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Huang S, Ge Y, Li Y, Cui N, Tan L, Guo S, Wang S, Hao L, Lei G, Yang X. Magnesium Status, Genetic Variants of Magnesium-Related Ion Channel Transient Receptor Potential Membrane Melastatin 6 (TRPM6) and the Risk of Gestational Diabetes Mellitus in Chinese Pregnant Women: A Nested Case-Control Study. Mol Nutr Food Res 2023; 67:e2200835. [PMID: 37759402 DOI: 10.1002/mnfr.202200835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/10/2023] [Indexed: 09/29/2023]
Abstract
SCOPE Magnesium plays an important role in regulating glucose metabolism. The study attempts to explore association between magnesium status and single nucleotide polymorphisms (SNPs) of gene involved in magnesium absorption-transient receptor potential membrane melastatin 6 (TRPM6) and gestational diabetes mellitus (GDM) risk METHODS AND RESULTS: A nested case-control study including 170 GDM cases and matched 340 controls is conducted based on Tongji Birth Cohort. Dietary, serum, and urine magnesium are evaluated before the diagnosis of GDM. Compared to the lowest tertile, women in the highest tertile of serum magnesium are at a lower risk of GDM (adjusted odds ratio [aOR] 0.42, 95% confidence intervals [CI] 0.21-0.84). Serum magnesium is inversely associated with insulin and homeostatic model assessment of insulin resistance (β = -0.05, p = 0.002; β = -0.04, p = 0.001, respectively). The aOR for GDM in carriers of the CT or CC genotypes of TRPM6 rs2274924 compared with carriers of the TT genotype is 2.76 (95% CI 1.78-4.26). Dietary magnesium is positively associated with serum magnesium (β = 0.02, p = 0.004), but not with GDM risk. CONCLUSION Serum magnesium and the TRPM6 rs2274924 polymorphism are associated with the risk of GDM.
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Affiliation(s)
- Shanshan Huang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Yanyan Ge
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Yan Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Ningning Cui
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Le Tan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Shu Guo
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Shanshan Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Gang Lei
- Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, 26 Shengli Street, Wuhan, Hubei, 430014, P. R. China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei, 430030, China
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Chen Y, Xiang X, Wu Y, Han S, Huang Z, Wu M. Magnesium Depletion Score Predicts Diabetic Retinopathy Risk among Diabetes: Findings from NHANES 2005-2018. Biol Trace Elem Res 2023; 201:2750-2756. [PMID: 35989402 PMCID: PMC10073168 DOI: 10.1007/s12011-022-03384-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/07/2022] [Indexed: 11/29/2022]
Abstract
Magnesium is essential for material and energy metabolism. The magnesium depletion score (MDS) is recognized as a more valuable and reliable predictor of body magnesium status than any other clinical used markers such as serum and urine magnesium. However, research on the relationship between MDS and diabetic retinopathy (DR) is limited. As a result, the current study sought to assess this issue in diabetic samples from a large population-based database in the United States. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. MDS was calculated, and multivariate logistic regression analysis was applied to evaluate the presence of association between variables and DR risk. A total of 4308 participants was comprised in this study. Samples with DR consumed less magnesium (259.1 ± 113.6 vs 269.8 ± 113.2 mg, P < 0.001), and their MDS levels differed significantly from non-DR participants (P < 0.001). Increased dietary magnesium was linked to a lower incidence of DR (all P for trend < 0.05), and patients with a high level of MDS were more prone to DR (P = 0.001). Furthermore, subgroup analysis revealed that high (Q3) amount magnesium supplements was associated with lower DR risk when MDS was none to low or middle level (both P = 0.02). Our results indicated that MDS levels are associated with DR risk and that magnesium supplementation is benefit to DR prevention.
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Affiliation(s)
- Yuan Chen
- Soochow University, 215031, Suzhou, China
- Department of Ophthalmology, Changshu No. 2 People's Hospital, Changshu, 215500, China
| | - Xiaoli Xiang
- Department of Ophthalmology, Changshu No. 2 People's Hospital, Changshu, 215500, China
| | - Yangyang Wu
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou, 310014, China
- Bengbu Medical College, Bengbu, 233030, China
| | - Shaojie Han
- Gushu College, Nanjing Medical University, Nanjing, 211166, China
| | - Zhengru Huang
- Department of Ophthalmology, Changshu No. 2 People's Hospital, Changshu, 215500, China.
| | - Miaoqin Wu
- Soochow University, 215031, Suzhou, China.
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou, 310014, China.
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KUPPUSAMY S, DHANASINGHU R, SAKTHIVADIVEL V, KALIAPPAN A, GAUR A, BALAN Y, TADI LJ, SUNDARAMURTHY R. Association of Serum Magnesium with Insulin Indices in Patients with Type 2 Diabetes Mellitus. Maedica (Bucur) 2022; 17:596-601. [PMID: 36540586 PMCID: PMC9720662 DOI: 10.26574/maedica.2022.17.3.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Introduction: Magnesium has a direct impact on glucose metabolism since it is a cofactor for numerous energy-metabolizing enzymes. Hypomagnesemia has been linked to poor glycemic control and a range of diabetes-related long-term complications. This study aimed to assess the association between blood magnesium levels and insulin sensitivity indices in patients with type 2 diabetes mellitus (T2DM). Material and methods:Two hundred newly diagnosed T2DM patients aged over 40 years were recruited after excluding those with a history of heart failure, kidney illness, liver disease, hypothyroidism, ascites, pregnancy, tumors, and complications such as diabetic ketoacidosis. Fasting glucose, serum magnesium, serum insulin, serum urea and creatinine were measured. Patients were divided into two groups based on their serum magnesium levels. Results:There were no age or sex differences between the subjects of the two groups. Participants in the group with low magnesium had significantly high fasting blood sugar (FBS), postprandial blood sugar (PPBS), glycated hemoglobin (HbA1c), serum insulin, homeostasis model assessment-estimated insulin resistance (HOMA-IR) (P < 0.001). The multivariable logistic regression analysis showed significant associations with PPBS [odds ratio (OR) 0.98 (95% CI 0.97-0.99)], HbA1c [OR 0.05 (95% CI=0.005-0.55)] and creatinine [OR 0.004 (95% CI=0.00-0.074)]. Correlation statistics showed a negative correlation between magnesium and PPBS (r =-0.204), HOMA-IR (r = -0.819) and creatinine (r = -0.151). Conclusion:Serum magnesium levels have a negative correlation with FBS and PPBS, as well as HOMA-IR. It may well be essential to include serum magnesium level as a regular assessment in patients with diabetes mellitus.
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Affiliation(s)
- Santhanam KUPPUSAMY
- Department of General Medicine, Government Villupuram Medical College, Mundiyambakkam, Tamilnadu, India
| | - Raju DHANASINGHU
- Department of General Medicine, Government Villupuram Medical College, Mundiyambakkam, Tamilnadu, India
| | - Varatharajan SAKTHIVADIVEL
- Department of General Medicine, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Ariyanachi KALIAPPAN
- Department of Anatomy, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Archana GAUR
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Yuvaraj BALAN
- Department of Biochemistry, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Lakshmi Jyothi TADI
- Department of Microbiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Raja SUNDARAMURTHY
- Department of Microbiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
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Li W, Jiao Y, Wang L, Wang S, Hao L, Wang Z, Wang H, Zhang B, Ding G, Jiang H. Association of Serum Magnesium with Insulin Resistance and Type 2 Diabetes among Adults in China. Nutrients 2022; 14:nu14091799. [PMID: 35565766 PMCID: PMC9104014 DOI: 10.3390/nu14091799] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/21/2022] [Accepted: 04/23/2022] [Indexed: 11/28/2022] Open
Abstract
Magnesium is an essential mineral for the human body and a cofactor or activator for more than 300 enzymatic reactions, including blood glucose control and insulin release. Diabetes is a well-known global burden of disease with increasing global prevalence. In China, the prevalence of diabetes in adults is higher than the global average. Evidence shows that magnesium is a predictor of insulin resistance and diabetes. However, the majority of studies focus on dietary magnesium instead of serum magnesium concentration. We study the correlation of serum magnesium levels with insulin resistance and Type 2 diabetes. In this prospective cohort study, we included 5044 participants aged 18 years and older without insulin resistance (IR) and diabetes at the baseline from China Health and Nutrition Survey (CHNS). A fasting blood sample was taken for the measurement of both types of magnesium, fasting blood glucose, hemoglobin A1c (HbA1c), and fasting insulin. The homeostatic model (HOMA-IR) was calculated. Demographic characteristics of participants, and risk factors such as intensity of physical activities, smoking status, drinking habit, and anthropometric information were recorded. IR was defined as HOMA-IR ≥ 2.5, and Type 2 diabetes mellitus was defined as fasting plasma glucose ≥ 7.0 mmol/L or HbA1c ≥ 6.5%, or a self-reported diagnosis or treatment of diabetes. A total of 1331 incident insulin resistance events and 429 incident diabetic events were recorded during an average follow-up of 5.8 years. The serum magnesium concentration was categorized into quintiles. After adjusting for relevant covariates, the third quintile of serum magnesium (0.89−0.93 mmol/L) was correlated with 29% lower risk of incident insulin resistance (hazard ratio = 0.71, 95% CI 0.58, 0.86) and with a lower risk of Type 2 diabetes. Multivariable-adjusted hazard ratios (95% confidence intervals) for insulin resistance were compared with the lowest quintile of serum magnesium (<0.85). We found similar results when evaluating serum magnesium as a continuous measure. Restricted cubic spline (RCS) curves showed a nonlinear dose−response correlation in both serum magnesium levels and insulin resistance, and in serum magnesium levels and Type 2 diabetes. Lower serum magnesium concentration was associated with a higher risk of insulin resistance and diabetes.
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Affiliation(s)
- Weiyi Li
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Yingying Jiao
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
| | - Liusen Wang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Shaoshunzi Wang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Lixin Hao
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Zhihong Wang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Huijun Wang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Bing Zhang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Gangqiang Ding
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
| | - Hongru Jiang
- Office of National Nutrition Plan, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China; (W.L.); (Y.J.); (L.W.); (S.W.); (L.H.); (Z.W.); (H.W.); (B.Z.); (G.D.)
- Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing 100050, China
- Correspondence: ; Tel.: +86-10-6623-7057
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Ebrahimi Mousavi S, Ghoreishy SM, Hemmati A, Mohammadi H. Association between magnesium concentrations and prediabetes: a systematic review and meta-analysis. Sci Rep 2021; 11:24388. [PMID: 34937856 DOI: 10.1038/s41598-021-03915-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/13/2021] [Indexed: 01/10/2023] Open
Abstract
Studies on the association between serum magnesium level and prediabetes yielded inconsistent results. Therefore, the present meta-analysis was designed to examine the association between serum magnesium levels and prediabetes. Online databases including PubMed, Embase, Scopus and Google Scholar were searched up to October, 2020. A total of 10 studies that reported mean and standard deviation (SD) of magnesium levels in prediabetes and healthy control group were identified. Random effects models were used to pool weighted mean differences (WMDs) of serum magnesium levels. Pooled-analysis showed that subjects with prediabetes had significantly lower serum magnesium levels compared with healthy controls (WMD = - 0.07 mmol/L; 95% CI - 0.09, - 0.05 mmol/L, P < 0.001). A significant heterogeneity observed across included studies (I2 = 95.6%, P < 0.001). However, different subgroup analysis did not detect the potential source of observed heterogeneity. Withdrawal of each individual study had no effect on the overall results. The present meta-analysis showed that circulating magnesium levels in people with prediabetes were significantly lower than healthy controls, confirming that magnesium deficiency may play a role in development and progression of prediabetes. Further studies with larger sample size and robust design are warranted to confirm present results.
