1
|
Magnesium and Hypertension in Old Age. Nutrients 2020; 13:nu13010139. [PMID: 33396570 PMCID: PMC7823889 DOI: 10.3390/nu13010139] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/27/2020] [Accepted: 12/29/2020] [Indexed: 12/15/2022] Open
Abstract
Hypertension is a complex condition in which various actors and mechanisms combine, resulting in cardiovascular and cerebrovascular complications that today represent the most frequent causes of mortality, morbidity, disability, and health expenses worldwide. In the last decades, there has been an exceptional amount of experimental, epidemiological, and clinical studies confirming a close relationship between magnesium deficit and high blood pressure. Multiple mechanisms may help to explain the bulk of evidence supporting a protective effect of magnesium against hypertension and its complications. Hypertension increases sharply with advancing age, hence older persons are those most affected by its negative consequences. They are also more frequently at risk of magnesium deficiency by multiple mechanisms, which may, at least in part, explain the higher frequency of hypertension and its long-term complications. The evidence for a favorable effect of magnesium on hypertension risk emphasizes the importance of broadly encouraging the intake of foods such as vegetables, nuts, whole cereals and legumes, optimal dietary sources of magnesium, avoiding processed food, which are very poor in magnesium and other fundamental nutrients, in order to prevent hypertension. In some cases, when diet is not enough to maintain an adequate magnesium status, magnesium supplementation may be of benefit and has been shown to be well tolerated.
Collapse
|
2
|
Maguire D, Ross DP, Talwar D, Forrest E, Naz Abbasi H, Leach JP, Woods M, Zhu LY, Dickson S, Kwok T, Waterson I, Benson G, Scally B, Young D, McMillan DC. Low serum magnesium and 1-year mortality in alcohol withdrawal syndrome. Eur J Clin Invest 2019; 49:e13152. [PMID: 31216056 DOI: 10.1111/eci.13152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/31/2019] [Accepted: 06/17/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND In 2014, the WHO reported that 6% of all deaths were attributable to excess alcohol consumption. The aim of the present study was to examine the relationship between serum magnesium concentrations and mortality in patients with alcohol withdrawal syndrome (AWS). MATERIALS AND METHODS A retrospective review of 700 patients with documented evidence of previous AWS indicating a requirement for benzodiazepine prophylaxis or evidence of alcohol withdrawal syndrome between November 2014 and March 2015. RESULTS Of 380 patients included in the sample analysis, 64 (17%) were dead at 1 year following the time of treatment for AWS. The majority of patients had been prescribed thiamine (77%) and a proton pump inhibitor (66%). In contrast, the majority of patients had low circulating magnesium concentrations (<0.75 mmol/L) (64%) and had not been prescribed magnesium (90%). The median age of death at one year was 55 years (P = 0.002). On univariate analysis, age (P < 0.05), GMAWS (P < 0.05), BDZ (P < 0.05), bilirubin (P < 0.001), alkaline phosphatase (P < 0.001), albumin (P < 0.001), CRP (P < 0.05), AST:ALT ratio >2 (P < 0.001), sodium (P < 0.05), magnesium (P < 0.001), platelets (P < 0.05) and the use of proton pump inhibitor medication (P < 0.001) were associated with death at 1 year. On multivariate binary logistic regression analysis, age > 50 years (OR 3.37, 95% CI 1.52-7.48, P < 0.01), AST:ALT ratio >2 (OR 3.10, 95% CI 1.38-6.94, P < 0.01) and magnesium < 0.75 mmol/L (OR 4.11, 95% CI 1.3-12.8, P < 0.05) remained independently associated with death at 1 year. CONCLUSION Overall, 1-year mortality was significantly higher among those patients who were magnesium deficient (<0.75 mmol/L) when compared to those who were replete (≥0.75 mmol/L; P < 0.001).
