Effect of oral magnesium supplement on cardiometabolic markers in people with prediabetes: a double blind randomized controlled clinical trial

The effect of magnesium supplementation on serum concentration of lipid profile: an updated systematic review and dose-response meta-analysis on randomized controlled trials

BACKGROUND

Some evidence suggests magnesium might reduce serum levels of lipid profile. Due to the significance of this matter on hand, we centralized our aim to conduct a systematic review and meta-analysis to interrogate the effect of magnesium supplementation on serum levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) in the general population aged ≥ 18 years.

METHODS

In line with conducting this study first, relevant articles were found through searching databases, including five databases: Cochrane Library, ClinicalTrials.gov, ISI Web of Science, Scopus, and PubMed until January 2024. Following fulfilling the first aim, their mean differences and standard deviations were calculated to conduct the meta-analysis. Ultimately, an assessment of the statistical heterogeneity of intervention effects was performed using I-squared statistics and Cochran's Q test.

RESULTS

Regarding serum levels of TC, TG, LDL-C, and HDL-C, twenty-one, twenty-three, twenty, and twenty-five studies were included in the meta-analysis. The pooled estimates showed no significant differences in serum levels of TC, TG, and LDL-C between the magnesium group and comparison group (weighted mean difference (WMD) = 0.34 mg/dl, 95% confidence interval (CI): -1.75 to 2.43, P = 0.749, I2 = 99.1%; WMD=-2.06 mg/dl, 95% CI: -6.35 to 2.23, P = 0.346, I2 = 99.1; WMD = 1.71 mg/dl, 95% CI: -0.81 to 4.24, P = 0.183, I2 = 99.4, respectively). However, magnesium significantly increased HDL-C (WMD = 1.21 mg/dl, 95% CI: 0.58 to 1.85, P < 0.001, I2 = 99.5).

CONCLUSION

In conclusion, our study showed that magnesium significantly increased HDL-C levels. However, due to high heterogeneity, we must note that more research is needed to make robust recommendations regarding magnesium supplementation in clinical practice.

REGISTRY NUMBER

This study was registered in PROSPERO under the protocol number CRD42024505142.

Utilizing a Combination of Supplements Comprising Boric Acid, Magnesium, Vitamin D3, and Extra Virgin Olive Oil to Improve Metabolism in Menopausal Ovariectomized Rats

Metabolic syndrome during menopause can lead to diabetes, cardiovascular problems, and increased mortality rates. Hormone replacement therapy is recommended to manage climacteric complications, but it has serious adverse effects. This study, therefore, investigated the potential of supplementing some minerals, vitamins, and natural products like boric acid, magnesium, vitamin D3, and extra virgin olive oil on metabolic status of menopausal ovariectomized rats. Fourty-two female adult rats were randomly assigned to seven groups: a) Sham Control, b) Ovariectomized Control, c) Ovariectomized + Boric acid, d) Ovariectomized + Magnesium, e) Ovariectomized + Vitamin D3, f) Ovariectomized + Extra virgin olive oil, and g) Ovariectomized + Combined treatment groups. Serum inflammatory and oxidative stress markers, serum lipogram pattern, hepatic triglycerides, body weight, fasting blood glucose, serum insulin, leptin, and adiponectin, as well as hepatic insulin signaling cascade, IRS1/pAKT/GLUT4 were measured in each group to assess metabolic function. Results revealed a significant improvement in inflammation, oxidative stress, and metabolic parameters by individual and concomitant treating ovariectomized rats with boric acid, magnesium, vitamin D3, and extra virgin olive oil. Interestingly, the concurrent use of these supplements displayed a better impact than individual use, suggesting their valuable therapeutic potential for managing metabolic syndrome in menopausal women. However, the necessity of all four supplements for optimal therapeutic effects remains unsubstantiated.

The Connection Between Magnesium and Heart Health: Understanding Its Impact on Cardiovascular Wellness

Magnesium is a crucial mineral that supports various enzymatic processes in the body. It plays a vital role in maintaining vascular, metabolic, and electrical homeostasis, making it an important factor for cardiovascular health. Magnesium is also involved in oxidative and inflammatory responses. Low levels of magnesium are associated with several cardiovascular issues, including arrhythmias, coronary artery disease, stroke, high blood pressure, and abnormal lipid levels. This suggests that a deficiency in magnesium could be a risk factor for cardiovascular disease (CVD), which is a major public health concern. Monitoring serum magnesium levels might help in identifying cardiovascular problems and related risk factors. Additionally, magnesium supplementation could lead to new approaches for managing CVDs.

