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Purpose: It has been assumed that magnesium (Mg) status may interact with vitamin D status. We therefore aimed at investigating the association between Mg and vitamin D status in a large cohort of adult individuals with a high prevalence of deficient/insufficient vitamin D and Mg status., Methods: We used data from the Ludwigshafen Risk and Cardiovascular Health Study (n = 2,286) to analyze differences according to serum Mg status in circulating 25-hydroxyvitamin D [25(OH)D] (primary endpoint), 24,25-dihydroxyvitamin D 3 [24,25(OH) 2 D 3 ], vitamin D metabolite ratio and calcitriol, and odds ratios for deficient or insufficient 25(OH)D (secondary endpoints). We performed unadjusted and risk score (RS) adjusted and matched analyses., Results: Of the study cohort (average age > 60 years), one third was 25(OH)D deficient (< 12 ng/mL), one third 25(OH)D insufficient (12 to < 20 ng/mL), about 10% Mg deficient (< 0.75 mmol/L) and additional 40% potentially Mg deficient (0.75 to 0.85 mmol/L). In adjusted/matched analyses, 25(OH)D was only non-significantly lower in Mg deficient or insufficient groups versus their respective control group (P > 0.05). Only the RS-adjusted, but not the RS-matched odds ratio of 25(OH)D deficiency was significantly lower for the group with adequate versus deficient/potentially deficient Mg status (0.83; 95%CI: 0.69-0.99), and only the RS-matched, but not the RS-adjusted odds ratio of 25(OH)D insufficiency was significantly lower for non-deficient versus deficient Mg status (0.69; 95%CI: 0.48-0.99). Other adjusted or matched secondary endpoints did not differ significantly between subgroups of Mg status., Conclusions: Our data indicate only little effect between Mg and vitamin D status in adults with high prevalence of vitamin D deficiency and insufficiency., (© 2024. The Author(s).)

Magnesium (Mg) is an essential element involved in cellular metabolism. We demonstrated that in patients with diffuse large B-cell lymphoma (DLBCL) undergoing autologous stem cell transplant (SCT), those with a serum Mg < 2.0 mg/dL at the time of transplant had worse outcomes. In this study, we aimed to learn the prognostic value of low serum Mg in patients with untreated DLBCL. We analyzed serum from 408 patients and tested 2 Mg cutpoints-low (<1.7 mg/dL) and low normal (<2.0 mg/dL), a range we found associated with lower survival in the SCT group. We found 3% of patients with low levels and 23% with low normal levels. Low normal serum Mg levels were associated with a higher stage at diagnosis, more extranodal involvement, higher international prognostic index score, lower overall survival (OS), and event-free survival. These data warrant testing Mg replacement to a target of >2.0 mg/dL to learn if survival can be improved., (© The Author(s) 2024. Published by Oxford University Press.)

Serum magnesium cannot accurately assess magnesium deficiency. The association between magnesium deficiency and metabolic dysfunction-associated fatty liver disease (MAFLD) remains unclear. Selecting 3,377 participants in the United States, we assessed the degree of magnesium deficiency in the population using magnesium depletion score (MDS). Multinomial logistic regression assessed the association between magnesium deficiency and MAFLD. Subgroup analyses assessed the association between dietary magnesium intake and MAFLD under different magnesium deficiency statuses. Structural equation modeling (SEM) revealed mediation effects. Magnesium deficiency was associated with MAFLD (ORseverevs.none: 1.69, 95%CI: 1.16-2.46; p for trend < 0.001). Magnesium intake was negatively associated with MAFLD only in the subgroup without magnesium deficiency (p for trend < 0.01). Inflammation, oxidative stress, and aging significantly mediated the association between MDS and MAFLD (all p < 0.05). In American adults, magnesium deficiency assessed by MDS might be a risk factor for MAFLD, with inflammation, oxidative stress, and aging potentially being key mechanisms. Simply increasing magnesium intake would not mitigate MAFLD risk associated with magnesium deficiency. Correcting magnesium deficiency might prevent MAFLD., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Magnesium deficiency influences the activation and cytotoxicity of immune cells. Nevertheless, whether serum magnesium levels influence the clinical outcomes of immune checkpoint blockers (ICBs) treatment still remains ambiguous. There is an urgent need for clinical research to elucidate the relationship between serum magnesium levels and the outcomes of ICB therapy. Such insights could offer new perspectives on immunotherapy for cancer., Methods: A multi-center retrospective study involving in pan-cancer patients treated with ICBs at three large cancer centers from August 2012 to May 2023 was conducted. The primary objective was to assess the correlation between serum magnesium levels and therapeutic response in patients receiving ICBs, and further evaluate the associations between serum magnesium levels and progression-free survival (PFS) and overall survival (OS)., Results: A total of 1441 patients treated with ICBs, including 1042 with lung cancer, 270 with esophageal cancer, and 129 with Hodgkin lymphoma, were enrolled in this study. We found that patients with elevated serum magnesium levels exhibited a favourable response to ICBs treatment. The optimal cut-off point for serum magnesium level (0.79 mmol/L) was applied for stratifying patients into distinct groups. In the three tumor cohorts, patients in high magnesium level group (Mg 2+ ≥ 0.79 mmol/L) had longer PFS and OS than those in low magnesium level group (Mg 2+ < 0.79 mmol/L). Univariate and multivariate analyses confirmed that the serum Mg 2+ level serves as an independent prognostic factor for cancer patients receiving ICBs therapy., Conclusion: Our multi-center study demonstrated that among patients receiving ICBs therapy, those with elevated serum magnesium levels exhibit significantly better clinical outcomes than those with low serum magnesium levels. Further prospective validation studies are needed to confirm these findings., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: To determine the association between blood metal mixture and HUA risk., Methods: A cross-sectional study was performed based on the populations from Kailuan cohort trial in China. Inductively coupled plasma mass spectrometry was utilized to detect the blood concentrations of iron (Fe), lead (Pb), calcium (Ca), copper (Cu), magnesium (Mg), zinc (Zn), selenium (Se), and manganese (Mn). Multivariate logistic regression (MLR) models and weighted quantile sum (WQS) regression models were employed to assess the relationships., Results: There were 3706 participants included in this study, and 464 (12.52%) were with HUA. The mean level of uric acid was 485.60 μmol/L in the subjects with HUA, which was remarkably increased compared to those without HUA (293.10 μmol/L). The multivariate-adjusted odds ratios (95% confidence intervals) of HUA were 2.15 (1.40, 3.29) for Pb, 3.42 (2.24, 5.23) for Fe, 1.61 (1.15, 2.25) for Ca, 3.06 (2.04, 4.59) for Mg, and 1.69 (1.26, 2.28) for Zn by comparing the highest and lowest metal quartiles using the single-metal logistic regression model. Meanwhile, the WQS regression models demonstrated a positive association between metal mixtures and HUA risk, to which, Fe, Mg, Pb, and Zn were the major contributors. Pb, Fe, and Zn were still robust in multiple-metal models. Age, gender, weight, smoking, and drinking status could modify these relationships with significant interactions., Conclusions: Co-exposure to Fe, Pb, Ca, Cu, Zn, Mg, Se, and Mn were related to increased HUA risk in Chinese adults, of with, Pb, Fe, and Zn appeared to have greater impacts. These relationships were more obvious in adults aged < 60 years, or women, or overweight, or non-smoking, or drinking with significant interactions. Key Points • Increased Fe, Pb, Mg, Ca, and Zn were related to increased HUA risk in dose-response fashion among Chinese adults. • The metal mixture dominated by Fe, Mg, Pb, and Zn was positively associated with HUA risk. Fe, Pb, and Zn were still robust in MM model. • Such association was stronger showed in adults aged < 60 years, or women, or overweight, or non-smoking, or drinking with significant interactions., Competing Interests: Declarations. Ethical approval and consent to participate: This study was approved by the Ethics Committee of the Kailuan Medical Group and the Chinese Academy of Medical Sciences (Approval No. 2018ZX10715005). All participants were signed informed consent. Consent for publication: All the authors have read and approved the final manuscript. