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AlShaibani T, Abdul Razzaq R, Radhi A, Meer H, Aljawder A, Jaradat A, Naguib YM. Ethnic-Based Assessment of Vitamin D and Magnesium Status in the Kingdom of Bahrain. Cureus 2024; 16:e55967. [PMID: 38469368 PMCID: PMC10927250 DOI: 10.7759/cureus.55967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Vitamin D deficiency is a major global health problem. Most previous studies focused attention on the significant role of sunlight exposure in the homeostasis of vitamin D and calcium blood levels. Magnesium is pivotal in the proper functioning of vitamin D, and the physiologic functions of different organs require a balanced vitamin D and magnesium status. The relationship between sunlight exposure and blood levels of vitamin D and magnesium has often been overlooked. The aim of this study was to evaluate vitamin D and magnesium status based on sunlight exposure and ethnicity in Bahraini and expatriate workers. METHODS A cross-sectional study was conducted between October 2018 and September 2019. One hundred and seventy-four subjects participated in this study were subdivided based on their ethnicity and work environment-dependent exposure to sunlight into four groups: (1) Bahraini exposed (n=94), (2) Bahraini non-exposed (n=25), (3) expatriate exposed (n=31), and (4) expatriate non-exposed (n=24). Blood levels of vitamin D and magnesium were evaluated for all the participants. RESULTS Independent of ethnicity, vitamin D levels were insignificantly different among the studied groups and were all below the normal reference range. Yet, there was still a sunlight-dependent increase in vitamin D level that could be seen only in Bahraini workers. Magnesium levels were significantly higher in expatriates when compared to Bahraini workers. Sunlight-exposed expatriates had significantly higher magnesium levels than their Bahraini counterparts, while there was no significant difference between both ethnicities in the non-exposed groups. CONCLUSION Country- and ethnic-specific definitions for vitamin D status and sunlight exposure are recommended. The assessment of magnesium status is pivotal in the overall assessment of vitamin D status.
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Affiliation(s)
| | | | - Ameera Radhi
- Pathology Department, Salmaniya Medical Complex, Manama, BHR
| | - Hussain Meer
- Radiology Department, Alhakeem Radiology Center, Manama, BHR
| | | | - Ahmed Jaradat
- Family and Community Medicine Department, Arabian Gulf University, Manama, BHR
| | - Yahya M Naguib
- Physiology Department, Arabian Gulf University, Manama, BHR
- Clinical Physiology Department, Faculty of Medicine, Menoufia University, Shibin El Kom, EGY
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2
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Matias P, Ávila G, Ferreira AC, Laranjinha I, Ferreira A. Hypomagnesemia: a potential underlooked cause of persistent vitamin D deficiency in chronic kidney disease. Clin Kidney J 2023; 16:1776-1785. [PMID: 37915933 PMCID: PMC10616498 DOI: 10.1093/ckj/sfad123] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Indexed: 11/03/2023] Open
Abstract
Magnesium and vitamin D play important roles in most cells of the body. These nutrients act in a coordinated fashion to maintain physiologic functions of various organs, and their abnormal balance could adversely affect these functions. Therefore, deficient states of both nutrients may lead to several chronic medical conditions and increased cardiovascular and all-cause mortality. Chronic kidney disease (CKD) patients have altered metabolism of both magnesium and vitamin D. Some studies indicate that magnesium could have a role in the synthesis and metabolism of vitamin D, and that magnesium supplementation substantially reversed the resistance to vitamin D treatment in some clinical situations. Recent observational studies also found that magnesium intake significantly interacted with vitamin D status and, particularly with the risk of cardiovascular mortality. It is therefore essential to ensure adequate levels of magnesium to obtain the optimal benefits of vitamin D supplementation in CKD patients. In this review, we discuss magnesium physiology, magnesium and vitamin D metabolism in CKD, potential metabolic interactions between magnesium and vitamin D and its clinical relevance, as well as the possible role of magnesium supplementation to assure adequate vitamin D levels.
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Affiliation(s)
- Patrícia Matias
- Nephrology Department, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
- NOVA Medical School, Lisbon, Portugal
| | - Gonçalo Ávila
- Nephrology Department, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
| | - Ana Carina Ferreira
- NOVA Medical School, Lisbon, Portugal
- Nephrology department, Hospital Curry Cabral - Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal
| | - Ivo Laranjinha
- Nephrology Department, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal
| | - Aníbal Ferreira
- NOVA Medical School, Lisbon, Portugal
- Nephrology department, Hospital Curry Cabral - Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal
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3
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Stefanache A, Lungu II, Butnariu IA, Calin G, Gutu C, Marcu C, Grierosu C, Bogdan Goroftei ER, Duceac LD, Dabija MG, Popa F, Damir D. Understanding How Minerals Contribute to Optimal Immune Function. J Immunol Res 2023; 2023:3355733. [PMID: 37946846 PMCID: PMC10632063 DOI: 10.1155/2023/3355733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/16/2023] [Accepted: 09/09/2023] [Indexed: 11/12/2023] Open
Abstract
Sufficient mineral supply is vital not only for the innate immune system but also for the components of the adaptive immune defense, which encompass defense mechanisms against pathogens and the delicate balance of pro- and anti-inflammatory regulation in the long term. Generally, a well-balanced diet is capable of providing the necessary minerals to support the immune system. Nevertheless, specific vulnerable populations should be cautious about obtaining adequate amounts of minerals such as magnesium, zinc, copper, iron, and selenium. Inadequate levels of these minerals can temporarily impair immune competence and disrupt the long-term regulation of systemic inflammation. Therefore, comprehending the mechanisms and sources of these minerals is crucial. In exceptional circumstances, mineral deficiencies may necessitate supplementation; however, excessive intake of supplements can have adverse effects on the immune system and should be avoided. Consequently, any supplementation should be approved by medical professionals and administered in recommended doses. This review emphasizes the crucial significance of minerals in promoting optimal functioning of the immune system. It investigates the indispensable minerals required for immune system function and the regulation of inflammation. Moreover, it delves into the significance of maintaining an optimized intake of minerals from a nutritional standpoint.
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Affiliation(s)
- Alina Stefanache
- “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Ionut-Iulian Lungu
- “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | | | - Gabriela Calin
- Faculty of Dental Medicine, “Apollonia” University of Iasi, 11 Pacurari Street, Iasi 700511, Romania
| | - Cristian Gutu
- Faculty of Medicine and Pharmacy, University Dunarea de Jos, 47 Domneasca Street, Galati 800008, Romania
| | - Constantin Marcu
- Faculty of Medicine and Pharmacy, University Dunarea de Jos, 47 Domneasca Street, Galati 800008, Romania
| | - Carmen Grierosu
- Faculty of Dental Medicine, “Apollonia” University of Iasi, 11 Pacurari Street, Iasi 700511, Romania
| | | | - Letitia-Doina Duceac
- Faculty of Medicine and Pharmacy, University Dunarea de Jos, 47 Domneasca Street, Galati 800008, Romania
| | | | - Florina Popa
- Faculty of Medicine and Pharmacy, University Dunarea de Jos, 47 Domneasca Street, Galati 800008, Romania
| | - Daniela Damir
- “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
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4
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Hassan N, Krieg T, Zinser M, Schröder K, Kröger N. An Overview of Scaffolds and Biomaterials for Skin Expansion and Soft Tissue Regeneration: Insights on Zinc and Magnesium as New Potential Key Elements. Polymers (Basel) 2023; 15:3854. [PMID: 37835903 PMCID: PMC10575381 DOI: 10.3390/polym15193854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023] Open
Abstract
The utilization of materials in medical implants, serving as substitutes for non-functional biological structures, supporting damaged tissues, or reinforcing active organs, holds significant importance in modern healthcare, positively impacting the quality of life for millions of individuals worldwide. However, certain implants may only be required temporarily to aid in the healing process of diseased or injured tissues and tissue expansion. Biodegradable metals, including zinc (Zn), magnesium (Mg), iron, and others, present a new paradigm in the realm of implant materials. Ongoing research focuses on developing optimized materials that meet medical standards, encompassing controllable corrosion rates, sustained mechanical stability, and favorable biocompatibility. Achieving these objectives involves refining alloy compositions and tailoring processing techniques to carefully control microstructures and mechanical properties. Among the materials under investigation, Mg- and Zn-based biodegradable materials and their alloys demonstrate the ability to provide necessary support during tissue regeneration while gradually degrading over time. Furthermore, as essential elements in the human body, Mg and Zn offer additional benefits, including promoting wound healing, facilitating cell growth, and participating in gene generation while interacting with various vital biological functions. This review provides an overview of the physiological function and significance for human health of Mg and Zn and their usage as implants in tissue regeneration using tissue scaffolds. The scaffold qualities, such as biodegradation, mechanical characteristics, and biocompatibility, are also discussed.
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Affiliation(s)
- Nourhan Hassan
- Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
- Biotechnology Department, Faculty of Science, Cairo University, Giza 12613, Egypt
| | - Thomas Krieg
- Translational Matrix Biology, Medical Faculty, University of Cologne, 50923 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50923 Cologne, Germany
- Center for Molecular Medicine (CMMC), University of Cologne, 50923 Cologne, Germany
| | - Max Zinser
- Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
- Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne, Kerpener Strasse 62, 50931 Cologne, Germany
| | - Kai Schröder
- Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Nadja Kröger
- Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
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Fouhy LE, Mangano KM, Zhang X, Hughes BD, Tucker KL, Noel SE. Association between a Calcium-to-Magnesium Ratio and Osteoporosis among Puerto Rican Adults. J Nutr 2023; 153:2642-2650. [PMID: 37164266 PMCID: PMC10550845 DOI: 10.1016/j.tjnut.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/22/2023] [Accepted: 05/04/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND The ratio of calcium-to-magnesium intake (Ca:Mg) may be important for bone due to their competitive absorption. The Ca:Mg ratio has been related to health outcomes, but few studies have related it to bone. OBJECTIVES The purpose of this analysis was to examine associations between the Ca:Mg intake with bone mineral density (BMD) and osteoporosis among Puerto Rican adults. METHODS Adults, aged 47-79 y, from the Boston Puerto Rican Osteoporosis Study, with complete BMD and dietary data (n = 955) were included. BMD was assessed with dual-energy X-ray absorptiometry and diet by a food frequency questionnaire. Calcium and magnesium intakes from food were energy adjusted, and the Ca:Mg was calculated. Adjusted linear and logistic regression models were utilized for testing associations between Ca:Mg and bone outcomes. RESULTS Calcium intake was greater in the highest compared with lowest tertile, whereas magnesium intake was similar across tertiles. Mean BMD at hip sites was higher in the middle, compared with the lowest, tertile. Higher odds of osteoporosis were observed for the highest and lowest tertiles, compared with the middle tertile, after adjustment (T3 compared with T2 OR: 2.79; 95% CI: 1.47, 5.3; T1 compared with T2 OR: 2.01; 95% CI: 1.03, 3.92). Repeated analyses without supplement users (n = 432) led to stronger differences and ORs, but lost significance for some comparisons. CONCLUSIONS Dietary calcium and magnesium are important for bone, perhaps not independently. The Ca:Mg intake ratio appeared most protective within a range of 2.2-3.2, suggesting that a balance of these nutrients may be considered in recommendations for osteoporosis..
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Affiliation(s)
- Liam E Fouhy
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, United States; The Center for Population Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Kelsey M Mangano
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, United States; The Center for Population Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Xiyuan Zhang
- The Center for Population Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Bess Dawson Hughes
- Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, United States; The Center for Population Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, United States; The Center for Population Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, United States.
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Guerrero-Romero F, Micke O, Simental-Mendía LE, Rodríguez-Morán M, Vormann J, Iotti S, Banjanin N, Rosanoff A, Baniasadi S, Pourdowlat G, Nechifor M. Importance of Magnesium Status in COVID-19. BIOLOGY 2023; 12:biology12050735. [PMID: 37237547 DOI: 10.3390/biology12050735] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/17/2023] [Accepted: 05/01/2023] [Indexed: 05/28/2023]
Abstract
A large amount of published research points to the interesting concept (hypothesis) that magnesium (Mg) status may have relevance for the outcome of COVID-19 and that Mg could be protective during the COVID disease course. As an essential element, Mg plays basic biochemical, cellular, and physiological roles required for cardiovascular, immunological, respiratory, and neurological functions. Both low serum and dietary Mg have been associated with the severity of COVID-19 outcomes, including mortality; both are also associated with COVID-19 risk factors such as older age, obesity, type 2 diabetes, kidney disease, cardiovascular disease, hypertension, and asthma. In addition, populations with high rates of COVID-19 mortality and hospitalization tend to consume diets high in modern processed foods, which are generally low in Mg. In this review, we review the research to describe and consider the possible impact of Mg and Mg status on COVID-19 showing that (1) serum Mg between 2.19 and 2.26 mg/dL and dietary Mg intakes > 329 mg/day could be protective during the disease course and (2) inhaled Mg may improve oxygenation of hypoxic COVID-19 patients. In spite of such promise, oral Mg for COVID-19 has thus far been studied only in combination with other nutrients. Mg deficiency is involved in the occurrence and aggravation of neuropsychiatric complications of COVID-19, including memory loss, cognition, loss of taste and smell, ataxia, confusion, dizziness, and headache. Potential of zinc and/or Mg as useful for increasing drug therapy effectiveness or reducing adverse effect of anti-COVID-19 drugs is reviewed. Oral Mg trials of patients with COVID-19 are warranted.
