Plasma Magnesium Levels Research Articles

Early magnesium modifications as a surrogate marker of efficacy of cetuximab-based anticancer treatment in KRAS wild-type advanced colorectal cancer patients

BackgroundKRAS wild-type mutational status is necessary but not sufficient to get benefit from epidermal growth factor receptor inhibition. Predictive markers are currently being evaluated. In this study, we investigated early hypomagnesemia as a predictor of efficacy and outcome in terms of time to progression (TtP) and overall survival (OS) in a cohort of patients affected by advanced colorectal adenocarcinoma KRAS wild-type cetuximab-treated. Patients and methodsOne hundred and forty-three patients affected by stage IV colorectal adenocarcinoma KRAS wild type receiving cetuximab + irinotecan (CTX+IRI) as third-line anticancer treatment and resistant to oxaliplatin- and irinotecan-based chemotherapy were retrospectively included. Magnesium plasma levels were measured before the first day and 7, 14, 21 and 28 days after CTX+IRI infusion. ResultsThe median magnesium basal value showed a statistically significant decrease after the start of CTX+IRI treatment (at 28 days, P < 0.0001). Patients with an early decrease of magnesium levels >50% compared with the basal level had a higher tumor response rate (55.8% versus 16.7%, P < 0.0001), a longer TtP (6.3 versus 3.6, P < 0.0001) and a longer median OS (11.0 versus 8.1, P = 0.002). ConclusionsWe have shown that early hypomagnesemia could be a predictor of efficacy and outcome in those patients. Magnesium circulating level is an easy and inexpensive biomarker to routinely be detected in patients treated with cetuximab.

P02-20 - Predictive value of magnesium levels in depressed patients

Background and aimHigh, normal or low plasma magnesium (Mg) levels have been observed in depressed patients. The aim of our study was to investigate the relationship of plasma Mg levels with depression severity, specific psychopathological dimensions and treatment outcome.Materials and methods123 outpatients (M/F 60/63; mean age = 48 ± 15) during a Major Depressive Episode (MDE) were recruited. Most of them were affected by “difficult to treat” depression, that includes patients with history of at least two MDE, risk of chronicization and who did not achieve remission in previous treatments.The psychopathological status was assessed using HAM-D, HAM-A, DRRS for psychomotor retardation and SHAPS for anhedonia. HAM-D was repeated at 3 months. A blood sample was collected to determine total plasma Mg levels.ResultsWe observed an association between Mg levels and psychomotor retardation scores (p = 0.045). Moreover, subjects with residual symptoms after treatment (HAM-D at 3 months &gt; 15) have lower starting Mg values compared to treatment-responsive individuals (2.14 ± 0.2 vs. 2.25 ± 0.21, p = 0,039).ConclusionsConflicting data on plasma Mg levels in depression could be due to the isolation of brain Mg compartments from blood Mg compartments. As in a previous study, the association between high Mg levels and psychomotor retardation found in this larger sample strengthens the notion that high Mg levels play a part in the hypoactivity so often observed in depressed patients. Also, low Mg values in patients with poor treatment outcome suggest Mg could have a therapeutic potential in “difficult-to-treat” patients.

Influence of magnesium status and magnesium intake on the blood glucose control in patients with type 2 diabetes

