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Purpose: Serum magnesium is the most frequently used laboratory test for evaluating clinical magnesium status. Hypomagnesemia (low magnesium status), which is associated with many chronic diseases, is diagnosed using the serum magnesium reference range. Currently, no international consensus for a magnesemia normal range exists. Two independent groups designated 0.85 mmol/L (2.07 mg/dL; 1.7 mEq/L) as the low cut-off point defining hypomagnesemia. MaGNet discussions revealed differences in serum magnesium reference ranges used by members' hospitals and laboratories, presenting an urgent need for standardization., Methods: We gathered and compared serum magnesium reference range values from our institutions, hospitals, and colleagues worldwide., Results: Serum magnesium levels designating "hypomagnesemia" differ widely. Of 43 collected values, only 2 met 0.85 mmol/L as the low cut-off point to define hypomagnesemia. The remainder had lower cut-off values, which may underestimate hypomagnesemia diagnosis in hospital, clinical, and research assessments. Current serum magnesium reference ranges stem from "normal" populations, which unknowingly include persons with chronic latent magnesium deficit (CLMD). Serum magnesium levels of patients with CLMD fall within widely used "normal" ranges, but their magnesium status is too low for long-term health. The lower serum magnesium reference (0.85 mmol/L) proposed specifically prevents the inclusion of patients with CLMD., Conclusions: Widely varying serum magnesium reference ranges render our use of this important medical tool imprecise, minimizing impacts of low magnesium status or hypomagnesemia as a marker of disease risk. To appropriately diagnose, increase awareness of, and manage magnesium status, it is critical to standardize lower reference values for serum magnesium at 0.85 mmol/L (2.07 mg/dL; 1.7 mEq/L)., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background: Exercise is an effective therapy for the management of diabetes because it helps regulate glucose and magnesium homeostasis. Nevertheless, the mechanisms by which exercise exerts effects on magnesium transport remain unclear. This study investigated the expression of genes encoding magnesium transporters (GMTs) after a three-month exercise program in diabetic patients., Methods: This study was conducted with a within-subject pre-post design. A total of 15 adult patients with type 2 diabetes mellitus (T2DM) were recruited and underwent a three-month indoor bicycle exercise program. The expression of five GMTs (CNNM2, TRPM6, TRPM7, SLC41A1, and SLC41A3) was determined in blood samples. Relevant anthropometric values and biochemical parameters were also determined., Results: Although the body weight and body mass index decreased after three months exercise, there were no significant differences. Fasting blood glucose, glycated hemoglobin (HbA1c), waist circumference, and magnesium levels decreased after the exercise program (p < 0.05). The expression of SLC41A1 and SLC41A3 were downregulated after exercise, but only CNNM2, TRPM6, and TRPM7 showed significantly decreased expression levels compared with those before the exercise program (p < 0.05)., Conclusion: The three-month exercise program ameliorated blood glucose levels and downregulated the expression of magnesium-responsive genes in patients with T2DM.

Previous studies have shown that the geometric development of femoral trabecular bone is affected by insufficient dietary intake of magnesium. However, it is not clear whether the development of femoral cortical bone can be quantitatively evaluated according to a diet with inadequate magnesium supplementation. Therefore, we used a micro computed tomography (CT) imaging approach with a laboratory mouse model to explore the potential application of texture analysis for the quantitative assessment of femoral cortical bones. C57BL/6J male mice were divided into two groups, where one group was fed a normal diet and the other group was fed a low-magnesium diet. We used a micro CT scanner for image acquisition, and the subsequent development of cortical bone was examined by texture analysis based on the statistical distribution of gray-scale intensities in which seven essential parameters were extracted from the micro CT images. Our calculations showed that the mean intensity increased by 7.20% (p = 0.000134), sigma decreased by 29.18% (p = 1.98E-12), skewness decreased by 19.52% (p = 0.0000205), kurtosis increased by 9.62% (p = 0.0877), energy increased by 24.19% (p = 3.32E-09), entropy decreased by 6.14% (p = 3.00E-10), and the Nakagami parameter increased by 104.32% (p = 4.13E-12) in the low-magnesium group when compared to the normal group. We found that the statistical parameters extracted from the gray-scale intensity distribution were able to differentiate between femoral cortical bone developments in the two different diet groups.

