Serum Magnesium Research Articles

Combined exposure to multiple essential elements and cadmium at early pregnancy on gestational diabetes mellitus: a prospective cohort study.

Minerals and trace elements were involved in the pathogenesis and progression of diabetes. However, the association of mixed exposure to essential elements and toxic elements with gestational diabetes mellitus (GDM) is poorly understood. This study aims to examine the associations between serum calcium (Ca), iron (Fe), zinc (Zn), copper (Cu), magnesium (Mg), and cadmium (Cd) concentrations in early pregnancy and GDM risk in Chinese pregnant women. A total of 1,168 pregnant women were included in this prospective cohort study. The concentrations of serum elements were measured using the polarography method before 14 gestational weeks and an oral glucose tolerance test was conducted at 24-28 gestational weeks to diagnose GDM. Binary logistic regression analysis and restricted cubic spline were applied to evaluate the association between serum individual element and GDM. Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) regression were used to assess the associations between mixed essential elements and Cd exposure and GDM risk. The mean concentrations of Zn (124.65 vs. 120.12 μmol/L), Fe (135.26 vs. 132.21 μmol/L) and Cu (23.33 vs. 23.03 μmol/L) in the GDM group were significantly higher than those in the control group. Single-element modeling results suggested that second and fourth-quartile maternal Zn and Fe concentration, third and fourth-quartile Cu concentration and fourth-quartile Ca concentration were associated with an increased risk of GDM compared to first-quartile values. Restricted cubic spline analysis showed U-shaped and non-linear relationships between Cd and GDM. According to the BKMR models and WQS analyses, a six-element mixture was significantly and positively associated with the risk of GDM. Additionally, Cd, Zn, and Cu contributed the most strongly to the association. Serum Zn, Cu, Fe, and Ca exposure during early pregnancy showed a positive association with GDM in the individual evaluation. The multiple-evaluation showed that high levels of elements mixture, particularly Cd, Zn, and Cu, may promote the development of GDM.

Blood Serum Levels of Magnesium in Patients with Benign Paroxysmal Positional Vertigo

Background and Aim: Magnesium is essential for the morphogenesis of otoconia. The imbalance in the chemical composition of otoconia can make people susceptible to Benign Paroxysmal Positional Vertigo (BPPV). The primary outcome was to compare serum magnesium levels in BPPV patients with controls. The Ca/Mg ratios in participants are also recorded and analyzed in the present study. Methods: In this case-control study, we measured the serum Mg, Ca, and vitamin D in BPPV patients and age-, sex-matched subjects without BPPV. The results were adjusted for Ca, vitamin D, hypertension, and body mass index. Results: A total of 123 BPPV patients participated in this study. The mean Mg value was higher in patients than controls (2.01 vs. 1.95 mg/dL, p=0.030). Condition logistic regression analyses showed a higher rate of BPPV among subjects with low Ca/Mg ratio (quartile 1), relative to subjects with medium ratio (quartiles 2 and 3) (adjusted OR: 3.92, p=0.003). Conclusion: The present study demonstrated an imbalance of Ca and Mg in the BPPV patients as significantly higher Mg levels and lower serum Ca/Mg ratio. Although it appears decreased Ca/Mg ratio to be a risk factor for BPPV, this result should be confirmed in confirmatory studies. Keywords: Magnesium; calcium; benign paroxysmal positional vertigo; otolithic membrane; matched-pair analysis

Alterations in serum albumin, magnesium, and phosphorus levels during hemadsorption with oXiris® in critically ill patients with septic shock

Alterations in serum albumin, magnesium, and phosphorus levels during hemadsorption with oXiris® in critically ill patients with septic shock

Assessment of serum calcium, magnesium and zinc levels in patients with type 2 diabetes mellitus in the Ukrainian population

