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Al Harasi S, Al-Maqbali JS, Falhammar H, Al-Mamari A, Al Futisi A, Al-Farqani A, Kumar S, Osman A, Al Riyami S, Al Riyami N, Al Farai Q, Al Alawi H, Al Alawi AM. Prevalence of Dysmagnesemia among Patients with Diabetes Mellitus and the Associated Health Outcomes: A Cross-Sectional Study. Biomedicines 2024; 12:1068. [PMID: 38791030 DOI: 10.3390/biomedicines12051068] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Introduction: Magnesium is a vital intracellular cation crucial for over 320 enzymatic reactions related to energy metabolism, musculoskeletal function, and nucleic acid synthesis and plays a pivotal role in human physiology. This study aimed to explore the prevalence of dysmagnesemia in patients with diabetes mellitus and evaluate its correlations with glycemic control, medication use, and diabetic complications. Methods: A cross-sectional study was conducted at Sultan Qaboos University Hospital, including 316 patients aged 18 years or older with diabetes mellitus. Data included demographics, medical history, medications, and biochemical parameters. Serum total magnesium concentrations were measured, and dysmagnesemia was defined as magnesium ≤ 0.69 mmol/L for hypomagnesemia and ≥1.01 mmol/L for hypermagnesemia. Results: The prevalence of hypomagnesemia in patients with diabetes was 17.1% (95% CI: 13.3-21.7%), and hypermagnesemia was 4.1% (95% CI: 2.4-7.0%). Females were significantly overrepresented in the hypomagnesemia group, while the hypermagnesemia group showed a higher prevalence of hypertension, retinopathy, an increased albumin/creatinine ratio, chronic kidney disease (CKD), elevated creatinine levels, and a lower adjusted calcium concentration. The multinominal logistic regression exhibited that the female sex and higher serum-adjusted calcium were independent risk factors of hypomagnesemia. In contrast, the presence of hypertension, higher levels of albumin/creatinine ratio, and stage 5 CKD were independent risk factors of hypermagnesemia. Conclusions: Hypomagnesemia was common among patients with diabetes mellitus; however, hypermagnesemia was associated with microvascular complications.
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Affiliation(s)
- Salwa Al Harasi
- Internal Medicine Residency Training Program, Oman Medical Specialty Board, Muscat 130, Oman
| | - Juhaina Salim Al-Maqbali
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Science, Sultan Qaboos University, Muscat 123, Oman
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - Henrik Falhammar
- Department of Endocrinology, Karolinska University Hospital, 17165 Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institute, 17177 Stockholm, Sweden
| | - Ali Al-Mamari
- Department of Medicine, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - Abdullah Al Futisi
- Department of Medicine, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - Ahmed Al-Farqani
- Department of Medicine, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - Suneel Kumar
- Department of Medicine, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - Alaa Osman
- Department of Medicine, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - Sulaiman Al Riyami
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - Nafila Al Riyami
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - Qatiba Al Farai
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - Hiba Al Alawi
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat 123, Oman
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Malinowska J, Małecka-Giełdowska M, Szymura W, Ciepiela O. Disturbances of calcium, magnesium, and phosphate homeostasis: incidence, probable causes, and outcome. Clin Chem Lab Med 2024; 0:cclm-2024-0212. [PMID: 38501348 DOI: 10.1515/cclm-2024-0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/29/2024] [Indexed: 03/20/2024]
Affiliation(s)
- Justyna Malinowska
- Department of Laboratory Medicine, 37803 Medical University of Warsaw , Warsaw, Poland
- 37803 Doctoral School at Medical University of Warsaw , Warsaw, Poland
| | - Milena Małecka-Giełdowska
- Department of Laboratory Medicine, 37803 Medical University of Warsaw , Warsaw, Poland
- Central Laboratory, 37803 Central Teaching Hospital of University Clinical Center of Medical University of Warsaw , Warsaw, Poland
| | | | - Olga Ciepiela
- Department of Laboratory Medicine, 37803 Medical University of Warsaw , Warsaw, Poland
- Central Laboratory, 37803 Central Teaching Hospital of University Clinical Center of Medical University of Warsaw , Warsaw, Poland
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Al Shukri Z, Al-Maqbali JS, Al Alawi AM, Al Riyami N, Al Riyami S, Al Alawi H, Al Farai Q, Falhammar H. Incidence of Dysmagnesemia among Medically Hospitalized Patients and Associated Clinical Characteristics: A Prospective Cohort Study. Int J Endocrinol 2023; 2023:6650620. [PMID: 37829115 PMCID: PMC10567362 DOI: 10.1155/2023/6650620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/16/2023] [Accepted: 09/27/2023] [Indexed: 10/14/2023] Open
Abstract
Background Magnesium (Mg) disorders are common among hospitalized patients and are linked to poor health outcomes. We aimed to determine the incidence of dysmagnesemia among medically hospitalized patients and to identify factors that are associated with dysmagnesemia. Methods A prospective cohort study was conducted at Sultan Qaboos University Hospital (SQUH) from April 1st, 2022, to October 31st, 2022, and involved hospitalized adult patients (≥18 years) under the care of the general internal medicine unit. The patients' serum total magnesium (Mg) concentrations were categorized as hypomagnesemia (≤0.69 mmol/L), hypermagnesemia (≥1.01 mmol/L), or dysmagnesemia, which encompassed either hypomagnesemia or hypermagnesemia. Results Of the 304 patients evaluated, dysmagnesemia was observed in 22.0%, which comprised of 17.4% with hypomagnesemia and 4.6% with hypermagnesemia. Statistically significant associations were identified between hypermagnesemia and chronic kidney disease (CKD) (p = 0.05) and elevated creatinine levels (p < 0.01) and lower estimated glomerular filtration rate (eGFR) (p < 0.01). Hypomagnesemia was linked to lower ionized calcium (p = 0.03) and admission due to infectious diseases (p = 0.02). However, ordered regression analysis did not find any significant associations with the different magnesium groups. Conclusion Dysmagnesemia was prevalent among hospitalized patients and was associated with different factors; however, ordered regression analysis did not find any association with the different magnesium group, probably due to the limited number of included individuals.
