência de Magnésio/epidemiologia , Masculino , Prevalência , Fatores de Risco , Sérvia/epidemiologia , Adulto Jovem
7.
Psychiatr Danub ; 31(Suppl 3): 221-226, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488730

RESUMO

BACKGROUND: Both Vitamin D deficiency and magnesium deficiency have an increased prevalence and have been associated with an increased risk of and increased severity of symptoms in both depression and schizophrenia (Boerman 2016, Tarleton & Littenberg 2015). This effect appears more pronounced in younger populations and is often apparent from the time of initial diagnosis and is present with adjustment for confounding factors. Thus, the evidence suggests that Vitamin D and magnesium deficiency reflects not only dietary or somatic aspects of health but also may have a role in the pathophysiology of depression and schizophrenia. SUBJECTS AND METHODS: A single site audit of serum Vitamin D and magnesium levels in patients at an Acute Day Treatment Unit was carried out. Blood tests were performed on admission and analysed in house. Data were collected between April - June 2019 and was analysed subsequently, as described below (n=73). RESULTS: Our data show that our psychiatric day treatment unit cohort (n=73) had a higher proportion of vitamin D deficiency (52%) than the general population (40%), although due to the limited sample size this was not significant (p=0.22, Chi-squared test). The percentage of patients who were magnesium deficient was 78.6% (n=22/28). However, the F60 subgroup of patients with personality disorders showed a high prevalence of vit D deficiency (p=0.07), highlighting a trend towards significance despite the limited size of this subgroup. CONCLUSIONS: We carried out a single-site audit of serum vitamin D and magnesium levels in a psychiatric day unit population in order to assess the extent of vitamin deficiency in such patients. These data indicate that that the proportion of patients with vitamin D deficiency is higher than in the general population. Further larger analysis is needed to establish the statistical significance of these data and whether treatment with vitamin D supplementation improves outcomes.


Assuntos
Magnésio/sangue , Transtornos Mentais/sangue , Vitamina D/sangue , Estudos de Coortes , Humanos , Deficiência de Magnésio/sangue , Deficiência de Vitamina D/sangue
8.
Nutrients ; 11(9)2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31443510

RESUMO

Patients with obesity and type 2 diabetes mellitus (T2DM) are regarded to have reduced serum magnesium (Mg) concentrations. We aimed to assess the changes in serum Mg concentrations at 12-month follow-up in patients, with and without T2DM, who underwent one anastomosis gastric bypass surgery. Overall, 50 patients (80% female, age 42.2 (12.5) years) with morbid obesity (mean baseline BMI 43.8 (4.3) kg/m2) were included in the analysis. Half of the included patients had T2DM diagnosed at baseline, and these patients showed lower serum Mg concentration (0.78 (0.07)) vs. 0.83 (0.05) mmol/L; p = 0.006), higher blood glucose levels (129.9 (41.3) vs. 87.6 (8.1) mg/dL; p < 0.001) as well as HbA1c concentrations (6.7 (1.4) vs. 5.3 (0.5)%; p < 0.001). During follow-up, BMI and glucose levels showed a decrease; however, serum Mg levels remained stable. At baseline 42% of patients were found to be Mg deficient, which was reduced to 33% at six months and to 30% at 12 months follow-up. Moreover, patients with T2DM had an odds ratio of 9.5 (95% CI = 3.0-29.7; p < 0.001) for magnesium deficiency when compared to patients without T2DM. Further research into the role of Mg and its role in T2DM and other obesity-related comorbidities are needed.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Derivação Gástrica , Deficiência de Magnésio/sangue , Magnésio/sangue , Obesidade/cirurgia , Adulto , Biomarcadores/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Humanos , Deficiência de Magnésio/diagnóstico , Masculino , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/diagnóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
9.
Vopr Pitan ; 88(3): 78-83, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31265778