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Background: The magnesium depletion score (MDS) is a scoring system developed to predict magnesium deficiency based on pathophysiological factors that affect renal reabsorption. The relationship between systemic magnesium status and arthritis is unclear. The purpose of this study was to determine the association between the MDS and rheumatoid arthritis (RA) as well as osteoarthritis (OA)., Methods: This study was conducted through a cross-sectional survey of 20,513 adults aged ≥ 20 years who participated in NHANES from 2007 to 2018. The four dimensions of the MDS included diuretics, proton pump inhibitors, glomerular filtration rate, and excessive alcohol consumption. Univariate and multivariable-weighted logistic regression were used to assess the associations between MDS and RA/OA, and a test for trend was performed to analyze the presence of a dose-response relationship. Subgroup analyses and interaction tests were performed according to confounders., Results: After adjustment for all covariates, we found a graded dose-response relationship between MDS and RA or OA. When MDS was considered as a continuous variable, each onefold increase in MDS was associated with a 1.21-fold increase in the odds of having RA (OR = 1.21, 1.10, 1.33) and a 1.12-fold increase in the odds of having OA (OR = 1.12, 1.04, 1.21). There was an interaction of sex in the effect of MDS on RA (P interaction  = 0.004) and age in the effect of MDS on OA (P interaction  = 0.006). In addition, these associations were further confirmed in sensitivity and subgroup analyses., Conclusions: Our study identified significant dose-response associations between MDS and both RA and OA. More biological mechanisms are needed in the future to validate and clarify the results of this study., Competing Interests: Compliance with ethical standards. Disclosures: None., (© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Background: Magnesium is closely associated with depression. The study aims to explore the relationship between magnesium depletion score (MDS), used to evaluate the body's magnesium deficiency status, and depression., Methods: This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey in 2005-2018 and included adults aged 20 to 60 years. Depression was determined using the Patient Health Questionnaire-9 (PHQ-9). MDS was a practical assessment instrument used to assess the status of magnesium deficiency. Multivariable logistic and restricted cubic spline models were used to assess the associations between MDS and depression., Results: Among the 18247 adults, 1753 participants were diagnosed with depression. Multivariable logistic regression analysis indicated that when MDS was treated as a continuous variable, each one-unit increase in MDS was associated with an odds ratio (OR) for depression of 1.15 (1.04, 1.26). When MDS was considered a categorical variable, compared to participants with MDS of 0, the ORs for depression for those with MDS of 1, 2, and ≥3 were 1.03 (0.87, 1.21), 1.41 (1.12, 1.78), and 1.58 (1.06, 2.35), respectively. Restricted cubic spline analysis showed that there was no non-linear relationship between MDS and the prevalence of depression. Subgroup analyses indicated the positive associations between MDS and depression were generally similar in different populations., Conclusions: MDS may be positively associated with the prevalence of depression. In the future, additional longitudinal studies are needed to validate our findings and investigate potential mechanisms., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Introduction: Recent data show that magnesium supplementation decreases systolic and diastolic blood pressure values depending on the blood pressure levels and improves metabolic parameters in cardiovascular disease., Materials and Methods: In this context, we conducted a prospective, randomized, double-blind study on serum and ionized magnesium, systolic and diastolic blood pressure values, interleukin-6, vitamin D, and metabolic profile in 27 patients (13 male/14 female, age: 60.2 ± 12.5 years) with metabolic syndrome. All patients received 400 mg of oral magnesium supplementation daily. Parameters were measured before and after 6 and 12 weeks of treatment. 27 patients served as controls without additional magnesium treatment (10 male/17 female, age: 64.6 ± 13.2 years)., Results: There was no significant change in serum magnesium after 6 and 12 weeks of magnesium supplementation and in controls. Ionized magnesium significantly increased from 0.56 ± 0.05 to up to 0.63 ± 0.08 mmol/L (mean ± SD) (p < 0.01). The ionized Ca ++ /Mg ++ ratio was significantly increased at baseline in about 32% of all patients; after 12 weeks of magnesium supplementation, the Ca ++ /Mg ++ ratio decreased significantly from 2.32 ± 0.22 to 2.04 ± 0.24 at the end of the study (mean ± SD, p < 0.05). In the magnesium-treated group, there was a significant decrease in systolic and diastolic blood pressure values after 12 weeks (systolic: 134.6 ± 6.8 to 126.3 ± 5.6 mmHg, diastolic: 84.1 ± 3.9 to 79.4 ± 1.6 mmHg) (mean ± SD) (p < 0.01). Additional magnesium supplementation decreased interleukin-6 values significantly from 4.94 ± 3.30 to 4.53 ± 6.89 pg/mL after 6 weeks to 3.01 ± 1.32 pg/mL after 12 weeks (mean ± SD) (p < 0.01). In the control group, interleukin-6 was 3.73 ± 4.36 pg/mL before the start of the supplementation, 4.87 ± 4.35 pg/mL after 6 weeks, and 4.41 ± 3.15 pg/mL after 12 weeks (means ± SD) (n.s.). In patients receiving magnesium supplementation, vitamin D levels significantly improved from 17.93 ± 8.96 to 24.41 ± 10.20 ng/mL (mean ± SD) (p < 0.05). HbA1c and serum cholesterol values improved under magnesium therapy, but the improvement did not reach significance. For statistical analysis, Mann-Whitney-U-Test was used., Conclusion: Using supplementation with 400 mg magnesium for 12 weeks in patients with metabolic syndrome, ionized magnesium concentrations significantly increased, while serum magnesium did not change significantly. Both systolic and diastolic blood pressure values decreased significantly in the magnesium-treated group. Magnesium supplementation also significantly decreased interleukin-6 levels and increased vitamin D in patients. HbA1c and cholesterol levels improved with magnesium supplementation, but the improvement did not reach significance. The anti-inflammatory effects of magnesium as well as anti-arteriosclerotic effects of magnesium therapy are beneficial for patients with metabolic syndrome at high risk of cardiovascular disease and mortality.