Background. The research deals with the provision of calcium, magnesium and zinc in patients with type 2 diabetes mellitus (T2DM). The purpose was to investigate the serum content of calcium, magnesium and zinc in patients with type 2 DM. Materials and methods. The open-label controlled study included 27 patients with T2DM. The control group consisted of 12 people without endocrine and somatic diseases. 70 % of patients had newly diagnosed DM; in others, the disease duration was up to 5 years. Most of the examined were of mature age, on average 61.83 ± 5.52 years for patients and 55.25 ± 5.52 years for controls. In the group with T2DM, women accounted for 62.96 %, among controls — 63.64 %. Anthropometric measurements and glucose indicators were determined according to a standard procedure. Concentrations of calcium, magnesium, zinc in serum were evaluated by atomic optical emission spectrometry with inductively coupled plasma (PerkinElmer Optima 2100 DV ICP-OES, USA) according to the original procedure approved by the Kundiiev Institute of Occupational Health of the NAMS of Ukraine. Results. The level of fasting blood sugar ranged from 7.1 to 17.2 mmol/l and indicated the presence of T2DM, glycated hemoglobin was from 7.1 to 11.2 %. According to anthropometric data, the group of patients almost completely corresponded to the control group. Although a slight increase in body weight and waist circumference was registered already at the stage of initial diabetes, the level of triglycerides increased significantly, and the level of high-density lipoprotein decreased. A significant reduction in the levels of calcium and magnesium in the blood serum of patients with T2DM was found. The zinc content was at the level of the lower edge of the reference value in 44 % of patients, in the control group — only in 16.6 % of cases. There were no significant differences in this indicator in the observation groups. A high correlation was found between the studied parameters in the blood, as well as an inverse correlation between the fasting glucose level and the content of calcium and magnesium. Conclusions. A significant decrease in the level of calcium and magnesium in the blood of Ukrainian patients with type 2 diabetes mellitus was found. There is a high correlation between serum calcium, magnesium and zinc levels in patients with T2DM. Significant risks of diabetes were revealed when the serum concentration of calcium and magnesium decreased.

Study on Serum Calcium, Magnesium and Uric acid Levels in Preeclamptic and Healthy Pregnant Women - A Comparative Study

Background & Objective: Pre-eclampsia is the most common medical complication of pregnancy associated with increased maternal and infant mortality and morbidity. Various dietary deficiencies or excesses have previously been linked to preeclampsia. Many studies have documented that the changes in the concentration of minerals like calcium, magnesium, and uric acid have a link to the etiopathogenesis of preeclampsia. The present study was undertaken to find the associations of serum calcium, magnesium, and uric acid with preeclampsia. Methods: This cross-sectional comparative study was carried out in the Department of Physiology in collaboration with the Department of Biochemistry, Rajshahi Medical College, Rajshahi over a period of one year between July 2018 to June 2019. Pre-eclamptic and healthy pregnant women aged 18-35 years with single-tone pregnancies having agestational age of 28-32 weeks were the study population. While preeclamptic pregnant women were included as cases, healthy pregnant women were included as controls. A total of 100 cases (pre-eclamptic women) and an equalnumber of controls (healthy pregnant women) were included. Serum calcium, magnesium, and uric acid levels of the subjects were compared between the case and the control groups to evaluate their association with preeclampsia. Result: The findings of the study revealed that cases were older and heavier than the controls. However, both groups were alike in terms of gestational age. Both systolic and diastolic blood pressures were much higher in the case group than those in the control group. The serum calcium was significantly decreased in the case group than that in the control group (p < 0.001). The serum magnesium was also significantly dropped in the case group compared to the control group (p < 0.001). However, the serum uric acid was dramatically raised in the former group than that in the latter group (p < 0.001). Conclusion: The study concluded that serum calcium and magnesium levels are significantly decreased and serum uricacid levels significantly increased in preeclamptic women. Ibrahim Card Med J 2022; 12 (2): 27-31

Hypokalaemia in pregnancy – Prevalence, underlying causes, and an approach to investigation

Objective To investigate the prevalence and aetiology of hypokalaemia in pregnancy. Methods This was a five-year retrospective audit of women who received care at a tertiary hospital, who developed hypokalaemia during pregnancy and within three weeks postpartum. Serum potassium and magnesium levels cause(s) of hospitalization and investigations for hypokalaemia were obtained from hospital records. Results One hundred and ten women developed hypokalaemia during pregnancy and the immediate postpartum period, representing 0.36% of total births. Ninety-one per cent of patients had mild to moderate hypokalaemia (K 2.6–3.1 mmol/L), while 9% had severe hypokalaemia (K < 2.6 mmol/L). The most common associations of hypokalaemia were infection (38%), vomiting (18%), hypertensive disorders (12%) and postpartum haemorrhage (9%). Twenty-four patients did not have a clear underlying aetiology of hypokalaemia, but only five had further investigations. Conclusions There was inadequate investigation and follow-up of hypokalaemia, particularly in women in whom an obvious cause was not apparent.