RESUMO

Insufficiency or deficiency of some micronutrients may be additional modifying factors that influence the pathogenesis of the disease and the effectiveness of standard pharmacotherapy. The aim of the study - to evaluate the level of magnesium and vitamin B2 in blood serum of patients with bronchial asthma and obesity in order to develop methods for individual correction of deficiency. Material and methods. The study included 51 children aged 12-17 years. The first group included 23 patients (12 girls and 11 boys) with asthma with comorbidities (obesity), and the second group consisted of 28 children (10 girls and 18 boys) with obesity. The concentration of magnesium in blood serum was determined by a colorimetric method without deproteinization, and vitamin B2 - by an immunological microbiological method. Results and discussion. When analyzing the concentration of magnesium in blood serum of the examined children, it was found that in patients with bronchial asthma and obesity, a reduced content of this mineral was observed in 15 (65.2%) patients. The average magnesium concentration was 0.66±0.02 mmol/l at a rate of 0.7-1.2 mmol/l. A statistically significant decrease in the magnesium level in children suffering from asthma and obesity was noted, compared with the level in children with obesity (0.66 [0.57; 0.73] vs 0.71 [0.67; 0.73] mmol/l, р<0.05). Low serum magnesium levels in obese patients were detected more rarely (р<0.05) - only in 6 (21.4%) children, mostly in patients with grade III obesity. The remaining 22 (78.6%) children had magnesium level within the normal range. Patients with low serum magnesium levels showed increased irritability, sleep disturbance, loss of memory and concentration. Vitamin B2 levels in all examined children were within the normal range (137-370 ng/ml). Conclusion. The results indicate a decrease in the concentration of magnesium and normal levels of vitamin B2 in serum in patients with bronchial asthma and obesity. Low serum magnesium levels were observed in children with low bronchial asthma control. To increase the effectiveness of therapy and control the symptoms of bronchial asthma, especially when combined with obesity, correction of the accompanying magnesium deficiency is necessary.


Assuntos
Asma/sangue , Deficiência de Magnésio/sangue , Magnésio/sangue , Obesidade/sangue , Riboflavina/sangue , Adolescente , Criança , Feminino , Humanos , Masculino
10.
Nutrients ; 11(7)2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31261707

RESUMO

Depression is common, places a large burden on the patient, their family and community, and is often difficult to treat. Magnesium supplementation is associated with improved depressive symptoms, but because the mechanism is unknown, it is unclear whether serum magnesium levels act as a biological predictor of the treatment outcome. Therefore, we sought to describe the relationship between serum magnesium and the Patient Health Questionnaire (PHQ, a measure of depression) scores. A cross-sectional analysis of medical records from 3604 adults (mean age 62 years; 42% men) seen in primary care clinics between 2015 and 2018, with at least one completed PHQ were included. The relationship between serum magnesium and depression using univariate analyses showed a significant effect when measured by the PHQ-2 (-0.19 points/mg/dL; 95% CI -0.31, -0.07; P = 0.001) and the PHQ-9 (-0.93 points/mg/dL; 95% CI -1.81, -0.06; P = 0.037). This relationship was strengthened after adjusting for covariates (age, gender, race, time between serum magnesium and PHQ tests, and presence of diabetes and chronic kidney disease) (PHQ-2: -0.25 points/mg/dL; 95% CI -3.33, -0.09; P < 0.001 and PHQ-9: -1.09 95% CI -1.96 -0.21; P = 0.015). For adults seen in primary care, lower serum magnesium levels are associated with depressive symptoms, supporting the use of supplemental magnesium as therapy. Serum magnesium may help identify the biological mechanism of depressive symptoms and identify patients likely to respond to magnesium supplementation.


Assuntos
Afeto , Depressão/sangue , Deficiência de Magnésio/sangue , Magnésio/sangue , Atenção Primária à Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos Transversais , Depressão/diagnóstico , Depressão/psicologia , Registros Eletrônicos de Saúde , Feminino , Humanos , Deficiência de Magnésio/diagnóstico , Deficiência de Magnésio/psicologia , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Medição de Risco , Fatores de Risco , Adulto Jovem
11.
J Ayub Med Coll Abbottabad ; 31(2): 226-229, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31094121

RESUMO

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.