Objectives: The objective of this study was to determine the in vivo correlation of ionized magnesium (iMg) with ionized calcium (iCa), total calcium, albumin and pH. In addition, the analytical interference of iCa on iMg measurement on the Stat Profile Prime Plus (Nova Biomedical) and vice versa was defined., Methods: In vivo correlation of iCa, iMg and pH was studied in 238 paired blood gas samples of 109 different patients admitted to the intensive care unit. Albumin and total magnesium (tMg) were measured in heparinized plasma samples. Measurement of iMg was performed with the ion selective magnesium electrode (ISE) of the Stat Profile Prime Plus (Nova Biomedical) and iCa and pH were measured with a Rapid Point 500 blood gas analyzer (Siemens). Albumin, total calcium and total magnesium were analyzed with a Siemens Atellica CH. Analytical interference of iCa with iMg and vice versa was investigated using unbuffered saline solutions., Results: In the studied patient population, no significant correlations were observed between iMg and iCa, albumin, and pH. An inverse relationship was observed between iCa and Mg-ISE. For every 0.1 mmol/L change in iCa concentration, the iMg concentration deviated by 0.01 mmol/L at an iMg concentration of 0.5 mmol/L and by 0.013 mmol/L at an iMg concentration of 1.0 mmol/L. The measurement of iCa was not affected by iMg., Conclusions: In vivo, no correlation was observed between iMg with iCa, albumin and pH. Interference of iCa on iMg measurement was noted, with a maximum deviation of ±0.02 mmol/L iMg across the reference range of iCa (1.15-1.32 mmol/L). Additionally, the iCa measurement was not affected by the iMg concentration., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: Previous cross-sectional studies have shown that higher magnesium intake is associated with better cognitive function, particularly in individuals with sufficient vitamin D status. The aim of this study was to evaluate the longitudinal associations between magnesium intake and cognitive impairment in a community-based cohort study in Taiwan., Methods: The study population included 5663 community-dwelling adults aged ≥ 55 years old recruited from 2009 to 2013 and followed up from 2013 to 2020. Magnesium intake was evaluated from a validated food frequency questionnaire at baseline. Cognitive performance was measured at baseline and follow-up for participants' Mini-Mental Status Examination (MMSE), Digit Symbol Substitution Test (DSST), and Clock-Drawing Test (CDT), and impairment was defined as MMSE < 24, DSST < 21, and CDT < 3, respectively. Multivariate logistic regression models were used to examine the associations and were stratified by sex and plasma vitamin D levels (≥ 50 or < 50 nmol/L)., Results: Higher baseline magnesium intake was associated with lower odds of a poor performance on the MMSE in both men and women (4th vs. 1st. quartile: OR = 0.43, 95% CI = 0.23-0.82, p trend  < 0.01 in men and OR = 0.53, 95% CI = 0.29-0.97, p trend  = 0.12 in women) and on the DSST in men (OR = 0.23, 95% CI = 0.09-0.61, p trend  < 0.01) at follow-up. Inverse associations between baseline magnesium intake and a poor performance on the MMSE or DSST were observed in men regardless of vitamin D status., Conclusion: Our study suggested that higher magnesium intake was associated with the development of cognitive impairment in men in a median follow-up period of 6 years., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

Some studies have indicated an association between serum magnesium and anemia, but these are primarily limited to research on serum magnesium. Few studies have explored the relationship between the bioavailability of magnesium and anemia. This study explores the association between the Magnesium Deficiency Score (MDS) and anemia among elderly Americans using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018. Anemia was defined based on World Health Organization criteria, and MDS was calculated considering factors such as the use of diuretics, proton-pump inhibitors, alcohol consumption, and renal function status. A total of 3383 individuals were included in our study. Results showed a positive correlation between MDS and anemia, with higher MDS levels associated with increased anemia prevalence. Subgroup analyses revealed that this association was consistent across different genders, poverty income ratio, and smoking populations, with a notably strong correlation in the non-Hispanic White group. The study suggests that improving the bioavailability of magnesium to reduce MDS may be a factor in preventing anemia in the elderly. This is the first study to explore the relationship between MDS and anemia in this population, highlighting the potential role of magnesium bioavailability in anemia prevention. Further prospective studies are needed to confirm these results and explore the underlying mechanisms., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Studies have shown that deficiencies in magnesium, selenium, and zinc in individuals with obesity compromise the endogenous antioxidant defense system. This study aimed to evaluate the impact of mineral deficiency on enzymatic antioxidant defense in women with obesity. The study involved 63 women with obesity (BMI ≥ 35 kg/m 2 ) and 77 eutrophic women (BMI between 18.5 and 24.9 kg/m 2 ). Variables such as fasting glucose, glycated hemoglobin, fasting insulin, and serum lipids were analyzed. Insulin resistance was measured using the homeostasis assessment model (HOMA-IR) and beta cell function using the homeostasis assessment model (HOMA-β). Dietary intake of energy, macronutrients (including magnesium, zinc, and selenium), and plasma, erythrocyte, and urinary concentrations of these minerals were measured and analyzed. Serum cortisol, plasma leptin, plasma thiobarbituric acid reactive substances, and the activity of erythrocyte superoxide dismutase (SOD), erythrocyte glutathione peroxidase (GPX), and erythrocyte catalase were also analyzed. Women with obesity had reduced plasma and erythrocyte concentrations and greater urinary excretion of all