Evaluation of association of Magnesium levels with Hand Grip Strength in geriatric patients with hip fracture

Abstract Introduction/Objective Magnesium is a macronutrient that plays a key role in several cellular processes.It is an essential mineral for bone metabolism. Not much is known about the association of magnesium and the risk of hip fractures in the Asian population. In this case control study, we evaluate the relationship between serum magnesium level and the risk of incident hip fracture. The purpose of this study was to investigate the association between magnesium and hand grip strength in hip fracture risk in the geriatric population residing in North India. Methods/Case Report Seventy-five patients with hip fracture, Group I and a similar number of controls, Group II were enrolled in the study. Samples were analyzed for serum levels of magnesium, 25 hydroxy Vitamin D, alkaline phosphatase, calcium, and phosphate by immunoassay. Hand grip strength of study subjects was measured using dynamometer. Correlation between magnesium levels and hand grip strength was analyzed in study population. Results (if a Case Study enter NA) Among the 75 subjects, 36 were men and 39 were women. The mean age of hip fracture cases was 63.7 ± 8.4 years which was comparable in men and women. Hypomagnesemia was observed in the hip fracture group (1.43 ± 2.36 mg/dl) whereas magnesium level in the control group was normal (2.35 ± 3.86 mg/dl) (p<0.05). 25 hydroxy Vitamin D levels were significantly lower in cases (9.63 ± 4.53 ng/ml) as compared to controls (24.38 ± 5.27 ng/ml). The mean hand grip strength among hip fracture group (18.31 ± 4.69 kg) was significantly lower compared to that of the control group (31.54 ± 6.12 kg). There was a significant positive correlation between magnesium levels and hand grip strength (r=0.74, p<0.05) in hip fracture population. Conclusion Hand grip strength as measured by hand held dynamometer was significantly lower in geriatric hip fracture patients, and there is a significant positive correlation between Magnesium and hand grip strength.

Serum Magnesium and Its Association with Vascular Calcification in Chronic Kidney Disease Patients on Haemodialysis

Serum Magnesium and Its Association with Vascular Calcification in Chronic Kidney Disease Patients on Haemodialysis

Assessment of clinical and biochemical parameters in calves of the dairy period when introducing a feed additive into the diet

This article examines the clinical health indicators of dairy calves, as well as data on laboratory tests of blood and urine, before and after conducting a scientific experiment on adding selenium and cobalt aspartate nanoparticles to their diet in the form of a feed additive. It was established that the hematological parameters of calves throughout the experiment did not go beyond the reference values for this type of animal. In the course of studying the biochemical parameters of the blood serum of calves, it was established that they, as well as the parameters of the clinical blood test, did not go beyond the physiological values for these animals throughout the experiment. At the same time, some differences were identified between groups of animals. Thus, a decrease in the activity of the alanine aminotransferase enzyme in calves of the first experimental group relative to control animals was reliably established. At the same time, a significant increase in the concentration of magnesium in the blood serum of experimental animals relative to control animals was established.

Utilidad de la relación calcio/magnesio en el diagnóstico de preeclampsia

Objective: To establish the usefulness of the calcium/magnesium ratio in the diagnosis of preeclampsia. Methods: A case-control study was performed between January 2014 and June 2022 on patients who were treated at the Central Hospital “Dr. Urquinaona”, Maracaibo, Venezuela. A group of pregnant women with a diagnosis of preeclampsia (group A, cases) and a control group of pregnant women with maternal age and body mass index similar to the study group (group B, controls) were selected. Demographic characteristics, laboratory parameters, and serum calcium and magnesium concentrations were evaluated. Results: 515 pregnant women were selected, 257 in group A and 258 in group B. Patients in group A had lower serum calcium and magnesium concentrations compared to patients in group B. The calcium/magnesium ratio was also lower in group A than in group B. (p < 0.0001). Analysis of the discriminatory ability of the calcium/magnesium ratio in the diagnosis of preeclampsia showed that the value of 3.44 had a value under the curve of 0.893 (95% confidence interval, 0.867–0.919) with a sensitivity of 66.3% (95%CI, 60.3%-71.8%), specificity 92.6% (95%CI, 88.7%-95.2%). The diagnostic accuracy was 79.4% (95% CI,75.7%–82.7%). Conclusion: The calcium/magnesium ratio is useful in the diagnosis of preeclampsia since its value is significantly lower, compared to healthy normotensive pregnant women.