Assuntos
Diabetes Mellitus Tipo 2 , Deficiência de Magnésio , Magnésio/sangue , Adulto , Glicemia/análise , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Hemoglobina A Glicada/análise , Humanos , Deficiência de Magnésio/sangue , Deficiência de Magnésio/epidemiologia , Masculino , Paquistão/epidemiologia
12.
Trans R Soc Trop Med Hyg ; 113(1): 31-35, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30325455

RESUMO

Background: Anaemia during pregnancy is associated with adverse maternal and child health. Investigations of anaemia and its predictors among pregnant women are needed for preventive measures. Methods: A cross-sectional study was conducted to investigate the prevalence and determinants of anaemia in early pregnancy in Khartoum, Sudan. Clinical characteristics were gathered using a questionnaire. Serum ferritin, magnesium and high-sensitivity C-reactive protein (hs-CRP) were measured using different laboratory methods. Results: Of the 180 women in the study, 65.0% had anaemia (haemoglobin [Hb] <11 g/dl), 0.6% had severe anaemia (Hb <7 g/dl), 38.9% had iron deficiency (serum ferritin <15 µg/l), 30.6% had iron deficiency anaemia (<11 g/dl and serum ferritin <15 µg/l) and 57.2% had magnesium deficiency (<1.80 mg/dl). There was no significant difference in the age, parity, gestational age, body mass index (BMI) and hs-CRP between anaemic and non-anaemic pregnant women. Anaemic pregnant women had significantly lower levels of serum ferritin and serum magnesium. While age, parity, gestational age, BMI and hs-CRP were not associated with anaemia, low serum ferritin (odds ratio [OR] 0.97 [95% confidence interval {CI} 0.96 to 0.99]) and low serum magnesium (OR 0.91 [95% CI 0.84 to 0.99]) were associated with anaemia. There were significant positive correlations between Hb and serum ferritin (r=0.382, p<0.001) and serum magnesium (r=0.192, p=0.010). Conclusion: The role of magnesium as a possible contributing factor to anaemia in pregnancy has important implications for prevention and treatment of these women.


Assuntos
Anemia Ferropriva/etiologia , Ferro/deficiência , Deficiência de Magnésio/complicações , Magnésio/sangue , Estado Nutricional , Complicações na Gravidez/etiologia , Adulto , Anemia/sangue , Anemia/epidemiologia , Anemia/etiologia , Anemia/prevenção & controle , Anemia Ferropriva/sangue , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/prevenção & controle , Proteína C-Reativa/metabolismo , Estudos Transversais , Feminino , Ferritinas/sangue , Idade Gestacional , Hemoglobinas/metabolismo , Humanos , Ferro/sangue , Deficiência de Magnésio/sangue , Deficiência de Magnésio/epidemiologia , Razão de Chances , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/prevenção & controle , Prevalência , Sudão/epidemiologia , Inquéritos e Questionários
13.
Am J Ther ; 26(1): e124-e132, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-28471760

RESUMO

BACKGROUND: Vitamin D and magnesium (Mg) are some of the most studied topics in medicine with enormous implications for human health and disease. Majority of the adults are deficient in both vitamin D and magnesium but continue to go unrecognized by many health care professionals. AREAS OF UNCERTAINTY: Mg and vitamin D are used by all the organs in the body, and their deficiency states may lead to several chronic medical conditions. Studies described in the literature regarding these disease associations are contradictory, and reversal of any of these conditions may not occur for several years after adequate replacement. One should consider the supplementation therapy to be preventative rather than curative at this time. DATA SOURCES: PubMed search of several reported associations between vitamin D and Mg with diseases. RESULTS: Vitamin D and Mg replacement therapy in elderly patients is known to reduce the nonvertebral fractures, overall mortality, and the incidence of Alzheimer dementia. CONCLUSIONS: Vitamin D screening assay is readily available, but the reported lower limit of the normal range is totally inadequate for disease prevention. Based on the epidemiologic studies, ∼75% of all adults worldwide have serum 25(OH)D levels of <30 ng/mL. Because of the recent increase in global awareness, vitamin D supplementation has become a common practice, but Mg deficiency still remains unaddressed. Screening for chronic magnesium deficiency is difficult because a normal serum level may still be associated with moderate to severe deficiency. To date, there is no simple and accurate laboratory test to determine the total body magnesium status in humans. Mg is essential in the metabolism of vitamin D, and taking large doses of vitamin D can induce severe depletion of Mg. Adequate magnesium supplementation should be considered as an important aspect of vitamin D therapy.