Magnesium from Deep Seawater as a Potentially Effective Natural Product against Insulin Resistance: A Randomized Trial

Background and Objectives: Deep seawater has been shown to restore pancreatic function in obese diabetic mice and considerably improve the homeostatic model assessment for insulin resistance, total cholesterol, and low-density lipoprotein cholesterol concentrations in patients with impaired fasting glucose or glucose tolerance. In this study, the effect of 12-week daily consumption of magnesium (Mg2+)-containing deep seawater mineral extracts on blood glucose concentration and insulin metabolism-associated indicators was investigated in patients with impaired glucose tolerance. Materials and methods: In this 12-week randomized, double-blind trial, patients (n = 37) with impaired glucose tolerance consumed deep seawater mineral extracts. Changes in blood glucose concentration and related indicators were compared between the treatment group and placebo group (n = 38). Results: The fasting insulin, C-peptide, homeostatic model assessment for insulin resistance, quantitative insulin sensitivity check index, homeostatic model assessment of beta-cell function, and Stumvoll insulin sensitivity index values in the deep seawater mineral extract group showed improvements compared with the placebo group. However, no significant differences between groups were observed in fasting blood glucose, postprandial blood glucose, glycated hemoglobin, or incremental area under the curve values. Conclusions: Oral supplementation with deep seawater mineral extracts enriched in Mg2+ markedly improves insulin sensitivity in patients with pre-diabetes. This study illustrates the potential clinical application of natural Mg2+ from deep seawater to alleviate insulin resistance in patients with pre-diabetes. Trial registration: This trial was retrospectively registered with Clinical Research information Service (CRIS), No. KCT0008695, on 8 August 2023.

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

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

Association between Serum Magnesium Levels and Risk of Dyslipidemia: A Cross-Sectional Study from the China Health and Nutrition Survey

A growing number of observational studies have been carried out on the relationship between serum magnesium and risk of dyslipidemia, but their results were conflicting. This study aimed to investigate the association between serum magnesium levels and risk of dyslipidemia in Chinese adult residents. We used data from the China Health and Nutrition Survey (CHNS) in the wave of 2009 to conduct a cross-sectional study. A total of 8,457 participants (47.2% male) with a mean age of 50.5 years were assessed and divided into 4 groups based on quartiles of serum magnesium levels. We found that higher quartiles of serum magnesium were associated with increased prevalence of dyslipidemia. After adjustment for confounders, the results of logistic regression analyses indicated that there was an increased trend in dyslipidemia risk as quartiles of serum magnesium increased. The restricted cubic spline model revealed a nonlinear relationship between serum magnesium levels and dyslipidemia. In subgroup analyses, the positive relationship between serum magnesium levels and dyslipidemia was more significant in females than in males. Our study suggested that serum magnesium levels were positively associated with risk of dyslipidemia in Chinese adult population. Further research is needed to provide a deep understanding of the underlying mechanism of magnesium on lipid metabolism.

Exploring the link: magnesium intake and hepatic steatosis in Americans

Purpose

The connection between magnesium and hepatic steatosis has not been well-studied. This study aimed to explore the link between magnesium intake and hepatic steatosis, utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020.

Materials and methods

The analysis included 5,935 participants, excluding individuals with hepatitis infection or substantial alcohol consumption. Magnesium intake assessment was based on 24-h dietary recalls. Hepatic steatosis evaluation employed the controlled attenuation parameter (CAP), measured via transient elastography. Multivariate regression and subgroup analyses were conducted to scrutinize the relationship between magnesium intake and CAP values.

Results

A higher magnesium intake was associated with lower CAP values, after adjusting for potential confounders. Subgroup analyses indicated an inverted U-shaped correlation between magnesium intake and CAP in women, White people, and non-hypertensive individuals, with respective inflection points at 126, 124.5, and 125 mg/day, respectively. Below these thresholds, a higher magnesium intake correlated with increased CAP values, while above these points, it was associated with decreased CAP.

Conclusion

This extensive population-based study indicates an inverse relationship between magnesium intake and hepatic steatosis in Americans. This relationship displays an inverted U-curve, varying before and after specified inflection points in women, White people, and non-hypertensive individuals. These findings offer insights into tailored magnesium supplementation strategies for preventing and treating liver steatosis, based on gender and ethnicity.

Association and dose-response relationship of plasma magnesium with metabolic syndrome in Chinese adults older than 45 years

Purpose

Magnesium (Mg) is an essential nutrient for the maintenance of vital physiological functions. Magnesium deficiency is associated with diseases such as obesity, type 2 diabetes mellitus (T2DM), and metabolic syndrome (MetS); however, conclusions have been inconsistent, and there is a particular lack of evidence regarding this association in Chinese population older than 45 years. This study aimed to assess the association between plasma magnesium and the risk of MetS and its components, the dose-response relationship, and the threshold effect relationship in a Chinese population involving older than 45 years.

