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Incidence of ionized hypomagnesemia in adult patients undergoing noncardiac major surgery: a prospective observational trial 接受非心脏大手术的成年患者电离性低镁血症的发生率:一项前瞻性观察性试验
IF 3.2 4区 医学 Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2022-01-01 DOI: 10.1684/mrh.2022.0498
Hyun-Jung Shin, Jiwon Han, Subin Yim, Sang-Hwan Do

Background: The present study aimed to investigate the incidence of preoperative ionized hypomagnesemia and compare with that of total hypomagnesemia.

Methods: This prospective observational study included 536 patients aged >20 years who were scheduled for elective surgery. Total and ionized magnesium levels were evaluated before and after the surgery. Based on these levels, patients were classified into the following groups: ionized hypo- (<0.42 mmol/L), normo- (0.42-0.59 mmol/L) and hypermagnesemia (>0.59 mmol/L), as well as total hypo- (<1.9 mg/dL[0.78 mmol/L]), normo- (1.9-2.7 mg/dL[0.78-1.11 mmol/L]) and hypermagnesemia (>2.7 mg/dL [1.11 mmol/L]). The primary objective was to establish the incidence of preoperative ionized hypomagnesemia.

Results: There was a marked difference between the incidence of preoperative ionized and total hypomagnesemia (28% vs. 19%; p<0.001). The postoperative values of ionized magnesium, ionized calcium, and albumin were significantly lower than the respective preoperative values (p<0.001 for all three variables).

Conclusion: The incidence of hypomagnesemia, determined by ionized magnesium concentration, was higher than that determined by total magnesium concentration.

背景:本研究旨在调查术前游离性低镁血症的发生率,并与完全性低镁血症进行比较。方法:本前瞻性观察研究纳入536例年龄>20岁的择期手术患者。在手术前和手术后评估总镁和离子镁水平。根据这些水平,将患者分为以下两组:离子化低氧组(0.59 mmol/L)和总低氧组(2.7 mg/dL [1.11 mmol/L])。主要目的是确定术前离子化低镁血症的发生率。结果:术前离子化和全低镁血症的发生率有显著差异(28% vs. 19%;结论:以离子镁浓度测定低镁血症发生率高于以总镁浓度测定低镁血症发生率。
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引用次数: 0
Magnesium sulphate activates the L-arginine/NO/cGMP pathway to induce peripheral antinociception in mice 硫酸镁激活l -精氨酸/NO/cGMP通路诱导小鼠外周抗伤感受
IF 3.2 4区 医学 Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2022-01-01 DOI: 10.1684/mrh.2022.0495
Loyara Rocha Miranda Teixeira, Andrea Castro Perez, Thiago Roberto Lima Romero, Igor Dimitri Gama Duarte

In the present study, we investigated whether magnesium sulphate activates the L-arginine/NO/cGMP pathway and elicits peripheral antinociception. The male Swiss mice paw pressure test was performed with hyperalgesia induced by intraplantar injection of prostaglandin E2. All drugs were administered locally into the right hind paw of animals. Magnesium sulphate (20, 40, 80 and 160 μg/paw) induced an antinociceptive effect. The dose of 80 μg/paw elicited a local antinociceptive effect that was antagonized by the non-selective NOS inhibitor, L-NOArg, and by the selective neuronal NOS inhibitor, L-NPA. The inhibitors, L-NIO and L-NIL, selectively inhibited endothelial and inducible NOS, respectively, but were ineffective regarding peripheral magnesium sulphate injection. The soluble guanylyl cyclase inhibitor, ODQ, blocked the action of magnesium sulphate, and the cGMP-phosphodiesterase inhibitor, zaprinast, enhanced the antinociceptive effects of intermediate dose of magnesium sulphate. Our results suggest that magnesium sulphate stimulates the NO/cGMP pathway via neuronal NO synthase to induce peripheral antinociceptive effects.