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Rey AI, Puig P, Cardozo PW, Hechavarría T. Supplementation Effect of Oleuropein Extract Combined with Betaine, Magnesium, and Vitamin E on Pigs' Performance and Meat Quality Characteristics. Animals (Basel) 2021; 11:ani11020443. [PMID: 33567784 PMCID: PMC7915345 DOI: 10.3390/ani11020443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/27/2021] [Accepted: 02/04/2021] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Oleuropein, betaine, magnesium, and vitamin E show antioxidant and/or metabolic effects on the organism that are reflected, in many cases, in performances and meat quality. This study evaluated whether the combination of these nutrients at two doses manifest different effects on the final product. Both combinations were enough to improve the oxidative status of pigs, although performances were not affected. However, the higher doses increased n-6 and n-3 PUFA in the triglycerides and free fatty acid fractions that resulted in meat that was more susceptible to oxidation. Abstract This study evaluates the effect of the dietary combination of oleuropein extract (1200 mg/kg) and betaine (1000 mg/kg), magnesium oxide (600 mg/kg), and α–tocopheryl acetate (400 mg/kg), or a half-dose of these compounds, on pigs’ performance, oxidative status, and meat quality characteristics (drip loss, TBARS, and texture and fatty acid profile of intramuscular fat). Sixty-six barrows and females were slaughtered at 120 kg of BW. Performance and carcass yield were not changed by treatments. The high-dose mixture resulted in higher serum ferric reducing/antioxidant power (p = 0.0026), lower glucose (p = 0.03) and a tendency to have lower serum TBARS (p = 0.07) when compared to control. Percentage of drip loss, moisture content, intramuscular fat, or texture parameters were not modified by dietary treatments. Pigs supplemented with the high-dose mixture had higher PUFA (p = 0.0001), n-6 (p = 0.0001), n-3 (p = 0.0095) and lower MUFA (p = 0.0064) in the neutral lipid fraction of intramuscular fat. Free PUFA, mainly n-3 fatty acids (p = 0.0009), were also higher in the meat of pigs fed the high-dose mixture compared with the others. A higher mobilization (neutral to free fatty acids hydrolysis) of n-3 and MUFA fatty acids in the muscle from pigs fed the high-dose mixture was observed. However, dietary mixture supplementation tended to increase MUFA (p = 0.056) and decrease the total PUFA (p = 0.0074) proportions in muscle polar lipids. This specific fatty acid composition of meat from pigs supplemented with the high-dose mixture could be responsible for the higher meat lipid oxidation observed in this group when compared to the other groups. Consequently, the low-dose mixture would be more adequate for maintaining the oxidative status of pigs and, meat lipid stability.
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Affiliation(s)
- Ana I. Rey
- Departamento Producción Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Avda. Puerta de Hierro s/n., 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-91-3943889
| | - Patricia Puig
- Andres Pintaluba, S.A. Polígono Industrial Agro-Reus Prudenci Bertrana, 5, 43206 Reus, Spain; (P.P.); (P.W.C.); (T.H.)
| | - Paul William Cardozo
- Andres Pintaluba, S.A. Polígono Industrial Agro-Reus Prudenci Bertrana, 5, 43206 Reus, Spain; (P.P.); (P.W.C.); (T.H.)
| | - Teresa Hechavarría
- Andres Pintaluba, S.A. Polígono Industrial Agro-Reus Prudenci Bertrana, 5, 43206 Reus, Spain; (P.P.); (P.W.C.); (T.H.)
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Shivakumar K, Rajalakshmi A, Jha KN, Nagarajan S, Srinivasan A, Lokesh Maran A. Serum magnesium in diabetic retinopathy: the association needs investigation. Ther Adv Ophthalmol 2021; 13:25158414211056385. [PMID: 34901747 PMCID: PMC8655827 DOI: 10.1177/25158414211056385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/08/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Magnesium has an essential role in glucose metabolism, and hypomagnesaemia is common in diabetes mellitus. However, the relationship between serum magnesium and diabetic retinopathy is poorly understood. AIM To determine the association between serum magnesium levels and retinopathy in type 2 diabetic patients with normal renal function and to correlate it with severity of retinopathy. METHODS This cross-sectional observational study was conducted in a semi-urban tertiary-care teaching hospital. Clinicodemographic profile and serum magnesium levels were determined in patients with type 2 diabetes mellitus (DM) with (group 1) and without (group 2) retinopathy. Serum magnesium levels were correlated with the presence and severity of retinopathy. RESULTS Of 104 type 2 DM patients, 50 had retinopathy. Younger age, longer duration of disease and poorer glycaemic control (p < 0.05) were found to be associated with retinopathy. The mean serum magnesium levels in patients with retinopathy and those without retinopathy were 1.63 ± 0.30 mg/dL and 1.76 ± 0.22 mg/dL, respectively (p = 0.029). Reduced serum magnesium was associated with elevated fasting sugars (p = 0.019) and female gender (p = 0.037). On comparative analysis of patients with sight-threatening diabetic retinopathy (STDR), non-STDR and no retinopathy by ANOVA test, patients with STDR had significantly lower serum magnesium (1.55 ± 0.33 mg/dL) (p = 0.031). CONCLUSION Serum magnesium levels were lower in patients with diabetic retinopathy. Patients with STDR had lower serum magnesium compared with those without STDR. SUMMARY Serum magnesium, studied extensively for its role in glucose metabolism, was found to be lower in patients with diabetic retinopathy compared with those without retinopathy. Sight-threatening diabetic retinopathy had significantly lower levels of serum magnesium.
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Affiliation(s)
- Koushik Shivakumar
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
| | - A.R. Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry UT 607402, India
| | - Kirti Nath Jha
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
| | - Swathi Nagarajan
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
| | - A.R. Srinivasan
- Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
| | - A. Lokesh Maran
- Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
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Sakhr HM, Hassan MH, Desoky T. Possible Associations of Disturbed Neurometals and Ammonia with Glycaemic Control in Type 1 Diabetic Children with Attention Deficit Hyperactivity Disorder. Biol Trace Elem Res 2020; 198:68-76. [PMID: 32020524 DOI: 10.1007/s12011-020-02063-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/30/2020] [Indexed: 12/30/2022]
Abstract
The chronicity of type 1 diabetes mellitus (T1DM) is reported to be associated with various psychological disorders. The current study aimed to evaluate the levels of serum ammonia and various neurometals (zinc, copper, and magnesium) in patients with T1DM with and without ADHD and to correlate their levels with glycaemic status. A prospective case-control study was conducted with 60 diabetic children with T1DM (allocated into a group of 20 patients with a diagnosis of ADHD and a group of 40 patients without ADHD) who were comparable to 60 matched controls. Assays of glucose, glycated haemoglobin (HbA1c), ammonia, zinc, copper, and magnesium were performed. Overall, ammonia and copper levels were significantly higher in the diabetic patients especially those with ADHD than in the control group (p ˂ 0.05 for all). The calculated copper/zinc ratio was significantly higher in the diabetic patient group than in the control group and higher in diabetic children with ADHD than in diabetic children without ADHD (p ˂ 0.05 for all). Diabetic children had significantly lower magnesium levels than the controls (p ˂ 0.05), but no significant difference between the diabetic subgroups was detected. A positive correlation between glycaemic control (HbA1c %) and ammonia level was found in the diabetic group and subgroups, and a positive correlation was found between HbA1c % and the Cu/Zn ratio in diabetic children with ADHD (p ˂ 0.05 for all). The current study confirms an association of elevated ammonia and copper/zinc ratio with poor glycaemic control and ADHD development among children with T1DM.
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Affiliation(s)
- Hala M Sakhr
- Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Mohammed H Hassan
- Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt.
| | - Tarek Desoky
- Department of Neuropsychiatry, Faculty of Medicine, South Valley University, Qena, Egypt
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Abstract
Evidence increasingly demonstrates that prediabetes is a toxic state, as well as a risk factor for diabetes, and is associated with pathophysiological changes in several tissues and organs. Unfortunately, use of available evidence-based treatments for prediabetes is low. This review seeks to explain why prediabetes must be viewed and treated as a serious pathological entity in its own right. It offers an overview of the pathophysiology and complications of prediabetes and describes how this condition can be reversed if all treatment avenues are deployed early in its course.
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Affiliation(s)
| | - Fatima Bello
- Ahmadu Bello University Teaching Hospital Zaria, Kaduna, Nigeria
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Barragán R, Llopis J, Portolés O, Sorlí JV, Coltell O, Rivas-García L, Asensio EM, Ortega-Azorín C, Corella D, Sánchez-González C. Influence of Demographic and Lifestyle Variables on Plasma Magnesium Concentrations and Their Associations with Cardiovascular Risk Factors in a Mediterranean Population. Nutrients 2020; 12:nu12041018. [PMID: 32276338 PMCID: PMC7230301 DOI: 10.3390/nu12041018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 12/11/2022] Open
Abstract
Several studies have shown that a low magnesium (Mg) intake in the diet is associated with greater cardiovascular risk and greater risk of diabetes. However, the results are not consistent in all populations. To minimize the biases derived from diet measurement, more objective biomarkers of magnesium status have been proposed. Although there is still no ideal biomarker for Mg, several studies have shown that plasma Mg concentrations could be a relatively acceptable biomarker for cardiovascular risk assessment. However, further studies are required to better characterize this marker in different populations. Our aim was to analyze the association between plasma Mg concentrations (measured through inductively coupled plasma mass spectrometry (ICP-MS)) methods, and cardiovascular risk factors in individuals from a general Mediterranean population (aged 18–80 years). The influence of demographic and lifestyle variables, including adherence to the Mediterranean diet, on plasma Mg concentrations was analyzed. The mean Mg level of the population studied was 0.77 ± 0.08 mmol/L, the prevalence of hypomagnesemia (<0.70 mmol/L) being 18.6%. We did not find any statistically significant differences between plasma Mg concentrations and sex, age, tobacco smoking and total adherence to the Mediterranean diet (p > 0.05). We found a statistically significant association between plasma Mg concentrations and the prevalence of type-2 diabetes (0.77 ± 0.08 mmol/L in non-diabetics versus 0.73 ± 0.13 mmol/L in diabetics; p = 0.009). Despite the low prevalence of type-2 diabetes in this population (11.24% in subjects with hypomagnesemia versus 3.91%, in normomagnesemia; p = 0.005), hypomagnesemia was associated with greater odds of being diabetic in comparison with normomagnesemia (OR = 3.36; p = 0.016, even after adjustment for sex, age, obesity, and medications). On the other hand, no statistically significant association of plasma Mg concentrations with obesity, hypertension, fasting triglycerides, HDL-cholesterol or uric acid was found. However, in contrast to what was initially expected, a statistically significant association was found between plasma Mg concentrations (basically in the highest quartile) and greater total cholesterol (p < 0.05) and LDL-cholesterol concentrations (p < 0.05). In conclusion, our results contribute to increasing the evidence gathered by numerous studies on the inverse association between hypomagnesemia and type-2 diabetes, as well as to the observation, previously reported in some studies, of a direct association with hypercholesterolemia. This paradoxical link should be deeply investigated in further studies.