Collapse
Affiliation(s)
- Donogh Maguire
- Emergency Medicine Department, Glasgow Royal Infirmary, Glasgow, UK.,Academic Unit of Surgery, School of Medicine, Royal Infirmary, University of Glasgow, Glasgow, UK
| | - David P Ross
- Emergency Medicine Department, Glasgow Royal Infirmary, Glasgow, UK.,Academic Unit of Surgery, School of Medicine, Royal Infirmary, University of Glasgow, Glasgow, UK
| | - Dinesh Talwar
- The Scottish Trace Elements and Micronutrient Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, UK
| | - Ewan Forrest
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
| | - Hina Naz Abbasi
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK
| | - John-Paul Leach
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK.,School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - Marylynne Woods
- School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - Luke Y Zhu
- School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - Scott Dickson
- School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - Tong Kwok
- School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - Isla Waterson
- School of Medicine Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
| | - George Benson
- Alcohol and Drug Recovery Service, Greater Glasgow and Clyde, Dykebar hospital, Glasgow, UK
| | - Benjamin Scally
- Emergency Department, Edinburgh Royal Infirmary, Edinburgh, UK
| | - David Young
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, Royal Infirmary, University of Glasgow, Glasgow, UK
| |
Collapse
|
3
|
Kunutsor SK, Whitehouse MR, Blom AW, Laukkanen JA. Low serum magnesium levels are associated with increased risk of fractures: a long-term prospective cohort study. Eur J Epidemiol 2017; 32:593-603. [PMID: 28405867 PMCID: PMC5570773 DOI: 10.1007/s10654-017-0242-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 03/24/2017] [Indexed: 12/31/2022]
Abstract
Magnesium, which is an essential trace element that plays a key role in several cellular processes, is a major component of bone; however, its relationship with risk of major bone fractures is uncertain. We aimed to investigate the association of baseline serum magnesium concentrations with risk of incident fractures. We analyzed data on 2245 men aged 42-61 years in the Kuopio Ischemic Heart Disease prospective cohort study, with the assessment of serum magnesium measurements and dietary intakes made at baseline. Hazard ratios [95% confidence intervals (CI)] for incident total (femoral, humeral, and forearm) and femoral fractures were assessed. During a median follow-up of 25.6 years, 123 total fractures were recorded. Serum magnesium was non-linearly associated with risk of total fractures. In age-adjusted Cox regression analysis, the hazard ratio (HR) (95% CIs) for total fractures in a comparison of the bottom quartile versus top quartile of magnesium concentrations was 2.10 (1.30-3.41), which persisted on adjustment for several established risk factors 1.99 (1.23-3.24). The association remained consistent on further adjustment for renal function, socioeconomic status, total energy intake, and several trace elements 1.80 (1.10-2.94). The corresponding adjusted HRs for femoral fractures were 2.56 (1.38-4.76), 2.43 (1.30-4.53) and 2.13 (1.13-3.99) respectively. There was no evidence of an association of dietary magnesium intake with risk of any fractures. In middle-aged Caucasian men, low serum magnesium is strongly and independently associated with an increased risk of fractures. Further research is needed to assess the potential relevance of serum magnesium in the prevention of fractures.
Collapse
Affiliation(s)
- Setor Kwadzo Kunutsor
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Learning and Research Building (Level 1), Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK.