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Affiliation(s)
| | - Oliver Micke
- Department of Radiation Therapy and Radiation Oncology, Franziskus Hospital, 33615 Bielefeld, Germany
| | | | | | - Juergen Vormann
- Institute for Prevention and Nutrition, 85737 Ismaning, Germany
| | - Stefano Iotti
- Department of Pharmacy and Biotechnology, Universita di Bologna, 40126 Bologna, Italy
- National Institute of Biostructures and Biosystems, 00136 Rome, Italy
| | - Nikolina Banjanin
- Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Andrea Rosanoff
- CMER Center for Magnesium Education & Research, Pahoa, HI 96778, USA
| | - Shadi Baniasadi
- Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran
| | - Guitti Pourdowlat
- Chronic Respiratory Diseases Research Centre, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran
| | - Mihai Nechifor
- Department of Pharmacology, Gr. T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
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7
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Segev A, Sagir A, Matetzky S, Segev A, Atar S, Shechter M. Admission Serum Magnesium Levels Is Associated with Short and Long-Term Clinical Outcomes in COVID-19 Patients. Nutrients 2023; 15:2016. [PMID: 37432174 DOI: 10.3390/nu15092016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND In the face of the global pandemic that the coronavirus disease 2019 (COVID-19) has created, readily available prognostic markers may be of great use. OBJECTIVE To evaluate the association between serum magnesium (sMg) levels on admission and clinical outcomes in hospitalized COVID-19 patients. METHODS We retrospectively analyzed all patients admitted to a single tertiary center with a primary de novo diagnosis of COVID-19. Patients were followed for a mean of 10 ± 7 months. Demographic, clinical and laboratory data were collected and compared between five groups of patients according to sMg quintiles on hospital admission. RESULTS The cohort included 1522 patients (58% male, 69 ± 17 years old). A low sMg level (1st quintile) was associated with higher rates of diabetes and steroid use, whereas a high sMg level (5th quintile) was associated with dyslipidemia, renal dysfunction, higher levels of inflammatory markers and stay in the intensive care unit. All-cause in-hospital and long-term mortality was higher in patients with both low and high sMg levels, compared with mid-range sMg levels (2nd, 3rd and 4th quintiles; 19% and 30% vs. 9.5%, 10.7% and 17.8% and 35% and 45.3% vs. 23%, 26.8% and 27.3% respectively; p < 0.001 for all). After adjusting for significant clinical parameters indicating severe disease and renal dysfunction, only low sMg state was independently associated with increased mortality (HR = 1.57, p < 0.001). CONCLUSIONS Both low and high sMg levels were associated with increased mortality in a large cohort of hospitalized COVID-19 patients. However, after correction for renal dysfunction and disease severity, only low sMg maintained its prognostic ability.
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Affiliation(s)
- Amitai Segev
- The Leviev Cardiothoracic & Vascular Center, Chaim Sheba Medical Center, Ramat Gan 5236723, Israel
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Adam Sagir
- Cardiovascular Division, Galilee Medical Center, Nahariya 2210001, Israel
- Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Shlomi Matetzky
- The Leviev Cardiothoracic & Vascular Center, Chaim Sheba Medical Center, Ramat Gan 5236723, Israel
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Amit Segev
- The Leviev Cardiothoracic & Vascular Center, Chaim Sheba Medical Center, Ramat Gan 5236723, Israel
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Shaul Atar
- Cardiovascular Division, Galilee Medical Center, Nahariya 2210001, Israel
- Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Michael Shechter
- The Leviev Cardiothoracic & Vascular Center, Chaim Sheba Medical Center, Ramat Gan 5236723, Israel
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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Dominguez LJ, Veronese N, Ciriminna S, Pérez-Albela JL, Vásquez-López VF, Rodas-Regalado S, Di Bella G, Parisi A, Tagliaferri F, Barbagallo M. Association between Serum Magnesium and Fractures: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2023; 15:nu15061304. [PMID: 36986033 PMCID: PMC10053795 DOI: 10.3390/nu15061304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
Magnesium, an essential cation for numerous cellular processes, is a major component of bone. However, its relationship with the risk of fractures is still uncertain. The present systematic review and meta-analysis aim to investigate the impact of serum Mg on the risk of incident fractures. A systematic search was conducted using several databases including PubMed/Medline and Scopus from inception to 24 May 2022, including observational studies investigating serum Mg and the incidence of fractures considered as outcomes. Abstract and full-text screenings, data extractions, and risk of bias assessments were conducted by two investigators independently. Any inconsistencies were resolved by consensus with a third author. The Newcastle–Ottawa Scale was used to assess the study quality/risk of bias. Among 1332 records initially screened, 16 were retrieved as full-texts; of them, four papers were included in the systematic review with a total of 119,755 participants. We found that lower serum Mg concentrations were associated with a significantly higher risk of incident fractures (RR = 1.579; 95%CI: 1.216–2.051; p = 0.001; I2 = 46.9%). Our systematic review with meta-analysis suggests a strong association of serum Mg concentrations with incident fractures. Further research is needed to confirm our results among other populations and to assess whether serum Mg is potentially relevant in the prevention of fractures, which continue to increase and represent a significant health burden due to the associated disability.
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Affiliation(s)
- Ligia J. Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
- Faculty of Medicine and Surgery, Kore University of Enna, 94100 Enna, Italy
- Correspondence: or
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Stefano Ciriminna
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | | | | | | | - Giovanna Di Bella
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Angela Parisi
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Federica Tagliaferri
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
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Cowan AC, Clemens KK, Sontrop JM, Dixon SN, Killin L, Anderson S, Acedillo RR, Bagga A, Bohm C, Brown PA, Cote B, Dev V, Harris C, Hiremath S, Kiaii M, Lacson E, Molnar AO, Oliver MJ, Parmar MS, McRae JM, Nathoo B, Quinn K, Shah N, Silver SA, Tascona DJ, Thompson S, Ting RH, Tonelli M, Vorster H, Wadehra DB, Wald R, Wolf M, Garg AX. Magnesium and Fracture Risk in the General Population and Patients Receiving Dialysis: A Narrative Review. Can J Kidney Health Dis 2023; 10:20543581231154183. [PMID: 36814964 PMCID: PMC9940170 DOI: 10.1177/20543581231154183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/18/2022] [Indexed: 02/19/2023] Open
Abstract
Purpose of Review Magnesium is an essential mineral for bone metabolism, but little is known about how magnesium intake alters fracture risk. We conducted a narrative review to better understand how magnesium intake, through supplementation, diet, or altering the concentration of dialysate magnesium, affects mineral bone disease and the risk of fracture in individuals across the spectrum of kidney disease. Sources of Information Peer-reviewed clinical trials and observational studies. Methods We searched for relevant articles in MEDLINE and EMBASE databases. The methodologic quality of clinical trials was assessed using a modified version of the Downs and Black criteria checklist. Key Findings The role of magnesium intake in fracture prevention is unclear in both the general population and in patients receiving maintenance dialysis. In those with normal kidney function, 2 meta-analyses showed higher bone mineral density in those with higher dietary magnesium, whereas 1 systematic review showed no effect on fracture risk. In patients receiving maintenance hemodialysis or peritoneal dialysis, a higher concentration of dialysate magnesium is associated with a lower concentration of parathyroid hormone, but little is known about other bone-related outcomes. In 2 observational studies of patients receiving hemodialysis, a higher concentration of serum magnesium was associated with a lower risk of hip fracture. Limitations This narrative review included only articles written in English. Observed effects of magnesium intake in the general population may not be applicable to those with chronic kidney disease particularly in those receiving dialysis.
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Affiliation(s)
- Andrea C. Cowan
- Division of Nephrology, Department of Medicine, Victoria Hospital, London Health Sciences Centre, ON, Canada,Andrea C. Cowan, Division of Nephrology, Department of Medicine, Victoria Hospital, London Health Sciences Centre, 800 Commissioners Road, Room ELL-215, London, ON N6A 5W9, Canada.
| | - Kristin K. Clemens
- Division of Endocrinology, Department of Medicine, St. Joseph’s Hospital, London, ON, Canada
| | - Jessica M. Sontrop
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Stephanie N. Dixon
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada,Lawson Health Research Institute, London Health Sciences Centre, ON, Canada
| | | | | | - Rey R. Acedillo
- Department of Medicine, Thunder Bay Regional Health Sciences Centre, ON, Canada
| | | | - Clara Bohm
- Chronic Disease Innovation Centre, Winnipeg, MB, Canada,University of Manitoba, Winnipeg, Canada
| | - Pierre Antoine Brown
- Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, ON, Canada
| | - Brenden Cote
- Patient Partner, London Health Sciences Centre, ON, Canada
| | - Varun Dev
- Humber River Hospital, Toronto, ON, Canada
| | - Claire Harris
- Division of Nephrology, Department of Medicine, Vancouver General Hospital, The University of British Columbia, Canada
| | | | - Mercedeh Kiaii
- Division of Nephrology, Department of Medicine, St. Paul’s Hospital, Vancouver, BC, Canada
| | - Eduardo Lacson
- Division of Nephrology, Tufts University School of Medicine, Boston, MA, USA
| | - Amber O. Molnar
- Department of Medicine, St Joseph’s Healthcare Hamilton, ON, Canada
| | - Matthew J. Oliver
- Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada
| | | | - Jennifer M. McRae
- Division of Nephrology, Department of Medicine, University of Calgary, AB, Canada
| | | | | | | | - Samuel A. Silver
- Division of Nephrology, Kingston Health Sciences Center, Queen’s University, ON, Canada
| | | | | | | | | | | | | | - Ron Wald
- Division of Nephrology, St. Michael’s Hospital, University of Toronto, ON, Canada
| | - Myles Wolf
- Division of Nephrology, Department of Medicine, Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - Amit X. Garg
- Division of Nephrology, Department of Medicine, Victoria Hospital, London Health Sciences Centre, ON, Canada
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Dall RD, Cheung MM, Shewokis PA, Altasan A, Volpe SL, Amori R, Singh H, Sukumar D. Combined vitamin D and magnesium supplementation does not influence markers of bone turnover or glycemic control: A randomized controlled clinical trial. Nutr Res 2023; 110:33-43. [PMID: 36640582 DOI: 10.1016/j.nutres.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 12/12/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
High-dose vitamin D supplementation can increase total osteocalcin concentrations that may reduce insulin resistance in individuals at risk for prediabetes or diabetes mellitus. Magnesium is a cofactor in vitamin D metabolism and activation. The purpose of this study was to determine the combined effect of vitamin D and magnesium supplementation on total osteocalcin concentrations, glycemic indices, and other bone turnover markers after a 12-week intervention in individuals who were overweight and obese, but otherwise healthy. We hypothesized that combined supplementation would improve serum total osteocalcin concentrations and glycemic indices more than vitamin D supplementation alone or a placebo. A total of 78 women and men completed this intervention in 3 groups: a vitamin D and magnesium group (1000 IU vitamin D3 and 360 mg magnesium glycinate), a vitamin D group (1000 IU vitamin D3), and a placebo group. Despite a significant increase in serum 25-hydroxyvitamin D concentrations in the vitamin D and magnesium group compared with the placebo group (difference = 5.63; CI, -10.0 to -1.21; P = .001) post-intervention, there were no differences in serum concentrations of total osteocalcin, glucose, insulin, and adiponectin or the homeostatic model assessment of insulin resistance (HOMA-IR) among groups (P > .05 for all). Additionally, total osteocalcin (β = -0.310, P = .081), bone-specific alkaline phosphatase (β = 0.004, P = .986), and C-terminal cross-linked telopeptide (β = 0.426, P = .057), were not significant predictors of HOMA-IR after the intervention. Combined supplementation was not associated with short-term improvements in glycemic indices or bone turnover markers in participants who were overweight and obese in our study. This trial was registered at clinicaltrials.gov (NCT03134417).