在本研究中,我们研究了硫酸镁是否激活l -精氨酸/NO/cGMP通路并引发外周抗伤感觉。用前列腺素E2足底注射致痛觉过敏的雄性瑞士小鼠进行足爪压力试验。所有药物均局部注入动物右后爪。硫酸镁(20、40、80和160 μg/爪)均有抗伤感受作用。80 μg/爪的剂量可引起局部的抗伤感受作用,该作用可被非选择性NOS抑制剂L-NOArg和选择性神经元NOS抑制剂L-NPA拮抗。抑制剂L-NIO和L-NIL分别选择性抑制内皮细胞和诱导细胞的NOS,但对外周硫酸镁注射无效。可溶性关酰环化酶抑制剂ODQ阻断了硫酸镁的作用,cgmp -磷酸二酯酶抑制剂zaprinast增强了中剂量硫酸镁的抗伤感受作用。我们的研究结果表明,硫酸镁通过神经元NO合成酶刺激NO/cGMP通路,诱导外周抗伤害感受作用。
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引用次数: 0
A potential protective role of magnesium in neuroCOVID 镁在神经covid中的潜在保护作用
IF 3.2 4区 医学 Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2022-01-01 DOI: 10.1684/mrh.2022.0497
Valentina Cenacchi, Jeanette A Maier, Maria Paola Perini

Several recent studies support a role of dysregulated magnesium homeostasis in COVID-19. In the present narrative review, we focus on the neurological aspects of this disease, collectively known as neuroCOVID, and we propose some mechanisms by which alterations of magnesium may contribute to the involvement of the nervous system in the context of SARS-CoV-2 infection. Further fundamental, translational, and clinical research is needed to underpin the potential relationships between altered magnesium status and neuro-COVID, with potentially novel therapeutic implications.

最近的几项研究支持镁稳态失调在COVID-19中的作用。在本综述中,我们将重点关注这种疾病的神经学方面,统称为neuroCOVID,并提出了镁的改变可能导致神经系统参与SARS-CoV-2感染的一些机制。需要进一步的基础、转化和临床研究来支持镁状态改变与神经covid之间的潜在关系,并具有潜在的新治疗意义。
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引用次数: 1
Increasing public health awareness of magnesium: one step at a time 提高公众对镁的健康意识:一步一步来
IF 3.2 4区 医学 Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2022-01-01 DOI: 10.1684/mrh.2022.0494
Rebecca B Costello, Andrea Rosanoff
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引用次数: 0
Relationship of dietary magnesium intake and serum magnesium with hypertension: a review. 膳食镁摄入量和血清镁与高血压的关系综述。
IF 3.2 4区 医学 Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2021-11-01 DOI: 10.1684/mrh.2021.0492
Nikolina Banjanin, Goran Belojevic

The relationship between magnesium and hypertension has been intensively investigated in the last few decades. Most of the so far reviews were focused on either dietary magnesium or serum magnesium or magnesium supplements. Our goal was to merge these findings with a more comprehensive approach. Internet search was performed in PubMed database without date limits, using the following search terms "dietary magnesium," "serum magnesium," "magnesium supplements," "hypertension," "drinking water," "food," "endothelial dysfunction," "arterial smooth muscle," and "arterial spasms." In general, there exists an inverse dose-dependent relationship between dietary magnesium intake and serum magnesium and the risk of hypertension. A negative correlation has been found between the serum magnesium concentration and Framingham risk score and intima-media carotid thickness and cardiovascular mortality. On the other hand, concentration of extracellular magnesium in the normal range acts as a natural calcium channel blocker, eliminates endothelial dysfunction, increases nitric oxide, and induces direct and indirect vasodilatation. In conclusion, an average magnesium dietary intake is below the recommended values and magnesium supplementation in the prevention and treatment of hypertension might be justified.