minerals compared to normal weight women (p < 0.05). There was a positive association between erythrocyte concentrations of zinc and selenium and the activity of the GPX and SOD enzymes in erythrocytes in women with obesity (p < 0.05), in addition to a positive association between serum insulin and the enzyme GPX, which is dependent on dietary selenium (p < 0.05). Individuals with obesity are deficient in magnesium, selenium, and zinc, which appears to impair the antioxidant defense system and contribute to important metabolic disorders such as oxidative stress in these patients., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests. Ethical approval: The study was registered on Plataforma Brasil and approved by the Research Ethics Committee of the Federal University of Piauí, as provided for by Resolution 466/12 of the National Health Council (CNS) under Certificate of Presentation for Ethical Appreciation (CAAE) n° 3,774 0.163. All participants signed the Free and Informed Consent Form. Consent to participate: Informed consent was obtained from all participating individuals included in the study. Consent for publication: Patients signed informed consent regarding publishing their data., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Colistin is an effective antibiotic utilized for the treatment of Gram-negative bacterial infections with coverage against a broad spectrum of bacteria. Despite the broad antibacterial coverage, this antibiotic can have serious complications such as acute kidney injury. Colistin also can have a toxic effect on the loop of Henle, causing tubulopathy, electrolyte imbalances, and the occurrence of Bartter-like syndrome (BLS) which is characterized by magnesium and calcium disturbances, polyuria, and metabolic alkalosis. We here report a 32-year-old male with a history of multiple trauma due to an accident that received colistin therapy for Pseudomonas isolation from wound culture on the 5th day of hospitalization. Polyuria, hypokalemic metabolic alkalosis, hypomagnesemia, and hypocalcemia were developed on the first week of colistin administration. The patient received colistin until the 21st day of hospitalization. Serum calcium and magnesium levels became normal 1 day after stopping colistin, while urine volume and metabolic alkalosis resolved 6 days after colistin discontinuing. Therefore, it is crucial to adjust the dose of colistin to minimize its toxicity., Competing Interests: Declarations. Conflict of interest: None to declare. Ethics approval and consent to participate: Informed consent was obtained from the patient. This study is approved by the ethics committee of Abadan University of Medical Sciences (IR.ABADANUMS.REC.1402.090). Human and animal rights: There is no studies with human or animals performed by the authors., (© 2024. The Author(s), under exclusive licence to Japanese Society of Nephrology.)

Magnesium and calcium are elements that have been associated with cardiometabolic risk factors related to metabolic syndrome (MetS). However, there are gaps in the knowledge regarding the impact of the calcium to magnesium (Ca/Mg) ratio in plasma. Thus, we aim to evaluate the associations between magnesium and calcium levels in plasma, and the Ca/Mg ratio in plasma with MetS components and other cardiometabolic risk factors. This cross-sectional study was carried out with 112 adults and older people, distributed into groups with (n = 60) and without MetS (n = 52). We evaluated sociodemographic, anthropometric, and biochemical data. Magnesium and calcium levels in plasma were measured by inductively coupled plasma mass spectrometry technique (ICP-MS). There was a high frequency of MetS, with no significant differences in magnesium and calcium levels and Ca/Mg ratio in plasma observed between groups. There were no associations between magnesium and MetS components or other cardiometabolic risk factors (all p > 0.05). Calcium levels were associated with total cholesterol (β =  - 0.020; p = 0.000) and high-density lipoprotein cholesterol (HDL-c) (β =  - 0.046; p = 0.005). The total cholesterol (β =  - 0.025; p = 0.000) and low-density lipoprotein cholesterol (LDL-c) (β = 0.017; p = 0.020) were preditors of the Ca/Mg ratio. These results indicate important associations of calcium and the Ca/Mg ratio in plasma with cardiometabolic risk factors related to MetS., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This study investigated the effects of quercetin on the alterations of serum elements in perimenopausal depression rat model induced by ovariectomy combined with chronic unpredictable mild stress (OVX-CUMS) and possible mechanisms. According to the results of the sucrose preference test, the rats were randomly assigned to four groups: sham, OVX-CUMS, OVX-CUMS + 17β-estradiol (17β-estradiol: 0.27 mg/kg.bw), and OVX-CUMS + Quercetin (Quercetin: 50 mg/kg.bw). At the end of experiment, serum and prefrontal cortex of rats were collected. The inductively coupled plasma mass spectrometry (ICP-MS) analysis showed that levels of calcium (Ca), magnesium (Mg), selenium (Se), cobalt (Co) and zinc (Zn) decreased, and levels of iron (Fe) and copper (Cu) increased in serum and prefrontal cortex of OVX-CUMS rats compared with sham group (p < 0.01). Meanwhile, the levels of the above elements in prefrontal cortex had correlation with behavioral characteristics in OVX-CUMS rats (p < 0.05 or p < 0.01). The abnormal elements in serum may cross blood-brain-barrier into the brain and induce oxidative stress, leading to ferroptosis. Furtherly, the expressions of ferroptosis-related protein including GPX4 and SLC7A11 were decreased in prefrontal cortex of OVX-CUMS rats (p < 0.01), which confirmed the above results. Quercetin treatment restored the above abnormal indicators (p < 0.05 or p < 0.01) induced by OVX-CUMS in rats. Our study suggested that quercetin regulated variation of elements in serum and prefrontal cortex, further inhibiting ferroptosis in prefrontal cortex through alleviating oxidative stress in OVX-CUMS rats., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Inorganic sources