Dietary Magnesium Intake Ameliorates the Association Between Household Pesticide Exposure and Type 2 Diabetes: Data From NHANES, 2007-2018

Impact of pesticides exposure and type 2 diabetes risk: a systematic review and meta-analysis

OBJECTIVE

We conducted a systematic review and meta-analysis of observational studies that assessed the relationship between pesticides exposure and type 2 diabetes. We also examined the presence of heterogeneity and biases across the available studies.

METHODS

We conducted a comprehensive literature search of peer-reviewed studies published from 2011 to 2023, without language limitations. A random-effects model was employed to calculate the overall odds ratio (OR) and its corresponding 95% confidence interval (CI).

RESULTS

We included 19 studies (n = 12 case-control and n = 7 cross-sectional) for a total of 45,813 participants in our analysis. Our findings revealed a notable correlation between pesticide exposure and type 2 diabetes (non-specific definition) when not limiting pesticide types (OR: 1.19, 95% CI: 1.11-1.28). Subgroup analysis identified associations between pyrethroid (OR: 1.17, 95% CI: 1.05-1.30) and type 2 diabetes, as well as between organochlorine (OR: 1.26, 95% CI: 1.11-1.43) and type 2 diabetes. However, no statistically significant association was observed between herbicide exposure and the onset of type 2 diabetes (OR: 1.26, 95% CI: 0.91-1.75). In the elderly group, pesticide exposure significantly heightened the risk of type 2 diabetes (OR: 1.25, 95% CI: 1.14-1.38), with no statistically significant heterogeneity among studies (I2 = 14.2%, p = 0.323).

CONCLUSIONS

Pesticide (organochlorine and pyrethroid) exposure constitutes a risk factor for type 2 diabetes.

Effect of Dietary Magnesium on the Association Between Serum Uric Acid and Female Infertility

Background

Few studies have evaluated the correlation between serum uric acid (SUA) levels and the prevalence of female infertility in the general population, and the effect of magnesium intake on this correlation has not been investigated.

Methods

All participants aged 18-45 years at baseline were enrolled from the National Health and Nutritional Examination Surveys (NHANES) 2013-2018. The continuous variable of SUA was divided into quartile (Q1: ≤3.7 mg/dL, Q2: 3.7-4.4 mg/dL, Q3: 4.4-5.1 mg/dL, Q4: ≥5.1 mg/dL). Multivariable logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Dietary magnesium was divided into two groups based on the median number of participants (low magnesium intake, <243 mg/day; high magnesium intake, ≥243 mg/day).

Results

A total of 3185 female participants were included in the final analysis, 10.58% of whom were infertile. In the full adjustment model, SUA was positively associated with female infertility (OR=1.13, 95% CI: 1.01-1.27). Compared to the lowest quartile (Q1), female participants with the highest SUA levels (Q4) had an increased risk of infertility by 62% (OR=1.62, 95% CI: 1.1-2.4). Moreover, we found an interactive effect of magnesium intake on the association between SUA and infertility in adjusted models (interaction likelihood ratio test: P=0.029), implying that high magnesium intake may ameliorate the association between SUA and female infertility.

Conclusion

This study is the first to report an interactive effect of dietary magnesium intake on the relationship between SUA and female infertility.

Exploring the link: magnesium intake and hepatic steatosis in Americans

Purpose

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

Materials and methods

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

Results

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

Conclusion

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

The long-term effects of blood urea nitrogen levels on cardiovascular disease and all-cause mortality in diabetes: a prospective cohort study

BACKGROUND

The long-term effects of blood urea nitrogen(BUN) in patients with diabetes remain unknown. Current studies reporting the target BUN level in patients with diabetes are also limited. Hence, this prospective study aimed to explore the relationship of BUN with all-cause and cardiovascular mortalities in patients with diabetes.

METHODS

In total, 10,507 participants with diabetes from the National Health and Nutrition Examination Survey (1999-2018) were enrolled. The causes and numbers of deaths were determined based on the National Death Index mortality data from the date of NHANES interview until follow-up (December 31, 2019). Multivariate Cox proportional hazard regression models were used to calculate the hazard ratios (HRs) and 95% confidence interval (CIs) of mortality.

RESULTS

Of the adult participants with diabetes, 4963 (47.2%) were female. The median (interquartile range) BUN level of participants was 5 (3.93-6.43) mmol/L. After 86,601 person-years of follow-up, 2,441 deaths were documented. After adjusting for variables, the HRs of cardiovascular disease (CVD) and all-cause mortality in the highest BUN level group were 1.52 and 1.35, respectively, compared with those in the lowest BUN level group. With a one-unit increment in BUN levels, the HRs of all-cause and CVD mortality rates were 1.07 and 1.08, respectively. The results remained robust when several sensitivity and stratified analyses were performed. Moreover, BUN showed a nonlinear association with all-cause and CVD mortality. Their curves all showed that the inflection points were close to the BUN level of 5 mmol/L.

CONCLUSION

BUN had a nonlinear association with all-cause and CVD mortality in patients with diabetes. The inflection point was at 5 mmol/L.

Association between dietary magnesium intake and gallstones: the mediating role of atherogenic index of plasma

BACKGROUND

Dyslipidemia and abnormalities in cholesterol metabolism are commonly observed in individuals with gallstone disease. Previous research has demonstrated that dietary magnesium can influence lipid metabolism. The atherogenic index of plasma (AIP) has emerged as a novel lipid marker. This study aimed to examine the possible correlation between dietary magnesium intake and gallstones and the potential mediating role of AIP in US adults.