This study was undertaken to assess magnesium intake and magnesium status in patients with type 2 diabetes, and to identify the parameters that best predict alterations in fasting glucose and plasma magnesium. A cross-sectional study was carried out in patients with type 2 diabetes (n = 51; 53.6 ± 10.5 y) selected within the inclusion factors, at the University Hospital Onofre Lopes. Magnesium intake was assessed by three 24-h recalls. Urine, plasma and erythrocytes magnesium, fasting and 2-h postprandial glucose, HbA1, microalbuminuria, proteinuria, and serum and urine creatinine were measured. Mean magnesium intake (9.37 ± 1.76 mmol/d), urine magnesium (2.80 ± 1.51 mmol/d), plasma magnesium (0.71 ± 0.08 mmol/L) and erythrocyte magnesium (1.92 ± 0.23 mmol/L) levels were low. Seventy-seven percent of participants presented one or more magnesium status parameters below the cut-off points of 3.00 mmol/L for urine, 0.75 mmol/L for plasma and 1.65 mmol/L for erythrocytes. Subjects presented poor blood glucose control with fasting glucose of 8.1 ± 3.7 mmol/L, 2-h postprandial glucose of 11.1 ± 5.1 mmol/L, and HbA1 of 11.4 ± 3.0%. The parameters that influenced fasting glucose were urine, plasma and dietary magnesium, while plasma magnesium was influenced by creatinine clearance. Magnesium status was influenced by kidney depuration and was altered in patients with type 2 diabetes, and magnesium showed to play an important role in blood glucose control.

Plasma Calcium, Phosphorous and Magnesium Levels in Cats with and without Tooth Resorption

Feline tooth resorption is a common and painful condition affecting many middle-aged and older cats. Though many theories exist on the cause of this condition, no etiology has yet been determined. It is likely that multiple factors are involved in the development and progression of tooth resorption including cytokines, growth factors, and plasma and crevicular fluid levels of key electrolytes, tissue pH, and activators of osteoclasts. This study examined 40 client-owned cats for the presence of tooth resorption. Serum levels of calcium, phosphorous, and magnesium were measured as well as the pH of oral tissues. Results did not demonstrate an association between electrolyte levels or pH and the presence of resorptive lesions. The overall prevalence of tooth resorption was lower than that of most previously published studies.

Alucinaciones visuales y dolor inusual en relación a hipomagnesemia en un paciente con cáncer avanzado

Hypomagnesemia has been related to high accumulated doses of cisplatin, and its clinical presence is characterized by neuromuscular and cardiovascular alterations. We present the case of an advanced cancer patient who had received successive lines of chemotherapy and who was receiving opioid treatment for cancer pain. During his hospital stay, he experienced visual hallucinations and very intense, unexplained pain in one shoulder. Symptoms reverted with the normalization of his plasma magnesium levels, which were low. We consider that plasma magnesium levels should be monitored in oncology patients with neurological or psychiatric symptoms or with unusual pain.

Serum Biochemistry Values, Plasma Mineral Levels, and Whole Blood Heavy Metal Measurements in Wild Northern Goshawks (Accipiter gentilis)

Serum chemistry panels and complete mineral and heavy metal screens were performed on blood samples from eight adult northern goshawks (Accipiter gentilis) breeding in Pennsylvania. Serum chemistry panels were performed to determine the health status of each bird. Biochemical values measured included serum glucose, sodium, potassium, chloride, magnesium, uric acid, creatine kinase, and aspartate transaminase. Glucose, creatine kinase, and aspartate transaminase values were elevated when compared with published values for northern goshawks and other species of raptors. Complete mineral screens were performed to better document the blood mineral content of northern goshawks. Plasma calcium, copper, iron, magnesium, total phosphorus, potassium, sodium, and zinc levels were determined. Whole blood heavy metal screens were done to evaluate the northern goshawk's exposure to environmental arsenic, cadmium, lead, thallium, and selenium. Arsenic, cadmium, lead, and thallium whole blood levels of less than 0.05 ppm in all birds indicated that the northern goshawks were not being exposed to significant levels of heavy metals in their environment. Whole blood selenium levels of the northern goshawks were above the minimum dietary requirement for avian species (0.130-0.200 ppm) and below published toxic selenium concentrations.