Comparison of incidence of acute rejection according to serum magnesium levels after kidney transplantation

Comparison of incidence of acute rejection according to serum magnesium levels after kidney transplantation

Association of Serum Magnesium with Preterm Labor

In recent years preterm labor is a significant obstetric concern. Alteration of basic biochemical function at cellular level is one of the etiologies of preterm labor. Several trace elements including magnesium are associated with normal cellular function. Magnesium sulfate is used as a tocolytic agent because high magnesium level causes relaxation of smooth muscle. Hypomagnesaemia leads to neuromuscular irritability leading to uterine hyperactivity which leads to cervical dilation. Therefore, this study was performed to find out the association of hypomagnesemia with preterm labor. This cross-sectional study was conducted in 100 women in labor, of them 50 were diagnosed case of preterm labor and 50 women were in labor at term attended in BSMMCH, Faridpur during July 2021 to December 2021. After overnight fasting 5ml blood sample was collected and was analyzed for serum magnesium using standard enzymatic method. Mean value of serum magnesium was compared between two groups by student unpaired t-test. A p-value was considered to be statistically significant at 0.05 at the 95% confidence interval. The mean serum magnesium was found 1.44±0.36 mg/dl in preterm labor and 2.0±0.27 mg/dl in term labor. Low serum magnesium level was significantly higher in preterm labor. Bangabandhu Sheikh Mujib Med. Coll. J. 2023;2(1): 45-48

The Effect of Body Mass Index on Post-Bolus Magnesium Levels in the Obstetric Patient.

In the setting of a growing obese obstetric population, we sought to determine whether differences in body mass index (BMI) and obesity class influenced both serum magnesium levels and the likelihood of achieving therapeutic levels for eclampsia prophylaxis after standard boluses of magnesium sulfate. This is a retrospective cohort study of patients treated with magnesium sulfate in the setting of either preeclampsia with severe features or preterm labor between 2010 and 2016. Subjects were categorized by BMI: Normal (BMI < 30 kg/m2), Class 1 (BMI 30-34.9 kg/m2), Class 2 (BMI 35-39.9 kg/m2), and Class 3 (BMI ≥ 40 kg/m2). Study participants' demographics, intrapartum characteristics, and adverse reactions were compared among the groups. Logistic regression models were used to calculate unadjusted and adjusted odds ratios comparing the likelihood of each BMI class reaching therapeutic eclamptic prophylactic levels. Linear regression models were also evaluated to determine the relationship between BMI and post-bolus serum magnesium levels. Of the 760 people who met the inclusion criteria, 313 (41.1%) had normal BMI, 190 (25.0%) had Class 1 obesity, 135 (17.8%) had Class 2 obesity, and 122 (16.1%) had Class 3 obesity. When adjusted for confounders, those with Class 1 obesity were 54% less likely to achieve serum levels deemed therapeutic for seizure prophylaxis compared with normal BMI counterparts. Meanwhile, those with Class 2 or 3 obesity were 90% less likely. Linear regression models also demonstrated an inverse association between BMI and post-bolus serum magnesium levels. Increasing BMI has a significant effect on post-bolus serum magnesium levels regardless of standard loading dose used. Immediately after bolus administration, obese gravidas are significantly less likely to reach levels effective for eclamptic seizure prophylaxis. When considering which bolus to administer in an obese gravida, it may be more beneficial to choose a 6 g load. · BMI has an inverse relationship with post-bolus serum magnesium levels.. · Obese gravidas were less likely to reach eclampsia prophylaxis levels regardless of bolus type.. · Obesity class, not just the presence or absence of obesity, plays a role in serum magnesium levels..

Serum magnesium and phosphorus values are lower among patients with paroxysmal atrial fibrillation: insights from the PLACEBO study