Assuntos
Suplementos Nutricionais , Deficiência de Magnésio/tratamento farmacológico , Magnésio/administração & dosagem , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/administração & dosagem , Doença Crônica/tratamento farmacológico , Interações Medicamentosas , Humanos , Magnésio/sangue , Magnésio/metabolismo , Magnésio/farmacologia , Deficiência de Magnésio/sangue , Deficiência de Magnésio/diagnóstico , Deficiência de Magnésio/epidemiologia , Recomendações Nutricionais , Vitamina D/sangue , Vitamina D/metabolismo , Vitamina D/farmacologia , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/epidemiologia
14.
J Am Coll Nutr ; 38(1): 31-39, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30160617

RESUMO

BACKGROUND: Hypomagnesemia could worsen glycemic control by impairing insulin release and promoting insulin resistance. On the contrary, type 2 diabetes mellitus (T2DM) may induce and/or exacerbate low serum magnesium levels, and this could, in turn, worsen glycemic control of diabetes. OBJECTIVE: The aim of this study was to investigate the relationship between serum magnesium level, dietary magnesium intake, and metabolic control parameters in patients with T2DM. METHODS: The study included 119 patients with T2DM (26 male, 93 female; mean age 54.7 ± 8.4 years). Serum magnesium level was measured by spectrophotometric method. Magnesium intake was assessed by food frequency questionnaire. Anthropometric measurements were taken. The General Linear Model procedure was applied to determine the relationship of serum magnesium with quantitative variables. RESULTS: Of the 119 patients, 23.5% of the patients had inadequate magnesium intake (lower than 67% of the recommended daily allowance), and 18.5% had hypomagnesemia. In patients with hypomagnesemia (< 0.75 mmol/l), serum levels of fasting plasma glucose (FPG), postprandial plasma glucose (PPG), and serum glycosylated hemoglobin (HbA1c) were higher compared to patients with normomagnesemia. FPG levels were significantly higher in patients with hypomagnesemia in Model 1 (179.0 ± 64.9 vs. 148.7 ± 52.0 mg/dl, p = 0.009) but the significance disappeared in other models. PPG levels were significantly higher in patients with hypomagnesemia in all models (287.9 ± 108.4 vs. 226.8 ± 89.4 mg/dl, p = 0.006 for Model 1, p = 0.027 for Model 2, p = 0.016 for Model 3). Serum HbA1c levels were significantly higher in patients with hypomagnesemia, and this significance proceeded (8.0 ± 1.9% vs. 6.5 ± 1.2%, p = 0.000 for all models). Body fat mass was significantly higher in patients with hypomagnesemia as compared to patients with normomagnesemia in model 3 (35.4 ± 9.4 kg, 34.6 ± 10.2 kg; p = 0.034). Dietary magnesium intake was not significantly associated with either metabolic parameters or anthropometric measurements. CONCLUSION: Hypomagnesemia in T2DM is directly associated with poor metabolic control. Clinical assessment should, therefore, focus on augmentation of magnesium status and adequate magnesium intake in patients with T2DM.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Dieta , Deficiência de Magnésio/complicações , Magnésio/sangue , Glicemia/metabolismo , Composição Corporal/fisiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Resistência à Insulina/fisiologia , Magnésio/administração & dosagem , Deficiência de Magnésio/sangue , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Inquéritos e Questionários
15.
J Nephrol ; 32(1): 93-100, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30465137