Background: Magnesium supplementation has potential for use in nerve regeneration. The expression of some magnesium transporter genes is reflective of the intracellular magnesium levels., Objective: To assess the expression of various magnesium transporter genes as they relate to neurological alterations in a sciatic nerve injury model., Methods: Sciatic nerve injury was induced in rats, which were then fed either basal or high magnesium diets. Magnesium concentrations and 5 magnesium transporter genes (SLC41A1, MAGT1, CNNM2, TRPM6, and TRPM7) were measured in the tissue samples., Results: The high magnesium diet attenuated cytoskeletal loss in a dose-dependent manner in isolated nerve explants. The high magnesium diet augmented nerve regeneration and led to the restoration of nerve structure, increased S-100, and neurofilaments. This increased regeneration was consistent with the improvement of neurobehavioral and electrophysiological assessment. The denervated muscle morphology was restored with the high magnesium diet, and that was also highly correlated with the increased expression of desmin and acetylcholine receptors in denervated muscle. The plasma magnesium levels were significantly elevated after the animals consumed a high magnesium diet and were reciprocally related to the down-regulation of CNNM2, MagT1, and SCL41A1 in the blood monocytes, nerves, and muscle tissues of the nerve crush injury model., Conclusion: The increased plasma magnesium levels after consuming a high magnesium diet were highly correlated with the down-regulation of magnesium transporter genes in monocytes, nerves, and muscle tissues after sciatic nerve crush injury. The study findings suggest that there are beneficial effects of administering magnesium after a nerve injury., (Copyright © 2018 by the Congress of Neurological Surgeons.)

Glucose mobilization and utilization in the periphery and central nervous system are important during exercise and are responsible for exercise efficacy. Magnesium (Mg) is involved in energy production and plays a role in exercise performance. This study aimed to explore the effects of Mg on the dynamic changes in glucose and lactate levels in the muscle, blood and brain of exercising rats using a combination of auto-blood sampling and microdialysis. Sprague-Dawley rats were pretreated with saline or magnesium sulfate (MgSO4, 90 mg/kg, i.p.) 30 min before treadmill exercise (20 m/min for 60 min). Our results indicated that the muscle, blood, and brain glucose levels immediately increased during exercise, and then gradually decreased to near basal levels in the recovery periods of both groups. These glucose levels were significantly enhanced to approximately two-fold (P<0.05) in the Mg group. Lactate levels in the muscle, blood, and brain rapidly and significantly increased in both groups during exercise, and brain lactate levels in the Mg group further elevated (P<0.05) than those in the control group during exercise. Lactate levels significantly decreased after exercise in both groups. In conclusion, Mg enhanced glucose availability in the peripheral and central systems, and increased lactate clearance in the muscle during exercise.

Background: Type 2 diabetes mellitus is a major global public health problem in the worldwide and is increasing in aging populations. Magnesium intake may be one of the most important factors for diabetes prevention and management. Low magnesium intake may exacerbate metabolic abnormalities. In this study, the relationships of magnesium intake with metabolic parameters, depression and physical activity in elderly patients with type 2 diabetes were investigated., Methods: This cross-sectional study involved 210 type 2 diabetes patients aged 65 years and above. Participants were interviewed to obtain information on lifestyle and 24-hour dietary recall. Assessment of depression was based on DSM-IV criteria. Clinical variables measured included anthropometric measurements, blood pressure, and biochemical determinations of blood and urine samples. Linear regression was applied to determine the relationships of magnesium intake with nutritional variables and metabolic parameters., Results: Among all patients, 88.6% had magnesium intake which was less than the dietary reference intake, and 37.1% had hypomagnesaemia. Metabolic syndromes and depression were associated with lower magnesium intake (p < 0.05). A positive relationship was found between magnesium intake and HDL-cholesterol (p = 0.005). Magnesium intake was inversely correlated with triglyceride, waist circumference, body fat percent and body mass index (p < 0.005). After controlling confounding factor, HDL-cholesterol was significantly higher with increasing quartile of magnesium intake (p for trend = 0005). Waist circumference, body fat percentage, and body mass index were significantly lower with increase quartile of magnesium intake (p for trend < 0.001). The odds of depression, central obesity, high body fat percentage, and high body mass index were significantly lower with increasing quartile of magnesium intake (p for trend < 0.05). In addition, magnesium intake was related to high physical activity level and demonstrated lower serum magnesium levels. Serum magnesium was not significantly associated with metabolic parameters., Conclusions: The majority of elderly type 2 diabetes who have low magnesium intake may compound this deficiency with metabolic abnormalities and depression. Future studies should determine the effects of increased magnesium intake or magnesium supplementation on metabolic control and depression in elderly people with type 2 diabetes.