Association Between Seminal Plasma Copper and Magnesium Levels with Oxidative Stress in Iraqi Infertile Men

To study the association between copper, magnesium and malondialdehyde levels in seminal plasma of oligozoospermic, azoospermic in relation to normozoospermic men. The present study was conducted at the Chemistry and Biochemistry department, College of Medicine, Al-Nahrain University, Baghdad-Iraq during September 2007 to February 2008 after obtaining approval from the research and ethics committee and obtaining written consent, 78 infertile men (age range 33.01±4.20 years) were recruited at the institute of embryo research and infertility treatment, Al-Kadhimiya teaching hospital, Iraq and were categorized according to their seminal fluid parameters to oligozoospermia (n=43) and azoospermia (n=35). 41 fertile men (age range 30.29±2.30 years) were selected as controls. Seminal plasma copper and magnesium were measured by atomic absorption spectrophotometry. Malondialdehyde was measured calorimetrically using thiobarbituric acid assay which detects thiobarbituric acid reactive substances. Seminal plasma copper level was decreased significantly (p=0.000) in the azoospermic group compared to the control group. Whereas, the level decreased non-significantly in the oligozoospermic group. Seminal plasma magnesium levels were decreased significantly (p=0.000) in all the infertility groups studied. On the other hand, malondialdehyde levels which is an end product of lipid peroxidation were significantly elevated (p=0.000) in all the infertility groups studied. Copper and magnesium work in different ways in order to maintain normal environment for spermatozoa for normal fertilization to occur.

Early magnesium modifications as a surrogate markers of efficacy of cetuximab-based anticancer treatment in KRAS wild-type colorectal cancer patients.

3564 Background: KRAS wild-type mutational status is necessary but not sufficient to get benefit from EGFR inhibition. Predictive markers are currently being evaluated including other EGFR downstream pathways and EGFR ligands. In the present study we reported hypomagnesemia as a predictor of efficacy and outcome in terms of TTP and OS in a selected cohort of patients affected by advanced colorectal adenocarcinoma KRAS wild-type cetuximab-treated. Methods: 143 patients affected by stage IV and histologically confirmed colorectal adenocarcinoma KRAS wild-type receiving cetuximab plus irinotecan as third-line anticancer treatment and resistant to oxaliplatin- and irinotecan-based chemotherapy were included. Magnesium plasma levels were measured before and 1, 7, 14 21, 28 days after cetuximab plus irinotecan infusion. Results: The median magnesium basal value showed a statistically significant decrease after the start of cetuximab plus irinotecan anticancer treatment (at 28 days, p < 0.0001). Patients with a decrease of magnesium levels > 50% compared to the basal level had a higher tumor response rate (55.8% vs. 16.7%, p < 0.0001), a longer TTP (6.3 vs. 3.6, p < 0.0001) and a longer median OS (11.0 vs. 8.1, p = 0.002) compared with those patients without magnesium modifications. Conclusions: We have shown that hypomagnesemia could be a predictor of efficacy and outcome in those patients harboring a wild type KRAS status treated with cetuximab plus irinotecan. There is growing evidence magnesium plays a key role in tumor biology. Criteria in selecting patients who are likely to benefit from cetuximab-based therapies are growing. Magnesium circulating level is an easy and economically inexpensive biomarker to routinely and serially be detected in patients cetuximab-treated. No significant financial relationships to disclose.

Prolonged high-dose intravenous magnesium therapy for severe tetanus in the intensive care unit: a case series

IntroductionTetanus rarely occurs in developed countries, but it can result in fatal complications including respiratory failure due to generalized muscle spasms. Magnesium infusion has been used to treat spasticity in tetanus, and its effectiveness is supported by several case reports and a recent randomized controlled trial.Case presentationsThree Caucasian Greek men aged 30, 50 and 77 years old were diagnosed with tetanus and admitted to a general 12-bed intensive care unit in 2006 and 2007 for respiratory failure due to generalized spasticity. Intensive care unit treatment included antibiotics, hydration, enteral nutrition, early tracheostomy and mechanical ventilation. Intravenous magnesium therapy controlled spasticity without the need for additional muscle relaxants. Their medications were continued for up to 26 days, and adjusted as needed to control spasticity. Plasma magnesium levels, which were measured twice a day, remained in the 3 to 4.5 mmol/L range. We did not observe hemodynamic instability, arrhythmias or other complications related to magnesium therapy in these patients. All patients improved, came off mechanical ventilation, and were discharged from the intensive care unit in a stable condition.ConclusionIn comparison with previous reports, our case series contributes the following meaningful additional information: intravenous magnesium therapy was used on patients already requiring mechanical ventilation and remained effective for up to 26 days (significantly longer than in previous reports) without significant toxicity in two patients. The overall outcome was good in all our patients. However, the optimal dose, optimal duration and maximum safe duration of intravenous magnesium therapy are unknown. Therefore, until more data on the safety and efficacy of magnesium therapy are available, its use should be limited to carefully selected tetanus cases.