在过去的几十年里,镁和高血压之间的关系已经被深入研究。到目前为止,大多数评论都集中在膳食镁或血清镁或镁补充剂上。我们的目标是将这些发现与更全面的方法结合起来。在PubMed数据库中进行互联网搜索,没有日期限制,使用以下搜索词“膳食镁”,“血清镁”,“镁补充剂”,“高血压”,“饮用水”,“食物”,“内皮功能障碍”,“动脉平滑肌”和“动脉痉挛”。总的来说,膳食镁摄入量和血清镁与高血压风险之间存在负剂量依赖关系。血清镁浓度与Framingham风险评分、颈动脉内膜-中膜厚度和心血管死亡率呈负相关。另一方面,正常范围内的细胞外镁浓度作为天然钙通道阻滞剂,消除内皮功能障碍,增加一氧化氮,诱导直接和间接血管舒张。总之,膳食镁的平均摄入量低于推荐值,补充镁预防和治疗高血压可能是合理的。
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引用次数: 6
The association between abnormal serum magnesium levels and prognosis of elderly patients with community-acquired pneumonia. 老年社区获得性肺炎患者血清镁水平异常与预后的关系。
IF 3.2 4区 医学 Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2021-11-01 DOI: 10.1684/mrh.2022.0493
Si-Qiong Wang, Dong-Xi Lu, Jian-Dong Zhang, Zhi-Wei Wang, Xiao-Wei Li, Chun-Ming Ma

To investigate the association between abnormal serum magnesium levels and the prognosis of elderly patients with community-acquired pneumonia (CAP). Methods: A retrospective study was conducted on 1381 elderly patients with CAP in the First Hospital of Qinhuangdao between January 2015 and December 2018. Serum magnesium concentrations in the range of 0.75-1.25 mmol/L were defined as normal. Patients were assigned into normal, hypomagnesemia, and hypermagnesemia groups. The primary outcome was in-hospital mortality, indicating whether a patient died at the time of discharge from the hospital. The percentages of respiratory failure and mechanical ventilation were 18.6% and 10.6 % in the normal group, 29% and 16.5 % in the hypomagnesemia, and 42.9% and 35.7% in the hypermagnesemia groups. The occurrence of shock was 8.5% and 4.5% in the hypomagnesemia group and the normal group. The percentages of the length of stay at ICU were 14.9%, 18.8%, and 57.1% in the hypomagnesemia, normal, and hypermagnesemia groups. The in-hospital mortality rate was 5.3%, 9.1%, and 35.7% in the normal, hypomagnesemia, and hypermagnesemia groups, respectively. The results of univariate analysis showed that the in-hospital mortality in the hypomagnesemia group was 1.790 (95% confidence interval (CI): 1.009∼3.176, P=0.046) times higher than that in the normal group; in the hypermagnesemia group, it was 9.947 (95% CI: 3.238-30.556, P<0.001) times higher than that in the normal group. The results of multivariate logistic regression analysis showed that after adjusting for gender, age, diabetes, heart failure, cerebrovascular disease, cancer, estimated glomerular filtration rate (eGFR), glucose, and CURB-65 score, in the hypomagnesemia group, the in-hospital mortality was 1.746 (95% confidence interval (CI): 0.956∼3.186, P=0.070) times higher than that in the normal group, and 5.689 (95% CI: 1.583- 20.446, P=0.008) times higher in the hypermagnesemia group than that in the normal group. Abnormal serum magnesium levels are strongly associated with in-hospital mortality in elderly patients with CAP. The measurement of serum magnesium levels in elderly patients with CAP at admission may assist clinicians to determine the prognosis of such patients.