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Affiliation(s)
- Rocío Barragán
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain; (R.B.); (O.P.); (J.V.S.); (E.M.A.); (C.O.-A.)
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Juan Llopis
- Department of Physiology, School of Pharmacy, University of Granada, 18071 Granada, Spain; (J.L.); (L.R.-G.); (C.S.-G.)
| | - Olga Portolés
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain; (R.B.); (O.P.); (J.V.S.); (E.M.A.); (C.O.-A.)
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Jose V. Sorlí
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain; (R.B.); (O.P.); (J.V.S.); (E.M.A.); (C.O.-A.)
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Oscar Coltell
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Department of Computer Languages and Systems, Universitat Jaume I, 12071 Castellón, Spain
| | - Lorenzo Rivas-García
- Department of Physiology, School of Pharmacy, University of Granada, 18071 Granada, Spain; (J.L.); (L.R.-G.); (C.S.-G.)
| | - Eva M. Asensio
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain; (R.B.); (O.P.); (J.V.S.); (E.M.A.); (C.O.-A.)
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Carolina Ortega-Azorín
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain; (R.B.); (O.P.); (J.V.S.); (E.M.A.); (C.O.-A.)
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Dolores Corella
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain; (R.B.); (O.P.); (J.V.S.); (E.M.A.); (C.O.-A.)
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Correspondence: ; Tel.: +34-96-386-4800
| | - Cristina Sánchez-González
- Department of Physiology, School of Pharmacy, University of Granada, 18071 Granada, Spain; (J.L.); (L.R.-G.); (C.S.-G.)
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Guo W, Zhou Q, Jia Y, Xu J. Cluster and Factor Analysis of Elements in Serum and Urine of Diabetic Patients with Peripheral Neuropathy and Healthy People. Biol Trace Elem Res 2020; 194:48-57. [PMID: 31140035 PMCID: PMC6987062 DOI: 10.1007/s12011-019-01747-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 05/03/2019] [Indexed: 12/27/2022]
Abstract
Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus, presented as a major teratogenic cause worldwide. This study discussed alternation and correlation of magnesium (Mg), calcium (Ca), copper (Cu), zinc (Zn), iron (Fe), chromium (Cr), and selenium (Se) among DPN patients and healthy people using multivariate statistical analysis. Fifty patients with DPN were recruited from endocrinology department, First Hospital of Jilin University between January 2010 and October 2011 and also 50 healthy subjects were enrolled at the same time. Inductively coupled plasma mass spectrometry (ICP-MS) was used to assay elements in serum and urine. Cluster analysis was used to clarify alternation of elements' homogeneity. Factor analysis was performed to evaluate the most informative kinds of elements. Mg, Ca, Zn, and Cr in DPN patients were significantly lower in serum whereas significantly higher in urine. Elements were clustered into 4 or 5 clusters based on internal association using between-groups linkage algorithm. Serum Cr, Se, and Fe were grouped, and Mg related to Ca more closely in both serum and urine in DPN. Factor analysis revealed discrepancies of elements' contribution. Cr, Se, and Fe appeared to be the most crucial factors contributing to DPN. Mg, Ca, Zn, and Cu were more influential, whereas Cr became less potent to disease. Contributed value of elements could be determined and specified using loadings in scree plot. Future studies and delicate statistical models should be applied.
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Affiliation(s)
- Wenjia Guo
- Department of Laboratory Medicine, First Hospital of Jilin University, Changchun, China
| | - Qi Zhou
- Department of Pediatrics, First Hospital of Jilin University, Changchun, China
| | - Yanan Jia
- Department of Laboratory Medicine, First Hospital of Jilin University, Changchun, China
| | - Jiancheng Xu
- Department of Laboratory Medicine, First Hospital of Jilin University, Changchun, China.
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12
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Rodrigues AK, Melo AE, Domingueti CP. Association between reduced serum levels of magnesium and the presence of poor glycemic control and complications in type 1 diabetes mellitus: A systematic review and meta-analysis. Diabetes Metab Syndr 2020; 14:127-134. [PMID: 32088645 DOI: 10.1016/j.dsx.2020.01.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/30/2020] [Accepted: 01/30/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate the association between reduced serum magnesium levels and poor glycemic control and/or complications in patients with type 1 diabetes mellitus through a systematic review and meta-analysis. METHODS The articles were selected using the Medline/PubMed, Web of Science, Scopus and Scielo databases. Eligibility criteria were cross-sectional, cohort or case-control observational studies that assessed the association between reduced magnesium levels and poor glycemic control and/or complications in patients with type 1 diabetes mellitus. RESULTS Nine articles were included in the systematic review and two in the meta-analysis, all articles being cross-sectional. Among the seven studies that were designed to evaluate glycemic control, five showed an association between reduced levels of magnesium and poor glycemic control, and these findings were corroborated by the meta-analysis. Among the two studies in which dyslipidemia was evaluated, both showed higher levels of triglycerides, total cholesterol and LDL cholesterol, and lower levels of HDL cholesterol in patients with lower levels of magnesium as compared to those with higher magnesium levels. The three studies that evaluated diabetes kidney disease and the two studies that evaluated diabetic retinopathy found divergent results. CONCLUSION There is an association between reduced levels of magnesium and poor glycemic control in patients with type 1 diabetes mellitus, however, this needs further studies.
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Affiliation(s)
- Ana Kelen Rodrigues
- Universidade Federal de São João del Rei, Campus Centro Oeste Dona Lindu, Divinópolis, MG, Brazil
| | - Ana Elisa Melo
- Universidade Federal de São João del Rei, Campus Centro Oeste Dona Lindu, Divinópolis, MG, Brazil
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13
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Ham JY, Shon YH. Natural Magnesium-Enriched Deep-Sea Water Improves Insulin Resistance and the Lipid Profile of Prediabetic Adults: A Randomized, Double-Blinded Crossover Trial. Nutrients 2020; 12:E515. [PMID: 32085495 DOI: 10.3390/nu12020515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 01/02/2023] Open
Abstract
Previous in vitro and in vivo studies have shown that the antidiabetic effect of balanced deep-sea water (BDSW) works through the suppression of hyperglycemia and improvement of glucose tolerance. Based on these promising results, we conducted an eight week randomized, double-blinded crossover trial of the effects of BDSW in prediabetic adults. The subjects consumed 440 mL of BDSW (hardness 4000) per day, and maintained an otherwise normal lifestyle and diet throughout. Efficacy assessments were made by measuring fasting glucose, postprandial glucose, fasting insulin, homeostasis model assessment for insulin resistance (HOMA-IR), C-peptide, glycosylated hemoglobin, lipid metabolism indicators, and physical metrics, along with safety assessments. Fasting insulin and HOMA-IR values of the BDSW group were significantly lower than those of the placebo group after eight weeks of BDSW ingestion. Total cholesterol and low-density lipoprotein–cholesterol were also significantly decreased in the BDSW group after eight weeks of BDSW ingestion compared with the placebo group. There were no statistically and clinically meaningful changes in adverse events, physical examination, laboratory medicine examination, or vital signs of the BDSW intake group. These results suggested that the intake of BDSW in prediabetic adults can improve glucose metabolism and lipid profiles and is safe for human consumption.
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14
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Sadeghian M, Azadbakht L, Khalili N, Mortazavi M, Esmaillzadeh A. Oral Magnesium Supplementation Improved Lipid Profile but Increased Insulin Resistance in Patients with Diabetic Nephropathy: a Double-Blind Randomized Controlled Clinical Trial. Biol Trace Elem Res 2020; 193:23-35. [PMID: 30835085 DOI: 10.1007/s12011-019-01687-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/21/2019] [Indexed: 02/05/2023]
Abstract
Low serum magnesium concentrations were associated with development of renal failure. We aimed to determine whether magnesium supplementation improves renal function, insulin resistance, and metabolic profiles in patients with diabetic nephropathy. A total of 80 hypomagnesemic patients diagnosed with type 2 diabetes and early-stage nephropathy were recruited. Subjects received either daily magnesium oxide or placebo for 12 weeks. Biochemical and anthropometric variables were measured. Physical activity and dietary intakes were also recorded. This study was approved by the ethics committee of Isfahan University of Medical Sciences and was registered on the Iranian Registry of Clinical Trials website (IRCT registration no. IRCT201404271485N12). Serum magnesium levels were not changed significantly. Although the supplementation did not influence glycemic indices, patients in the magnesium group had greater insulin resistance compared with the placebo group after intervention (0.3 ± 2.3 μIU/mL vs. - 0.04 ± 2.05, P = 0.04). No significant changes were observed in serum total cholesterol, triglycerides, HDL, LDL, and total cholesterol/HDL cholesterol ratio. Furthermore, magnesium did not affect inflammation, serum levels of creatinine, and blood urine nitrogen. However, a marginal decrease in microalbuminuria (- 3.1 ± 2.2 mg/L vs. - 14 ± 9.9, P = 0.09) was observed. Oral magnesium supplementation slightly improved microalbuminuria but resulted in increased insulin resistance in patients with diabetic nephropathy.
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Affiliation(s)
- Mehdi Sadeghian
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Research Committee of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Azadbakht
- Research Committee of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Noushin Khalili
- Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Kidney Diseases Research Center, Department of Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Mortazavi
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.
- Tehran University of Medical Sciences, International Campus, Tehran, Iran.
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15
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Gohari-kahou M, Darroudi S, Saberi-karimian M, Parizadeh S, Asadi Z, Javandoost A, Safarian M, Mouhebati M, Ebrahimi M, Ferns GA, Kazerani HR, Ghayour-mobarhan M. The association between serum and dietary magnesium with cardiovascular disease risk factors in Iranian adults with metabolic syndrome. Translational Metabolic Syndrome Research 2020; 3:42-8. [DOI: 10.1016/j.tmsr.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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16
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Abstract
Homeostasis imbalance of selenium (Se) in diabetes has received great attention. This study investigated serum and urinary Se levels in patients with impaired fasting glucose (IFG), impaired glucose tolerance (IGT), type 1 diabetes (T1D), and type 2 diabetes (T2D) in Northeast Chinese populations. From January 2010 to October 2011, patients with IFG (n = 12), IGT (n = 15), T1D (n = 25), T2D (n = 137), and healthy controls (n = 50) were enrolled in the First Hospital of Jilin University. Se was detected using inductively coupled plasma spectrometer. The serum Se level was dramatically lower in patients with T1D and was significantly higher in IFG subjects, and the urinary Se concentration was markedly lower in IGT and T2D groups. The serum Se levels were positively correlated with serum zinc (Zn) in both IFG and IGT groups, while urinary Se were positively associated with urinary Zn and copper (Cu) in IGT group. The serum Se levels were positively correlated with serum Cu in both T1D and T2D groups, and urinary levels of Se were positively associated with serum zinc and urinary Cu, Zn, calcium (Ca), and magnesium (Mg) and negatively correlated with serum Ca and Mg in T2D group, while the urinary levels of Se were positively correlated with urinary Zn and Mg both in peripheral neuropathy (DPN) and retinopathy (DR) groups. One month of simvastatin therapy reduced serum Se levels. These results suggest the potential role of Se in diabetes should receive attention.