Magnesium sulfate enhances exercise performance and manipulates dynamic changes in peripheral glucose utilization

The effect of magnesium supplementation on exercise performance remains controversial. In the present study, the effects of magnesium sulfate on exercise performance and blood glucose metabolism were examined. In order to provide a non-invasive measure of continuous exercise, we developed an auto-blood sampling system was coupled to a microdialysis analyzer to detect the dynamic changes in glucose metabolism in conscious and freely moving gerbils subjected to forced swimming. Gerbils were pretreated with saline or magnesium sulfate (90 mg kg(-1), ip) 30 min before exercise. The duration times were significantly increased by 71% in the magnesium sulfate-treated groups (p < 0.01) when compared with those in the control. Another group of gerbils were subjected to blood sampling assay. A catheter was implanted in the jugular vein of each gerbil for collecting blood samples by the computer-aided blood sampler. The basal levels of plasma glucose, lactate, and magnesium were 6,245 +/- 662, 1,067 +/- 309, and 590 +/- 50 microM, respectively, with no significant difference between groups. Plasma glucose, lactate, and magnesium levels increased to 134 and 204%, 369 and 220%, and 155 and 422% of basal levels during swimming in both the control and magnesium sulfate-treated groups, respectively (p < 0.05). Pretreatment with magnesium sulfate elevated glucose and magnesium levels to 175 and 302% of the basal levels (p < 0.05), respectively, whereas pretreatment with magnesium sulfate reduced the lactate levels 150% of the basal level (p < 0.05) during swimming. Furthermore, the magnesium levels increased to about 152-422% of basal levels during forced swimming and the recovery period (p < 0.05). The present study demonstrates that magnesium sulfate improved the duration time of forced swimming exercise. In addition, magnesium raised glucose levels and attenuated lactate levels during forced swimming. These results indicate that positive effects of magnesium supplementation may contribute to the enhancement of exercise performance in athletes.

On the insulin effect on the magnesium homeostasis.

In 10 healthy, normoglycemic children the intravenous application of 0.1 I.U. insulin per kg body mass is followed by a decline of the plasma magnesium levels of about 15 to 20 percent of the basal levels. This effect is explained as a result of transport of extracellular magnesium into the intracellular space of the insulin-dependent tissues, and is discussed on the basis of known insulin-magnesium interactions at the receptor level.

Gitelman Syndrome

Gitelman Syndrome

The effect of hypermagnesemic treatment on cerebrospinal fluid magnesium level in patients with aneurysmal subarachnoid hemorrhage

Preliminary evidence has suggested that magnesium sulfate infusion reduces delayed ischemic neurological deficit and improves clinical outcome after aneurysmal subarachnoid hemorrhage. However, little is known about its site of action in vivo. We studied 22 aneurysmal subarachnoid hemorrhage patients with or without magnesium sulfate infusion for 10-14 days. Thirteen patients had external ventricular drains inserted for hydrocephalus and daily cerebrospinal fluid magnesium levels were measured. For patients given magnesium sulfate infusion, the aim was to raise the plasma magnesium level to double the baseline level. We found that the magnesium sulfate infusion bought an 11% to 21% increase in cerebrospinal fluid magnesium. The elevation of cerebrospinal fluid magnesium was sustained for at least nine days. Whether this mild elevation in cerebrospinal fluid magnesium level was adequate for neuroprotection awaits the results of ongoing clinical trials.