探讨老年社区获得性肺炎(CAP)患者血清镁水平异常与预后的关系。方法:对2015年1月至2018年12月在秦皇岛第一医院就诊的1381例老年CAP患者进行回顾性研究。血清镁浓度在0.75 ~ 1.25 mmol/L范围内为正常。患者被分为正常、低镁血症和高镁血症组。主要结局是住院死亡率,表明患者在出院时是否死亡。正常组呼吸衰竭和机械通气发生率分别为18.6%和10.6%,低镁血症组为29%和16.5%,高镁血症组为42.9%和35.7%。低镁血症组和正常组休克发生率分别为8.5%和4.5%。低镁血症组、正常镁血症组和高镁血症组住院时间分别为14.9%、18.8%和57.1%。正常组、低镁血症组和高镁血症组的住院死亡率分别为5.3%、9.1%和35.7%。单因素分析结果显示,低镁血症组住院死亡率为正常组的1.790倍(95%可信区间(CI): 1.009 ~ 3.176, P=0.046);高镁血症组为9.947 (95% CI: 3.238 ~ 30.556, P
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引用次数: 1
Relationship of magnesemia with myocardial damage and mortality in patients with COVID-19. 新冠肺炎患者镁血症与心肌损害及死亡率的关系
IF 3.2 4区 医学 Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2021-08-01 DOI: 10.1684/mrh.2021.0485
Seyda Gunay, Serhat Caliskan, Deniz Sigirli

Magnesium (Mg) is the second most abundant intracellular cation and plays a significant role in immune system and cardiac protection. Mg deficiency contributes to chronic low-grade inflammation leading to cardiovascular diseases, and low Mg level exacerbates virus-induced inflammation. The aim of the study was to investigate whether serum magnesium level is associated with myocardial damage and prognosis of COVID-19. This was a single-center, observational retrospective study of patients with COVID-19. The study population was divided into two groups according to in-hospital mortality: a survivor group (SG) and a non-survivor group (NSG). Myocardial damage was defined as blood levels of cardiac troponin I (cTnI) above the 99th percentile upper reference limit. Magnesium, variables regarding inflammation, and myocardial damage were compared between the groups. A total of 629 patients with COVID-19 were included. Mortality rate was 11.85% (n = 82). There were 61 (74.4%) and 294 male patients (53.7%) in NSG and SG, respectively (p = 0.001). The median age of NSG was 64.5 years (min-max: 37-93) and the median age of SG was 56.0 years (min-max: 22-92) (p < 0.001). Median serum magnesium levels of NSG and SG were 1.94 mg/dL (min-max: 1.04-2.87) and 2.03 mg/dL (min-max: 1.18-2.88), respectively (p = 0.027). Median cTnI levels of NSG and SG were 25.20 pg/mL (min-max: 2.10-2240.80) and 4.50 pg/mL (min-max: 0.50-984.3), respectively (p < 0.001). The cTnI levels were lower in those patients whose serum Mg levels were higher than 1.94. Although serum magnesium level was not a predictor for in-hospital mortality, there was a significant negative correlation between magnesemia and myocardial damage.

镁(Mg)是第二丰富的细胞内阳离子,在免疫系统和心脏保护中起着重要作用。镁缺乏导致慢性低度炎症导致心血管疾病,低镁水平加剧病毒诱导的炎症。本研究的目的是探讨血清镁水平是否与COVID-19心肌损伤和预后相关。这是一项针对COVID-19患者的单中心、观察性回顾性研究。根据住院死亡率将研究人群分为两组:幸存者组(SG)和非幸存者组(NSG)。心肌损伤定义为血液中心肌肌钙蛋白I (cTnI)水平高于参考上限的第99个百分位。比较两组之间的镁、炎症变量和心肌损伤。共纳入629例新冠肺炎患者。死亡率为11.85% (n = 82)。男性NSG组61例(74.4%),男性SG组294例(53.7%)(p = 0.001)。NSG的中位年龄为64.5岁(最小-最大值为37 ~ 93),SG的中位年龄为56.0岁(最小-最大值为22 ~ 92)
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引用次数: 4
Magnesium citrate supplementation decreased blood pressure and HbA1c in normomagnesemic subjects with metabolic syndrome: a 12-week, placebo-controlled, double-blinded pilot trial. 补充柠檬酸镁可降低代谢综合征正常镁血症患者的血压和HbA1c:一项为期12周的安慰剂对照双盲先导试验。
IF 3.2 4区 医学 Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2021-08-01 DOI: 10.1684/mrh.2021.0489
Kseniia Afitska, Julia Clavel, Klaus Kisters, Jürgen Vormann, Tanja Werner