Methods

A total of 2,101 individuals were randomly selected from the China Nutrition and Health Surveillance (CNHS) (2015-2017) by considering monitoring points. We used the joint statement of the International Diabetes Federation (IDF) in 2009 to define participants with MetS. The plasma magnesium was tested by inductively coupled plasma mass spectrometry (ICP-MS). The logistic regression and restricted cubic spline (RCS) models were used to analyze the association and dose-response relationship between plasma Mg and MetS and its components.

Results

Compared with the lowest quintile (Q1) for plasma Mg, the odds ratios (ORs) and 95% confidence intervals (95% CI) for MetS, impaired fasting glucose (IFG), hypertension, and triglyceride (TG) elevation at the highest quintile (Q5) were 0.419 (0.301, 0.583), 0.303 (0.221, 0.415), 0.446 (0.322, 0.618), and 0.526 (0.384, 0.720), respectively, with all p < 0.05. However, in the components of decreased high-density lipoprotein cholesterol (HDL-C) and central obesity, no trend toward lowering with higher plasma magnesium was observed (p = 0.717, p = 0.865). These associations were not altered by further adjustment for potential confounding variables, including age, gender, education, nationality, area, residence, body mass index (BMI), and heart rate. The RCS analysis showed that, when plasma magnesium was lower than 0.85 mmol/L, the curve was leveled off, and then, the curve showed a decreasing trend with the increase in plasma magnesium.

Conclusion

Therefore, plasma Mg was negatively associated with MetS and its components (including IFG, hypertension, and elevated TG) in people older than 45 years. In addition, plasma Mg greater than or equal to 0.85 mmol/L, which is higher than the commonly used threshold of 0.75 mmol/L, may be protective against MetS and its components (including elevated FPG, elevated blood pressure, and elevated TG). More prospective studies, such as randomized controlled trials, are necessary to confirm the effective impact of Mg on MetS and its components. Plasma Mg levels in the MetS population older than 45 years require attention.

Recent advancements in Mg-based micromotors for biomedical and environmental applications

Synthetic micro/nanomotors have attracted considerable attention due to their promising potential in the field of biomedicine. Despite their great potential, major micromotors require chemical fuels or complex devices to generate external physical fields for propulsion. Therefore, for future practical medical and environmental applications, Mg-based micromotors that exhibit water-powered movement and thus eliminate the need for toxic fuels, and that display optimal biocompatibility and biodegradability, are attracting attention. In this review, we summarized the recent microarchitectural design of Mg-based micromotors for biomedical applications. We also highlight the mechanism for realizing their water-powered motility. Furthermore, recent biomedical and environmental applications of Mg-based micromotors are introduced. We envision that advanced Mg-based micromotors will have a profound impact in biomedicine.

Magnesium Deficiency and Cardiometabolic Disease

Magnesium (Mg²⁺) has many physiological functions within the body. These include important roles in maintaining cardiovascular functioning, where it contributes to the regulation of cardiac excitation-contraction coupling, endothelial functioning and haemostasis. The haemostatic roles of Mg²⁺ impact upon both the protein and cellular arms of coagulation. In this review, we examine how Mg²⁺ homeostasis is maintained within the body and highlight the various molecular roles attributed to Mg²⁺ in the cardiovascular system. In addition, we describe how nutritional and/or disease-associated magnesium deficiency, seen in some metabolic conditions, has the potential to influence cardiac and vascular outcomes. Finally, we also examine the potential for magnesium supplements to be employed in the prevention and treatment of cardiovascular disorders and in the management of cardiometabolic health.

The Link between Magnesium Supplements and Statin Medication in Dyslipidemic Patients

Many investigations have discovered a connection between statins and magnesium supplements. On one hand, increasing research suggests that chronic hypomagnesemia may be an important factor in the etiology of some metabolic illnesses, including obesity and overweight, insulin resistance and type 2 diabetes mellitus, hypertension, alterations in lipid metabolism, and low-grade inflammation. Chronic metabolic problems seem to be prevented by a high Mg intake combined with diet and/or supplements. On the other hand, it is known that statins lower the frequency of cardiac events, stroke, and mortality, not by lowering LDL-C, but by the capacity to reduce mevalonate formation. That will enhance endothelial function, inhibit vascular smooth muscle cell proliferation and migration and encourage macrophages to promote plaque stability and regression while reducing inflammation. Taking these factors into consideration, we did an extensive analysis of the relevant literature, comparing the effects of Mg² and statin medications on lipoproteins and, implicitly, on the key enzymes involved in cholesterol metabolism.