of Mg are commonly used in dairy cow diets, but their availability varies significantly. This study assessed the relative availability of 4 commonly used inorganic Mg sources and a novel alkalinizing proprietary mineral blend (PMB; Multesium; GLC Minerals LLC, Green Bay, WI). The study was a duplicated 6 × 6 Latin square, with 12 nonlactating, nonpregnant Holstein dairy cows assigned to a square based on BW and parity. Cows were fed 90% of their voluntary DMI (diet contained 0.21% Mg). Each experimental period lasted 7 d. On d 2 of each period, urinary catheters were fitted. Total urine collection started on d 3 for 48 h with samples collected and measured every 12 h. On d 4, 30 g of Mg were administered as boluses with gelatin capsules: negative control (one empty capsule), magnesium oxide (MgO), magnesium sulfate (MgSO 4 ), calcium magnesium hydroxide [CaMg(OH) 4 ], calcium magnesium carbonate [CaMg(CO 3 ) 2 ], and PMB [a blend of Ca and Mg sources that includes CaMg(CO 3 ) 2 , CaMg(OH) 4 , and MgO]. Blood samples were collected at 0, 1, 2, 3, 12, and 24 h after treatment administration on d 4 of each treatment period. Urine and blood samples were analyzed for Mg and Ca concentration. Statistical analyses were conducted with PROC GLIMMIX including treatment, time, period, square, treatment × time, treatment × period, and time × period as fixed effects, and cow nested within square as a random effect in the model. Urinary Mg excretion for 4 of the Mg sources studied [PMB, MgO, CaMg(OH) 4 , and MgSO 4 ] increased significantly, representing an increase of at least 40.8% relative to control. The supplementation of CaMg(CO 3 ) 2 did not significantly increase relative to control. There were no significant changes in blood Mg concentration with treatment, but a significant treatment × time effect was observed. Calcium-rich sources [PMB, CaMg(OH) 4 , CaMg(CO 3 ) 2 ] had lower blood Mg concentrations at 12 or 24 h after treatment than control and CaMg(CO 3 ) 2 . Based on urinary Mg excretion 24 h after treatment, 4 of the Mg sources evaluated (including PMB) showed a similar availability, however, the availability of the commercial CaMg(CO 3 ) 2 source included in our study was similar to the negative control (nonsupplemented cows)., (© 2024, The Authors. Published by Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Background: Post-transplantation diabetes mellitus (PTDM) is common after solid organ transplantation. In the past decade, there has been increasing interest in the association between hypomagnesaemia and the development of PTDM. This systematic review aimed to investigate the current knowledge regarding the association between hypomagnesaemia and PTDM in adult liver and renal transplant recipients., Methods: A literature search of five databases, Medline, Embase, ProQuest, Scopus and Google Scholar, as well as article reference lists, was performed. Eligible studies that focused on adult liver and renal transplant recipients without pretransplantation hyperglycaemia or diabetes were included. Other eligibility criteria included quantitative studies which reported magnesium concentrations, studies with at least 6 months of follow-up, and studies published in English. The Newcastle-Ottawa Assessment Tool was used for the quality assessment., Results: In total, 12 studies were included in the final analysis. Eleven focused on renal transplantation and one on liver transplantation. All studies were medium to high quality with eight out of 12 achieving the highest rating of nine. Eight studies found a negative association between either pretransplant or early post-transplant serum magnesium concentration and the risk of PTDM, three studies found no association between these two variables, and one study found a positive association between the magnesium concentration at 8 weeks after transplantation and glycosylated haemoglobin A1C., Conclusions: Further large-scale prospective studies with at least 6 months of follow-up are needed to confirm these findings, particularly in liver transplantation, to further clarify and explore the relationship between hypomagnesaemia and PTDM., (© 2024 British Dietetic Association.)

Serum magnesium levels exceeding 0.9 mmol/L are associated with increased survival rates in patients with CKD. This retrospective study aimed to identify risk factors for cardio-cerebrovascular events among patients receiving continuous ambulatory peritoneal dialysis (CAPD) and to examine their correlations with serum magnesium levels. Sociodemographic data, clinical physiological and biochemical indexes, and cardio-cerebrovascular event data were collected from 189 patients undergoing CAPD. Risk factors associated with cardio-cerebrovascular events were identified by univariate binary logistic regression analysis. Correlations between the risk factors and serum magnesium levels were determined by correlation analysis. Univariate regression analysis identified age, C-reactive protein (CRP), red cell volume distribution width standard deviation, red cell volume distribution width corpuscular volume, serum albumin, serum potassium, serum sodium, serum chlorine, serum magnesium, and serum uric acid as risk factors for cardio-cerebrovascular events. Among them, serum magnesium ≤0.8 mmol/L had the highest odds ratio (3.996). Multivariate regression analysis revealed that serum magnesium was an independent risk factor, while serum UA (<440 μmol/L) was an independent protective factor for cardio-cerebrovascular events. The incidence of cardio-cerebrovascular events differed significantly among patients with different grades of serum magnesium ( χ 2  = 12.023, p  = 0.002), with the highest incidence observed in patients with a serum magnesium concentration <0.8 mmol/L. High serum magnesium levels were correlated with high levels of serum albumin ( r  = 0.399, p  < 0.001), serum potassium ( r  = 0.423, p  < 0.001), and serum uric acid ( r  = 0.411, p  < 0.001), and low levels of CRP (r = -0.279, p <  0.001). In conclusion, low serum magnesium may predict cardio-cerebrovascular events in patients receiving CAPD.