| | - Michael Richard Whitehouse
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Learning and Research Building (Level 1), Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Ashley William Blom
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Learning and Research Building (Level 1), Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK
| | - Jari Antero Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Internal Medicine, Central Finland Central Hospital, Jyväskylä, Finland
| |
Collapse
|
4
|
Hayhoe RPG, Lentjes MAH, Luben RN, Khaw KT, Welch AA. Dietary magnesium and potassium intakes and circulating magnesium are associated with heel bone ultrasound attenuation and osteoporotic fracture risk in the EPIC-Norfolk cohort study. Am J Clin Nutr 2015; 102:376-84. [PMID: 26135346 DOI: 10.3945/ajcn.114.102723] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 05/27/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In our aging population, maintenance of bone health is critical to reduce the risk of osteoporosis and potentially debilitating consequences of fractures in older individuals. Among modifiable lifestyle and dietary factors, dietary magnesium and potassium intakes are postulated to influence bone quality and osteoporosis, principally via calcium-dependent alteration of bone structure and turnover. OBJECTIVE We investigated the influence of dietary magnesium and potassium intakes, as well as circulating magnesium, on bone density status and fracture risk in an adult population in the United Kingdom. DESIGN A random subset of 4000 individuals from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort of 25,639 men and women with baseline data was used for bone density cross-sectional analyses and combined with fracture cases (n = 1502) for fracture case-cohort longitudinal analyses (mean follow-up 13.4 y). Relevant biological, lifestyle, and dietary covariates were used in multivariate regression analyses to determine associations between dietary magnesium and potassium intakes and calcaneal broadband ultrasound attenuation (BUA), as well as in Prentice-weighted Cox regression to determine associated risk of fracture. Separate analyses, excluding dietary covariates, investigated associations of BUA and fractures with serum magnesium concentration. RESULTS Statistically significant positive trends in calcaneal BUA for women (n = 1360) but not men (n = 968) were apparent across increasing quintiles of magnesium plus potassium (Mg+K) z score intake (P = 0.03) or potassium intake alone (P = 0.04). Reduced hip fracture risk in both men (n = 1958) and women (n = 2755) was evident for individuals in specific Mg+K z score intake quintiles compared with the lowest. Statistically significant trends in fracture risk in men across serum magnesium concentration groups were apparent for spine fractures (P = 0.02) and total hip, spine, and wrist fractures (P = 0.02). None of these individual statistically significant associations remained after adjustment for multiple testing. CONCLUSIONS These findings enhance the limited literature studying the association of magnesium and potassium with bone density and demonstrate that further investigation is warranted into the mechanisms involved and the potential protective role against osteoporosis.
Collapse
Affiliation(s)
- Richard P G Hayhoe
- Department of Population Health and Primary Care, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom; and
| | - Marleen A H Lentjes
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | - Robert N Luben
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | - Ailsa A Welch
- Department of Population Health and Primary Care, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom; and
| |
Collapse
|
5
|
Navarro-Alarcon M, Ruiz-Ojeda FJ, Blanca-Herrera RM, Kaki A, Adem A, Agil A. Melatonin administration in diabetes: regulation of plasma Cr, V, and Mg in young male Zucker diabetic fatty rats. Food Funct 2014; 5:512-6. [PMID: 24441643 DOI: 10.1039/c3fo60389j] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The use of melatonin, a neurohormone present in plants, represents an exciting approach for the maintenance of optimum health conditions. Melatonin administration ameliorates glucose homeostasis in Zucker diabetic fatty (ZDF) rats. The objective of this study was to investigate the effects of melatonin in diabetes in relation to the levels and regulation of plasma chromium (Cr), vanadium (V), and magnesium (Mg) in Zucker diabetic fatty (ZDF) and Zucker lean (ZL) rats. At the age of 6 weeks, ZDF (n = 30) and ZL (n = 30) groups were each subdivided into three groups: control (C) (n = 10), vehicle-treated (V') (n = 10) and melatonin-treated (M) (10 mg kg(-1) per day; n = 10) groups for a 6 week period. After treatment, plasma mineral concentrations were measured by flame (Mg) and electrothermal (Cr and V) atomic absorption spectrometry. No significant differences were found between the C and V' groups (p > 0.05). Plasma Mg levels were significantly lower in C-ZDF vs. C-ZL rats, demonstrating the presence of hypomagnesemia in this diabetes mellitus model. Plasma V and Cr levels were significantly higher in M-ZDF vs. C-ZDF rats. Plasma Mg levels in ZDF rats were not affected by melatonin treatment (p > 0.05). Melatonin administration ameliorates the diabetic status of ZDF rats by enhancing plasma Cr and V concentrations. This appears to be the first report of a beneficial effect of melatonin treatment on plasma Cr and V regulation in ZDF rats.