Abstract Background Magnesium and phosphorus comprise micronutrients in circulating blood, while associated disorders have been linked with increased risk of cardiovascular disease (CVD). Low serum magnesium has been connected to atrial fibrillation (AF) development among individuals without CVD, as patients with higher serum phosphorus levels, without chronic kidney disease (CKD), demonstrate an increased risk of AF plus higher rates of cardiovascular morbidity. Patients with paroxysmal atrial fibrillation (PAF) seem to hold the same cardiovascular risk as patients with permanent AF. The exact connection between serum magnesium and phosphorus levels and PAF has not been adequately explored. Purpose We aimed to investigate the potential relationship between serum magnesium and phosphorus levels and the number of AF paroxysms during the past 6 months from enrollment. Methods We analyzed preliminary data from the Ergospirometry in Paroxysmal Atrial Fibrillation Prognosis (PLACEBO) trial (NCT05246423), an observational, prospective, single-center cohort study aiming to examine the prognostic role of cardiopulmonary exercise testing variables in the future paroxysms of AF. We included 53 patients diagnosed with PAF, without CKD, and 30 healthy individuals. Normality was assessed with the Shapiro-Wilk test. Normally distributed variables are presented as mean±SD and significance was investigated with T-test while non-normally variables were distributed as median (IQR) and investigated with the Mann-Whitney U test. A p-value &amp;lt;0.05 was considered statistically significant. Results The study cohort comprised 54 patients with PAF, without CKD, and 30 healthy individuals. Baseline demographics are presented in the relevant table. Patients with PAF were older than controls and they had more comorbidities, as expected. Serum magnesium and phosphorus levels were significantly lower among patients with PAF compared to controls [1.9±0.22 versus 2.13±0.26 mg/dl and 3.95 (0.75) versus 3.3 (0.65) respectively (p&amp;gt;0.001)]. Higher serum phosphorus levels were associated with lowest frequency of AF paroxysms within the previous 6 months (R=-0.293, p=0.039). Conclusions Patients with PAF demonstrate lower serum magnesium and phosphorus levels compared to healthy individuals. This might be in part explained by the fact that serum phosphorus is known to be inversely associated with BMI; in our cohort, BMI was higher among patients with PAF. The lowest the frequency of AF episodes, the highest the serum phosphorus levels, a finding that comes in contrary with previous reports pointing towards an increased risk of AF development and higher cardiovascular mortality among individuals with higher serum phosphorus levels. Our findings may highlight novel potential therapeutic strategies targeting serum magnesium and phosphorus in patients with PAF, with an eye to minimize the number of AF paroxysms.Table

Mediators of the benefit of sotagliflozin in patients with worsening heart failure in SOLOIST-WHF

Abstract Background In SOLOIST-WHF, the dual SGLT1 and SGLT2 inhibitor sotagliflozin (SOTA) reduced primary endpoint events – total occurrences of cardiovascular (CV) death and hospitalizations and urgent visits for heart failure (HF) – by 33% relative to placebo (PBO) among 1222 patients hospitalized for worsening HF. The extent to which treatment group differences in biomarkers assessed during study follow-up contributed to this benefit of SOTA is unknown. Purpose The contributions of 20 biomarkers (identified in published mediation analyses of SGLT2 inhibitors: HbA1c; weight; BMI; systolic and diastolic BP; heart rate; serum creatinine, urate, albumin, sodium, and magnesium; eGFR; hematocrit; hemoglobin; erythrocytes; total cholesterol; LDL-C; HDL-C; non-HDL-C; triglycerides) to the reduction of primary endpoint events by SOTA relative to PBO were quantified via mediation analyses to describe the mechanisms of SOTA. Methods Patients were randomized 1:1 to SOTA 200 mg/day (with possible increase to 400 mg/day) or PBO and followed for a median 9 months. Two conditions must be met for a biomarker to be a mediator: there had to be a treatment group difference on the biomarker and an association between the biomarker and risk of primary endpoint events. For the first condition, treatment group differences in change from baseline in each biomarker were analyzed by mixed effects repeated measures models. For the second condition, time-varying values of each biomarker were related to the risk of primary endpoint events by calculating the time-weighted moving average (TWMA) for each variable, using all values for a given patient. Each was analyzed in a competing risks marginal model for total events (stratified according to left ventricular ejection fraction at baseline and geographic region of enrollment), in which non-CV deaths were treated as competing terminal events and TWMA values were included as a time-varying covariate. The individual and joint mediation of those biomarkers determined to be mediators were assessed in competing risks marginal models that included treatment assignment. If biomarkers that would otherwise be included in multivariable models were strongly correlated (baseline values R2&amp;gt;0.5), the marker with the greatest univariate mediation was included. All analyses were intention-to-treat. Results Among the biomarkers considered, serum urate, hemoglobin, and total cholesterol met the criteria for being mediators. Serum urate was the strongest single mediator, while the joint mediation for these three biomarkers was 22.3% (Figure 1). Conclusion In SOLOIST-WHF, a fraction of the benefit of SOTA was attributable to effects on biomarkers accounting for most of the treatment benefits of other SGLT2 inhibitors on CV death and HF events. Further investigation is therefore needed to identify what unique biomarker treatment effects might account for the majority of SOTA benefit.Figure 1