Background: In various disease contexts, magnesium abnormalities are associated with acute kidney injury (AKI) incidence. However, this association remains unclear and has not been systematically investigated in patients with cirrhosis. Hence, we aimed to elucidate the association between admission serum magnesium levels and AKI incidence in intensive care unit (ICU)-admitted cirrhotic patients., Methods: A retrospective cohort study was conducted using MIMIC-IV2.2 data, focusing on critically ill patients with cirrhosis. We employed univariable and multivariable logistic regression and restricted cubic spline analyses to robustly address our research objectives. To further substantiate the findings, subgroup and sensitivity analyses were also conducted., Results: Among the 3,228 enrolled ICU-admitted cirrhotic patients, 34.4% were female, and the overall AKI incidence was 68.6% (2,213/3,228). Multivariable logistic regression analysis revealed an independent relationship between elevated serum magnesium levels and increased AKI risk (OR = 1.55 [95% CI = 1.15-2.09], p  = 0.004). Compared with individuals with serum magnesium levels < 1.6 mg/dL, individuals with serum magnesium levels in Q2 (1.6-2.6 mg/dL) and Q3 (≥2.6 mg/dL) had adjusted ORs for AKI of 1.89 (95% CI = 1.34-2.65, p  < 0.001) and 2.19 (95% CI = 1.27-3.75, p  = 0.005), respectively. The restricted cubic spline analysis revealed that AKI risk increased linearly with increasing serum magnesium levels. Subgroup analysis revealed that the association between serum magnesium levels and AKI incidence was remarkably stable in subgroup analysis (all P interaction >0.05)., Conclusions: High serum magnesium concentrations were significantly associated with an increased AKI risk in ICU-admitted patients with cirrhosis. Further randomized trials are needed to confirm this association.

Magnesium (Mg), iron (Fe), copper (Cu), and zinc (Zn) are indispensable elements in children's growth and development. However, epidemiological evidence regarding essential elements and their mixed exposure to behavior problems remains in its infancy. The objective of the present study was to evaluate the association between essential elements and the manifestation of behavior problems, with an additional focus on the implications of their mixture. An electronic medical records review was performed among 4122 subjects aged 6-18 years who underwent examinations at Children's Hospital, Zhejiang University School of Medicine, between January 2019 and July 2022. The concentrations of essential elements were measured by atomic absorption spectrometry, and behavior problems were assessed by using the Conners' Parent Rating Scale (CPRS). A total of 895 (21.7%) children and adolescents were identified as having behavior problems. For single exposure, inversely linear dose-response relationships were identified between continuous Mg and Zn levels and the prevalence of behavior problems, and the prevalence ratios (PRs) in the categorical lowest tertile were 1.28 (95% confidence interval, CI: 1.07-1.54) for Mg and 1.31 (95% CI: 1.05-1.63) for Zn compared to the highest tertile. For mixture exposure, an inverse association between essential elements and behavior problems was also found, mainly contributed by Mg (posterior inclusion probability, PIP = 0.854). Whole blood levels of Mg and Zn were significantly inversely associated with behavior problems. The findings highlight the pivotal role of essential elements in behavior problems and emphasize the importance of maintaining adequate levels of essential elements during children's maturation., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Trace elements, specifically magnesium (Mg), zinc (Zn), and selenium (Se) have been linked with immunomodulatory properties. This research delves into identifying the potential impression of serum levels Mg, Zn, and Se on the protective immunity arisen through Sinopharm COVID-19 vaccine in the vaccinated subjects. Levels of Mg, Zn, and Se, cytokine and antibody production as well as virus neutralization potency were investigated in 75 males and 75 females before and 2 weeks after first and second dose of vaccination. Level of Mg, Zn, and Se did not change significantly before and 2 weeks after first and second dose of vaccine administration. Concentrations of Interleukin (IL)-2, IL-6, and Interferon (IFN)-γ were significantly higher in the supernatant of peripheral blood mononuclear cells (PBMCs) obtained from subjects 2 weeks after both first and second dose of vaccination compared to before vaccination. Serum level IgG was significantly higher 2 weeks after first and second dose of vaccination compared to before vaccination. Serum level IgM was only higher after first dose of vaccination compared with before vaccine. Also, 2 weeks after both first and second dose of vaccination compared to before vaccination, FRNT 50 titer was significantly higher. Levels of Mg, Zn, and Se did not significantly correlate with levels of IL-2, IL-6, IFN-γ, IgM and IgG, and FRNT 50 after first and second dose of vaccination. No severe unwanted clinical symptoms were detected after vaccination. Mg, Zn, and Se do not play a role in modulating protective immunity during Sinopharm COVID-19 vaccine., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: The study protocol was approved from the local Ethical Review committee located in Rafsanjan University of Medical Sciences (Permission No. IR.RUMS.REC.1400.165) and written informed consent form was taken by all subjects. All methods were carried out in accordance with relevant guidelines and regulations provided by Rafsanjan University of Medical Sciences. Research carried out here were in compliance with the Helsinki Declaration. The protocol of this study was approved by the Human Research Ethics Committee from the Rafsanjan University of Medical Sciences, Rafsanjna, Iran (Permission No. IR.RUMS.REC.1400.165). Written informed consent forms were obtained from all subjects before blood taking., (© 2024. The Author(s).)