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Affiliation(s)
- Qi Zhou
- Department of Pediatrics, First Hospital of Jilin University, Changchun, 130021 China
| | - Wenjia Guo
- Department of Laboratory Medicine, First Hospital of Jilin University, Changchun, 130021 China
| | - Yanan Jia
- Department of Laboratory Medicine, First Hospital of Jilin University, Changchun, 130021 China
| | - Jiancheng Xu
- Department of Laboratory Medicine, First Hospital of Jilin University, Changchun, 130021 China
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17
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Zhou Q, Guo W, Jia Y, Xu J. Effect of 4-Phenylbutyric Acid and Tauroursodeoxycholic Acid on Magnesium and Calcium Metabolism in Streptozocin-Induced Type 1 Diabetic Mice. Biol Trace Elem Res 2019; 189:501-510. [PMID: 30171596 PMCID: PMC6469655 DOI: 10.1007/s12011-018-1494-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/24/2018] [Indexed: 12/19/2022]
Abstract
Recent evidence has identified a role of micronutrients, such as magnesium (Mg2+) and calcium (Ca2+), in glycemic control. 4-Phenylbutyric acid (PBA) and tauroursodeoxycholic acid (TUDCA) are molecular chaperones that can improve protein folding and alleviate endoplasmic reticulum (ER) stress. Increasingly, research is focusing on the association between molecular chaperones and micronutrients. This study established and characterized a mouse model of type 1 diabetes (T1D) and investigated the effect of PBA and TUDCA on Mg2+ and Ca2+ metabolism in these mice. T1D was established in Friend virus B-type mice using multiple low doses of streptozotocin. Mice were administered chaperones. Mg2+and Ca2+ levels in tissues and serum were detected using acid digestion and ICP-MS. At 2 weeks and 2 months after chaperone administration was initiated, Mg2+ levels in the heart, liver, kidney, and serum and Ca2+ levels in spleen and serum of T1D mice were significantly decreased compared with controls; Ca2+ levels in the kidney and muscle of T1D mice were significantly increased; Mg2+ and Ca2+ levels in the heart, liver, kidney, muscle, spleen, and serum were positively correlated in control and T1D mice; and PBA restored renal Mg2+ levels to normal values and TUDCA restored hepatic, renal, and serum Mg2+ levels and renal and serum Ca2+ levels to normal values in T1D mice. PBA restored muscular Ca2+ levels to normal values in T1D mice at 2 months after chaperone or vehicle administration was initiated. Further research is required to investigate the underlying mechanisms by which chaperones regulate micronutrients in diabetes.
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Affiliation(s)
- Qi Zhou
- Department of Pediatrics, First Hospital of Jilin University, Changchun, 130021, China
| | - Wenjia Guo
- Department of Laboratory Medicine, First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, China
| | - Yanan Jia
- Department of Laboratory Medicine, First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, China
| | - Jiancheng Xu
- Department of Laboratory Medicine, First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, China.
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18
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Kurstjens S, Smeets B, Overmars-Bos C, Dijkman HB, den Braanker DJW, de Bel T, Bindels RJM, Tack CJJ, Hoenderop JGJ, de Baaij JHF. Renal phospholipidosis and impaired magnesium handling in high-fat-diet-fed mice. FASEB J 2019; 33:7192-7201. [PMID: 30848940 DOI: 10.1096/fj.201801778rr] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Hypomagnesemia (blood Mg2+ concentration <0.7 mM) is a common electrolyte disorder in patients with type 2 diabetes (T2D), but the etiology remains largely unknown. In patients with T2D, reduced blood Mg2+ levels are associated with an increased decline in renal function, independent of glycemic control and hypertension. To study the underlying mechanism of this phenomenon, we investigated the renal effects of hypomagnesemia in high-fat-diet (HFD)-fed mice. In mice fed a low dietary Mg2+, the HFD resulted in severe hypomagnesemia within 4 wk. Renal or intestinal Mg2+ wasting was not observed after 16 wk on the diets. Despite the absence of urinary or fecal Mg2+ loss, the HFD induced a reduction in the mRNA expression transient receptor potential melastatin type 6 in both the kidney and colon. mRNA expression of distal convoluted tubule (DCT)-specific genes was down-regulated by the LowMg-HFD, indicating atrophy of the DCT. The low dietary Mg2+ resulted in severe HFD-induced proximal tubule phospholipidosis, which was absent in mice on a NormalMg-HFD. This was accompanied by albuminuria, moderate renal damage, and alterations in renal energy metabolism, including enhanced gluconeogenesis and cholesterol synthesis. In conclusion, this study shows that hypomagnesemia is a consequence of diet-induced obesity and insulin resistance. Moreover, hypomagnesemia induces major structural changes in the diabetic kidney, including proximal tubular phospholipidosis, providing a novel mechanism for the increased renal decline in patients with hypomagnesemic T2D.-Kurstjens, S., Smeets, B., Overmars-Bos, C., Dijkman, H. B., den Braanker, D. J. W., de Bel, T., Bindels, R. J. M., Tack, C. J. J., Hoenderop, J. G. J., de Baaij, J. H. F. Renal phospholipidosis and impaired magnesium handling in high-fat-diet-fed mice.
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Affiliation(s)
- Steef Kurstjens
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bart Smeets
- Department of Pathology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Caro Overmars-Bos
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Henry B Dijkman
- Department of Pathology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dirk J W den Braanker
- Department of Nephrology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; and
| | - Thomas de Bel
- Department of Pathology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - René J M Bindels
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Cees J J Tack
- Department of Internal Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joost G J Hoenderop
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen H F de Baaij
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Zhang Q, Ji L, Zheng H, Li Q, Xiong Q, Sun W, Zhu X, Li Y, Lu B, Liu X, Zhang S. Low serum phosphate and magnesium levels are associated with peripheral neuropathy in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract 2018; 146:1-7. [PMID: 30273706 DOI: 10.1016/j.diabres.2018.09.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 08/31/2018] [Accepted: 09/25/2018] [Indexed: 01/19/2023]
Abstract
AIMS To determine the relationship of serum phosphate, serum magnesium and peripheral nerve function in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 254 patients diagnosed with T2DM were included. Peripheral nerve function was evaluated by nerve conduction study with the use of electromyography. Composite z scores of conduction velocity, latency, and amplitude were constructed, respectively. Demographic, medical and laboratory data including serum phosphate and magnesium were collected. RESULTS Serum phosphate and serum magnesium levels were significantly lower in patients with diabetic peripheral neuropathy (DPN) (P < 0.01). And the percentages of DPN patients were lower in high tertile of serum phosphate and serum magnesium (P < 0.05). Furthermore, composite z score of conduction velocity (CV) (P = 0.012) were positively associated with serum phosphate levels and the composite z score of amplitude (P < 0.001) and CV (P = 0.041) were positively associated with serum magnesium levels. After adjusting potential related factors (age, gender, smoking, diabetes duration, body mass index, systolic blood pressure, glycated hemoglobin, total cholesterol, estimated glomerular filtration rate), serum levels of phosphate and magnesium were still related to status of DPN in logistic regression (P < 0.05). CONCLUSION Lower serum phosphate and magnesium significantly correlated with parameters of nerve conduction in T2DM patients. Serum phosphate and magnesium might underlie the pathophysiologic features of DPN.
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Affiliation(s)
- Qi Zhang
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Lijin Ji
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Hangping Zheng
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qingchun Li
- Jing'an District Center Hospital of Shanghai, Fudan University, Shanghai 200040, China
| | - Qian Xiong
- Jing'an District Center Hospital of Shanghai, Fudan University, Shanghai 200040, China
| | - Wanwan Sun
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xiaoming Zhu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yiming Li
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Bin Lu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xiaoxia Liu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Shuo Zhang
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai 200040, China.
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20
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Wang Y, Wei J, Zeng C, Yang T, Li H, Cui Y, Xie D, Xu B, Liu Z, Li J, Jiang S, Lei G. Association between serum magnesium concentration and metabolic syndrome, diabetes, hypertension and hyperuricaemia in knee osteoarthritis: a cross-sectional study in Hunan Province, China. BMJ Open 2018; 8:e019159. [PMID: 30206073 PMCID: PMC6144480 DOI: 10.1136/bmjopen-2017-019159] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To examine the associations between serum magnesium (Mg) concentration with the prevalence of metabolic syndrome (MetS), diabetes mellitus (DM), hypertension (HP) and hyperuricaemia (HU) in patients with radiographic knee osteoarthritis (OA). METHODS The present study was conducted at the Health Management Center of Xiangya Hospital. Radiographic OA was evaluated for patients aged over 40 years with basic characteristics and blood biochemical assessment. Serum Mg concentration was measured using the chemiluminescence method. MetS, DM, HP and HU were diagnosed based on standard protocols. The associations between serum Mg concentration with MetS, DM, HP and HU were evaluated by conducting multivariable adjusted logistic regression. RESULTS A total of 962 patients with radiographic knee OA were included. Compared with the lowest quintile, the multivariable adjusted ORs and related 95% CIs of DM were 0.40 (95% CI 0.23 to 0.70, p=0.001), 0.33 (95% CI 0.18 to 0.60, p<0.001), 0.27 (95% CI 0.14 to 0.52, p<0.001) and 0.22 (95% CI 0.11 to 0.44, p<0.001) in the second, third, fourth and highest quintiles of serum Mg, respectively (p for trend <0.001); the multivariable adjusted ORs of HU were 0.33 (95% CI 0.19 to 0.59, p<0.001), 0.52 (95% CI 0.30 to 0.91, p=0.022) and 0.39 (95% CI 0.22 to 0.70, p=0.001) in the third, fourth and highest quintiles of serum Mg, respectively (p for trend <0.001); and the multivariable adjusted ORs of MetS were 0.59 (95% CI 0.36 to 0.94, p=0.027) in the second and 0.56 (95% CI 0.34 to 0.93, p=0.024) in the highest quintiles of serum Mg. However, the inverse association between serum Mg and the prevalence of MetS was non-linear (p for trend=0.067). There was no significant association between serum Mg and HP in patients with OA. CONCLUSIONS The serum Mg concentration was inversely associated with the prevalence of MetS, DM and HU in patients with radiographic knee OA. LEVEL OF EVIDENCE Level III, cross-sectional study.