Magnesium (Mg) supplements have been shown to significantly improve functional recovery in various neurological disorders. The essential benefits of Mg supplementation in peripheral nerve disorders have not been elucidated yet. The effect and mechanism of Mg supplementation on a sciatic nerve crush injury model was investigated. Sciatic nerve injury was induced in mice by crushing the left sciatic nerve. Mice were randomly divided into three groups with low-, basal- or high-Mg diets (corresponding to 10, 100 or 200% Mg of the basal diet). Neurobehavioral, electrophysiological and regeneration marker studies were conducted to explore nerve regeneration. First, a high Mg diet significantly increased plasma and nerve tissue Mg concentrations. In addition, Mg supplementation improved neurobehavioral, electrophysiological functions, enhanced regeneration marker, and reduced deposits of inflammatory cells as well as expression of inflammatory cytokines. Furthermore, reduced Schwann cell apoptosis was in line with the significant expression of bcl-2, bcl-X(L) and down-regulated expression of active caspase-3 and cytochrome C. In summary, improved neurological function recovery and enhanced nerve regeneration were found in mice with a sciatic nerve injury that were fed a high- Mg diet, and Schwann cells may have been rescued from apoptosis by the suppression of inflammatory responses.

Objectives: Description of use of equipment for on-line microdialysis (MD) coupled with graphite furnace atomic absorption spectrometry (GFAAS) system, for dynamic monitoring of extracellular Mg in gerbils subjected to transient focal cerebral ischemia., Methods: Gerbils' right middle cerebral artery (MCA) and common carotid artery (CCA) were occluded for 60 minutes, and then reperfused for 60 minutes with Ringer's solution, after which extracellular fluid samples were collected via a microdialysis probe inserted into the right cortex before, during and after inducing ischemia. Reperfusion was at a rate of 2 microL/min through the microdialysis probe, on-line diluted with measured water injected onto the GFAAS via an autosampler for Mg analysis., Results: The detection limit of the Mg concentrations has ranged from 0.50 to 3.00 microg/L; our detection limit was 0.03 microg/L. We applied this on-line system to monitor extracellular Mg levels in the cortex during focal cerebral ischemia. Mg concentrations significantly decreased to 41% of baseline during cerebral ischemia and gradually returned to 67% of baseline after 60 minutes of reperfusion., Conclusions: We presume that derangement of Mg homeostasis could be important in brain cell injury and is closely associated with cerebral ischemia event. The described analytic system permits autosampling in the brain and allows for continuous determination of Mg and trace minerals in minute sample volumes in a living system.

Objective: The aim of this study was to develop a microdialysis-graphite furnace atomic absorption spectroscopy (MD-GFAAS) for monitoring dynamic changes of extracellular magnesium (Mg) and zinc (Zn) in the cortex of gerbils subjected to focal cerebral ischemia, that had been produced in anesthetized gerbils by occlusion of the right middle cerebral artery., Methods: Two microdialysis probes were inserted into both sides of the cortex to simultaneously collect dialysates during cerebral ischemia. Dynamic changes in these analytes, on ipsilateral and contralateral sides of the brain, were assayed by MD-GFAAS. Optimal conditions and analytical precision of GFAAS were studied in the present assay., Results: The present study demonstrated significant decreases in Mg (65% of baseline) and zinc (74% of baseline) maintained their levels within 3 h on the ipsilateral side of cortex during cerebral ischemia. Slight changes of Mg and Zn on the contralateral sides were also observed., Conclusion: The derangement of extracellular Mg and Zn could be important in the progression of cell injury and may be associated with cerebral ischemia insult.