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Affiliation(s)
- Rosemary D Dall
- Department of Nutrition Sciences, Drexel University, Philadelphia, PA, USA
| | - May M Cheung
- City University of New York - Brooklyn College, Brooklyn, New York, USA
| | | | - Asma Altasan
- Department of Nutrition Sciences, Drexel University, Philadelphia, PA, USA
| | - Stella L Volpe
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Renee Amori
- St. Luke's University Health Network, Bethlehem, PA, USA
| | | | - Deeptha Sukumar
- Department of Nutrition Sciences, Drexel University, Philadelphia, PA, USA.
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11
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Coman AE, Ceasovschih A, Petroaie AD, Popa E, Lionte C, Bologa C, Haliga RE, Cosmescu A, Slănină AM, Bacușcă AI, Șorodoc V, Șorodoc L. The Significance of Low Magnesium Levels in COVID-19 Patients. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020279. [PMID: 36837480 PMCID: PMC9965430 DOI: 10.3390/medicina59020279] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/22/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023]
Abstract
Magnesium is the fourth most common mineral in the human body and the second richest intracellular cation. This element is necessary for many physiological reactions, especially in the cardiovascular and respiratory systems. COVID-19 is an infectious disease caused by SARS-CoV-2. The majority of people who become ill as a result of COVID-19 have mild-to-moderate symptoms and recover without specific treatment. Moreover, there are people who develop severe forms of COVID-19, which require highly specialized medical assistance. Magnesium deficiency may play a role in the pathophysiology of infection with SARS-CoV-2. The primary manifestation of COVID-19 remains respiratory, but the virus can spread to other organs and tissues, complicating the clinical picture and culminating in multiorgan failure. The key mechanisms involved in the disease include direct viral cytotoxicity, endothelial dysfunction, and exaggerated release of inflammatory cytokines. The aim of this review was to summarize the available data regarding the role of magnesium in COVID-19 patients and its particularities in different clinical settings.
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Affiliation(s)
- Adorata Elena Coman
- Preventive Medicine and Interdisciplinarity Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Alexandr Ceasovschih
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Correspondence: (A.C.); (C.L.)
| | - Antoneta Dacia Petroaie
- Preventive Medicine and Interdisciplinarity Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Elena Popa
- Preventive Medicine and Interdisciplinarity Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Cătălina Lionte
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
- Correspondence: (A.C.); (C.L.)
| | - Cristina Bologa
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Raluca Ecaterina Haliga
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adriana Cosmescu
- Preventive Medicine and Interdisciplinarity Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Ana Maria Slănină
- Preventive Medicine and Interdisciplinarity Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Agnes Iacinta Bacușcă
- Preventive Medicine and Interdisciplinarity Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Victorița Șorodoc
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Laurențiu Șorodoc
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
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12
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Matias PJ, Laranjinha I, Ávila G, Azevedo A, Jorge C, Ferreira C, Aires I, Amaral T, Gil C, Ferreira A. Long-term cholecalciferol supplementation in hemodialysis patients: Effects on mineral metabolism, inflammation, and cardiac parameters. Semin Dial 2023; 36:29-36. [PMID: 35262225 DOI: 10.1111/sdi.13066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 02/13/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Low levels of 25-hydroxyvitamin D [25(OH)D] are frequent in chronic kidney disease and are associated with adverse outcomes. The aim of this 5-year prospective study was to evaluate the effects of cholecalciferol supplementation on mineral metabolism, inflammation and cardiac parameters in hemodialysis (HD) patients. METHODS The study included 97 patients. Cholecalciferol was given after HD according to 25(OH)D baseline levels measured twice (end of winter and of summer). The 25(OH)D levels, circulating bone metabolism, inflammation parameters, brain natriuretic peptide (BNP), pulse pressure (PP), and left ventricular mass index (LVMI) were evaluated before and after supplementation. RESULTS There was a significant increase in 25(OH)D levels after supplementation (p < 0.001); however, serum calcium (p = 0.02), phosphorus (p = 0.018), and iPTH (p = 0.03) were decreased. Magnesium levels increased during the study (p = 0.03). A reduction in the number of patients under active vitamin D (p < 0.001) and in the dose and number of patients treated with darbepoetin (p = 0.02) was observed. Serum albumin increased (p < 0.001), and C-reactive protein decreased (p = 0.01). BNP (p < 0.001), PP (p = 0.007), and LVMI (p = 0.02) were significantly reduced after supplementation. CONCLUSIONS Long-term cholecalciferol supplementation allowed correction of 25(OH)D deficiency, improved mineral metabolism with less use of active vitamin D, attenuated inflammation, reduced the dose of the erythropoiesis-stimulating agent, and improved cardiac dysfunction.
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Affiliation(s)
- Patrícia João Matias
- Dialysis Unit, Nephrocare Vila Franca de Xira, Vila Franca de Xira, Portugal.,Dialysis Unit, Dialverca, Forte da Casa, Portugal.,NIDAN, Lisbon, Portugal.,Faculdade de Ciências Médicas, NOVA Medical School, Lisboa, Portugal
| | - Ivo Laranjinha
- Dialysis Unit, Nephrocare Vila Franca de Xira, Vila Franca de Xira, Portugal.,Dialysis Unit, Dialverca, Forte da Casa, Portugal.,NIDAN, Lisbon, Portugal
| | - Gonçalo Ávila
- Dialysis Unit, Nephrocare Vila Franca de Xira, Vila Franca de Xira, Portugal.,Dialysis Unit, Dialverca, Forte da Casa, Portugal.,NIDAN, Lisbon, Portugal
| | - Ana Azevedo
- Dialysis Unit, Nephrocare Vila Franca de Xira, Vila Franca de Xira, Portugal.,Dialysis Unit, Dialverca, Forte da Casa, Portugal.,NIDAN, Lisbon, Portugal
| | - Cristina Jorge
- Dialysis Unit, Nephrocare Vila Franca de Xira, Vila Franca de Xira, Portugal.,Dialysis Unit, Dialverca, Forte da Casa, Portugal.,NIDAN, Lisbon, Portugal
| | - Carina Ferreira
- Dialysis Unit, Nephrocare Vila Franca de Xira, Vila Franca de Xira, Portugal.,Dialysis Unit, Dialverca, Forte da Casa, Portugal.,NIDAN, Lisbon, Portugal.,Faculdade de Ciências Médicas, NOVA Medical School, Lisboa, Portugal
| | - Inês Aires
- Dialysis Unit, Nephrocare Vila Franca de Xira, Vila Franca de Xira, Portugal.,Dialysis Unit, Dialverca, Forte da Casa, Portugal.,NIDAN, Lisbon, Portugal.,Faculdade de Ciências Médicas, NOVA Medical School, Lisboa, Portugal
| | - Tiago Amaral
- Dialysis Unit, Nephrocare Vila Franca de Xira, Vila Franca de Xira, Portugal.,Dialysis Unit, Dialverca, Forte da Casa, Portugal.,NIDAN, Lisbon, Portugal
| | - Célia Gil
- Dialysis Unit, Nephrocare Vila Franca de Xira, Vila Franca de Xira, Portugal.,Dialysis Unit, Dialverca, Forte da Casa, Portugal.,NIDAN, Lisbon, Portugal
| | - Aníbal Ferreira
- Dialysis Unit, Nephrocare Vila Franca de Xira, Vila Franca de Xira, Portugal.,Dialysis Unit, Dialverca, Forte da Casa, Portugal.,NIDAN, Lisbon, Portugal.,Faculdade de Ciências Médicas, NOVA Medical School, Lisboa, Portugal
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13
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Weyh C, Krüger K, Peeling P, Castell L. The Role of Minerals in the Optimal Functioning of the Immune System. Nutrients 2022; 14:nu14030644. [PMID: 35277003 PMCID: PMC8840645 DOI: 10.3390/nu14030644] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 02/04/2023] Open
Abstract
Minerals fulfil a wide variety of functions in the optimal functioning of the immune system. This review reports on the minerals that are essential for the immune system’s function and inflammation regulation. We also discuss nutritional aspects of optimized mineral supply. The supply of minerals is important for the optimal function of the innate immune system as well as for components of adaptive immune defense; this involves defense mechanisms against pathogens in addition to the long-term balance of pro- and anti-inflammatory regulation. Generally, a balanced diet is sufficient to supply the required balance of minerals to help support the immune system. Although a mineral deficiency is rare, there are nevertheless at-risk groups who should pay attention to ensure they are receiving a sufficient supply of minerals such as magnesium, zinc, copper, iron, and selenium. A deficiency in any of these minerals could temporarily reduce immune competence, or even disrupt systemic inflammation regulation in the long term. Therefore, knowledge of the mechanisms and supply of these minerals is important. In exceptional cases, a deficiency should be compensated by supplementation; however, supplement over-consumption may be negative to the immune system, and should be avoided. Accordingly, any supplementation should be medically clarified and should only be administered in prescribed concentrations.
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Affiliation(s)
- Christopher Weyh
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, University of Giessen, 35394 Giessen, Germany;
| | - Karsten Krüger
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, University of Giessen, 35394 Giessen, Germany;
- Correspondence:
| | - Peter Peeling
- School of Human Sciences (Sport and Exercise Science), University of Western Australia, Crawley, WA 6009, Australia;
- Western Australian Institute of Sport, Mt Claremont, WA 6010, Australia
| | - Lindy Castell
- Green Templeton College, University of Oxford, Oxford OX2 6HG, UK;
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14
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Wang J, Lin S, Li HY, Tang W, Liu Y, Zhou T. Influencing factors of serum magnesium in CKD5 patients: A multicenter study in southern China. Front Public Health 2022; 10:1047602. [PMID: 36589976 PMCID: PMC9794747 DOI: 10.3389/fpubh.2022.1047602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Magnesium (Mg) disturbances are related to cardiac, bone, and renal patient mortality. In this study, we compared biochemical markers in hemodialysis (HD) and peritoneal dialysis (PD) patients and explored the influencing factors of serum Mg in stage 5 chronic kidney disease (CKD5) patients. MATERIAL AND METHODS All 598 patients with CKD5 from three medical centers in South China were recruited into this prospective cohort study from March 1, 2018, to January 31, 2021. Our study recorded the clinical characteristics and laboratory data of the patients. RESULTS Hemodialysis patients (0.99 ± 0.19 mmol/L) had a higher mean serum Mg level than PD patients (0.86 ± 0.20 mmol/L; p < 0.01). Regression analysis showed that only corrected calcium (Ca), phosphate (P), Ca/Mg, Ca × P, albumin (Alb), total protein and creatine (Cr) predicted Mg levels in CKD5 patients (p < 0.01). Ca/Mg predicts hypomagnesemia with 78% sensitivity and 85% specificity in CKD5 patients. The AUC value corresponding to Ca/Mg was 0.88. CONCLUSIONS This multicenter study in southern China showed that for all CKD5 patients, corrected Ca and Alb had a significant positive effect on serum Mg, while Ca/Mg had a significant negative effect on serum Mg. In 123 HD patients, Ca × P was positively associated with Mg while Ca/Mg and P were negatively associated with Mg. In 398 PD patients, Ca × P, Alb, and total protein were positively associated with Mg while Ca/Mg and P were negatively associated with Mg. In 77 non-dialysis patients, corrected Ca, Cr, and total protein were positively associated with Mg while Ca/Mg was negatively associated with Mg. Furthermore, Ca/Mg might be another useful technique to monitor blood Mg levels in CKD5 patients. CLINICAL TRIAL REGISTRATION ChiCTR1800014557.