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Affiliation(s)
- Yilun Wang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Wei
- Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Tuo Yang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hui Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yang Cui
- International Medical Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Dongxing Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bei Xu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhichen Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiatian Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shide Jiang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guanghua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Yu L, Zhang J, Wang L, Li S, Zhang Q, Xiao P, Wang K, Zhuang M, Jiang Y. Association between serum magnesium and blood lipids: influence of type 2 diabetes and central obesity. Br J Nutr 2018; 120:250-8. [PMID: 29789028 DOI: 10.1017/S0007114518000685] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To assess the changes in the relationship between serum Mg and blood lipids of Chinese adults with type 2 diabetes (T2D) or central obesity, a total of 8163 subjects (mean age 59·6 years, 54·9 % men) were analysed. Participants were classified according to blood Mg (below 0·65 mmol/l, 0·65-0·95 mmol/l and above 0·95 mmol/l), T2D (yes/no) and central obesity (yes/no). Blood lipids (TAG, total cholesterol (TC), HDL-cholesterol and LDL-cholesterol) were determined by standardised methods and conditions. A significant increase in blood lipids, with the exception of HDL-cholesterol, across progressive Mg groups in all subjects was noted (P0·05). TAG, TC, HDL-cholesterol and LDL-cholesterol were significantly higher among subjects with T2D than those without T2D (P<0·05). Multivariable models for TAG and LDL-cholesterol failed to attain statistical significance in diabetics, by using a generalised linear or parsimonious model. TAG, TC, HDL-cholesterol and LDL-cholesterol were significantly higher among subjects with T2D or central obesity. Blood lipids, with the exception of HDL-cholesterol, were associated with serum Mg, but this association was somehow influenced by T2D in LDL-cholesterol. In addition, multivariable models for both TAG and LDL-cholesterol failed to attain statistical significance among subjects with T2D, different from subjects without T2D.
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Chen S, Jin X, Liu J, Sun T, Xie M, Bao W, Yu X, Yang X, Zhang Y, Zhang H, Shan Z, Liu L. Association of Plasma Magnesium with Prediabetes and Type 2 Diabetes Mellitus in Adults. Sci Rep 2017; 7:12763. [PMID: 28986547 PMCID: PMC5630593 DOI: 10.1038/s41598-017-13050-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 09/13/2017] [Indexed: 12/15/2022] Open
Abstract
Our study aimed to assess the associations of plasma magnesium with prediabetes and type 2 diabetes (T2D) among Chinese adults. We conducted a case-control analysis of 4447 participants: 867 newly diagnosed prediabetes patients, 1475 newly diagnosed T2D patients and 2105 normal glucose tolerance (NGT) individuals. In a subsample of 599 apparently healthy individuals, we measured plasma hs-CRP levels to examine their relation to plasma magnesium. Plasma magnesium and hs-CRP were measured by inductively coupled plasma mass spectrometry and an enzyme-linked immunosorbent assay, respectively. Plasma magnesium decreased from NGT to prediabetes to T2D, and was inversely associated with prediabetes and T2D. After adjustment for potential confounding factors, the ORs from the lowest to highest quartiles of plasma magnesium were 1, 0.57 (95%CI, 0.44–0.74), 0.49 (0.37–0.65) and 0.51 (0.37–0.70) for prediabetes, and 1, 0.26 (0.20–0.33), 0.15 (0.12–0.20) and 0.15 (0.11–0.20) for T2D. Consistently, plasma magnesium was inversely correlated with plasma hs-CRP in our subsample analysis; the geometric mean hs-CRP concentration for ascending quartiles of plasma magnesium were 1.29 (1.06–1.57), 1.16 (0.95–1.41), 1.00 (0.81–1.22), and 0.71 (0.58–0.88) mg/l. Plasma magnesium was independently and inversely associated with prediabetes and T2D in Chinese adults.
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Affiliation(s)
- Sijing Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiaoling Jin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Taoping Sun
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Manling Xie
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, 52242, USA
| | - Xuefeng Yu
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yan Zhang
- Hubei Provincial Key Laboratory of Yeast Function, Yichang, 443003, China
| | - Haibo Zhang
- Hubei Provincial Key Laboratory of Yeast Function, Yichang, 443003, China
| | - Zhilei Shan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. .,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. .,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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You S, Zhong C, Du H, Zhang Y, Zheng D, Wang X, Qiu C, Zhao H, Cao Y, Liu CF. Admission Low Magnesium Level Is Associated with In-Hospital Mortality in Acute Ischemic Stroke Patients. Cerebrovasc Dis 2017; 44:35-42. [PMID: 28419989 DOI: 10.1159/000471858] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/20/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Low magnesium levels are associated with an elevated risk of stroke. In this study, we investigated the association between magnesium levels on hospital admission and in-hospital mortality in acute ischemic stroke (AIS) patients. METHODS A total of 2,485 AIS patients, enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city, were included in this study. The patients were divided into 4 groups according to their level of admission magnesium: Q1 (<0.82 mmol/L), Q2 (0.82-0.89 mmol/L), Q3 (0.89-0.98 mmol/L), and Q4 (≥0.98 mmol/L). Cox proportional hazard model was used to estimate the effect of magnesium on all-cause in-hospital mortality in AIS patients. RESULTS During hospitalization, 92 patients (3.7%) died from all causes. The lowest serum magnesium level (Q1) was associated with a 2.66-fold increase in the risk of in-hospital mortality in comparison to Q4 (hazard ratio [HR] 2.66; 95% CI 1.55-4.56; p-trend < 0.001). After adjusting for age, sex, time from onset to hospital admission, baseline National Institutes of Health Stroke Scale score, and other potential covariates, HR for Q1 was 2.03 (95% CI 1.11-3.70; p-trend = 0.014). Sensitivity and subgroup analyses further confirmed a significant association between lower magnesium levels and a high risk of in-hospital mortality. CONCLUSIONS Decreased serum magnesium levels at admission were independently associated with in-hospital mortality in AIS patients.
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Affiliation(s)
- Shoujiang You
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Shahbah D, Hassan T, Morsy S, Saadany HE, Fathy M, Al-Ghobashy A, Elsamad N, Emam A, Elhewala A, Ibrahim B, Gebaly SE, Sayed HE, Ahmed H. Oral magnesium supplementation improves glycemic control and lipid profile in children with type 1 diabetes and hypomagnesaemia. Medicine (Baltimore) 2017; 96:e6352. [PMID: 28296769 PMCID: PMC5369924 DOI: 10.1097/md.0000000000006352] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Dietary supplementation with magnesium (Mg) in addition to classical therapies for diabetes may help in prevention or delaying of diabetic complications.We aimed to evaluate the status of serum Mg in children with type 1 diabetes and assessing its relationship to glycemic control and lipid profile. Then evaluating the effect of oral Mg supplementation on glycemic control and lipid parameters.We included 71 children at Pediatric Endocrinology Outpatient Clinic, Zagazig University, Egypt with type 1 diabetes and assessed HBA1c, lipid profile, and serum Mg at the start of study. Patients with serum Mg level < 1.7 mg/dL were given 300 mg Mg oxide for 3 months. After that we reevaluated HBA1c, lipid profile, and serum Mg in all patients.The study included 71 patients with type 1 diabetes (32 males and 39 females); their mean age was 9.68 ± 3.99 years. The mean serum Mg level was 1.83 ± .27 mg/dL. Hypomagnesemia was detected in 28.2% study patients. Serum Mg was found to be positively correlated with high density lipoprotein, mean corpuscular volume and platelet count (P < 0.001), and negatively correlated with age, HbA1c, triglycerides, total cholesterol, low density lipoprotein, and duration of diabetes (P < 0.001). There was significant reduction in HBA1c in group given Mg supplementation. HBA1c was initially 10.11% ± 0.87%. After 3 months of oral Mg supplementation it is reduced to 7.88% ± 0.42% (P < 0.001). There was statistically significant difference in lipid parameters in hypomagnesemic diabetic patients before and after Mg supplementation with significant reduction in serum triglycerides, LDL, and total cholesterol following Mg supplementation with P < 0.001. Although HDL shows a significant increase after Mg supplementation in hypomagnesemic diabetic children with P < 0.001.Correction of hypomagnesemia in type 1 diabetic children with oral Mg supplements is associated with optimization of glycemic control and reduction of atherogenic lipid fraction as well as increase in protective lipid fraction.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Hanan Ahmed
- Department of Clinical Pathology, Zagazig University, Zagazig, Egypt
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Chua FB, Cinco JE, Paz-Pacheco E. Efficacy of Magnesium Supplementation on Glycemic Control in Type 2 Diabetes Patients: A Meta-analysis. J ASEAN Fed Endocr Soc 2017; 32:38-45. [PMID: 33442083 DOI: 10.15605/jafes.032.01.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 07/13/2016] [Indexed: 11/17/2022] Open
Abstract
Objective To evaluate if magnesium supplementation, in addition to standard therapy, improves fasting blood sugar (FBS) and/or glycosylated hemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM) compared to placebo or other comparator. Methodology We searched MEDLINE/PubMed, Cochrane Library, Acta Medica Philippina, Health Research and Development Information Network (HERDIN) and references of reviewed journals from 1966 to July 2015 using the following search terms: “magnesium” OR “magnesium supplementation” OR “magnesium replacement”, AND randomized controlled trial AND diabetes OR diabetes mellitus OR non-insulin dependent diabetes mellitus OR diabetic OR diab* (with MeSH, where available). Studies were retrieved and rated independently using the standards provided by The Cochrane Collaboration. High quality trials were included in a systematic review and meta-analysis. Results Of the 689 records screened, 10 studies were included in the qualitative synthesis and 7 studies in the meta-analysis. Pooled data showed a non-significant trend towards improvement in glycemic control in the magnesium-treated group (mean difference -0.19, CI -0.58 to 0.21). There was a stronger but still non-significant trend in T2DM patients with hypomagnesemia (mean difference -1.16, CI -2.92 to 0.6). Conclusion Routine magnesium supplementation for improvement in glycemic control in T2DM patients cannot be recommended based on data from included studies in this meta-analysis.