Cocaine Use Disorders and Serum Magnesium Profile

Introduction: Magnesium influences the nervous system via its actions on the release and metabolism of neurotransmitters, and abnormal magnesium metabolism has been implicated in several neuropsychiatric disorders with prominent mood symptoms. The aim of this study was to compare the serum levels of magnesium of cocaine addicts to those of heroin addicts and normal controls. We also attempted to clarify the relationship between the pathophysiology of cocaine abuse and magnesium levels by investigating their association with various clinical dimensions. Methods: Eighty-five consecutive subjects with a history of cocaine or opiate use disorders were recruited, evaluated and compared with 100 controls. The cocaine and heroin abusers were assessed with a 10-cm Visual Analogue Scale, the Symptom Check List-90 Revised, the Brown-Goodwin Scale, and the Barrat Impulsiveness Scale. Results: Magnesium levels were higher in the cocaine group compared to the opiate group and control. Male subjects had lower magnesium levels than the females of all three groups. Scores of impulsiveness, aggressiveness, craving and psychiatric symptomatology were not significantly different between the opiate and cocaine addicts. Discussion: This is the first study evaluating the magnesium level in cocaine addicts. Cocaine addicts showed higher total plasma magnesium levels than opiate addicts and normal controls, even though they remained in the normal range. The roles of the psychiatric comorbidity, of a pharmacokinetic association and of a pharmacodynamic interaction are discussed. Further prospective studies comparing serum levels of cocaine at different times are needed.

Effects of Genotype on Testis, Semen Quality, and Mineral Composition of Semen in Various Ram Breeds

This study was carried out on nine 3-5-year-old rams of different species: four Norduz, two Karakas, and three Ile de France × Akkaraman rams. Sperm of each ram was collected by means of an artificial vagina once per month from June to October 2007. In each case, the sperm volume, pH, viscosity, mass activity, motility, concentration, abnormal spermatozoa ratio, and the sperm death/live ratio were recorder along with the animals' testis diameter and scrotum circumferences. The concentrations of calcium, potassium, copper, magnesium, iron, and zinc levels in seminal plasma were determined. There were changes in the measured parameters according to genotype and time of sampling, which can be useful for better planning of anestrous mating programs for these ram species.

HNF1B mutations associate with hypomagnesemia and renal magnesium wasting.

Mutations in hepatocyte nuclear factor 1B (HNF1B), which is a transcription factor expressed in tissues including renal epithelia, associate with abnormal renal development. While studying renal phenotypes of children with HNF1B mutations, we identified a teenager who presented with tetany and hypomagnesemia. We retrospectively reviewed radiographic and laboratory data for all patients from a single center who had been screened for an HNF1B mutation. We found heterozygous mutations in 21 (23%) of 91 cases of renal malformation. All mutation carriers had abnormal fetal renal ultrasonography. Plasma magnesium levels were available for 66 patients with chronic kidney disease (stages 1 to 3). Striking, 44% (eight of 18) of mutation carriers had hypomagnesemia (<1.58 mg/dl) compared with 2% (one of 48) of those without mutations (P < 0.0001). The median plasma magnesium was significantly lower among mutation carriers than those without mutations (1.68 versus 2.02 mg/dl; P < 0.0001). Because hypermagnesuria and hypocalciuria accompanied the hypomagnesemia, we analyzed genes associated with hypermagnesuria and detected highly conserved HNF1 recognition sites in FXYD2, a gene that can cause autosomal dominant hypomagnesemia and hypocalciuria when mutated. Using a luciferase reporter assay, we demonstrated HNF1B-mediated transactivation of FXYD2. These results extend the phenotype of HNF1B mutations to include hypomagnesemia. HNF1B regulates transcription of FXYD2, which participates in the tubular handling of Mg(2+), thus describing a role for HNF1B not only in nephrogenesis but also in the maintenance of tubular function.

Hypomagnesaemia in type-2 diabetes mellitus patients: A study on the status of oxidative and nitrosative stress.