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Affiliation(s)
- Jiali Wang
- Department of Nephrology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Shujun Lin
- Department of Nephrology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Hong-Yan Li
- Department of Nephrology, Huadu District People's Hospital of Guangzhou, Southern Medical University, Guangzhou, China
| | - Wenzhuang Tang
- Department of Blood Purification, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yiping Liu
- Department of Nephrology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Tianbiao Zhou
- Department of Nephrology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
- *Correspondence: Tianbiao Zhou
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15
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Fan L, Zhu X, Zheng Y, Zhang W, Seidner DL, Ness R, Murff HJ, Yu C, Huang X, Shrubsole MJ, Hou L, Dai Q. Magnesium treatment on methylation changes of transmembrane serine protease 2 (TMPRSS2). Nutrition 2021; 89:111340. [PMID: 34116393 PMCID: PMC8102075 DOI: 10.1016/j.nut.2021.111340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The viral entry of SARS-CoV-2 requires host-expressed TMPRSS2 to facilitate the viral spike protein priming. This study aims to test the hypothesis that magnesium (Mg) treatment leads to DNA methylation changes in TMPRSS2. METHODS This study is nested within the Personalized Prevention of Colorectal Cancer Trial, a double-blind 2 × 2 factorial randomized controlled trial, which enrolled 250 participants from Vanderbilt University Medical Center. RESULTS We found that 12 wk of personalized Mg treatment significantly increased 5-methylcytosine methylation at cg16371860 (TSS1500, promoter) by 7.2% compared to the placebo arm (decreased by 0.1%) in those ages < 65 y. The difference remained statistically significant after adjusting for age, sex, and baseline methylation as well as correction for false discovery rate (adjusted P = 0.014). Additionally, Mg treatment significantly reduced 5-hydroxymethylcytosine levels at cg26337277 (close proximity to TSS200 and the 5' untranslated region, promoter) by 2.3% compared to an increase of 7.1% in the placebo arm after adjusting for covariates in those ages < 65 y (P = 0.003). The effect remained significant at a false discovery rate of 0.10 (adjusted P = 0.088). CONCLUSIONS Among individuals ages < 65 y with calcium-to-magnesium intake ratios equal to or over 2.6, reducing the ratio to around 2.3 increased 5-methylcytosine modifications (i.e., cg16371860) and reduced 5-hydroxymethylcytosine modifications (i.e., cg26337277) in the TMPRSS2 gene. These findings, if confirmed, provide another mechanism for the role of Mg intervention in the prevention of COVID-19 and treatment of early and mild disease by modifying the phenotype of the TMPRSS2 genotype.
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Affiliation(s)
- Lei Fan
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Xiangzhu Zhu
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Yinan Zheng
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Wei Zhang
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Douglas L Seidner
- Center for Human Nutrition, Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease and Surgical Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Reid Ness
- Department of Medicine, Division of Gastroenterology, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Harvey J Murff
- Division of Geriatric Medicine, General Internal Medicine and Public Health, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Chang Yu
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Xiang Huang
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Martha J Shrubsole
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lifang Hou
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Qi Dai
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
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16
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Isse N, Hashimoto M. Republished: Omeprazole-induced hypomagnesaemia, causing renal tubular acidosis with hypokalaemia, hypocalcaemia, hyperlactacidaemia and hyperammonaemia. Drug Ther Bull 2021; 59:60-63. [PMID: 33766923 DOI: 10.1136/dtb.2021.235385rep] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Naohi Isse
- Department of Internal Medicine, Ako City Hospital, Ako, Hyogo, Japan
| | - Masashi Hashimoto
- Department of Internal Medicine, Ako City Hospital, Ako, Hyogo, Japan
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17
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Fan L, Zhu X, Zheng Y, Zhang W, Seidner DL, Ness R, Murff HJ, Yu C, Huang X, Shrubsole MJ, Hou L, Dai Q. Magnesium Treatment on Methylation Changes of Transmembrane Serine Protease 2 (TMPRSS2). MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.03.11.21253287. [PMID: 33758885 PMCID: PMC7987044 DOI: 10.1101/2021.03.11.21253287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
BACKGROUND The viral entry of SARS-CoV-2 requires host-expressed TMPRSS2 to facilitate the viral spike (S) protein priming. OBJECTIVES To test the hypothesis that Mg treatment leads to DNA methylation changes in TMPRSS2 . METHODS This study is nested within the Personalized Prevention of Colorectal Cancer Trial (PPCCT), a double-blind 2×2 factorial randomized controlled trial, which enrolled 250 participants from Vanderbilt University Medical Center. Target doses for both Mg and placebo arms were personalized. RESULTS We found that 12-week of personalized Mg treatment significantly increased 5-mC methylation at cg16371860 (TSS1500, promoter) by 7.2% compared to placebo arm (decreased by 0.1%) in those aged < 65 years old. The difference remained statistically significant after adjusting for age, sex and baseline methylation as well as FDR correction (FDR-adjusted P =0.014). Additionally, Mg treatment significantly reduced 5-hmC level at cg26337277 (close proximity to TSS200 and 5'UTR, promoter) by 2.3% compared to increases by 7.1% in the placebo arm after adjusting for covariates in those aged < 65 years old ( P =0.003). The effect remained significant at FDR of 0.10 (adjusted P value=0.088). CONCLUSION Among individuals aged younger than 65 years with the Ca:Mg intake ratios equal to or over 2.6, reducing Ca:Mg ratios to around 2.3 increased 5-mC modifications (i.e. cg16371860) and reduced 5-hmC modifications (i.e. cg26337277) in the TMPRSS2 gene. These findings, if confirmed, provide another mechanism for the role of Mg intervention for the prevention of COVID-19 and treatment of early and mild disease by modifying the phenotype of the TMPRSS2 genotype.
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18
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Dominguez LJ, Veronese N, Guerrero-Romero F, Barbagallo M. Magnesium in Infectious Diseases in Older People. Nutrients 2021; 13:nu13010180. [PMID: 33435521 PMCID: PMC7827130 DOI: 10.3390/nu13010180] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 12/30/2020] [Accepted: 01/04/2021] [Indexed: 12/14/2022] Open
Abstract
Reduced magnesium (Mg) intake is a frequent cause of deficiency with age together with reduced absorption, renal wasting, and polypharmacotherapy. Chronic Mg deficiency may result in increased oxidative stress and low-grade inflammation, which may be linked to several age-related diseases, including higher predisposition to infectious diseases. Mg might play a role in the immune response being a cofactor for immunoglobulin synthesis and other processes strictly associated with the function of T and B cells. Mg is necessary for the biosynthesis, transport, and activation of vitamin D, another key factor in the pathogenesis of infectious diseases. The regulation of cytosolic free Mg in immune cells involves Mg transport systems, such as the melastatin-like transient receptor potential 7 channel, the solute carrier family, and the magnesium transporter 1 (MAGT1). The functional importance of Mg transport in immunity was unknown until the description of the primary immunodeficiency XMEN (X-linked immunodeficiency with Mg defect, Epstein–Barr virus infection, and neoplasia) due to a genetic deficiency of MAGT1 characterized by chronic Epstein–Barr virus infection. This and other research reporting associations of Mg deficit with viral and bacterial infections indicate a possible role of Mg deficit in the recent coronavirus disease 2019 (COVID-19) and its complications. In this review, we will discuss the importance of Mg for the immune system and for infectious diseases, including the recent pandemic of COVID-19.
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Affiliation(s)
- Ligia J. Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90100 Palermo, Italy; (L.J.D.); (M.B.)
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90100 Palermo, Italy; (L.J.D.); (M.B.)
- Correspondence: ; Tel.: +39-0916554828; Fax: +39-0916552952
| | | | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90100 Palermo, Italy; (L.J.D.); (M.B.)
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19
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Al Alawi AM, Al Badi A, Al Huraizi A, Falhammar H. Magnesium: The recent research and developments. ADVANCES IN FOOD AND NUTRITION RESEARCH 2021; 96:193-218. [PMID: 34112353 DOI: 10.1016/bs.afnr.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Magnesium is the fourth most abundant mineral in the human body, which facilitates more than 300 enzymatic reactions. Magnesium is essential for nucleic material and protein synthesis, neuromuscular conduction, cardiac contractility, energy metabolism, and immune system function. Gastrointestinal system and kidneys closely regulate magnesium absorption and elimination to maintain adequate storage of magnesium. Magnesium deficiency has been linked to many diseases and poor health outcomes. Magnesium has also been proven to be an effective therapeutic agent in many diseases, such as bronchial asthma, cardiac arrhythmia, and pre-eclampsia.
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Affiliation(s)
- Abdullah M Al Alawi
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman; Oman Medical Specialty Board, Muscat, Oman.
| | | | - Aisha Al Huraizi
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Henrik Falhammar
- Department of Endocrinology, Metabolism, and Diabetes, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
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20
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Elucidation of the levels of vitamin D, calcium, and magnesium in the serum of Egyptian migraine patients: a case-control study. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00174-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Migraine, although, is a prevalent disease; its pathogenesis is complex and still not fully elucidated. The effect of vitamin D on various neurological disorders is thought to be exerted either directly via its specific receptors or through the related minerals. We investigated the possible relationship between vitamin D level and its related minerals (calcium and magnesium) and migraine characteristics in patients.
Subjects and methods
Thirty healthy individuals and 60 age- and sex-matched migraineurs (22 chronic and 38 episodic migraineurs), diagnosed according to the International Headache Society criteria (ICHD-III), were recruited. After obtaining basic data, a visual analogue scale (VAS) for the severity of migraine pain was assessed. Migraine severity questionnaire (MIGSEV) and the Migraine Disability Assessment (MIDAS) questionnaire were given and illustrated to the participants. Blood samples were obtained, and serum concentrations of vitamin D, calcium, and magnesium were determined.
Results
Migraine patients had significantly lower level of serum vitamin D and magnesium than healthy subjects with (P < 0.001 and P = 0.04), respectively. However, the difference between the serum calcium levels of the patient and the control group was not statistically significant. Moreover, vitamin D and magnesium had a significant negative correlation with frequency, duration, severity, and disability in migraine.
Conclusion
Vitamin D and magnesium were significantly deficient in migraine patients and were related to the severity and disability of migraine attacks. Low vitamin D and magnesium levels were associated with more frequency and longer duration of migraine attacks.
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Hellwege JN, Zhu X, Huang X, Shrubsole MJ, Fan L, Li B, Ness R, Seidner DL, Giovannucci EL, Edwards TL, Dai Q. Blunted PTH response to vitamin D insufficiency/deficiency and colorectal neoplasia risk. Clin Nutr 2020; 40:3305-3313. [PMID: 33190990 DOI: 10.1016/j.clnu.2020.10.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND & AIMS In contrast to many observational studies, large-scale randomized trials do not support the protective role of vitamin D for the prevention of colorectal neoplasia. However, in previous studies, individuals with blunted parathyroid hormone (PTH) response to vitamin D insufficiency/deficiency (BPRVID), were not differentiated from those with high PTH response to vitamin D insufficiency/deficiency (HPRVID). Individuals with BPRVID are responsive to magnesium treatment, particularly treatment of magnesium plus vitamin D while those with HPRVID are responsive to vitamin D treatment. We prospectively compared these two distinct groups (i.e. BPRVID and HPRVID) for risk of incident adenoma, metachronous adenoma, and incident colorectal cancer (CRC) METHODS: Three nested case-control studies in the Prostate, Lung, Colorectal and Ovarian Cancer (PLCO) Screening Trial. RESULTS We found optimal 25(OH)D levels were associated with a significantly reduced risk of CRC, primarily among women. The associations between 25(OH)D and CRC risk significantly differed by PTH levels, particularly among women. Compared to individuals with optimal levels for both 25(OH)D and PTH, all others were at an elevated risk of incident CRC, primarily in women. We found those with BPRVID had 2.56-fold significantly increased risk of CRC compared to 1.65-fold non-significantly increased risk for those with HPRVID. Among women, we observed those with BPRVID had 4.79-6.25-fold significantly increased risks of incident CRC and adenoma whereas those with HPRVID had 3.65-fold significantly increased risk of CRC. CONCLUSIONS Individuals with BPRVID are at higher risks of incident adenoma and CRC compared to those with HPRVID, particularly among women.
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Affiliation(s)
- Jacklyn N Hellwege
- Division of Epidemiology, Vanderbilt Ingram Cancer Center, Department of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37203, USA
| | - Xiangzhu Zhu
- Division of Epidemiology, Vanderbilt Ingram Cancer Center, Department of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37203, USA
| | - Xiang Huang
- Division of Epidemiology, Vanderbilt Ingram Cancer Center, Department of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37203, USA
| | - Martha J Shrubsole
- Division of Epidemiology, Vanderbilt Ingram Cancer Center, Department of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37203, USA
| | - Lei Fan
- Master of Public Health Program, School of Medicine, Vanderbilt University, Nashville, TN, 37232, USA
| | - Bingshan Li
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Reid Ness
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Douglas L Seidner
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Edward L Giovannucci
- Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, 02115, USA
| | - Todd L Edwards
- Division of Epidemiology, Vanderbilt Ingram Cancer Center, Department of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37203, USA
| | - Qi Dai
- Division of Epidemiology, Vanderbilt Ingram Cancer Center, Department of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37203, USA.
