Abstract
This study aimed to ascertain whether there is an independent association between serum magnesium (Mg) and the Carotid Intima-Media Thickness (IMT-CC), a well-accepted atherosclerotic-biomarker surrogate of cardiovascular disease (CVD), in a population with high cardiovascular risk. Serum Mg and traditional atherosclerotic risk factors were recorded in 939 patients (mean age, 59.6 ± 0.3 years, 83.2% men) with coronary heart disease (CHD) enrolled in the CORDIOPREV trial. Serum Mg strongly associated with IMT-CC. Before adjusting for potential confounding factors, IMT-CC decreased by 0.111 ± 0.011 mm per mg/dl increase in serum Mg (p < 0.001). After adjustment, the effect of Mg did not appear mediated through factors related to glucose metabolism, the lipid profile or the mineral metabolism and renal function. Multivariate models showed the lower Mg levels (quartile 1) as a strong independent factor contributing to IMT-CC along with age, sex, SBP, HDL-C, and diuretic use. Logistic regression analysis confirmed the predictive ability of serum Mg to differentiate patients at higher atherosclerotic risk as defined by an IMT-CC ≥ 1.0 mm, yielding a OR for the lower quartile of 10.623 (95%CI 2.311–48.845; P = 0.002) and a ROC-derived cutoff of 1.61 mg/dl. Therefore, our findings outline low serum magnesium as a possible independent risk factor for carotid atherosclerosis.
Highlights
Cardiovascular disease (CVD) is considered one of the most important causes of mortality and morbidity around the world
Lower quartiles of serum Mg were associated with increased intima-media thickness of both common carotid arteries (IMT-CC), and with age, SBP, fasting glucose, glycated hemoglobin (HbA1c), HOMA-IR, serum corrected calcium, diabetes, oral antidiabetic drugs and insulin use
Increasing evidences show that traditional risk factors fail to explain all the risk for cardiovascular disease (CVD), which has lead to the search of new or emerging risk factors[1]
Summary
Cardiovascular disease (CVD) is considered one of the most important causes of mortality and morbidity around the world. Traditional cardiovascular risk factors as aging, obesity, hypertension, diabetes, dyslipidemia, inflammation, etc., cannot explain a significant proportion of cases and new risk factors are being on search[1] In this regard, factors related to mineral metabolism, such as magnesium (Mg) concentration, might play a role in the development of cardiovascular disease (CVD)[2,3,4,5]. Observational studies have shown an association between reduced serum levels of Mg and a number of CVD biomarkers and endpoints such as the risk of ischemic stroke[6,7], high blood pressure[8], dyslipidemia[9], type 2 diabetes mellitus[9,10] and mortality[11]. The aim of the present cross-sectional study was to determine whether there is a relationship between serum Mg level and the IMT-CC in a large cohort of European patients with high cardiovascular risk diagnosed of CHD but with preserved renal function
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