Background: Chronic prostatitis (CP) is one of the general diseases in urological practice, with category III prostatitis being particularly prevalent. The trace metal abnormalities might be a primary cause of prostatitis, however, their specific roles in category III prostatitis remain largely unexplored., Method: In total, 42 expressed prostatic secretion (EPS) samples from IIIa prostatitis patients, 42 from IIIb prostatitis patients, and 45 from controls were collected, along with 42 serum samples from IIIa prostatitis patients, 45 from IIIb prostatitis patients, and 50 from controls for analysis in this study. To investigate the diagnostic potential of trace metals in category III prostatitis, we analyzed the concentration of zinc (Zn), copper (Cu), calcium (Ca) and magnesium (Mg) in EPS and serum of patients with category III prostatitis and healthy controls using a flame atomic absorption spectrometer (FAAS)., Results: The Results showed that the concentrations of Zn, Ca and Mg in both serum and EPS samples of all subjects with category III prostatitis were significantly different compared to controls (all P < 0.05), while Cu levels were significantly altered in all EPS samples (P < 0.000). In the category of IIIa prostatitis group, the levels of Zn, Ca, Mg in EPS, as well as Ca in serum were significantly reduced (all P < 0.000), whereas the serum Zn level was markedly elevated (P < 0.000). In the category IIIb prostatitis group, the EPS levels of Zn, Ca, Mg were decreased significantly (all P < 0.05), and the levels of serum Ca, Mg were markedly decreased (all P < 0.000), however, the EPS Cu level increased significantly (P < 0.05). Moreover, receiver operating characteristic (ROC) analysis showed that the levels of Mg and Zn/Mg in EPS had better diagnostic value for category IIIa prostatitis (Area Under the ROC Curve(AUC) = 0.796, 0.791, respectively, all P < 0.0001); while Cu and Cu/Ca levels exhibited better diagnostic value for category IIIb prostatitis (AUC = 0.880, 0.901, respectively, all P < 0.0001)., Conclusion: Summarily, there are significant abnormalities in the concentrations of Cu, Mg, Ca, and Zn in EPS and serum samples of patients with category III prostatitis. The levels of Mg, Cu, Zn/Mg, Cu/Ca in EPS may serve as potential diagnostic markers for category III prostatitis., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the the Guilin Medical University Ethics and Anthropology Committee (Number: GLMC202001011), and written informed consent was obtained from the patient. Consent for publication: Not applicable. Clinical trial number: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Context: Low magnesium levels, which are common in people with type 2 diabetes, are associated with increased levels of proinflammatory molecules. It is unknown whether magnesium supplementation decreases this low-grade inflammation in people with type 2 diabetes., Objective: We performed multidimensional immunophenotyping to better understand the effect of magnesium supplementation on the immune system of people with type 2 diabetes and low magnesium levels., Methods: Using a randomized, double-blind, placebo-controlled, 2-period, crossover study, we compared the effect of magnesium supplementation (15 mmol/day) with placebo on the immunophenotype, including whole blood immune cell counts, T-cell and CD14+ monocyte function after ex vivo stimulation, and the circulating inflammatory proteome., Results: We included 12 adults with insulin-treated type 2 diabetes (7 males, mean ± SD age 67 ± 7 years, body mass index 31 ± 5 kg/m2, HbA1c 7.5 ± 0.9%) and low magnesium levels (0.73 ± 0.05 mmol/L). Magnesium treatment significantly increased serum magnesium and urinary magnesium excretion compared with placebo. Interferon-γ production from phorbol myristate acetate/ionomycin stimulated CD8+ T-cells and T-helper 1 cells, as well as interleukin (IL) 4/IL5/IL13 production from T-helper 2 cells was lower after treatment with magnesium compared with placebo. Magnesium supplementation did not affect immune cell numbers, ex vivo monocyte function, and circulating inflammatory proteins, although we found a tendency for lower high sensitivity C-reactive protein levels after magnesium supplementation compared with placebo., Conclusion: In conclusion, magnesium supplementation modulates the function of CD4+ and CD8+ T-cells in people with type 2 diabetes and low serum magnesium levels., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)

Context: The association between magnesium status and metabolic syndrome (MetS) remains unclear., Objective: This study aimed to examine the relationship between kidney reabsorption-related magnesium depletion score (MDS) and MetS among US adults., Methods: We analyzed data from 15 565 adults participating in the National Health and Nutrition Examination Survey (NHANES) 2003 to 2018. MetS was defined according to the National Cholesterol Education Program's Adult Treatment Panel III report. The MDS is a scoring system developed to predict the status of magnesium deficiency that fully considers the pathophysiological factors influencing the kidneys' reabsorption capability. Weighted univariate and multivariable logistic regression were used to assess the association between MDS and MetS. Restricted cubic spline (RCS) analysis was conducted to characterize dose-response relationships. Stratified analyses by sociodemographic and lifestyle factors were also performed., Results: In both univariate and multivariable analyses, higher MDS was significantly associated with increased odds of MetS. Each unit increase in MDS was associated with approximately a 30% higher risk for MetS, even after adjusting for confounding factors (odds ratio 1.31; 95% CI, 1.17-1.45). RCS graphs depicted a linear dose-response relationship across the MDS range. This positive correlation remained consistent across various population subgroups and exhibited no significant interaction by age, sex, race, adiposity, smoking status, or alcohol consumption., Conclusion: Higher urinary magnesium loss as quantified by MDS may be an independent linear risk factor for MetS in US adults, irrespective of sociodemographic and behavioral factors. Optimizing magnesium nutritional status could potentially confer benefits to patients with MetS., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)

Purpose: The relationship between dysmagnesemia and all-cause mortality probability in individuals with acute kidney injury (AKI) have not been investigated. In this study, we evaluated the correlation of varying magnesium levels with mortality in older adults undergoing AKI., Patients and Methods: Older adults receiving treatment at the Chinese PLA General Hospital between 2007 and 2018 were retrospectively recruited. All-cause mortality was evaluated at four preset magnesium concentrations: <0.8, 0.8-0.9, 0.9-1.0, and ≥ 1.0 mmol/L. Using multivariable-adjusted Cox assessment, the all-cause mortality risk was approximated by setting the reference magnesium concentration at 0.8-0.9 mmol/L., Results: Totally 744 participants were enrolled, whose median age was 88 years, with most of them being male (94.2%). Among them, 184 patients were assigned into the < 0.8 mmol/L group, 156 into the 0.8-0.9 mmol/L group, 206 into the 0.9-1.0 mmol/L group, and 198 into the ≥ 1.0 mmol/L group. After 28 days, the mortality rates in the four strata were 26.6, 17.9, 17.5, and 37.4%, respectively. The corresponding mortalities after 90 days were 42.4, 23.7, 26.7, and 45.5%, respectively. Compared