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Chang J, Yu D, Ji J, Wang N, Yu S, Yu B. The Association Between the Concentration of Serum Magnesium and Postmenopausal Osteoporosis. Front Med (Lausanne) 2020; 7:381. [PMID: 32850896 PMCID: PMC7417435 DOI: 10.3389/fmed.2020.00381] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/19/2020] [Indexed: 12/30/2022] Open
Abstract
Background: Osteoporosis is the most common and widespread chronic skeletal metabolic disease in the world and can lead to catastrophic fractures. Therefore, it is important to look for factors that can be modified or controlled to prevent osteoporosis. Although serum Mg is believed to be associated with osteoporosis in many individuals, there are conflicting reports on the association between serum Mg and osteoporosis. Therefore, this meta-analyses aimed to explore the association between the concentration of serum Mg and osteoporosis as well as that between the concentration of serum Mg and osteopenia. Methods: Articles were searched in PubMed. We also reviewed the reference lists of the relevant publications and reviews as of December 2019. Finally, 11 eligible studies involving 2,776 postmenopausal women were selected. We performed subgroup analysis, and publication bias was assessed. Results: According to the forest plot analysis, postmenopausal women with osteoporosis had a lower concentration of serum Mg than normal controls [standardized mean difference (SMD) = −0.56, 95% confidence interval (CI) = −1.02 to −0.09]. However, this result was not applicable to those with osteopenia (SMD = −0.30, 95% CI = −0.69 to 0.09). The subgroup analysis by geographical location found a similar pattern in European postmenopausal women with osteoporosis (SMD = −0.73, 95% CI = −1.322 to −0.143), but not in Asian (SMD = −0.007, 95% CI = −0.381 to 0.394). The subgroup analysis by site of bone mineral density (BMD) showed the serum Mg concentration of postmenopausal women with osteoporosis (BMD of femur) was lower than in healthy controls (SMD = −0.44, 95% CI = −0.77 to −0.12), and BMD of the spine group had the same conclusion (SMD = −0.78, 95% CI = −1.36 to −0.19). Besides, the serum Mg concentration of postmenopausal women with osteoporosis was lower than that of the normal bone mass group in the studies those included more than 50 postmenopausal women with osteoporosis (SMD = −0.57, 95% CI = −1.04 to −0.11). We also found postmenopausal women under the age of 60 with osteoporosis had a lower concentration of serum Mg than the healthy controls (SMD = −0.61, 95% CI = −1.09 to −0.13). Conclusion: Postmenopausal women with osteoporosis have a lower concentration of serum Mg. However, the association between the concentration of serum Mg and osteopenia needs further confirmation.
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Affiliation(s)
- Jinlei Chang
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Degang Yu
- Department of Orthopaedics, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jindou Ji
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ning Wang
- The College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shengwen Yu
- The College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Bo Yu
- Department of Orthopaedics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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Wallace TC. Combating COVID-19 and Building Immune Resilience: A Potential Role for Magnesium Nutrition? J Am Coll Nutr 2020; 39:685-693. [PMID: 32649272 DOI: 10.1080/07315724.2020.1785971] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: In December 2019, the viral pandemic of respiratory illness caused by COVID-19 began sweeping its way across the globe. Several aspects of this infectious disease mimic metabolic events shown to occur during latent subclinical magnesium deficiency. Hypomagnesemia is a relatively common clinical occurrence that often goes unrecognized since magnesium levels are rarely monitored in the clinical setting. Magnesium is the second most abundant intracellular cation after potassium. It is involved in >600 enzymatic reactions in the body, including those contributing to the exaggerated immune and inflammatory responses exhibited by COVID-19 patients.Methods: A summary of experimental findings and knowledge of the biochemical role magnesium may play in the pathogenesis of COVID-19 is presented in this perspective. The National Academy of Medicine's Standards for Systematic Reviews were independently employed to identify clinical and prospective cohort studies assessing the relationship of magnesium with interleukin-6, a prominent drug target for treating COVID-19.Results: Clinical recommendations are given for prevention and treatment of COVID-19. Constant monitoring of ionized magnesium status with subsequent repletion, when appropriate, may be an effective strategy to influence disease contraction and progression. The peer-reviewed literature supports that several aspects of magnesium nutrition warrant clinical consideration. Mechanisms include its "calcium-channel blocking" effects that lead to downstream suppression of nuclear factor-Kβ, interleukin-6, c-reactive protein, and other related endocrine disrupters; its role in regulating renal potassium loss; and its ability to activate and enhance the functionality of vitamin D, among others.Conclusion: As the world awaits an effective vaccine, nutrition plays an important and safe role in helping mitigate patient morbidity and mortality. Our group is working with the Academy of Nutrition and Dietetics to collect patient-level data from intensive care units across the United States to better understand nutrition care practices that lead to better outcomes.
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Affiliation(s)
- Taylor C Wallace
- Think Healthy Group, Washington, DC, USA.,Department of Nutrition and Food Studies, George Mason University, Fairfax, Virginia, USA.,Center for Magnesium Education & Research, Pahoa, Hawaii, USA
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Isse N, Hashimoto M. Omeprazole-induced hypomagnesaemia, causing renal tubular acidosis with hypokalaemia, hypocalcaemia, hyperlactacidaemia and hyperammonaemia. BMJ Case Rep 2020; 13:13/7/e235385. [PMID: 32641306 DOI: 10.1136/bcr-2020-235385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
A 72-year-old Japanese man treated with omeprazole for 11 years was admitted due to loss of consciousness and muscle weakness. Wolff-Parkinson-White syndrome-induced tachycardia was considered as the cause of syncope. His blood examination revealed rhabdomyolysis, hypokalaemia, hypomagnesaemia, hypocalcaemia, hyperlactacidaemia, hyperammonaemia and high-anion-gap metabolic acidosis. Hypomagnesaemia could be caused by magnesium malabsorption due to omeprazole use. Hypocalcaemia might be caused by the inhibitory effect of hypomagnesemia on the parathyroid gland hormone secretion. Hyperammonaemia might be caused by two reasons: (1) renal ammonium production induced by hypokalaemia; (2) inhibition of ammonium secretion by omeprazole. Both hypocalcaemia and hypokalaemia might cause chronic elevation of serum creatinine phosphokinase which ended up with rhabdomyolysis. Correction of serum electrolytes rapidly improved his muscle weakness. Discontinuation of omeprazole no longer caused these abnormalities. A physician should be aware of unexplained signs and symptoms of patients using proton-pump inhibitors to avoid life-threatening electrolyte and physiologic disturbances.
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Affiliation(s)
- Naohi Isse
- Department of Internal Medicine, Ako City Hospital, Ako, Hyogo, Japan
| | - Masashi Hashimoto
- Department of Internal Medicine, Ako City Hospital, Ako, Hyogo, Japan
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Uwitonze AM, Rahman S, Ojeh N, Grant WB, Kaur H, Haq A, Razzaque MS. Oral manifestations of magnesium and vitamin D inadequacy. J Steroid Biochem Mol Biol 2020; 200:105636. [PMID: 32084549 DOI: 10.1016/j.jsbmb.2020.105636] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 12/04/2019] [Accepted: 02/17/2020] [Indexed: 12/11/2022]
Abstract
Adequate nutrition is essential for maintaining good oral health. Minerals such as magnesium, calcium, and phosphorus found in the diet constitute the main structural components of the tooth. Their inadequacy leads to absorption impairment, increased bleeding tendency, bone resorption, looseness, and premature tooth loss. Inadequacy of those essential minerals is associated with delayed tooth eruption and with enamel or dentin hypoplasia. Taking calcium without magnesium results in soft dental enamel, which cannot resist the acids causing tooth decay. In addition to magnesium, calcium, and phosphorus, adequate vitamin D is needed to maintain optimal oral health. Vitamin D exerts anti-inflammatory effects and helps in calcium absorption and bone remodeling. Moreover, adequate vitamin D status could reduce formation of dental caries by delaying its onset and progression. Here we summarize the oral manifestations of vitamin D and magnesium inadequacy.
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Affiliation(s)
- Anne Marie Uwitonze
- Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda
| | - Sayeeda Rahman
- Department of Pharmacology & Public Health, School of Medicine, American University of Integrative Sciences, Bridgetown, Barbados
| | - Nkemcho Ojeh
- Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - William B Grant
- Sunlight, Nutrition, & Health Research Center, San Francisco, CA, USA
| | - Harleen Kaur
- Department of Computer Science & Engineering, School of Engineering Sciences & Technology, Jamia Hamdard, New Delhi, India
| | - Afrozul Haq
- Department of Food Technology, School of Interdisciplinary Sciences, Jamia Hamdard, New Delhi, India
| | - Mohammed S Razzaque
- Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda; College of Advancing & Professional Studies (CAPS), University of Massachusetts Boston (UMB), Boston, MA, USA; Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, USA.
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Cheung MM, DeLuccia R, Ramadoss RK, Aljahdali A, Volpe SL, Shewokis PA, Sukumar D. Low dietary magnesium intake alters vitamin D-parathyroid hormone relationship in adults who are overweight or obese. Nutr Res 2019; 69:82-93. [PMID: 31675537 DOI: 10.1016/j.nutres.2019.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/16/2019] [Accepted: 08/02/2019] [Indexed: 01/10/2023]
Abstract
Vitamin D metabolism is dependent on magnesium (Mg) as a cofactor; therefore, poor Mg status may alter the relationship between vitamin D metabolite serum 25-hydroxyvitamin D (s25OHD) and serum parathyroid hormone (sPTH). We hypothesized that low dietary Mg intake may alter sPTH response to s25OHD in a population with excess body weight, thereby leading to a worsening of cardiometabolic health. To explore this hypothesis, we conducted a cross-sectional study on adults who were either overweight or obese (owt/ob). Dietary Mg intake was measured using a Mg food frequency questionnaire (MgFFQ). Body composition information was measured using Dual Energy X-ray Absorptiometry (DXA). Blood samples were obtained for all biochemical analyses. A total of 57 participants, 22 to 65 years of age, with a body mass index between 25 to 45 kg/m2 were divided into 3 groups, according to dietary Mg intake percentiles (Low Mg Group = <33 percentile, Medium Mg Group = 33 to 66 percentile, High Mg Group = >66 percentile). Higher s25OHD was negatively associated with lower sPTH in the High Mg Intake group (r = -0.472, P = .041), but not in other groups. A positive relationship between s25OHD and serum high-molecular weight adiponectin concentrations was observed in the High Mg Group (r = 0.532, r = 0.022), but not in other groups. Serum Interleukin-6 concentrations were negatively associated with s25OHD (r = -0.316, P = .017) for the entire study group. Based on these results, our study demonstrated that a low dietary Mg intake may alter PTH response to 25OHD.
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Affiliation(s)
- May M Cheung
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, 1601 Cherry St., Philadelphia, PA 19102.
| | - Rosemary DeLuccia
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, 1601 Cherry St., Philadelphia, PA 19102.
| | - Rohit Kumar Ramadoss
- Department of Culinary Arts and Food Sciences, College of Nursing and Health Professions, Drexel University, 1601 Cherry St., Philadelphia, PA 19102.
| | - Abeer Aljahdali
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, 1601 Cherry St., Philadelphia, PA 19102.
| | - Stella L Volpe
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, 1601 Cherry St., Philadelphia, PA 19102.
| | - Patricia A Shewokis
- Department of Nutrition Sciences, College of Nursing and Health Professions, School of Biomedical Engineering, Science and Health System, Drexel University, 1601 Cherry St., Philadelphia, PA 19102.
| | - Deeptha Sukumar
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, 1601 Cherry St., Philadelphia, PA 19102.