This study was undertaken to evaluate the levels of plasma magnesium, lipid peroxides, nitric oxide end products, erythrocyte membrane lipid peroxides, erythrocyte reduced glutathione and erythrocyte superoxide dismutase activity in type-2 diabetes mellitus patients. 60 patients with type-2 diabetes mellitus and 30 healthy control subjects were included in this study. Among 60 type-2 diabetic patients, 30 patients were without complication and 30 patients were with various complications. Decreased levels of plasma magnesium, erythrocyte reduced glutathione and erythrocyte superoxide dismutase activity while increased levels of plasma lipid peroxides, nitric oxide end products and erythrocyte membrane lipid peroxides were observed in patients with type-2 diabetes mellitus. We propose that, under the shadow of hypomagnesaemia, there is excessive production of reactive oxygen species and reactive nitrogen species as reflected by elevated lipid peroxides and nitric oxide end products concomitant with dwindled antioxidants and suggest their association with late complications in type-2 diabetes mellitus.

Magnesium in Canine Epilepsy

Epilepsy is the expression of a functional paroxysmal neural impulses disturbance where neurons discharge excessive nerve impulses with a high frequency and abnormal synchrony. Investigations were conducted on a total of 45 dogs diagnosed with epilepsy aged between 3 months and 10 years. A number of 40 clinically healthy dogs were controll group (group M). Were determined plasma and erythrocyte magnesium, calcium, inorganic phosphate, potassium and sodium by molecular absorption spectrophotometry (colorimetric methods). In dogs with primary and secondary epilepsy has recorded a negative balance of magnesium with a statistically significant decrease of plasma and erythrocyte magnesium and also a negative correlation between attacks frequency-plasma and erythrocyte magnesium; the dogs with status epilepticus recorde the lowest levels of plasma and erythrocyte magnesium. The hypomagnesaemia, hypocalcemia and hyperphosphatemia recorded in dogs with secondary epilepsy are the important biochemical changes of magnesium deficiency syndrome with neuromusculare symptoms.

Associations between added sugars and micronutrient intakes and status: further analysis of data from the National Diet and Nutrition Survey of Young People aged 4 to 18 years

Added sugars are often viewed as 'empty calories', negatively impacting micronutrient intakes, yet reviews consider the evidence inconclusive. This study aimed to quantify associations between dietary added sugars (as a percentage of energy) and micronutrient intake and biochemical status in the National Diet and Nutrition Survey. Using data from 1688 British children aged 4-18 years who completed 7 d weighed dietary records in 1997, micronutrient intakes were examined across quintiles of added sugars. After excluding low energy reporters, mean dietary intakes of most nutrients exceeded the reference nutrient intake, except for zinc. Compared with quintile 1 (9% added sugars), high consumers in quintile 5 (23% added sugars) had micronutrient intakes ranging from 24% lower to 6% higher (mean 14% lower). Zinc intakes in quintile 1 v. quintile 5 averaged 93% v. 78% of reference nutrient intake; magnesium 114% v. 94%; iron 115% v. 100%; and vitamin A 111% v. 92%, respectively. Plasma levels of magnesium, zinc and carotenoids did not vary across quintiles, but weak negative correlations were observed with serum ferritin and transferrin saturation. Plasma selenium was inversely correlated with added sugars (r -0.17; P < 0.0001) but there was no association with glutathione peroxidase. The impact of added sugars on micronutrient intakes appears modest overall but may have relevance for children consuming inadequate amounts of nutrient-rich foods coupled with a diet high in added sugars (approximately 23%). Further work is needed to explore the impact of different sources of added sugars and to refine assessments of inadequate intakes and status.

Calcium and magnesium in male reproductive system and in its secretion. Part II within-subject variability in human seminal plasma and spermatozoa

This study was undertaken to find out what, if any, within-subject variability exists in semen parameters, and calcium and magnesium levels in seminal plasma and spermatozoa. Significant changes (p&lt;0.05) were found in semen volume and in the percentage of sluggish motile spermatozoa. No other significant changes were seen in semen parameters or in calcium or magnesium in spermatozoa and seminal plasma.