METHODS

A total of 4,841 adults were included in this study from the National Health and Nutrition Examination Survey (NHANES) conducted from 2017 to 2020. A variety of statistical techniques such as logistic regression, subgroup analysis, smoothed curve fitting, and causal mediation analysis were utilized to analyze the information collected from the participants.

RESULTS

In the fully adjusted model, a statistically noteworthy inverse relationship was observed between dietary magnesium intake and the presence of gallstones, as indicated by an odds ratio (OR) of 0.58 and a 95% confidence interval (CI) of (0.42, 0.81). Causal intermediary analysis revealed that the association between magnesium intake and gallstones was partially mediated by AIP, with a mediation ratio of 3.2%.

CONCLUSION

According to this study, dietary magnesium intake had a significant linear negative association with the prevalence of gallstones, in which AIP played a mediating role. This discovery offers novel perspectives on the prevention and management of gallstones.

Associations between dietary magnesium intake and hypertension, diabetes, and hyperlipidemia

Hypertension, diabetes, and hyperlipidemia significantly impact chronic diseases and mortality. Magnesium is an essential nutrient for maintaining critical physiological functions, and magnesium deficiency is often associated with adverse health outcomes. In a cross-sectional study of US adults, we aimed to explore dietary magnesium intake and its association with the prevalence of hypertension, diabetes, and hyperlipidemia in US adults over 20 years of age in NHANES 2007-2018. We obtained data on 24,171 samples of hypertension, 9950 samples of diabetes, and 12,149 samples of hyperlipidemia. We used multivariable logistic regression models adjusted for multiple sociodemographic, anthropometric, and lifestyle factors, with participants subdivided into five groups based on quintiles of daily dietary magnesium. After adjusting for the major lifestyle and dietary variables, an independent and significant inverse relationship between dietary magnesium and hypertension, diabetes, and hyperlipidemia was observed. Compared with the lowest quintile of magnesium intake, the prevalence of hypertension, diabetes, and hyperlipidemia was significantly reduced in the highest magnesium quintile. The OR of hypertension in the highest quintile was 0.66 (95% CI: 0.51-0.87; P trend < 0.001), the OR of diabetes was 0.56 (95% CI: 0.39-0.81; P trend < 0.001), and the OR of hyperlipidemia was 0.68 (95% confidence interval: 0.53-0.86; P trend = 0.007). In the subgroup analysis, most of the inverse relationships persisted. Our findings highlight the potential of magnesium-rich foods to prevent hypertension, diabetes, and hyperlipidemia in US adults. This article summarizes and discuss recent findings on: 1) A high dietary magnesium intake was associated with a lower prevalence of hypertension; 2) An inverse relationship between dietary magnesium with diabetes hyperlipidemia; 3) Monitoring and management of magnesium was important.

Association of Dietary Magnesium Intake with the Risk of Stroke among Adults

The relationship between dietary magnesium intake and the risk of stroke is controversial. This study aimed to examine the association of dietary magnesium intake with the risk of stroke among American adults.The relationship between dietary magnesium intake and the risk of stroke was analyzed using the National Health and Nutrition Examination Survey (NHANES) 2007-2018 data with 29,653 adults. The amount of magnesium from the diet was assessed by two 24-hour dietary recalls. Stroke outcomes were defined using the results of the self-reported questionnaires. The association between dietary magnesium intake and the risk of stroke was evaluated using logistic regression models and restricted cubic spline.In our study, an inverse association between dietary magnesium intake and the risk of stroke was found. For the highest versus lowest quartile of dietary magnesium intake, the multivariate-adjusted odds ratio (95% confidence interval) of stroke was 0.56 (0.36-0.86). The magnesium intake of women was negatively associated with stroke risk, but this negative association was not found in men. Then, the inverse association was statistically significant among the 40-59 year-old group. The results from the dose-response analysis show a linear relationship between dietary magnesium intake and the risk of stroke.Dietary magnesium intake was inversely associated with the risk of stroke, especially in women. Therefore, our study emphasizes the importance of appropriately increasing dietary magnesium intake.

Association between magnesium intake and the risk of anemia among adults in the United States

Background

Magnesium deficiency is related to an increased risk of anemia, but epidemiological evidence supporting this association remains scarce. The purpose of the present survey was to evaluate the relationship between dietary magnesium intake and the risk of anemia.

Methods

In total, 13,423 participants aged 20-80 years were enrolled using data from the National Health and Nutrition Examination Survey 2011-2016. Magnesium consumption was evaluated using 24 h dietary recalls. Multivariable generalized linear models were developed to demonstrate the association between dietary magnesium intake and the prevalence of anemia.

Results

An inverse association between dietary magnesium intake and the risk of anemia was detected based on a full adjustment model. We evaluated magnesium intake as a categorical variable (five quartiles). Compared with the lowest value, the highest multivariate adjusted odds ratio (95% confidence interval) for anemia was 0.64 (0.46-0.89). Stratified analyses revealed a reverse relationship between magnesium intake and anemia in women. However, no significant association was observed in men (p _{for trend} = 0.376). A similar reverse association was found among the older group (aged ≥60 years).

Conclusion

Magnesium deficiency is closely related to a higher rate of anemia occurrence, especially among women and older Americans. Further larger-scale prospective studies are required to confirm these conclusions.