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Dai Q, Zhu X, Manson JE, Song Y, Li X, Franke AA, Costello RB, Rosanoff A, Nian H, Fan L, Murff H, Ness RM, Seidner DL, Yu C, Shrubsole MJ. Magnesium status and supplementation influence vitamin D status and metabolism: results from a randomized trial. Am J Clin Nutr 2018; 108:1249-1258. [PMID: 30541089 PMCID: PMC6693398 DOI: 10.1093/ajcn/nqy274] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 09/13/2018] [Indexed: 12/11/2022] Open
Abstract
Background Previous in vitro and in vivo studies indicate that enzymes that synthesize and metabolize vitamin D are magnesium dependent. Recent observational studies found that magnesium intake significantly interacted with vitamin D in relation to vitamin D status and risk of mortality. According to NHANES, 79% of US adults do not meet their Recommended Dietary Allowance of magnesium. Objectives The aim of this study was to test the hypothesis that magnesium supplementation differentially affects vitamin D metabolism dependent on baseline 25-hydroxyvitamin D [25(OH)D] concentration. Methods The study included 180 participants aged 40-85 y and is a National Cancer Institute independently funded ancillary study, nested within the Personalized Prevention of Colorectal Cancer Trial (PPCCT), which enrolled 250 participants. The PPCCT is a double-blind 2 × 2 factorial randomized controlled trial conducted in the Vanderbilt University Medical Center. Doses for both magnesium and placebo were customized based on baseline dietary intakes. Subjects were randomly assigned to treatments using a permuted-block randomization algorithm. Changes in plasma 25-hydroxyvitamin D3 [25(OH)D3], 25-hydroxyvitamin D2 [25(OH)D2], 1,25-dihydroxyvitamin D3, 1,25-dihydroxyvitamin D2, and 24,25-dihydroxyvitamin D3 [24,25(OH)2D3] were measured by liquid chromatography-mass spectrometry. Results The relations between magnesium treatment and plasma concentrations of 25(OH)D3, 25(OH)D2, and 24,25(OH)2D3 were significantly different dependent on the baseline concentrations of 25(OH)D, and significant interactions persisted after Bonferroni corrections. Magnesium supplementation increased the 25(OH)D3 concentration when baseline 25(OH)D concentrations were close to 30 ng/mL, but decreased it when baseline 25(OH)D was higher (from ∼30 to 50 ng/mL). Magnesium treatment significantly affected 24,25(OH)2D3 concentration when baseline 25(OH)D concentration was 50 ng/mL but not 30 ng/mL. On the other hand, magnesium treatment increased 25(OH)D2 as baseline 25(OH)D increased. Conclusion Our findings suggest that optimal magnesium status may be important for optimizing 25(OH)D status. This trial was registered at clinicaltrials.gov as NCT03265483.
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Affiliation(s)
- Qi Dai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN,Address correspondence to QD (e-mail: )
| | - Xiangzhu Zhu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA
| | - Yiqing Song
- Department of Epidemiology, Richard M Fairbanks School of Public Health, Indiana University–Purdue University, Indianapolis, IN
| | - Xingnan Li
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Adrian A Franke
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | | | | | | | - Lei Fan
- Master of Public Health Program
| | - Harvey Murff
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
| | - Reid M Ness
- Division of Gastroenterology, Department of Medicine, School of Medicine, Vanderbilt University, Nashville, TN
| | - Douglas L Seidner
- Division of Gastroenterology, Department of Medicine, School of Medicine, Vanderbilt University, Nashville, TN
| | | | - Martha J Shrubsole
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
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Severe Hypocalcemia and Hypomagnesemia with Denosumab in Advanced Chronic Kidney Disease: Case Report and Literature Review. Case Rep Oncol Med 2018; 2018:2059364. [PMID: 30405927 PMCID: PMC6204163 DOI: 10.1155/2018/2059364] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 09/17/2018] [Indexed: 11/18/2022] Open
Abstract
Background Denosumab has become the preferred agent over zolendronic acid to help prevent skeletal-related events in patients with metastatic bone disease and multiple myeloma because it is approved for use in those with kidney dysfunction. However, denosumab has been linked to cases of hypocalcemia, particularly in those with advanced kidney disease. Case Presentation We present the case of a patient with metastatic prostate cancer and chronic kidney disease due to obstructive nephropathy who developed severe hypocalcemia and hypomagnesemia after denosumab injection, which required intensive care unit admission, aggressive calcium supplementation, and hemodialysis assistance. We reviewed the evidence behind the safety profile of denosumab in chronic kidney disease, and we also looked at additional factors that may precipitate severe hypocalcemia with denosumab in advanced kidney disease. Conclusion We believe that denosumab should be avoided in advanced chronic kidney disease due to the potential life-threatening, severe hypocalcemia that has been observed.
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Dietary magnesium deficiency impaired intestinal structural integrity in grass carp (Ctenopharyngodon idella). Sci Rep 2018; 8:12705. [PMID: 30139942 PMCID: PMC6107577 DOI: 10.1038/s41598-018-30485-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/30/2018] [Indexed: 02/07/2023] Open
Abstract
Grass carp (223.85–757.33 g) were fed diets supplemented with magnesium (73.54–1054.53 mg/kg) for 60 days to explore the impacts of magnesium deficiency on the growth and intestinal structural integrity of the fish. The results demonstrated that magnesium deficiency suppressed the growth and damaged the intestinal structural integrity of the fish. We first demonstrated that magnesium is partly involved in (1) attenuating antioxidant ability by suppressing Nrf2 signalling to decrease antioxidant enzyme mRNA levels and activities (except CuZnSOD mRNA levels and activities); (2) aggravating apoptosis by activating JNK (not p38MAPK) signalling to upregulate proapoptotic protein (Apaf-1, Bax and FasL) and caspase-2, -3, -7, -8 and -9 gene expression but downregulate antiapoptotic protein (Bcl-2, IAP and Mcl-1b) gene expression; (3) weakening the function of tight junctional complexes (TJs) by promoting myosin light chain kinase (MLCK) signalling to downregulate TJ gene expression [except claudin-7, ZO-2b and claudin-15 gene expression]. Additionally, based on percent weight gain (PWG), against reactive oxygen species (ROS), against caspase-9 and claudin-3c in grass carp, the optimal dietary magnesium levels were calculated to be 770.38, 839.86, 856.79 and 811.49 mg/kg, respectively.
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Hansen BA, Bruserud Ø. Hypomagnesemia in critically ill patients. J Intensive Care 2018; 6:21. [PMID: 29610664 PMCID: PMC5872533 DOI: 10.1186/s40560-018-0291-y] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/13/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Magnesium (Mg) is essential for life and plays a crucial role in several biochemical and physiological processes in the human body. Hypomagnesemia is common in all hospitalized patients, especially in critically ill patients with coexisting electrolyte abnormalities. Hypomagnesemia may cause severe and potential fatal complications if not timely diagnosed and properly treated, and associate with increased mortality. MAIN BODY Mg deficiency in critically ill patients is mainly caused by gastrointestinal and/or renal disorders and may lead to secondary hypokalemia and hypocalcemia, and severe neuromuscular and cardiovascular clinical manifestations. Because of the physical distribution of Mg, there are no readily or easy methods to assess Mg status. However, serum Mg and the Mg tolerance test are most widely used. There are limited studies to guide intermittent therapy of Mg deficiency in critically ill patients, but some empirical guidelines exist. Further clinical trials and critical evaluation of empiric Mg replacement strategies is needed. CONCLUSION Patients at risk of Mg deficiency, with typical biochemical findings or clinical symptoms of hypomagnesemia, should be considered for treatment even with serum Mg within the normal range.
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Affiliation(s)
| | - Øyvind Bruserud
- Section for Endocrinology, Department of Clinical Science, University of Bergen, Bergen, Norway
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Berridge MJ. Vitamin D deficiency accelerates ageing and age-related diseases: a novel hypothesis. J Physiol 2017; 595:6825-6836. [PMID: 28949008 DOI: 10.1113/jp274887] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/11/2017] [Indexed: 12/24/2022] Open
Abstract
Ageing can occur at different rates, but what controls this variable rate is unknown. Here I have developed a hypothesis that vitamin D may act to control the rate of ageing. The basis of this hypothesis emerged from studyng the various cellular processes that control ageing. These processes such as autophagy, mitochondrial dysfunction, inflammation, oxidative stress, epigenetic changes, DNA disorders and alterations in Ca2+ and reactive oxygen species (ROS) signalling are all known to be regulated by vitamin D. The activity of these processes will be enhanced in individuals that are deficient in vitamin D. Not only will this increase the rate of ageing, but it will also increase the probability of developing age-related diseases such as Alzheimer's disease, Parkinson's disease, multiple sclerosis and cardiovascular disease. In individual with normal vitamin D levels, these ageing-related processes will occur at lower rates resulting in a reduced rate of ageing and enhanced protection against these age-related diseases.
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Leno BM, LaCount SE, Ryan CM, Briggs D, Crombie M, Overton TR. The effect of source of supplemental dietary calcium and magnesium in the peripartum period, and level of dietary magnesium postpartum, on mineral status, performance, and energy metabolites in multiparous Holstein cows. J Dairy Sci 2017; 100:7183-7197. [PMID: 28711248 DOI: 10.3168/jds.2017-12773] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/01/2017] [Indexed: 11/19/2022]
Abstract
The objective of this study was to determine the effects of feeding different supplemental sources of Ca and Mg in the peripartum period, and different dietary levels of Mg postpartum, on plasma mineral status, performance, and aspects of energy metabolism in transition dairy cows. Multiparous Holstein cows (n = 41) were used in a completely randomized design with a 2 × 2 factorial arrangement of treatments starting at 28 d before expected parturition. Main effects were source assignments (CS = common sources of supplemental Ca and Mg, or MA = a blend of common and commercial mineral sources with supplemental minerals primarily from a commercial Ca-Mg dolomite source; MIN-AD, Papillon Agricultural Company Inc., Easton, MD) beginning at 21 d before due date; cows were further randomized within source treatments to 1 of 2 levels of Mg supplementation (LM = formulated postpartum diet Mg at 0.30% of dry matter (DM), or HM = formulated postpartum diet Mg at 0.45% of DM) beginning within 1 d after parturition. Final treatment groups included the following: common source, low Mg (CS-LM, n = 11); common source, high Mg (CS-HM, n = 11); MIN-AD, low Mg (MA-LM, n = 10); and MIN-AD, high Mg (MA-HM, n = 9). Treatment diets were fed and data collected through 42 d in milk. Postpartum plasma Mg concentrations tended to be higher for cows fed HM and cows fed CS, but no effects were observed on peripartum plasma Ca concentrations. Peripartum plasma P concentrations were higher for cows fed MA. Dry matter intake (DMI) in the prepartum period was higher for cows fed MA (CS = 15.9 vs. MA = 16.8 kg/d) and postpartum DMI was higher in some groups depending on week. Plasma nonesterified fatty acid concentrations were lower for cows fed MA during both the prepartum and postpartum periods. A source by level interaction was observed for postpartum plasma β-hydroxybutyrate (BHB) concentrations such that cows fed CS-LM had numerically higher BHB and cows fed MA-LM had numerically lower BHB (geometric means; CS-LM = 7.9, CS-HM = 6.9, MA-LM = 6.3, and MA-HM = 7.3 mg/dL) than cows fed the other 2 treatments. Higher milk fat yield, milk fat content, and fat- and energy-corrected yield during wk 1 for cows fed MA resulted in source by week interactions for these outcomes. This study demonstrated that varying supplemental Ca and Mg sources and feeding rates had minimal effect on plasma Ca status despite differences in plasma Mg and P concentrations. Effects on DMI and plasma energy metabolites suggest an opportunity for strategic use of mineral sources in the transition period to promote metabolic health.
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Affiliation(s)
- B M Leno
- Department of Animal Science, Cornell University, Ithaca, NY 14853
| | - S E LaCount
- Department of Animal Science, Cornell University, Ithaca, NY 14853
| | - C M Ryan
- Department of Animal Science, Cornell University, Ithaca, NY 14853
| | - D Briggs
- Papillon Agricultural Company Inc., Easton, MD 21601
| | | | - T R Overton
- Department of Animal Science, Cornell University, Ithaca, NY 14853.
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Affiliation(s)
- Mitchell H Rosner
- Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia
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Knapen MHJ, Braam LAJLM, Teunissen KJ, Van't Hoofd CM, Zwijsen RML, van den Heuvel EGHM, Vermeer C. Steady-state vitamin K2 (menaquinone-7) plasma concentrations after intake of dairy products and soft gel capsules. Eur J Clin Nutr 2016; 70:831-6. [PMID: 26908424 DOI: 10.1038/ejcn.2016.3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 01/11/2016] [Accepted: 01/15/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND In a previous human intervention study, we observed an improved vitamin K status after 8 weeks of intake of a yogurt that was fortified with vitamin K2 (as menaquinone-7, MK-7) and enriched with vitamins C and D3, magnesium and polyunsaturated fatty acids. It was hypothesized that the added nutrients contributed to this improvement. Here we report on a study in which we compared the fasting plasma concentrations of MK-7 from (a) yogurt enriched with MK-7, vitamins D3 and C, magnesium, n-3 poly unsaturated fatty acids (n-3 PUFA) and fish oil (yogurt Kplus), (b) yogurt fortified with MK-7 only (yogurt K) and (c) soft gel capsules containing only MK-7. SUBJECTS/METHODS For 42 days, healthy men and postmenopausal women between 45 and 65 years of age daily consumed either yogurt K, yogurt Kplus or capsules. Circulating MK-7, 25-hydroxy vitamin D (25(OH)D) and markers for vitamin K status (uncarboxylated osteocalcin (ucOC) and desphospho-uncarboxylated matrix Gla-protein (dp-ucMGP)) were assessed. Plasma MK-7 was also measured during the washout period of 2 weeks. MK-7 and dp-ucMGP were measured in citrated plasma, and 25(OH)D3 and ucOC were measured in the serum. RESULTS The increase in plasma MK-7 with the yogurt Kplus product was more pronounced than the increase in MK-7 with the capsules. Circulating dp-ucMGP and ucOC were significantly lowered after consumption of the yogurt products and the MK-7 capsules, reflecting vitamin K status improvement. No significant differences in fasting plasma concentrations of various biomarkers between the yogurts were found. CONCLUSIONS Dairy matrix and nutrient composition may affect MK-7 delivery and improvement of vitamin K status. Yogurt fortified with MK-7 is a suitable matrix to improve the nutritional status of the fat-soluble vitamins.