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Shahbah D, El Naga AA, Hassan T, Zakaria M, Beshir M, Al Morshedy S, Abdalhady M, Kamel E, Rahman DA, Kamel L, Abdelkader M. Status of serum magnesium in Egyptian children with type 1 diabetes and its correlation to glycemic control and lipid profile. Medicine (Baltimore) 2016; 95:e5166. [PMID: 27893657 PMCID: PMC5134850 DOI: 10.1097/md.0000000000005166] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Diabetes mellitus has been suggested to be the most common metabolic disorder associated with magnesium deficiency, having 25% to 39% prevalence. This deficit could be associated with the development of late diabetic complications, especially macroangiopathy.We aimed to evaluate the status of serum Mg in children with type 1 diabetes and assess its relation to glycemic control and lipid profile.We included 71 Egyptian children with type 1diabetes having their follow-up at Pediatric Endocrinology outpatient clinic, Zagazig University Hospital and 71 age- and sex-matched control. We measured Serum magnesium, HbA1c, and lipid profile in all study subjects.Diabetic children had significantly lower serum magnesium level compared to control children (1.83 ± .27 mg/dL in diabetic children versus 2.00 ± .16 mg/dL in control children). Taking cut-off level of serum magnesium <1.7 mg/dL for definition of hypomagnesemia, hypomagnesemia was detected in 28.2% of diabetic children compared to 9.9% of control children. In diabetic patients, there was statistically significant difference in HbA1c between hypomagnesemic and normomagnesemic group being higher in the low magnesium group, as it is mean ± SD was 11.93 ± 3.17 mg/dL in group I versus 8.92 ± 0.93 mg/dL in the normomagnesemic group. Serum magnesium was found to be positively correlated with HDL (P < 0.001), and negatively correlated with age, HbA1c, triglycerides, total cholesterol, LDL, and duration of diabetes (P < 0.001).We concluded that total serum magnesium was frequently low in Egyptian children with type 1 diabetes and it is correlated with HbA1c and with lipid profile. Hypomagnesemia was more evident in patients with poor diabetic control and those with higher atherogenic lipid parameters. We suggest that low serum magnesium may be included in pathogenesis of poor glycemic control and abnormal lipid profile in children with type 1 diabetes. We need to perform further studies on giving magnesium supplements in diabetic children with hypomagnesemia to observe the effect of correction of serum magnesium on glycemic control, lipid profile, and the risk of diabetic complications.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Lamiaa Kamel
- Department of Clinical Pathology, Zagazig University, Egypt
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Wei J, Zeng C, Li XX, Gong QY, Lei GH, Yang TB. Association among dietary magnesium, serum magnesium, and diabetes: a cross-sectional study in middle-aged and older adults. J Health Popul Nutr 2016; 35:33. [PMID: 27756380 PMCID: PMC5069897 DOI: 10.1186/s41043-016-0071-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/04/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND A number of studies have reported the association between magnesium (Mg) and diabetes. However, the various conclusions were inconsistent and the data on the Chinese population was limited. The objective of this study was to evaluate the association among dietary Mg, serum Mg, and diabetes in Chinese adults. METHODS A cross-sectional study that contained 2904 subjects was conducted. Biochemical test results and dietary intakes of subjects were collected for analysis. The adjusted odds ratios (ORs) and the corresponding 95 % confidence intervals (95 % CIs) were used to determine the relationship between Mg status and diabetes by logistic regression. RESULTS The prevalence of diabetes of the investigated population was 10.1 %. Dietary Mg intake was not significantly correlated with diabetes (P > 0.05). The significant negative association between serum Mg and diabetes existed, and the multivariate adjusted OR was 0.34 (95 % CI 0.24, 0.49) in model 3 for the highest quartile of serum Mg compared with the lowest. The P values for trend were all less than 0.001 for the relationship between serum Mg and diabetes. Dietary Mg intake and serum Mg were not significantly correlated in the diabetes population (P = 0.936). CONCLUSIONS Dietary Mg was not significantly correlated with diabetes, while serum Mg was inversely correlated with diabetes in the Chinese population. Meanwhile, dietary Mg intake and serum Mg were not significantly correlated in the diabetes population.
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Affiliation(s)
- Jie Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410008, China
- Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Xiao-Xiao Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410008, China
| | - Qian-Yi Gong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410008, China
| | - Guang-Hua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, 410008, China
| | - Tu-Bao Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410008, China.
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Fang C, Wang X, Wu W, Gu X, Ye T, Deng H, Wang X, Shen F. Association of Serum Magnesium Level with Odds of Prediabetes and Diabetes in a Southern Chinese Population: a Prospective Nested Case-Control Study. Biol Trace Elem Res 2016; 172:307-314. [PMID: 26706038 DOI: 10.1007/s12011-015-0594-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 12/14/2015] [Indexed: 12/15/2022]
Abstract
Although emerging clinical evidence supports that magnesium deficiency is a risk factor for the development of type 2 diabetes, there are sparse studies concerning the dynamic change of serum magnesium with the risk of diabetes and its early stages. In this nested case-control study, we performed a 75-g oral glucose tolerance test or a standardized steamed bread meal test in 178 subjects with incident glucose metabolism impairment (33 with type 2 diabetes and 145 with prediabetes) and 178 matched controls at baseline and at 3-year follow-up and determined the associations between baseline serum magnesium levels as well as changes in serum magnesium levels at follow-up and odds of prediabetes and diabetes. After adjusting for potential confounders, the odds ratios of risk for prediabetes and type 2 diabetes in the highest quartile of serum magnesium levels were 0.22 (95 % confidence intervals [CI] 0.10-0.49; p for trend <0.001) and 0.02 (95 % CI 0.00-0.29; p for trend = 0.009), respectively, as compared with the lowest quartile. In addition, a significant decline in the serum magnesium level was detected in type 2 diabetes cases (p = 0.015) at 3 years as compared with at baseline. These results suggest that a low magnesium level is an independent risk factor for prediabetes and type 2 diabetes, and that the reduction of serum magnesium is associated with type 2 diabetes in a southern Chinese population.
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Affiliation(s)
- Chenchen Fang
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xuebao Wang
- Analytical and Testing Center, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wenjun Wu
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xuejiang Gu
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Tingting Ye
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huihui Deng
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xianqin Wang
- Analytical and Testing Center, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Feixia Shen
- Departments of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Sarrafzadegan N, Khosravi-Boroujeni H, Lotfizadeh M, Pourmogaddas A, Salehi-Abargouei A. Magnesium status and the metabolic syndrome: A systematic review and meta-analysis. Nutrition 2016; 32:409-17. [DOI: 10.1016/j.nut.2015.09.014] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 09/19/2015] [Accepted: 09/21/2015] [Indexed: 12/18/2022]
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Abstract
UNLABELLED There is conflicting evidence regarding the relationship between magnesium deficiency and metabolic syndrome, and a systematic assessment of the literature has not been performed. Our objective was to clarify the association between magnesium levels and metabolic syndrome by performing a meta-analysis. Based on 13 eligible studies involving 14 analyses and 5496 enrolled participants, magnesium levels were significantly lower in adults with metabolic syndrome than in controls (standardized mean difference [SMD] = -0.98, 95 % confidence interval [CI] = -1.44 to -0.52). There was marked heterogeneity when all comparisons were considered (I (2) = 98 %, p < 0.001). In the subgroup meta-analysis and meta-regression model, a significant difference in magnesium levels was noted by geographic location and study quality. Magnesium levels were lower in the experimental cases than in the controls in West Asia (SMD = -3.80, 95 % CI = -5.36, -2.23) and Latin America (SMD = -1.38, 95 % CI = -1.88, -0.87), but not in East Asia (SMD = -0.01, 95 % CI = -0.30, 0.29) or Europe/Oceania (SMD = -0.25, 95 % CI = -0.53, 0.03). Moreover, the inverse association was greater in high-quality studies (SMD = -2.52, 95 % CI = -3.72, -1.32) than in low-quality studies (SMD = -0.33, 95 % CI = -0.57, -0.08). In conclusion, although there was a high level of heterogeneity, this meta-analysis provided convincing evidence of reduced magnesium levels in adults with metabolic syndrome based on the findings of observational studies. However, the present findings should be validated by additional prospective studies or trans-regional multicenter randomized controlled trials, which generally yield higher-level evidence than case-control studies and cross-sectional studies. CLINICAL TRIAL REGISTRATION NUMBER NCT02151227 ( ClinicalTrials.gov Protocol Registration System); CRD42015017946 ( www.crd.york.ac.uk/PROSPERO ).
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Affiliation(s)
- Sang A La
- Department of Family Medicine, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 150-713, Republic of Korea
| | - June Young Lee
- Department of Biostatistics, College of Medicine, Korea University, 145, Anam-ro, Seongbuk-gul, 136-701, Republic of Korea
| | - Do Hoon Kim
- Department of Family Medicine, Korea University Ansan Hospital, 516, Gojan 1-Dong, Danwon-Gu, Ansan-Si Gyeonggi-Do, 425-707, Republic of Korea
| | - E Lang Song
- Department of Family Medicine, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 150-713, Republic of Korea
| | - Jin Hee Park
- Department of Research, Research and Development Center, Food and Drug Networking Co., Ltd, Seoul, Republic of Korea
| | - Sang Yhun Ju
- Department of Family Medicine, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul, 150-713, Republic of Korea.
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Lu J, Gu Y, Guo M, Chen P, Wang H, Yu X. Serum Magnesium Concentration Is Inversely Associated with Albuminuria and Retinopathy among Patients with Diabetes. J Diabetes Res 2016; 2016:1260141. [PMID: 27547762 PMCID: PMC4983386 DOI: 10.1155/2016/1260141] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 06/09/2016] [Accepted: 07/01/2016] [Indexed: 02/05/2023] Open
Abstract
Aim. To investigate the association between serum magnesium levels and microvascular complications among patients with diabetes. Methods. Patients with diabetes were recruited between April 2012 and January 2015. All patients received an assay of serum magnesium concentration, were screened for 24 h albumin excretion rate, and underwent nonmydriatic fundus photography. Albuminuria and retinopathy were defined accordingly. A total of 3,100 patients with normal serum magnesium levels were included in this study. Results. Patients with albuminuria and/or retinopathy had lower levels of serum magnesium than patients without these complications (P < 0.001). The prevalence of isolated albuminuria, isolated retinopathy, and combined albuminuria and retinopathy decreased as the concentration of serum magnesium increased. Multiple logistic regression analysis indicated that the odds ratio for isolated albuminuria, isolated retinopathy, and concomitant albuminuria and retinopathy decreased by approximately 20% for every 0.1 mmol/L increase in serum magnesium concentration. Conclusion. Serum magnesium levels were negatively associated with the risk of diabetic microvascular complications among patients with serum magnesium levels within the normal range.