Collapse
Affiliation(s)
- Miguel Navarro-Alarcon
- Department of Nutrition and Food Science, School of Pharmacy, University of Granada, Spain.
| | | | | | | | | | | |
Collapse
|
6
|
Velasco-Reynold C, Navarro-Alarcon M, Lopez-Ga de la Serrana H, Perez-Valero V, Agil A, Lopez-Martinez MC. Dialysability of magnesium and calcium from hospital duplicate meals: influence exerted by other elements. Biol Trace Elem Res 2010; 133:313-24. [PMID: 19582377 DOI: 10.1007/s12011-009-8444-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Accepted: 06/23/2009] [Indexed: 10/20/2022]
Abstract
Total and dialysable magnesium and calcium levels and corresponding dialysabilities were measured in duplicate meals (n = 108) during 36 consecutive days. The interaction exerted by other nutrients and energy on them was also performed. Total mean magnesium and calcium fractions of 113.9 +/- 98.3 and 337.2 +/- 278.9 mg/meal respectively, were found. The Mg and Ca levels supplied by meals are positively (p < 0.05) correlated with macronutrient contents (carbohydrates and proteins). The mean dialysable Mg and Ca fractions were 56.9 +/- 36.3 and 127.4 +/- 112.3 mg/meal (50.4 +/- 13.2 and 37.8 +/- 10.7% as dialysabilities, respectively). Total Mg and Ca levels are significantly correlated with corresponding element dialysabilities (p < 0.05). For both minerals, significant correlations between their total and dialysable fractions and between their dialysable level and dialysabilities were noted (p < 0.01). The mean Mg and Ca daily dietary intakes (DDI) were 341.7 +/- 68.0 and 1,011.6 +/- 424.4 mg/day, respectively. For Ca and Mg the existence of similarities in their behaviour in meals and absorptive processes has been found. Duplicate meals with raw vegetables are good sources of bioaccessible Mg. High Ca dialysability has been found in the analysed meals. The fish and products constitute a good source of bioaccessible Ca. Mg, Ca, zinc, and chromium levels enhanced significantly the Mg dialysability. The Ca dialysability rose significantly with dialysable Ca and chromium fractions (p < 0.05).
Collapse
|
7
|
Jodral-Segado AM, Navarro-Alarcón M, López-Ga de la Serrana H, López-Martínez MC. Magnesium and calcium contents in foods from SE Spain: influencing factors and estimation of daily dietary intakes. THE SCIENCE OF THE TOTAL ENVIRONMENT 2003; 312:47-58. [PMID: 12873398 DOI: 10.1016/s0048-9697(03)00199-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The magnesium and calcium content (fresh weight basis) of 243 food, 69 beverages and 11 potable water samples were determined using flame atomic absorption spectrometry. Analyses of NIST and CBR-CEC reference materials demonstrated the reliability and accuracy of this technique. The highest magnesium and calcium levels corresponded to molluscs and crustacea, and dairy products, respectively. Magnesium concentrations found in different food groups were significantly and linearly related with corresponding calcium levels (P<0.001) with the exception of fish products. Significant linear relationships among magnesium and calcium concentrations, and fiber content for cereals, legumes and dry-fruits were found (P<0.001); however, total fat contents of considered foods were not related (P>0.05) with levels of elements considered. Significant linear relationships among magnesium and calcium concentrations in cereals, legumes and fruits, and protein content were found (P<0.001). In meat and by-products, magnesium concentrations found in organ meats were significantly lower (P<0.01); for calcium, levels measured in sausages were significantly higher (P<0.001) than those found in meats and organ meats. In fish products, magnesium levels in molluscs and crustacea were significantly higher than those measured in fish and cephalopoda (P<0.001); for calcium, concentrations in cephalopoda were significantly lower (P<0.001). Mean magnesium and calcium concentrations analyzed in cheese were statistically higher than those determined in other dairy products (P<0.01). In alcoholic drinks, magnesium and calcium levels measured in distilled beverages (whisky, gin, rum, brandy and alcoholic liquors) were statistically lower than those found in fermented types (wine and beer) (P<0.01). The daily intake of magnesium and calcium in the Spanish diet was 366.1 and 1266.6 mg/day per person, respectively. Results revealed that the intake of analyzed elements was similar to recommended dietary allowances.
Collapse
Affiliation(s)
- Antonio M Jodral-Segado
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071-Granada, Spain
| | | | | | | |
Collapse
|