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Affiliation(s)
- M H J Knapen
- R&D Group VitaK, Biopartner Center Maastricht, Maastricht University, Maastricht, The Netherlands
| | - L A J L M Braam
- R&D Group VitaK, Biopartner Center Maastricht, Maastricht University, Maastricht, The Netherlands
| | - K J Teunissen
- R&D Group VitaK, Biopartner Center Maastricht, Maastricht University, Maastricht, The Netherlands
| | - C M Van't Hoofd
- R&D Group VitaK, Biopartner Center Maastricht, Maastricht University, Maastricht, The Netherlands
| | | | | | - C Vermeer
- R&D Group VitaK, Biopartner Center Maastricht, Maastricht University, Maastricht, The Netherlands
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Suppression of Parathyroid Hormone in a Patient with Severe Magnesium Depletion. Case Rep Nephrol 2016; 2016:2608538. [PMID: 27190662 PMCID: PMC4850250 DOI: 10.1155/2016/2608538] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 03/31/2016] [Indexed: 11/30/2022] Open
Abstract
Hypomagnesemia is often associated with coexisting electrolyte abnormalities like hypokalemia and hypocalcemia. Hypocalcemia has been shown to be secondary to hypoparathyroidism induced by hypomagnesemia. Here, we discuss a case of a patient with severe hypomagnesemia and associated hypocalcemia. A 38-year-old lady was admitted to the hospital for weakness of lower extremities and an eventual fall. The exam was significant for decreased motor strength and some paresthesias. The laboratory data was significant for hypomagnesemia, hypokalemia, and low parathyroid level in the face of hypocalcemia. After replacing magnesium, the parathyroid hormone levels normalized and led to eventual correction of calcium levels without any additional calcium replacement therapy. There was complete symptom resolution with correction of electrolyte abnormalities. This case highlights the importance of looking for all associated abnormalities in a patient with hypomagnesemia and starting the replacement therapy by first replacing the magnesium and then the others as needed. Replacing the magnesium alone may correct the hypoparathyroidism and eliminate the need for calcium replacement.
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Rosanoff A, Dai Q, Shapses SA. Essential Nutrient Interactions: Does Low or Suboptimal Magnesium Status Interact with Vitamin D and/or Calcium Status? Adv Nutr 2016; 7:25-43. [PMID: 26773013 PMCID: PMC4717874 DOI: 10.3945/an.115.008631] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Although much is known about magnesium, its interactions with calcium and vitamin D are less well studied. Magnesium intake is low in populations who consume modern processed-food diets. Low magnesium intake is associated with chronic diseases of global concern [e.g., cardiovascular disease (CVD), type 2 diabetes, metabolic syndrome, and skeletal disorders], as is low vitamin D status. No simple, reliable biomarker for whole-body magnesium status is currently available, which makes clinical assessment and interpretation of human magnesium research difficult. Between 1977 and 2012, US calcium intakes increased at a rate 2-2.5 times that of magnesium intakes, resulting in a dietary calcium to magnesium intake ratio of >3.0. Calcium to magnesium ratios <1.7 and >2.8 can be detrimental, and optimal ratios may be ∼2.0. Background calcium to magnesium ratios can affect studies of either mineral alone. For example, US studies (background Ca:Mg >3.0) showed benefits of high dietary or supplemental magnesium for CVD, whereas similar Chinese studies (background Ca:Mg <1.7) showed increased risks of CVD. Oral vitamin D is widely recommended in US age-sex groups with low dietary magnesium. Magnesium is a cofactor for vitamin D biosynthesis, transport, and activation; and vitamin D and magnesium studies both showed associations with several of the same chronic diseases. Research on possible magnesium and vitamin D interactions in these human diseases is currently rare. Increasing calcium to magnesium intake ratios, coupled with calcium and vitamin D supplementation coincident with suboptimal magnesium intakes, may have unknown health implications. Interactions of low magnesium status with calcium and vitamin D, especially during supplementation, require further study.
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Affiliation(s)
| | - Qi Dai
- Vanderbilt Epidemiology Center, Department of Medicine, School of Medicine, Vanderbilt University, Nashville, TN; and
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Zhu X, Shrubsole MJ, Ness RM, Hibler EA, Cai Q, Long J, Chen Z, Li G, Jiang M, Hou L, Kabagambe EK, Zhang B, Smalley WE, Edwards TL, Giovannucci EL, Zheng W, Dai Q. Calcium/magnesium intake ratio, but not magnesium intake, interacts with genetic polymorphism in relation to colorectal neoplasia in a two-phase study. Mol Carcinog 2015; 55:1449-57. [PMID: 26333203 DOI: 10.1002/mc.22387] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/24/2015] [Accepted: 08/03/2015] [Indexed: 12/20/2022]
Abstract
Some studies suggest that the calcium to magnesium ratio intakes modify the associations of calcium or magnesium with risk of colorectal adenoma, adenoma recurrence, and cancer. Parathyroid hormone (PTH) plays a key role in the regulation of homeostasis for both calcium and magnesium. We hypothesized that polymorphisms in PTH and 13 other genes may modify the association between the calcium/magnesium intake ratio and colorectal neoplasia risk. We conducted a two-phase study including 1336 cases and 2891 controls from the Tennessee Colorectal Polyp Study. In Phase I, we identified 19 SNPs that significantly interacted with the calcium/magnesium intake ratio in adenoma risk. In Phase II, rs11022858 in PTH was replicated. In combined analysis of phases I and II, we found high calcium/magnesium intake ratio tended to be associated with a reduced risk of colorectal adenoma (P for trend, 0.040) among those who carried the TT genotype in rs11022858. In stratified analyses, calcium intake (≥ 1000 mg/d) was significantly associated with 64% reduced adenoma risk (OR = 0.36 (95% CI : 0.18-0.74)) among those homozygous for the minor allele (TT genotype) (P for trend, 0.012), but not associated with risk in other genotypes (CC/TC). Conversely, we found that highest magnesium intake was significantly associated with 27% reduced risk (OR = 0.73 (95% CI : 0.54-0.97)) of colorectal adenoma (P for trend, 0.026) among those who possessed the CC/TC genotypes, particularly among those with the TC genotype, whereas magnesium intake was not linked to risk among those with the TT genotype. These findings, if confirmed, will help for the development of personalized prevention strategies for colorectal cancer. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Xiangzhu Zhu
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee.,Department of Veterans Affairs, Tennessee Valley Healthcare System, Geriatric, Research, Education and Clinical Center (GRECC), Nashville, Tennessee
| | - Martha J Shrubsole
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee.,Department of Veterans Affairs, Tennessee Valley Healthcare System, Geriatric, Research, Education and Clinical Center (GRECC), Nashville, Tennessee.,Vanderbilt Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Reid M Ness
- Department of Medicine, Division of Gastroenterology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Elizabeth A Hibler
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Qiuyin Cai
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Jirong Long
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Zhi Chen
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Guoliang Li
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Ming Jiang
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Lifang Hou
- Institute for Public Health and Medicine, Northwestern University, Chicago, Illinois
| | - Edmond K Kabagambe
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Bing Zhang
- Department of Biomedical informatics, Vanderbilt University, Nashville, Tennessee
| | - Walter E Smalley
- Department of Veterans Affairs, Tennessee Valley Healthcare System, Geriatric, Research, Education and Clinical Center (GRECC), Nashville, Tennessee.,Department of Medicine, Division of Gastroenterology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Todd L Edwards
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee.,Department of Veterans Affairs, Tennessee Valley Healthcare System, Geriatric, Research, Education and Clinical Center (GRECC), Nashville, Tennessee.,Vanderbilt Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Edward L Giovannucci
- Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Wei Zheng
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee.,Department of Veterans Affairs, Tennessee Valley Healthcare System, Geriatric, Research, Education and Clinical Center (GRECC), Nashville, Tennessee.,Vanderbilt Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Qi Dai
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee. .,Department of Veterans Affairs, Tennessee Valley Healthcare System, Geriatric, Research, Education and Clinical Center (GRECC), Nashville, Tennessee. .,Vanderbilt Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee.
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Walsh SB, Zdebik AA, Unwin RJ. Magnesium: The Disregarded Cation. Mayo Clin Proc 2015; 90:993-5. [PMID: 26250724 DOI: 10.1016/j.mayocp.2015.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 06/29/2015] [Indexed: 12/27/2022]
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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The association between serum 25-hydroxyvitamin D3 concentration and risk of disease death in men: modification by magnesium intake. Eur J Epidemiol 2015; 30:343-7. [PMID: 25762172 DOI: 10.1007/s10654-015-0006-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 02/20/2015] [Indexed: 10/23/2022]
Abstract
Low vitamin D status increases the risk of death. Magnesium plays an essential role in vitamin D metabolism and low magnesium intake may predispose to vitamin D deficiency and potentiate the health problems. We investigated whether magnesium intake modifies the serum 25(OH)D3 concentration and its associations with mortality in middle-aged and older men. We included 1892 men aged 42-60 years without cardiovascular disease or cancer at baseline in 1984-1989 from the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Serum 25(OH)D3 was measured with the high-performance liquid chromatography using coulometric electrode array detection. Magnesium intake was assessed with 4-day food recording. Deaths were ascertained by a computer linkage to the national cause of death register. Deaths due accidents and suicides were excluded. Cox proportional hazards regression models were used to analyze the associations. The multivariate-adjusted hazard ratio (HR) for death in the lowest (<32.1 nmol/L) versus the highest (>49.4 nmol/L) serum 25(OH)D3 tertile was 1.31 (95 % CI 1.07-1.60, Ptrend = 0.01). Stratified by the magnesium intake, the higher risk was observed only in the lower magnesium intake median (<414 mg/day); HR = 1.60 (95 % CI 1.19-2.13, Ptrend = 0.002) in the lowest versus the highest 25(OH)D3 tertile, whereas the corresponding HR = 1.07, 95 % CI 0.75-1.36, Ptrend = 0.63) in the higher magnesium intake median, P for interaction = 0.08. In this cohort of middle-aged and older men low serum 25(OH)D3 concentration was associated with increased risk of death mainly in those with lower magnesium intake.
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Huang JH, Cheng FC, Wu HC. Low Magnesium Exacerbates Osteoporosis in Chronic Kidney Disease Patients with Diabetes. Int J Endocrinol 2015; 2015:380247. [PMID: 26273297 PMCID: PMC4530248 DOI: 10.1155/2015/380247] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 01/19/2015] [Accepted: 03/09/2015] [Indexed: 12/18/2022] Open
Abstract
The aim of this study is to investigate the impact of serum Mg on bone mineral metabolism in chronic kidney disease (CKD) patients with or without diabetes. A total of 56 CKD patients not receiving dialysis were recruited and divided into two groups, one group of 27 CKD patients with diabetes and another group of 29 CKD patients without diabetes. Biochemical determinations were made, and the estimated glomerular filtration rate (eGFR) was measured. Bone mineral density was measured by dual-energy X-ray absorptiometry. Serum Mg was inversely correlated with serum Ca (P = 0.023) and positively correlated with serum parathyroid hormone (PTH) (P = 0.020), alkaline phosphatase (P = 0.044), and phosphate (P = 0.040) in the CKD patients with diabetes. The CKD patients with diabetes had lower serum albumin and a higher proportion of hypomagnesemia and osteoporosis than the nondiabetic patients did (P < 0.05). Serum Mg was inversely correlated with eGFR in the CKD patients with or without diabetes (P < 0.05). Serum Mg showed an inverse correlation with 25-hydroxyvitamin D in CKD patients without diabetes (P = 0.006). Furthermore, the diabetic CKD patients with low serum Mg had a lower iPTH (P = 0.007) and a higher serum Ca/Mg ratio (P < 0.001) than the other CKD patients. The lower serum Mg subgroup showed a higher incidence of osteoporosis than the moderate and higher serum Mg subgroups did (66.7%, 39.4%, and 29.4%, resp.). In conclusion, low serum Mg may impact iPTH and exacerbates osteoporosis in CKD patients, particularly with diabetes.