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Affiliation(s)
- Jun Lu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, 6600 Nanfeng Road, Shanghai 201499, China
| | - Yuying Gu
- Department of Mathematics, Shanghai Business School, 2271 West Zhongshan Road, Shanghai 200235, China
| | - Meixiang Guo
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, 6600 Nanfeng Road, Shanghai 201499, China
| | - Peihong Chen
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, 6600 Nanfeng Road, Shanghai 201499, China
| | - Hongtao Wang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, 6600 Nanfeng Road, Shanghai 201499, China
| | - Xuemei Yu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, 6600 Nanfeng Road, Shanghai 201499, China
- *Xuemei Yu:
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Yin Y, Han W, Wang Y, Zhang Y, Wu S, Zhang H, Jiang L, Wang R, Zhang P, Yu Y, Li B. Identification of Risk Factors Affecting Impaired Fasting Glucose and Diabetes in Adult Patients from Northeast China. Int J Environ Res Public Health 2015; 12:12662-78. [PMID: 26473900 PMCID: PMC4626992 DOI: 10.3390/ijerph121012662] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 09/17/2015] [Accepted: 10/08/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND Besides genetic factors, the occurrence of diabetes is influenced by lifestyles and environmental factors as well as trace elements in diet materials. Subjects with impaired fasting glucose (IFG) have an increased risk of developing diabetes mellitus (DM). This study aimed to explore risk factors affecting IFG and diabetes in patients from Northeast China. METHODS A population-based, cross-sectional survey of chronic diseases and related risk factors was conducted in Jilin Province of Northeast China. All adult residents, aged 18-79, were invited to participate in this survey using the method of multistage stratified random cluster sampling. One hundred thirty-four patients with IFG or DM and 391 healthy control subjects were recruited. We compared demographic factors, body size measurements, healthy-related behaviors, and hair metallic element contents between IFG/diabetes patients and healthy individuals. RESULTS IFG/diabetes patients had a greater weight, waist, hip, and body mass index (BMI) than control subjects. Significant differences in the content of zinc (Zn), potassium (K), copper (Ca), and sodium (Na) as well as Cu/Zn ratios between IFG or DM patients and control subjects (p < 0.05) were also observed. Hair Cu, selenium (Se), and Na contents were positively correlated with blood glucose levels (Cu: rs = 0.135, p = 0.002; Se: rs = 0.110, p = 0.012; Na: rs = 0.091, p = 0.038). Polytomous logistic regression adjusting for age, sex, family history of diabetes and BMI, showed that subjects with high BMI were more likely to develop IFG and DM (IFG: OR = 1.15, OR 95% CI = 1.02-1.29; DM: OR = 1.15, OR 95% CI = 1.01-1.33). Moreover, rarely or never eating fruits was a risk factor for DM (OR = 5.46, OR 95% CI = 1.87-15.98) but not for IFG (OR = 1.70, OR 95% CI = 0.72-4.02). Subjects with abdominal obesity or DM history were more susceptible to DM (abdominal obesity: OR = 2.99, OR 95% CI = 1.07-8.37; DM history: OR = 2.69, OR 95% CI = 1.01-7.20). We found that subjects living in Changling County had a significantly lower chance to suffer from IFG (OR and 95% CI for OR: 0.25, 0.08-0.74). Men and 60-69 years old subjects were at increased risk for IFG (male: OR = 3.51, OR 95% CI = 1.34-9.18; age 60-69: OR = 6.64, OR 95% CI = 1.36-32.47). We did not find significant associations of IFG or DM with certain lifestyles (such as eating more meat, exercise or physical activity, smoking, or alcohol drinking) or the content of some metallic elements (such as iron (Fe), Zn , K, calcium (Ca), Na, or magnesium (Mg)). CONCLUSIONS This study demonstrated that less or no fruit eating, DM family history, abdominal obesity conferred vulnerability to DM. Living in Changling County, men and 60-69 years old subjects were found to be risk factors for IFG. Subjects with high BMI were more likely to develop IFG and DM.
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Affiliation(s)
- Yutian Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Weiqing Han
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Yuhan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Yue Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Shili Wu
- Administration Bureau of Changbai Mountain Natural Mineral Water Source Protection Areas, Jilin 130021, China.
| | - Huiping Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA.
| | - Lingling Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Rui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Peng Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun, Jilin 130021, China.
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun, Jilin 130021, China.
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Abstract
Magnesium is actively involved in a number of metabolic reactions as an important co-factor, with special emphasis on carbohydrate metabolism. After a brief overview of the regulation of intra- and extracellular magnesium, the present review first describes the regulatory role of magnesium in important metabolic pathways involved in energy metabolism and glycaemic control. Next the clinical significance of hypomagnesaemic conditions with regard to the management of glucose in prediabetic stages, such as insulin resistance/impaired glucose tolerance and in type 2 diabetes mellitus are characterized. Cross-sectional as well as longitudinal studies suggest that a reduced dietary magnesium intake serves as a risk factor for the incidence of both impaired glucose regulation and type 2 diabetes. Mechanisms that might be responsible for diabetes-associated hypomagnesaemia are discussed. Furthermore, the role of hypomagnesaemia in the development and progression of chronic diabetic complications are addressed. Finally, the available literature on the effects of magnesium supplementation on glycaemic control parameters during prediabetic conditions (preventive approach) as well as type 2 diabetes mellitus (therapeutic approach) are reviewed systematically. There is considerable evidence that chronic magnesium supplementation may delay the progression from impaired glucose regulation to type 2 diabetes; however, the effects of oral magnesium supplementation as an adjunct therapy for type 2 diabetes are quite heterogeneous with respect to the various measures of glycaemic control. The results of this review suggest a requirement for critical consideration of the pros and cons of magnesium replacement therapy, based on variables such as magnesium status, stage of disease and glycaemic control.
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Affiliation(s)
- Frank C Mooren
- Department of Sports Medicine, Institute of Sports Sciences, Justus-Liebig-University, Giessen, Germany
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Guerrero-Romero F, Simental-Mendía LE, Hernández-Ronquillo G, Rodriguez-Morán M. Oral magnesium supplementation improves glycaemic status in subjects with prediabetes and hypomagnesaemia: A double-blind placebo-controlled randomized trial. Diabetes Metab 2015; 41:202-7. [PMID: 25937055 DOI: 10.1016/j.diabet.2015.03.010] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 03/30/2015] [Accepted: 03/30/2015] [Indexed: 01/31/2023]
Abstract
AIM This study evaluated the efficacy of oral magnesium supplementation in the reduction of plasma glucose levels in adults with prediabetes and hypomagnesaemia. METHODS A total of 116 men and non-pregnant women, aged 30 to 65 years with hypomagnesaemia and newly diagnosed with prediabetes, were enrolled into a randomized double-blind placebo-controlled trial to receive either 30 mL of MgCl2 5% solution (equivalent to 382 mg of magnesium) or an inert placebo solution once daily for four months. The primary trial endpoint was the efficacy of magnesium supplementation in reducing plasma glucose levels. RESULTS At baseline, there were no significant statistical differences in terms of anthropometric and biochemical variables between individuals in the supplement and placebo groups. At the end of follow-up, fasting (86.9 ± 7.9 and 98.3 ± 4.6 mg/dL, respectively; P = 0.004) and post-load glucose (124.7 ± 33.4 and 136.7 ± 23.9 mg/dL, respectively; P = 0.03) levels, HOMA-IR indices (2.85 ± 1.0 and 4.1 ± 2.7, respectively; P = 0.04) and triglycerides (166.4 ± 90.6 and 227.0 ± 89.7, respectively; P = 0.009) were significantly decreased, whereas HDL cholesterol (45.6 ± 10.9 and 46.8 ± 9.2 mg/dL, respectively; P = 0.04) and serum magnesium (1.96 ± 0.27 and 1.60 ± 0.26 mg/dL, respectively; P = 0.005) levels were significantly increased in those taking MgCl2 compared with the controls. A total of 34 (29.4%) people improved their glucose status (50.8% and 7.0% in the magnesium and placebo groups, respectively; P < 0.0005). CONCLUSION Our results show that magnesium supplementation reduces plasma glucose levels, and improves the glycaemic status of adults with prediabetes and hypomagnesaemia.
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Arpaci D, Tocoglu AG, Ergenc H, Korkmaz S, Ucar A, Tamer A. Associations of serum Magnesium levels with diabetes mellitus and diabetic complications. Hippokratia 2015; 19:153-157. [PMID: 27418765 PMCID: PMC4938107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Magnesium (Mg) deficiency is a common problem in diabetic patients. Deficiency of Mg may increase the incidence of diabetes mellitus (DM) and occurrence of diabetic complications. In this study, our aim was to evaluate an association between serum Mg level, glycemic regulation, and diabetic complications. MATERIAL-METHODS In this retrospective study 673 diabetic patients were evaluated. According to Mg levels, the patients were divided into two groups; as normomagnesemic patients and hypomagnesemic patients. RESULTS Among the patients, 57.8% were men and 42.2% were women. Mean age was 55.6 years and the mean duration of diabetes was 81 ± 86.9 months. The mean glycosylated hemoglobin (HbA1c) was 9.0 ±2.4 % (4.5-18); mean magnesium level was 1.97 ± 0.25 (1.13 to 3.0) mg / dl. There were 55 patients (8.2%) with diabetic retinopathy and 95 patients (14.1%) with diabetic neuropathy. Five hundred patients (74.3%) had normoalbuminuria; 133 patients (19. 8%) had microalbuminuria (MA) and 40 patients (5.9%) had overt proteinuria. One hundred and seventy one patients (25.4%) had HbA1c levels equal or below 7%; and 502 patients (74.6%) had HbA1c levels above 7%. There was no statistical difference in age or duration of diabetes between the groups formed according to Mg levels. Although there were no differences between the groups for retinopathy and neuropathy, MA was more common in hypomagnesemic patients (p =0.004). HbA1c levels did not differ between the groups (p =0.243). However there was a weak negative correlation between serum Mg and HbA1c levels (r =-0.110, p =0.004) and also between serum Mg and urine protein level (r =-0.127, p =0.018). CONCLUSION Mg depletion is a common problem in patients with DM. It affects both glycemic regulation and the occurence of complications. Also, poor glycemic regulation affects serum Mg levels. Hippokratia 2015; 19 (2):153-157.
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Affiliation(s)
- D Arpaci
- Department of Internal Medicine, Sakarya Education and Research Hospital, Sakarya University, Sakarya, Turkey
| | - A G Tocoglu
- Department of Internal Medicine, Sakarya Education and Research Hospital, Sakarya University, Sakarya, Turkey
| | - H Ergenc
- Department of Internal Medicine, Sakarya Education and Research Hospital, Sakarya University, Sakarya, Turkey
| | - S Korkmaz
- Department of Internal Medicine, Sakarya Education and Research Hospital, Sakarya University, Sakarya, Turkey
| | - A Ucar
- Department of Internal Medicine, Sakarya Education and Research Hospital, Sakarya University, Sakarya, Turkey
| | - A Tamer
- Department of Internal Medicine, Sakarya Education and Research Hospital, Sakarya University, Sakarya, Turkey
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Affiliation(s)
- Zhuoshi Zhang
- Department of Human Nutrition; University of Otago; Dunedin New Zealand
| | - Jessica Kane
- Department of Human Nutrition; University of Otago; Dunedin New Zealand
| | - Amy Yee Liu
- Auckland Diabetes Centre, Greenlane Clinical Centre; Auckland District Health Board; Auckland New Zealand
| | - Bernard J. Venn
- Department of Human Nutrition; University of Otago; Dunedin New Zealand
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Abstract
PURPOSE OF REVIEW To update findings supporting the opinion that commonly occurring subclinical magnesium deficiency induced by a low dietary intake is a predisposing factor for chronic inflammatory stress that contributes to the incidence of chronic diseases such as cardiovascular disease and diabetes. RECENT FINDINGS Both deficient magnesium intakes (<250 mg/day) and serum magnesium concentrations (≤ 0.75 mmol/l) have been associated with elevated serum C-reactive protein concentration, a widely used indicator of inflammation. Achieving magnesium intakes or serum magnesium concentrations that indicate an adequate magnesium status generally attenuates elevated serum C-reactive protein to concentrations that are not indicative of chronic low-grade inflammation. Individuals that are obese or have chronic diseases for which low-grade inflammation is a risk factor are commonly found to be magnesium-deficient. SUMMARY Subclinical magnesium deficiency caused by low dietary intake often occurring in the population is a predisposing factor for chronic inflammatory stress that is conducive for chronic disease. Magnesium deficiency should be considered a nutrient of significant concern for health and well-being.