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Affiliation(s)
- Zahra Al Shukri
- Internal Medicine Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Juhaina Salim Al-Maqbali
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman
| | - Abdullah M. Al Alawi
- Internal Medicine Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Nafila Al Riyami
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Sulaiman Al Riyami
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Hiba Al Alawi
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Qatiba Al Farai
- Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Henrik Falhammar
- Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
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Malinowska J, Małecka-Giełdowska M, Pietrucha K, Górska G, Kogut D, Ciepiela O. Massive Transfusion Increases Serum Magnesium Concentration. J Clin Med 2023; 12:5157. [PMID: 37568557 PMCID: PMC10419839 DOI: 10.3390/jcm12155157] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Background: The massive transfusion of packed red blood cells (RBCs) is a lifesaving procedure, but it is associated with complications, e.g., dysmagnesemia. Since magnesium is an intracellular ion, the transfused RBCs can significantly influence the magnesium concentration in the recipient's blood. (2) Methods: A retrospective study was performed among 49 patients hospitalized in the Central Clinical Hospital of the Medical University of Warsaw who received a massive blood transfusion (≥4 units/h). Data on laboratory results and patient history were collected from the hospital database. The intracellular RBCs magnesium concentration was measured in 231 samples using the colorimetric method. (3) Results: There were statistically significant changes in the mean serum magnesium concentration preoperatively and 24 h postoperatively (0.87 ± 0.13 vs. 1.03 ± 0.14, p < 0.00001) and 48 h postoperatively (0.87 ± 0.13 vs. 1.06 ± 0.15, p < 0.00001). Patients who died had significantly higher serum magnesium concentrations (p < 0.05). The median intracellular magnesium concentration in RBCs was 0.91 (0.55-1.8) mmol/L, which is below the reference values of 1.65-2.65 mmol/L. (4) Conclusions: Transfused RBCs significantly increased the serum magnesium concentration 24 h and 48 h postoperatively. It could be a result of mild hemolysis, as the median intracellular magnesium concentration in RBCs was below the reference values.
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Affiliation(s)
- Justyna Malinowska
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland;
- Doctoral School, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Milena Małecka-Giełdowska
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland;
- Central Laboratory, Central Teaching Hospital of University Clinical Center, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Katarzyna Pietrucha
- Students Scientific Group of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Gabriela Górska
- Students Scientific Group of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Dagmara Kogut
- Central Laboratory, Central Teaching Hospital of University Clinical Center, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Olga Ciepiela
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland;
- Central Laboratory, Central Teaching Hospital of University Clinical Center, Medical University of Warsaw, 02-097 Warsaw, Poland
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Thongprayoon C, Sy-Go JPT, Nissaisorakarn V, Dumancas CY, Keddis MT, Kattah AG, Pattharanitima P, Vallabhajosyula S, Mao MA, Qureshi F, Garovic VD, Dillon JJ, Erickson SB, Cheungpasitporn W. Machine Learning Consensus Clustering Approach for Hospitalized Patients with Dysmagnesemia. Diagnostics (Basel) 2021; 11:2119. [PMID: 34829467 DOI: 10.3390/diagnostics11112119] [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: 09/23/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The objectives of this study were to classify patients with serum magnesium derangement on hospital admission into clusters using unsupervised machine learning approach and to evaluate the mortality risks among these distinct clusters. METHODS Consensus cluster analysis was performed based on demographic information, principal diagnoses, comorbidities, and laboratory data in hypomagnesemia (serum magnesium ≤ 1.6 mg/dL) and hypermagnesemia cohorts (serum magnesium ≥ 2.4 mg/dL). Each cluster's key features were determined using the standardized mean difference. The associations of the clusters with hospital mortality and one-year mortality were assessed. RESULTS In hypomagnesemia cohort (n = 13,320), consensus cluster analysis identified three clusters. Cluster 1 patients had the highest comorbidity burden and lowest serum magnesium. Cluster 2 patients had the youngest age, lowest comorbidity burden, and highest kidney function. Cluster 3 patients had the oldest age and lowest kidney function. Cluster 1 and cluster 3 were associated with higher hospital and one-year mortality compared to cluster 2. In hypermagnesemia cohort (n = 4671), the analysis identified two clusters. Compared to cluster 1, the key features of cluster 2 included older age, higher comorbidity burden, more hospital admissions primarily due to kidney disease, more acute kidney injury, and lower kidney function. Compared to cluster 1, cluster 2 was associated with higher hospital mortality and one-year mortality. CONCLUSION Our cluster analysis identified clinically distinct phenotypes with differing mortality risks in hospitalized patients with dysmagnesemia. Future studies are required to assess the application of this ML consensus clustering approach to care for hospitalized patients with dysmagnesemia.
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