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Affiliation(s)
- Jui-Hua Huang
- Department of Community Health, Chia-Yi Christian Hospital, Chiayi 600, Taiwan
| | - Fu-Chou Cheng
- Stem Cell Center, Department of Medical Research, Taichung Veterans General Hospital, Taichung 402, Taiwan
| | - Hsu-Chen Wu
- Division of Nephrology, Department of Internal Medicine, Changhua Christian Medical Foundation Erlin Christian Hospital, Changhua 526, Taiwan
- *Hsu-Chen Wu:
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Floege J. Magnesium in CKD: more than a calcification inhibitor? J Nephrol 2014; 28:269-77. [PMID: 25227765 PMCID: PMC4439441 DOI: 10.1007/s40620-014-0140-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 09/02/2014] [Indexed: 01/30/2023]
Abstract
Magnesium fulfils important roles in multiple physiological processes. Accordingly, a tight regulation of magnesium homeostasis is essential. Dysregulated magnesium serum levels, in particular hypomagnesaemia, are common in patients with chronic kidney disease (CKD) and have been associated with poor clinical outcomes. In cell culture studies as well as in clinical situations magnesium levels were associated with vascular calcification, cardiovascular disease and altered bone-mineral metabolism. Magnesium has also been linked to diseases such as metabolic syndrome, diabetes, hypertension, fatigue and depression, all of which are common in CKD. The present review summarizes and discusses the latest clinical data on the impact of magnesium and possible effects of higher levels on the health status of patients with CKD, including an outlook on the use of magnesium-based phosphate-binding agents in this context.
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Affiliation(s)
- Jürgen Floege
- Division of Nephrology and Clinical Immunology, RWTH University of Aachen, Pauwelsstr. 30, 52057, Aachen, Germany,
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Berthet É, Soubrier M, Tournadre A, Malochet-Guinamand S. Une hypocalcémie réfractaire. Presse Med 2014; 43:335-7. [DOI: 10.1016/j.lpm.2013.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 06/11/2013] [Accepted: 06/17/2013] [Indexed: 11/17/2022] Open
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Abstract
Like vitamin D deficit, magnesium deficit is considered to be a risk factor for cardiovascular disease. Several steps in the vitamin D metabolism, such as vitamin D binding to its transport protein and the conversion of vitamin D into the hormonal form 1,25-dihydroxyvitamin D by hepatic and renal hydroxylation, depend on magnesium as a cofactor. A new analysis of two National Health and Nutrition Examination Surveys data sets, published in BMC Medicine, investigated potential interactions between magnesium intake, circulating 25-hydroxyvitamin D, which is the generally accepted indicator of vitamin D status, and mortality. Data indicate a reduced risk of insufficient/deficient vitamin D status at high magnesium intake and an inverse association between circulating 25-hydroxyvitamin D and mortality, particularly cardiovascular mortality, among those with magnesium intake above the median. The study provides important findings concerning potential metabolic interactions between magnesium and vitamin D and its clinical relevance. However, results should be considered preliminary since biochemical data on individual magnesium status were lacking, confounding cannot be excluded and questions on the dose?response relationship still remain to be answered. Please see related research article: http://www.biomedcentral.com/1741-7015/11/187.
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Deng X, Song Y, Manson JE, Signorello LB, Zhang SM, Shrubsole MJ, Ness RM, Seidner DL, Dai Q. Magnesium, vitamin D status and mortality: results from US National Health and Nutrition Examination Survey (NHANES) 2001 to 2006 and NHANES III. BMC Med 2013; 11:187. [PMID: 23981518 PMCID: PMC3765911 DOI: 10.1186/1741-7015-11-187] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 07/24/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Magnesium plays an essential role in the synthesis and metabolism of vitamin D and magnesium supplementation substantially reversed the resistance to vitamin D treatment in patients with magnesium-dependent vitamin-D-resistant rickets. We hypothesized that dietary magnesium alone, particularly its interaction with vitamin D intake, contributes to serum 25-hydroxyvitamin D (25(OH)D) levels, and the associations between serum 25(OH)D and risk of mortality may be modified by magnesium intake level. METHODS We tested these novel hypotheses utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2001 to 2006, a population-based cross-sectional study, and the NHANES III cohort, a population-based cohort study. Serum 25(OH)D was used to define vitamin D status. Mortality outcomes in the NHANES III cohort were determined by using probabilistic linkage with the National Death Index (NDI). RESULTS High intake of total, dietary or supplemental magnesium was independently associated with significantly reduced risks of vitamin D deficiency and insufficiency respectively. Intake of magnesium significantly interacted with intake of vitamin D in relation to risk of both vitamin D deficiency and insufficiency. Additionally, the inverse association between total magnesium intake and vitamin D insufficiency primarily appeared among populations at high risk of vitamin D insufficiency. Furthermore, the associations of serum 25(OH)D with mortality, particularly due to cardiovascular disease (CVD) and colorectal cancer, were modified by magnesium intake, and the inverse associations were primarily present among those with magnesium intake above the median. CONCLUSIONS Our preliminary findings indicate it is possible that magnesium intake alone or its interaction with vitamin D intake may contribute to vitamin D status. The associations between serum 25(OH)D and risk of mortality may be modified by the intake level of magnesium. Future studies, including cohort studies and clinical trials, are necessary to confirm the findings.
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Affiliation(s)
- Xinqing Deng
- Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN 37203, USA.
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Castiglioni S, Cazzaniga A, Albisetti W, Maier JAM. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients 2013; 5:3022-33. [PMID: 23912329 PMCID: PMC3775240 DOI: 10.3390/nu5083022] [Citation(s) in RCA: 237] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 07/14/2013] [Accepted: 07/22/2013] [Indexed: 01/25/2023] Open
Abstract
A tight control of magnesium homeostasis seems to be crucial for bone health. On the basis of experimental and epidemiological studies, both low and high magnesium have harmful effects on the bones. Magnesium deficiency contributes to osteoporosis directly by acting on crystal formation and on bone cells and indirectly by impacting on the secretion and the activity of parathyroid hormone and by promoting low grade inflammation. Less is known about the mechanisms responsible for the mineralization defects observed when magnesium is elevated. Overall, controlling and maintaining magnesium homeostasis represents a helpful intervention to maintain bone integrity.
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Affiliation(s)
- Sara Castiglioni
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Via GB Grassi 74, Milan I-20157, Italy; E-Mails: (S.C.); (A.C.)
| | - Alessandra Cazzaniga
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Via GB Grassi 74, Milan I-20157, Italy; E-Mails: (S.C.); (A.C.)
| | - Walter Albisetti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Commenda 10, Milan I-20157, Italy; E-Mail:
| | - Jeanette A. M. Maier
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Via GB Grassi 74, Milan I-20157, Italy; E-Mails: (S.C.); (A.C.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +39-02-5031-9648; Fax: +39-02-5031-9659
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Soliman A, Salama H, Alomar S, Shatla E, Ellithy K, Bedair E. Clinical, biochemical, and radiological manifestations of vitamin D deficiency in newborns presented with hypocalcemia. Indian J Endocrinol Metab 2013; 17:697-703. [PMID: 23961489 PMCID: PMC3743373 DOI: 10.4103/2230-8210.113764] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The Clinical and radiological manifestations of newborns with severe VDD have not been studied well. MATERIALS AND METHODS We studied the clinical, biochemical, and radiological manifestations of 10 full-term (FT) newborns (6: M, 4: F) infant presented to with symptomatic hypocalcemia (seizure) secondary to vitamin D deficiency (VDD) during the first 10 days of life are described. All were exclusively breastfed since birth. All their mothers have low 25 hydroxy vitamin D (25OHD) level <10 ng/mL and were not taking vitamin supplements during pregnancy. RESULTS FT newborns with hypocalcemia secondary to VDD presented with generalized convulsions (10/10) and craniotabes (8/10), but none had rachitic chest rosaries or joint broadening. Cranial ultrasonographic evaluation was normal. Serum 25OHD concentrations were low in these newborns (13.2 ± 3.8 ng/mL) and their mothers (8.1 ± 1.5 ng/mL). A total of 60% of them had increased parathormone (PTH) concentrations (>60 ng/mL) and 60% had decreased magnesium (Mg) concentrations (<0.7 mmol/L). Their alkaline phosphatase (ALP) concentrations were significantly higher than normal newborns. All other laboratory results (liver function tests, urea and electrolytes, C reactive protein, lumbar puncture, blood culture, and lactate) were normal. In all patients, seizures ceased within 2 days of starting treatment with alphacalcidol and calcium. Radiological manifestations included metaphyseal band of relative lucency (osteopenia), just under the line of provisional calcification, within distal radius (7/10), femur (4/10), and tibia (3/10), mild cupping and haziness of distal radius (2/10). DISCUSSION Newborns with VDD had significantly lower serum calcium, ALP and PTH and higher phosphate concentrations, compared to older infants with VDD rickets. In newborns with VDD, serum calcium levels were correlated significantly with 25OHD (r = 0.597, P < 0.001), Mg concentrations (r = 0.436, P < 0.001) and negatively with ALP concentrations (r = -0.451, P < 0.001). Serum PTH concentrations were correlated significantly with serum Mg (r = 0.78, P < 0.0001) but not with serum calcium (r = -0.103, P = 0.3) or 25OHD (r = -0.03, P = 0.7) concentrations. CONCLUSION The clinical, biochemical, and radiological manifestations of VDD in newborns indicate that they are less adapted to VDD compared to older infants. VD supplementation for mothers and newborns should be considered to avoid short-term complications of VDD in the neonatal period and on the growing infants especially in countries with high prevalence of VDD.
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Affiliation(s)
- Ashraf Soliman
- Department of Pediatrics, Women's Hospital, Hamad Medical Center, Doha, Qatar
| | - Husam Salama
- Newborn and Infant Intensive Care Unit, Women's Hospital, Hamad Medical Center, Doha, Qatar
| | - Sufwan Alomar
- Newborn and Infant Intensive Care Unit, Women's Hospital, Hamad Medical Center, Doha, Qatar
| | - Emad Shatla
- Newborn and Infant Intensive Care Unit, Women's Hospital, Hamad Medical Center, Doha, Qatar
| | - Khaled Ellithy
- Pediatric Intensive Care Unit, Hamad General Hospital, Hamad Medical Center, Doha, Qatar
| | - Elsaid Bedair
- Department of Radiology, Al Khor Hospital, Hamad Medical Center, Hamad Medical Center, Doha, Qatar
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Opuntia humifusa supplementation increased bone density by regulating parathyroid hormone and osteocalcin in male growing rats. Int J Mol Sci 2012; 13:6747-6756. [PMID: 22837661 PMCID: PMC3397493 DOI: 10.3390/ijms13066747] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 05/24/2012] [Accepted: 05/28/2012] [Indexed: 11/29/2022] Open
Abstract
We investigated the effect of Opuntia humifusa (O. humifusa) supplementation on bone density and related hormone secretion in growing male rats. Sixteen six-week-old male Sprague-Dawley rats were randomly divided into two groups; control diet group (CG, n = 8), and experimental diet group (EG, n = 8). The rats in the CG were given a control diet and those in the EG were given 5% O. humifusa added to the control diet for eight weeks. The serum OC level of the EG was significantly higher than that of the CG, and the serum parathyroid hormone (PTH) level of EG was significantly lower than that of the CG. In addition, the femoral and tibial BMD of the EG were significantly higher values than those of the CG, and the tibial BMC of the EG was significantly higher than that of the CG. These results suggest that O. humifusa supplementation has a positive effect on bone density by suppressing PTH and increasing the OC level in growing male rats.
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Abstract
In recent years, increasing awareness of hypomagnesemia has resulted in clinical trials that associate this mineral deficiency with diabetes, metabolic syndrome, and drug therapies for cancer and cardiovascular diseases. However, diagnostic testing for tissue deficiency of magnesium still presents a challenge. Investigations of animal and cellular responses to magnesium deficiency have found evidence of complex proinflammatory pathways that may lead to greater understanding of mediators of the pathobiology in neuronal, cardiovascular, intestinal, renal, and hematological tissues. The roles of free radicals, cytokines, neuropeptides, endotoxin, endogenous antioxidants, and vascular permeability, and interventions to limit the inflammatory response associated with these parameters, are outlined in basic studies of magnesium deficiency. It is hoped that this limited review of inflammation associated with some diseases complicated by magnesium deficiency will prompt greater awareness by clinicians and other health providers and in turn increase efforts to prevent and treat this disorder.
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Affiliation(s)
- William B Weglicki
- Department of Biochemistry and Molecular Biology, Division of Experimental Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA.
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