RESUMO

AIMS: Cardiovascular (CV) complications are common in chronic kidney disease (CKD). Numerous metabolic disturbances including hyperphosphatemia, high circulating calciprotein particles (CPP), hyperparathyroidism, metabolic acidosis, and magnesium deficiency are associated with, and likely pathogenic for CV complications in CKD. The goal of this feasibility study was to determine whether effervescent calcium magnesium citrate (EffCaMgCit) ameliorates the aforementioned pathogenic intermediates. METHODS: Nine patients with Stage 3 and nine patients with Stage 5D CKD underwent a randomized crossover study, where they took EffCaMgCit three times daily for 7 days in one phase, and a conventional phosphorus binder calcium acetate (CaAc) three times daily for 7 days in the other phase. Two-hour postprandial blood samples were obtained on the day before and on the 7th day of treatment. RESULTS: In Stage 5D CKD, EffCaMgCit significantly increased T50 (half time for conversion of primary to secondary CPP) from baseline by 63% (P = 0.013), coincident with statistically non-significant declines in serum phosphorus by 25% and in saturation of octacalcium phosphate by 35%; CaAc did not change T50. In Stage 3 CKD, neither EffCaMgCit nor CaAc altered T50. With EffCaMgCit, a significant increase in plasma citrate was accompanied by statistically non-significant increase in serum Mg and phosphate. CaAc was without effect in any of these parameters in Stage 3 CKD. In both Stages 3 and 5D, both drugs significantly reduced serum parathyroid hormone. Only EffCaMgCit significantly increased serum bicarbonate by 3 mM (P = 0.015) in Stage 5D. CONCLUSIONS: In Stage 5D, EffCaMgCit inhibited formation of CPP, suppressed PTH, and conferred magnesium and alkali loads. These effects were unique, since they were not observed with CaAc. In Stage 3 CKD, neither of the regimens have any effect. These metabolic changes suggest that EffCaMgCit might be useful in protecting against cardiovascular complications of CKD by ameliorating pathobiologic intermediates.


Assuntos
Acidose/prevenção & controle , Doenças Cardiovasculares/prevenção & controle , Ácido Cítrico/uso terapêutico , Hiperfosfatemia/prevenção & controle , Deficiência de Magnésio/prevenção & controle , Compostos Organometálicos/uso terapêutico , Insuficiência Renal Crônica/tratamento farmacológico , Equilíbrio Ácido-Base/efeitos dos fármacos , Acidose/sangue , Acidose/diagnóstico , Acidose/etiologia , Idoso , Bicarbonatos/sangue , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Ácido Cítrico/efeitos adversos , Ácido Cítrico/sangue , Estudos Cross-Over , Estudos de Viabilidade , Feminino , Humanos , Concentração de Íons de Hidrogênio , Hiperfosfatemia/sangue , Hiperfosfatemia/diagnóstico , Hiperfosfatemia/etiologia , Magnésio/sangue , Deficiência de Magnésio/sangue , Deficiência de Magnésio/diagnóstico , Deficiência de Magnésio/etiologia , Masculino , Pessoa de Meia-Idade , Compostos Organometálicos/efeitos adversos , Compostos Organometálicos/sangue , Hormônio Paratireóideo/sangue , Fosfatos/sangue , Fósforo/sangue , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/diagnóstico , Texas , Fatores de Tempo , Resultado do Tratamento
16.
Nutrients ; 10(12)2018 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-30513803

RESUMO

Magnesium is essential for maintaining normal cellular and organ function. In-adequate magnesium balance is associated with various disorders, such as skeletal deformities, cardiovascular diseases, and metabolic syndrome. Unfortunately, routinely measured serum magnesium levels do not always reflect total body magnesium status. Thus, normal blood magnesium levels eclipse the wide-spread magnesium deficiency. Other magnesium measuring methods, including the magnesium loading test, may provide more accurate reflections of total body magnesium status and thus improve identification of magnesium-deficient individuals, and prevent magnesium deficiency related complications.