Magnesium (Mg) supplementation was shown to improve metabolic syndrome (MetS) parameters in hypomagnesemic patients. The current study evaluated the role of Mg in normomagnesemic individuals with MetS. Patients were randomly assigned to 400 mg Mg as Mg citrate or placebo daily for 12 weeks. Blood pressure (BP), HbA1c, plasma concentrations of glucose, Mg and Ca, blood-ionized Mg, serum concentrations of cholesterol, triglycerides, vitamin D, creatinine, interleukin-6, and C-reactive protein were measured at baseline and after 12 weeks. Data were obtained from n = 13 in the Mg supplemented and n = 11 in the placebo group. Mg supplementation led to a significant increase in plasma Mg concentration (0.78 ± 0.07 mmol/L to 0.83 ± 0.07 mmol/L) and a decrease in systolic and diastolic BP (baseline: 145 ± 10/85 ± 3 mmHg; 12 weeks: 121 ± 5/79 ± 3 mmHg). HbA1c decreased significantly in the Mg group (6.43 ± 0.64% to 6.15 ± 0.55%), and the difference in change between placebo and Mg group was significant. Serum vitamin D levels significantly increased only in the Mg group. In normomagnesemic individuals with MetS, oral Mg citrate supplementation reduced HbA1c and BP.

镁(Mg)补充剂被证明可以改善低镁血症患者的代谢综合征(MetS)参数。目前的研究评估了镁在正常镁血症的MetS患者中的作用。患者被随机分配服用400毫克柠檬酸mg或安慰剂,持续12周。在基线和12周后测量血压(BP)、HbA1c、血浆葡萄糖、Mg和Ca浓度、血离子Mg、血清胆固醇、甘油三酯、维生素D、肌酐、白细胞介素-6和c反应蛋白浓度。数据来源于补充Mg组n = 13,安慰剂组n = 11。Mg补充导致血浆Mg浓度显著升高(0.78±0.07 mmol/L至0.83±0.07 mmol/L),收缩压和舒张压降低(基线:145±10/85±3 mmHg;12周:121±5/79±3 mmHg)。Mg组HbA1c明显降低(6.43±0.64% ~ 6.15±0.55%),安慰剂组与Mg组差异有统计学意义。血清维生素D水平仅在Mg组显著升高。在患有MetS的正常镁血症个体中,口服枸橼酸镁补充剂可降低HbA1c和血压。
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引用次数: 0
Serum magnesium in patients with severe acute respiratory syndrome coronavirus 2 from Wuhan, China. 武汉地区严重急性呼吸综合征冠状病毒2型患者血清镁含量测定
IF 3.2 4区 医学 Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2021-08-01 DOI: 10.1684/mrh.2021.0488
Linyun Zhu, Xingxing Bao, Junjie Bi, Yuhua Lin, Cuiting Shan, Xuanfei Fan, Junmei Bian, Xiongbiao Wang

The aim of the study was to evaluate the significance of hypomagnesemia in patients with coronavirus disease 2019 (COVID-19) and clarify its possible pathogenesis. A retrospective cohort study was conducted by reviewing 83 patients hospitalized in Guanggu district, Wuhan Third Hospital, China. Clinical histories, laboratory findings and outcome data were collected. Eighteen patients had hypomagnesemia during hospitalization. Fourteen patients were in the critical group and six died. In the critical group, serum magnesium (0.72 ± 0.15 mmol/L) was much lower than that in the moderate and severe groups. At the same time, we also found that several indicators are correlated with the level of magnesium. The level of magnesium was positively associated with the lymphocyte count (r = 0.203, P = 0.004) and platelet count (r = 0.217, P = 0.002) but negatively related to the levels of CRP (r = -0.277, P = 0.000), LDH (r = -0.185, P = 0.011) and α-hydroxybutyrate dehydrogenase (r = -0.198, P = 0.008) in the critical group. Hypomagnesemia might increase symptoms and may be associated with mortality in COVID-19 by affecting enzyme activity and activating the inflammatory response. Thus, magnesium might play a key role in the pathogenesis of COVID-19.