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Affiliation(s)
- Forrest H Nielsen
- Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, North Dakota, USA
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Abstract
BACKGROUND AND PURPOSE Lower plasma magnesium levels may be associated with higher blood pressure and endothelial dysfunction, but sparse prospective data are available for stroke. METHODS Among 32,826 participants in the Nurses' Health Study who provided blood samples in 1989 to 1990, incident ischemic strokes were identified and confirmed by medical records through 2006. We conducted a nested case-control analysis of 459 cases, matched 1:1 to controls on age, race/ethnicity, smoking status, date of blood draw, fasting status, menopausal status, and hormone use. We used conditional logistic regression models to estimate the multivariable adjusted association of plasma magnesium and the risk of ischemic stroke and ischemic stroke subtypes. RESULTS Median magnesium levels did not differ between ischemic stroke cases and controls (median, 0.86 mmol/L for both; P=0.14). Conditional on matching factors, women in the lowest magnesium quintile had a relative risk of 1.34 (95% confidence interval, 0.86-2.10; P trend=0.13) for total ischemic stroke compared with women in the highest quintile. Additional adjustment for risk factors and confounders did not substantially alter the risk estimates for total ischemic stroke. Women with magnesium levels<0.82 mmol/L had significantly greater risk of total ischemic stroke (multivariable relative risk, 1.57; 95% confidence interval, 1.09-2.27; P=0.01) and thrombotic stroke (multivariable relative risk, 1.66; 95% confidence interval, 1.03-2.65; P=0.03) compared with women with magnesium levels≥0.82 mmol/L. No significant effect modification was observed by age, body mass index, hypertension, or diabetes mellitus. CONCLUSIONS Lower plasma magnesium levels may contribute to higher risk of ischemic stroke among women.
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Affiliation(s)
- Sally N Adebamowo
- From the Departments of Nutrition (S.N.A.-A., S.E.C., W.C.W.), Epidemiology (D.S., W.C.W.), and Biostatistics (D.S.), Harvard School of Public Health, Boston, MA; and Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.N.A.-A., M.C.J., S.E.C., K.M.R.).
| | - Monik C Jiménez
- From the Departments of Nutrition (S.N.A.-A., S.E.C., W.C.W.), Epidemiology (D.S., W.C.W.), and Biostatistics (D.S.), Harvard School of Public Health, Boston, MA; and Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.N.A.-A., M.C.J., S.E.C., K.M.R.)
| | - Stephanie E Chiuve
- From the Departments of Nutrition (S.N.A.-A., S.E.C., W.C.W.), Epidemiology (D.S., W.C.W.), and Biostatistics (D.S.), Harvard School of Public Health, Boston, MA; and Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.N.A.-A., M.C.J., S.E.C., K.M.R.)
| | - Donna Spiegelman
- From the Departments of Nutrition (S.N.A.-A., S.E.C., W.C.W.), Epidemiology (D.S., W.C.W.), and Biostatistics (D.S.), Harvard School of Public Health, Boston, MA; and Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.N.A.-A., M.C.J., S.E.C., K.M.R.)
| | - Walter C Willett
- From the Departments of Nutrition (S.N.A.-A., S.E.C., W.C.W.), Epidemiology (D.S., W.C.W.), and Biostatistics (D.S.), Harvard School of Public Health, Boston, MA; and Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.N.A.-A., M.C.J., S.E.C., K.M.R.)
| | - Kathryn M Rexrode
- From the Departments of Nutrition (S.N.A.-A., S.E.C., W.C.W.), Epidemiology (D.S., W.C.W.), and Biostatistics (D.S.), Harvard School of Public Health, Boston, MA; and Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.N.A.-A., M.C.J., S.E.C., K.M.R.)
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Ha BG, Park JE, Shin EJ, Shon YH. Modulation of glucose metabolism by balanced deep-sea water ameliorates hyperglycemia and pancreatic function in streptozotocin-induced diabetic mice. PLoS One 2014; 9:e102095. [PMID: 25013896 DOI: 10.1371/journal.pone.0102095] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 06/13/2014] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was to determine the effects of balanced deep-sea water (BDSW) on hyperglycemia and glucose intolerance in streptozotocin (STZ)-induced diabetic mice. BDSW was prepared by mixing DSW mineral extracts and desalinated water to yield a final hardness of 1000–4000 ppm. Male ICR mice were assigned to 6 groups; mice in each group were given tap water (normal and STZ diabetic groups) or STZ with BDSW of varying hardness (0, 1000, 2000, and 4000 ppm) for 4 weeks. The STZ with BDSW group exhibited lowered fasting plasma glucose levels than the STZ-induced diabetic group. Oral glucose tolerance tests showed that BDSW improves impaired glucose tolerance in STZ-induced diabetic mice. Histopathological evaluation of the pancreas showed that BDSW restores the morphology of the pancreatic islets of Langerhans and increases the secretion of insulin in STZ-induced diabetic mice. Quantitative real-time PCR assay revealed that the expression of hepatic genes involved in gluconeogenesis, glucose oxidation, and glycogenolysis was suppressed, while the expression of the genes involved in glucose uptake, β-oxidation, and glucose oxidation in muscle were increased in the STZ with BDSW group. BDSW stimulated PI3-K, AMPK, and mTOR pathway-mediated glucose uptake in C2C12 myotubes. BDSW increased AMPK phosphorylation in C2C12 myotubes and improved impaired AMPK phosphorylation in the muscles of STZ-induced diabetic mice. Taken together, these results suggest that BDSW is a potential anti-diabetic agent, owing to its ability to suppress hyperglycemia and improve glucose intolerance by modulating glucose metabolism, recovering pancreatic islets of Langerhans and increasing glucose uptake.
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Chen H, Li J, Jiao L, Petersen RB, Li J, Peng A, Zheng L, Huang K. Apelin inhibits the development of diabetic nephropathy by regulating histone acetylation in Akita mouse. J Physiol 2013; 592:505-21. [PMID: 24247978 DOI: 10.1113/jphysiol.2013.266411] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Diabetic nephropathy is the primary cause of end-stage renal disease. Increasing numbers of patients are suffering from this disease and therefore novel medications and therapeutic approaches are urgently needed. Here, we investigated whether apelin-13, the most active member of the adipokine apelin group, could effectively suppress the development of nephropathy in Akita mouse, a spontaneous type 1 diabetic model. Apelin-13 treatment decreased diabetes-induced glomerular filtration rate, proteinuria, glomerular hypertrophy, mesangial expansion and renal inflammation. The inflammatory factors, activation of NF-κB, histone acetylation and the enzymes involved in histone acetylation were further examined in diabetic kidneys and high glucose- or sodium butyrate-treated mesangial cells in the presence or absence of apelin-13. Apelin-13 treatment inhibited diabetes-, high glucose- and NaB-induced elevation of inflammatory factors, and histone hyperacetylation by upregulation of histone deacetylase 1. Furthermore, overexpression of apelin in mesangial cells induced histone deacetylation under high glucose condition. Thus, apelin-13 may be a novel therapeutic candidate for treatment of diabetic nephropathy via regulation of histone acetylation.
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Affiliation(s)
- Hong Chen
- College of Life Sciences, Wuhan University, Wuhan 430072, China. ; Kun Huang: Tongji School of Pharmacy, Huazhong University of Science and Technology, Wuhan 430030, China.
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Xu J, Zhou Q, Liu G, Tan Y, Cai L. Analysis of serum and urinal copper and zinc in Chinese northeast population with the prediabetes or diabetes with and without complications. Oxid Med Cell Longev 2013; 2013:635214. [PMID: 24175012 DOI: 10.1155/2013/635214] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 08/21/2013] [Indexed: 01/09/2023]
Abstract
This study investigated the association of copper and zinc levels in the serum or urine of patients living in northeast China, with either prediabetes or diabetes. From January 2010 to October 2011, patients with type 1 diabetes (T1D, n = 25), type 2 diabetes (T2D, n = 137), impaired fasting glucose (IFG, n = 12) or impaired glucose tolerance (IGT, n = 15), and age/gender matched controls (n = 50) were enrolled. In the T2D group, there were 24 patients with nephropathy, 34 with retinopathy, and 50 with peripheral neuropathy. Serum copper levels were significantly higher in IFG, IGT, and T2D groups. Serum zinc level was dramatically lower, and urinary zinc level was significantly higher in both T1D and T2D subjects compared with controls. The serum zinc/copper ratio was significantly lower in all the patients with IFG, ITG, T1D, and T2D. The serum copper level was positively associated with HbA1c in T2D subjects. Simvastatin treatment in T2D patients had no significant effect on serum and urinary copper and zinc. These results suggest the need for further studies of the potential impact of the imbalanced serum copper and zinc levels on metabolic syndrome, diabetes, and diabetic complications.
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Xu B, Sun J, Deng X, Huang X, Sun W, Xu Y, Xu M, Lu J, Bi Y. Low serum magnesium level is associated with microalbuminuria in chinese diabetic patients. Int J Endocrinol 2013; 2013:580685. [PMID: 24065990 PMCID: PMC3770069 DOI: 10.1155/2013/580685] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 07/26/2013] [Accepted: 07/26/2013] [Indexed: 11/18/2022] Open
Abstract
Whether serum magnesium deficiency is independently associated with the prevalence of microalbuminuria is still unclear. The objective of the present study was to elucidate the association between serum magnesium and microalbuminuria in diabetic patients. A cross-sectional study was conducted in 1829 diabetic subjects (aged ≥ 40 years) from Shanghai, China. Subjects were divided into three groups according to serum magnesium tertiles. A first-voided early-morning spot urine sample was obtained for urinary albumin-creatinine ratio (UACR) measurement. Microalbuminuria was defined as 30 mg/g ≤ UACR < 300 mg/g. Overall, 208 (11.37%) of the study population had microalbuminuria, with similar proportions in both genders (P = 0.44). The prevalence of microalbuminuria in tertile 1 of serum magnesium was higher than the prevalence in tertile 2 and tertile 3 (15.98%, 9.72%, and 8.46%, resp.; P for trend <0.0001). After adjustment for age, sex, BMI, blood pressure, lipidaemic profile, HbA1c, eGFR, history of cardiovascular disease, HOMA-IR, antihypertensive and antidiabetic medication, and diabetes duration, we found that, compared with the subjects in tertile 3 of serum magnesium, those in tertile 1 had 1.85 times more likeliness to have microalbuminuria. We concluded that low serum magnesium level was significantly associated with the prevalence of microalbuminuria in middle-aged and elderly Chinese.
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Affiliation(s)
- Baihui Xu
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Jichao Sun
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Xinru Deng
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Xiaolin Huang
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Wanwan Sun
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Yu Xu
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Min Xu
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Jieli Lu
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Yufang Bi
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- *Yufang Bi:
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