Objective: Flame atomic absorption spectrometry (FAAS) and a microdialysis analyzer were employed for dynamic monitoring of magnesium (Mg), glucose and lactate levels in blood samples of gerbils subjected to cerebral ischemia., Methods: Focal cerebral ischemia was induced by occlusion of the unilateral common carotid artery and the middle cerebral artery for 60 minutes followed by 180 minutes of reperfusion. Whole blood samples were continuously collected from the jugular vein via an auto-blood sampling system. The dynamic profiles of Mg, glucose and lactate before, during and after ischemia were determined., Results: During cerebral ischemia, blood Mg levels gradually rose to 130% of the baseline and returned to the basal levels within 30 minutes after reperfusion. Lactate concentrations decreased to approximately 50% of the basal levels during cerebral ischemia and returned to basal levels immediately after reperfusion. Glucose levels remained the same during cerebral ischemia and gradually fell to 50% of basal levels at the end of reperfusion. The linearity ranges of glucose, lactate and Mg were 0.1-25 mM, 0.02-2.5 mM and 5-1500 microg/L, respectively. The required volume of each blood sample is less than 30 microL. The intra- and inter-assay variation was less than 3%. Since blood loss is minimal from repeated blood sampling, it is suitable for small animals., Conclusions: Mg may be accumulated in blood cells, which are helpful for reducing glucose utilization. As a result, less lactate was produced during the acute phase of cerebral ischemia. Preservation of glucose is advantageous for brain cells' restoration after ischemia.

Cerebral ischemia engages multiple terminal pathways involving the loss of ionic homeostasis, and acute and delayed neuronal damage. Several studies have focused on the derangement of energy metabolism and calcium, but not on magnesium. Hypomagnesium or low dietary magnesium intake may increase the risk of stroke and other cardiovascular diseases. The neuroprotective effects of magnesium have been attributed to a variety of effects on pathophysiologic mechanisms during and after cerebral ischemia, such as antagonizing calcium-mediated metabolic processes, inhibition of the N-methyl-D-aspartate (NMDA) receptors and relaxing vascular smooth muscles. Systemically administered magnesium provides beneficial effects in both clinical patients and cerebral ischemic animal models. Magnesium, as one of the therapeutic agents in stroke treatment, has the advantages of being inexpensive, widely available, and causing few side effects. The optimal doses for the treatment of cerebral ischemia both in animal models and in humans have not been defined yet. Thus, we attempted to evaluate the effects of magnesium on experimental cerebral ischemia.

Background: A method for determining extracellular magnesium (Mg) levels in gerbil brain dialysates was developed by microdialysis and graphite furnace atomic absorption spectroscopy (GFAAS)., Methods: Two microdialysis probes were inserted into the right and left cortices of a gerbil subjected to a focal cerebral ischemia. Extracellular magnesium concentrations in diluted dialysates were 1.10 and 1.12 ppb in the ipsilateral and contralateral gerbil cortex, respectively., Results: During cerebral ischemia, these concentrations decreased significantly to approximately 60% of basal in the ipsilateral cortex, whereas no changes in the contralateral cortex were detected. Extracellular magnesium concentrations returned to baseline within 3 h of reperfusion. The linearity of magnesium concentrations ranged from 0.50 to 5.0 ppb with a detection limit of 0.03 ppb in the present assay. A complete analysis can be performed within 2 min. The intra- and interassay precision was < 5%., Conclusion: To our knowledge, the present method is the first analytical assay measuring dynamic extracellular magnesium concentrations during cerebral ischemia by microdialysis and graphite furnace atomic absorption spectroscopy.

We aimed to investigate expression of magnesium transporter genes in patients with head and neck cancer who underwent cisplatin-based neoadjuvant chemotherapy and their association with serum magnesium level. Head and neck cancer patients scheduled to undergo neoadjuvant cisplatin-based chemotherapy were eligible for enrollment. Blood samples were obtained at three time points: prior to, during, and after completion of chemotherapy. Expression levels of magnesium transporter genes were determined by quantitative real-time PCR. A total of 23 patients were included in the final analysis. The average serum magnesium levels dropped 6.98 and 5.20 % during and after completion of chemotherapy. There were neither significant associations between serum magnesium level and demographic variables nor tumor-related variables. SLC41A1 expression level was positively correlated with serum magnesium whereas TRPM6 expression level was negatively correlated with serum magnesium. Serum magnesium level decreased during cisplatin-based chemotherapy in head and neck cancer patients. Further studies are warranted to investigate optimal magnesium measurement and substitution protocol. [ABSTRACT FROM AUTHOR]

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 μM, 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. [ABSTRACT FROM AUTHOR]