Abstract 13409: Maintaining a High Total Serum Magnesium Level With Intravenous Magnesium Sulfate

Introduction: Understanding how intravenous magnesium sulfate (MgSO4) administration affects total serum magnesium concentration (TsMg) is important in maintaining a target TsMg level in acute heart failure patients on loop diuretics. Hypothesis: Describe how TsMg changes after single dose of MgSO4 and estimate how often MgSO4 should be given to maintain TsMg above 2 mg/dL. Methods: We studied hospitalizations of veterans from the Veterans Health Administration (VHA) aged ≥ 65 without severe renal disease (EGFR &gt; 15 cc/min per 1.73 m2) from 2013-2017 with a primary diagnosis of acute heart failure. We constructed linear and logistic mixed-effects models with values of TsMg at level 1, nested within dose, hospitalization, and patient. Results: There were 27,474 doses of intravenous MgSO4 administered in 16,139 hospitalizations to 13,439 unique veterans across 145 hospitals in the VHA. Veterans were elderly (mean age 76), 98% male, 72% non-Hispanic white. Mean TsMg was initially high and leveled off 24-48 hours after MgSO4 administration, with an average TsMg increase of 0.2 mg/dL regardless of dose administered (Figure) . The probability of maintaining a TsMg above 2.0 mg/dL just one day after MgSO4 ranged from 49-54% (Table) . Conclusions: TsMg is often targeted above 2.0 gm/dL, especially in the setting of arrhythmias or QT-prolonging medications. As MgSO4 is frequently administered in heart failure patients on diuretics, understanding that TsMg may be misleadingly elevated for the first 48 hours after MgSO4 is important. We recommend administering MgSO4 at least once per day if the goal TsMg level is ≥ 2.0 gm/dL.

Oral magnesium supplementation does not affect insulin sensitivity in people with insulin-treated type 2 diabetes and a low serum magnesium: a randomised controlled trial

Aims/hypothesisHypomagnesaemia has been associated with insulin resistance and an increased risk of type 2 diabetes. Whether magnesium supplementation improves insulin sensitivity in people with type 2 diabetes and a low serum magnesium level is unknown.MethodsUsing a randomised, double-blind (both participants and investigators were blinded to the participants’ treatment sequences), placebo-controlled, crossover study design, we compared the effect of oral magnesium supplementation (15 mmol/day) for 6 weeks with that of matched placebo in individuals with insulin-treated type 2 diabetes (age ≥18 years, BMI 18–40 kg/m2, HbA1c <100 mmol/mol [11.3%], serum magnesium ≤0.79 mmol/l). Participants were recruited from the outpatient clinic and through advertisements. Randomisation to a treatment sequence order was done using a randomisation list. We used block randomisation and the two possible treatment sequences were evenly distributed among the trial population. The primary outcome was the mean glucose infusion rate during the final 30 min of a hyperinsulinaemic–euglycaemic clamp (i.e. M value). Secondary outcomes included variables of glucose control, insulin need, BP, lipid profile and hypomagnesaemia-related symptoms during follow-up.ResultsWe recruited 14 participants (50% women, 100% White, mean ± SD age 67±6 years, BMI 31±5 kg/m2, HbA1c 58±9 mmol/mol [7.4±0.9%]) with insulin-treated type 2 diabetes. Magnesium supplementation increased both mean ± SEM serum magnesium level (0.75±0.02 vs 0.70±0.02 mmol/l, p=0.016) and urinary magnesium excretion (magnesium/creatinine ratio, 0.23±0.02 vs 0.15±0.02, p=0.005), as compared with placebo. The M value of the glucose clamp did not differ between the magnesium and placebo study arms (4.6±0.5 vs 4.4±0.6 mg kg−1 min−1, p=0.108). During the 6 weeks of treatment, continuous glucose monitoring outcomes, HbA1c, insulin dose, lipid profile and BP also did not differ, except for a lower HDL-cholesterol concentration after magnesium compared with placebo (1.14±0.08 vs 1.20±0.09 mmol/l, p=0.026). Symptoms potentially related to hypomagnesaemia were similar for both treatment arms.Conclusions/interpretationDespite an albeit modest increase in serum magnesium concentration, oral magnesium supplementation does not improve insulin sensitivity in people with insulin-treated type 2 diabetes and low magnesium levels.Trial registrationEudraCT number 2021-001243-27.FundingThis study was supported by a grant from the Dutch Diabetes Research Foundation (2017–81–014).Graphical

Serum Magnesium Level as a Biomarker to Predict the Risk of Labor Epidural Anesthesia Associated Fever.