本研究旨在评价低镁血症在2019冠状病毒病(COVID-19)患者中的意义,并阐明其可能的发病机制。回顾性队列研究对武汉第三医院光谷区住院的83例患者进行回顾性队列研究。收集临床病史、实验室结果和结局数据。18例患者住院期间出现低镁血症。危重组14例,死亡6例。危重组血清镁含量(0.72±0.15 mmol/L)明显低于中、重度组。同时,我们还发现有几个指标与镁的水平相关。危急组患者血镁水平与淋巴细胞计数(r = 0.203, P = 0.004)、血小板计数(r = 0.217, P = 0.002)呈正相关,与CRP (r = -0.277, P = 0.000)、LDH (r = -0.185, P = 0.011)、α-羟基丁酸脱氢酶(r = -0.198, P = 0.008)水平呈负相关。低镁血症可能会加重症状,并可能通过影响酶活性和激活炎症反应而与COVID-19患者的死亡率相关。因此,镁可能在COVID-19的发病机制中发挥关键作用。
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引用次数: 13
Magnesium favors the capacity of vitamin D3 to induce the monocyte differentiation of U937 cells. 镁有利于维生素D3诱导U937细胞单核细胞分化的能力。
IF 3.2 4区 医学 Q4 Biochemistry, Genetics and Molecular Biology Pub Date : 2021-08-01 DOI: 10.1684/mrh.2021.0490
Sandra Parenti, Laura Sandoni, Monica Montanari, Tommaso Zanocco-Marani, Alexandre Anesi, Stefano Iotti, Rossella Manfredini, Chiara Frassineti, Pierpaola Davalli, Alexis Grande

The hematopoietic U937 cells are able to differentiate into monocytes, macrophages, or osteoclasts when stimulated, respectively, with vitamin D3 (VD3), phorbol 12-myristate 13-acetate (PMA) or PMA plus VD3. We have previously demonstrated that magnesium (Mg) strongly potentiates the osteoclastic differentiation of U937 cells. In this study, we investigated whether such an effect may be ascribed to a capacity of Mg to modulate the monocyte differentiation of U937 cells and/or to an ability of Mg and VD3 to act directly and independently on the early phases of the osteoclastic differentiation. To address this issue, we subjected U937 cells to an individual and combined treatment with Mg and VD3 and then we analyzed, by flow cytometry and quantitative real-time polymerase chain reaction, the expression of a number of genes related to the early phases of the differentiation pathways under consideration. The results obtained indicated that Mg favors the monocyte differentiation of U937 cells induced by VD3 and at the same time, Mg contrasts the inhibitory effect that VD3 exerts on the osteoclastic differentiation in the absence of PMA. The crucial and articulated role played by Mg in diverse pathways of the osteoclastic differentiation of U973 cells is emphasized.

造血U937细胞分别在维生素D3 (VD3)、12-肉豆蔻酸13-乙酸佛波酯(PMA)或PMA加VD3刺激下能够分化为单核细胞、巨噬细胞或破骨细胞。我们之前已经证明,镁(Mg)强烈增强U937细胞的破骨分化。在这项研究中,我们调查了这种影响是否可能归因于Mg调节U937细胞单核细胞分化的能力和/或Mg和VD3直接和独立作用于破骨细胞分化的早期阶段的能力。为了解决这个问题,我们对U937细胞进行了单独和Mg和VD3联合处理,然后我们通过流式细胞术和定量实时聚合酶链反应分析了与所考虑的分化途径早期阶段相关的一些基因的表达。结果表明,Mg有利于VD3诱导的U937细胞单核细胞分化,同时对比了VD3在缺乏PMA的情况下对破骨细胞分化的抑制作用。强调了Mg在U973细胞破骨分化的多种途径中所起的关键和明确的作用。
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引用次数: 3
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