Assuntos
Dieta , Deficiência de Magnésio/diagnóstico , Magnésio/administração & dosagem , Eritrócitos/química , Reações Falso-Negativas , Humanos , Magnésio/sangue , Deficiência de Magnésio/sangue , Deficiência de Magnésio/complicações , Necessidades Nutricionais , Estado Nutricional , Recomendações Nutricionais
18.
Nutrients ; 10(9)2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-30200431

RESUMO

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.


Assuntos
Deficiência de Magnésio/diagnóstico , Magnésio/sangue , Avaliação Nutricional , Estado Nutricional , Biomarcadores/sangue , Dieta Saudável , Absorção Gastrointestinal , Humanos , Deficiência de Magnésio/sangue , Deficiência de Magnésio/epidemiologia , Deficiência de Magnésio/fisiopatologia , Valor Preditivo dos Testes , Recomendações Nutricionais , Reprodutibilidade dos Testes , Fatores de Risco , Distribuição Tecidual
19.
Nutrients ; 10(6)2018 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-29882768

RESUMO

Magnesium (Mg) status has recently drawn close attention in chronic kidney disease and in kidney transplant recipients. This review aims to evaluate the body of evidence linking hypomagnesemia to clinical consequences in these specific populations. After a brief summary of the main mechanisms involved in Mg regulation and of Mg status in end-stage renal disease, the review focuses on the relationship between hypomagnesemia and cardiovascular risk in kidney transplant recipients. A body of evidence in recent studies points to a negative impact of hypomagnesemia on post-transplant diabetes mellitus (PTDM) and cardiovascular risk, which currently represent the main threat for morbidity and mortality in kidney transplantation. Deleterious biological mechanisms induced by hypomagnesemia are also discussed. While data analysis enables us to conclude that hypomagnesemia is linked to the development of PTDM, studies prospectively evaluating the impact of hypomagnesemia correction after kidney transplantation are still lacking and needed.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim , Rim/cirurgia , Deficiência de Magnésio/sangue , Magnésio/sangue , Animais , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Humanos , Rim/metabolismo , Rim/fisiopatologia , Falência Renal Crônica/sangue , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/fisiopatologia , Transplante de Rim/efeitos adversos , Deficiência de Magnésio/epidemiologia , Deficiência de Magnésio/fisiopatologia , Eliminação Renal , Reabsorção Renal , Fatores de Risco , Resultado do Tratamento
20.
Nephron ; 139(4): 359-366, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29791908

RESUMO

Mutations in the KCNA1 gene encoding the voltage-gated potassium (K+) channel Kv1.1 have been linked to rare neurological syndromes, episodic ataxia type 1 (EA1) and myokymia. In 2009, a KCNA1 mutation was identified in a large family with autosomal dominant hypomagnesemia. Despite efforts in establishing a genotype-phenotype correlation for the wide variety of symptoms in EA1, little is known on the serum magnesium (Mg2+) levels in these patients. In the present study, we describe a new de novo KCNA1 mutation in a Polish patient with tetany and hypomagnesemia. Electrophysiological and biochemical analyses were performed to determine the pathogenicity of the mutation. A female patient presented with low serum Mg2+ levels, renal Mg2+ wasting, muscle cramps, and tetanic episodes. Whole exome sequencing identified a p.Leu328Val mutation in KCNA1 encoding the Kv1.1 K+ channel. Electrophysiological examinations demonstrated that the p.Leu328Val mutation caused a dominant-negative loss of function of the encoded Kv1.1 channel. Cell surface biotinylation showed normal plasma membrane expression. Taken together, this is the second report linking KCNA1 with hypomagnesemia, thereby emphasizing the need for further evaluation of the clinical phenotypes observed in patients carrying KCNA1 mutations.


Assuntos
Canal de Potássio Kv1.1/genética , Deficiência de Magnésio/genética , Tetania/genética , Biotinilação , Pré-Escolar , DNA/genética , Fenômenos Eletrofisiológicos/genética , Exoma , Feminino , Células HEK293 , Humanos , Magnésio/sangue , Deficiência de Magnésio/sangue , Cãibra Muscular/genética , Mutação/genética , Técnicas de Patch-Clamp , Linhagem , Análise de Sequência de DNA
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