Excessive pain will have adverse effects on the mother and fetus. Labor epidural analgesia greatly reduces the pain, which is widely carried out abroad. Labor epidural anesthesia-associated fever (LEAF) is the biggest problem for labor epidural anesthesia. This study aimed to evaluate the clinical value of serum magnesium levels to predict the LEAF. Overall 528 singleton term-pregnant women who underwent labor epidural anesthesia in Fujian Provincial Maternity and Children's Health Hospital, affiliated hospital of Fujian Medical University from January 2019 to June 2019, were analyzed retrospectively. The serum magnesium level was detected using venous blood samples. The relationship between the serum magnesium level and LEAF was interpreted, and the optimal cut-off values of the serum magnesium level to predict LEAF were calculated. Overall, 65 (12.30%) participants had LEAF. And a higher rate of the bulging membrane, gestational hypertension, neonatal intensive care unit (NICU) admission, and the different mode of delivery was significantly associated with LEAF. Also, the serum magnesium level demonstrated higher significantly in presence of LEAF than absence (P<0.05). What is more, it indicated that the area under the receiver operating characteristic curve (AUC) for the serum magnesium level was 0.825, and an optimal cut-off of the serum magnesium level was 0.855 mg/dl. Furthermore, it demonstrated that the serum magnesium level had the highest OR (OR= 7.49; 95% CI (4.58-14.35)) (P<0.001). The bulging membrane is an independent risk factor presence of LEAF (OR = 1.55; 95% CI (1.01-2.43)) (P=0.038). This study demonstrated that the baseline of serum magnesium can provide a suitable biomarker to predict LEAF. It can help to provide a useful target for LEAF treatment and enhance surveillance before fever.

Endostatin and Cystatin C as Potential Biomarkers for Early Prediction of Preeclampsia.

Preeclampsia (PE) is characterized by new onset hypertension and proteinuria. Undoubtedly, some individuals do not fit precisely into this description, and it could be challenging to spot newly developed PE in females who already have hypertension or renal illness. Monitoring the disease's progression enables the optimization of delivery time while minimizing premature births. The current study explores the diagnostic benefits of serum endostatin and cystatin C in addition to serum and urinary magnesium (Mg) and fractional excretion magnesium (FEMg) for early prediction of PE. The population sample included 82 pregnant women divided into 3 groups: normal pregnancy group served as a control (n = 26), nonpreeclampsia (NPE, n = 34) group included pregnant women with one or more risk factors but did not progress to PE, and pregnant women who developed preeclampsia (PE, n = 22) group. Blood samples were withdrawn at two sampling times: at 12th to 16th and 24th to 26th weeks of gestation. Compared to normal pregnancy, results (X̅ ± SD) indicated a significant increase in serum endostatin in NPE at the first sample (10.78 ± 3.63 ng/mL) and the second sample (28.03 ± 3.79 ng/mL), while cystatin C was at the first sample (0.68 ± 0.06 mg/dL) and the second sample (0.71 ± 0.07 mg/dL). In the PE group, the serum endostatin was 18.86 ± 4.37 ng/mL at the first sampling time and 53.56 ± 9.76 ng/mL for the second sample. Serum cystatin C was also elevated in PE with X̅ ± SD equivalent to 0.73 ± 0.08 and 0.89 ± 0.08 mg/dL at the first and second samples, respectively. On the other hand, serum and urinary Mg in addition to FEMg levels did not significantly differ across the groups under study. Receiver operating characteristic (ROC) curve analysis proved that both endostatin and cystatin C could be good indicators for PE. The findings imply that measuring endostatin and cystatin C at early pregnancy and before progression to PE may be effective in detecting the likelihood of PE. Endostatin could be more precise and sensitive in assessing the probability of PE than cystatin C; however, coupling of the two parameters may be promising.

Association of Serum Magnesium Concentration with Renal Prognosis in Patients with CKD

Association of Serum Magnesium Concentration with Renal Prognosis in Patients with CKD