with patients who had magnesium levels of 0.8-0.9 mmol/L, those with magnesium levels < 0.8 mmol/L (P = 0.048), and ≥ 1.0 mmol/L (P < 0.001) exhibited higher 28-day mortalities. Significant correlations also showed that patients with magnesium levels < 0.8 mmol/L (P = 0.017) and ≥ 1.0 mmol/L (P < 0.001) were significantly related to the increased 90-day mortality., Conclusion: Magnesium levels outside the interval of 0.8-1.0 mmol/L were related to the higher risks of 28- and 90-day mortalities among older adults with AKI., Competing Interests: Declarations Ethical approval This study has been approved by the Ethics Committee of the Chinese PLA General Hospital (No.: S2023–725–01). Consent for publication The manuscript has been read and its submission approved by all coauthors. Informed consent The requirement for written informed consent was waived by the ethics committee of the designated hospital because this was an observational retrospective study. Human and animal rights All the procedures in the study were in accordance with the ethical standards of the Chinese PLA General Hospital Ethical Committee and with the 1964 Helsinki Declaration (with amendments). Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Nutritional metals (NM) are essential for neurodevelopment and cognitive performance during growth. Nevertheless, epidemiological evidence regarding the associations between NM and brain function remains understudied, particularly among adolescents. Therefore, the objective of this pilot study was to examine the effects of NM biomarkers such as iron (Fe), selenium (Se), zinc (Zn), magnesium (Mg), and copper (Cu) on neurobehavioral functions among a group of rural Bangladeshi adolescents. Methodology: We conducted a cross-sectional study involving 105 adolescents aged 13-17 from Araihazar, Bangladesh. Cognitive function was assessed using the computer-based Behavioral Assessment and Research System (BARS), focusing attention, memory, and executive function, and blood NM levels (Fe, Se, Zn, Mg, and Cu) were measured. Associations between individual minerals, NM composite scores, and cognition were analyzed using multiple linear regressions. Results: This study included 47 boys and 58 girls with an average age of 15 years. Fe levels were correlated with Continuous Performance Test (CPT) latency (r = -0.42, p < 0.05) and Se levels correlated with Match-to-Sample (MTS) correct count (r = 0.32, p < 0.01). Linear regressions showed that Se was associated with MTS correct count (b = 0.02, 95%CI: 0.01, -0.04), reflecting visual memory, and Fe was associated with CPT latency (b = -0.68, 95%CI: -1.11, -0.26), reflecting improved attention. The same BARS measures were also significantly associated with the 3-NM composite score. Conclusions: Our findings suggest that NM, particularly Fe, Se, and NM mixtures, could play a crucial role in brain development and neurocognitive function during adolescence. Further studies will help design national public health policies and strategies to address and mitigate brain health deficiencies among adolescents.

Purpose: There is some evidence that trace element and mineral deficiencies may promote the occurrence of febrile seizures. However, the role of these elements in the occurrence of complex seizures in children with FS has not been comprehensively investigated. The present study was conducted to evaluate this issue., Methods: In a cross-sectional study, 220 patients including 110 febrile and 110 FS children aged 6-60 months were studied. Blood samples were taken and serum zinc, potassium, sodium, magnesium and calcium levels were measured. Demographic and clinical characteristics were also recorded., Results: The patients were similar in age and sex. Higher serum zinc levels decreased the risk of seizure (RR = 0.95, p-value = 0.0001) and complex seizure (OR = 0.96, p-value = 0.03). Higher serum sodium levels decreased the risk of complex seizures (OR = 0.85, p-value = 0.023). Higher serum potassium levels were associated with a lower risk of seizure (OR = 0.55, p-value = 0.035). Serum calcium and magnesium levels were not associated with the risk of seizure and complex seizure. A BMI at the upper end of the normal range decreased the risk of complex seizures (OR = 0.83, p-value = 0.05). Male sex increased the risk of complex seizure (OR = 4.14, p-value = 0.016)., Conclusions: Low serum levels of zinc, potassium and sodium are risk factors for seizure and complex seizure in febrile children. Male sex is also a risk factor for complex seizures. The time from fever to seizure was shorter in younger children. Children with a BMI at the upper end of the normal range have a lower risk of having a complex seizure., Competing Interests: Declarations Ethical approval The ethics committee of Mashhad University of Medical Sciences approved the study protocol (code: IR.MUMS.MEDICAL.REC.1399.261). Consent to participate The written informed consent was obtained from patients or their parents. Consent of publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Evidence from observational studies suggests that increased calcium exposure may elevate the risk of adverse events in patients with coronary artery disease, while magnesium may exert a protective effect on disease risk. However, there have been limited investigations into the relationship between these minerals and acute coronary syndrome (ACS). Therefore, this study aimed to explore the association between the Serum calcium-magnesium ratio (Ca/Mg ratio) in patients with acute coronary syndrome and their clinical outcomes., Methods: This retrospective analysis reviewed the clinical data of 1,775 patients with ACS who underwent coronary angiography and/or percutaneous coronary intervention (PCI) at the Fujian Heart Center between May 2017 and December 2022. The patients were categorized into four groups based on their Ca/Mg ratio at admission (Group 1, ≤2.373, n = 443; Group 2, 2.374-2.517, n = 442; Group 3, 2.518-2.675, n = 446; Group 4, ≥2.676, n = 444). Single-factor analysis and multivariate logistic regression were employed to analyze the clinical characteristics and postoperative clinical outcomes of patients in different groups. The primary outcome included major adverse cardiovascular and cerebrovascular events (MACCEs), while the secondary outcomes included contrast-induced nephropathy (CIN)、all-cause rehospitalization raten and hematorrhea., Results: Univariate analysis showed that the patients had a mean age of 64.50±10.79 years, with 370 female patients (20.8%). Additionally, 1,158 patients had hypertension (65.2%), and 710 patients had diabetes (40.5%). Univariate analysis showed an inverse relationship between the serum calcium-to-magnesium ratio and all-cause in-hospital mortality, with patients in the lowest quartile having the highest mortality rate. Multivariate analysis showed that the Ca/Mg ratio at admission was independently associated with MACCEs. Among them, this ratio was inversely associated with all-cause mortality [adjusted odds ratio (aOR) 0.07; 95% CI 0.01-0.63; P<0.05] and positively associated with new-onset atrial fibrillation (aOR 1.86; 95% CI 1.08-3.21; P<0.05). Additionally, the Ca/Mg ratio was positively correlated with an increased risk of postoperative major bleeding (aOR 6.58; 95% CI 1.43-30.29; P<0.05)., Conclusion: In this large retrospective study, serum calcium and magnesium levels at admission were significantly associated with adverse outcomes in patients with ACS. The Ca/Mg ratio was identified as a reliable predictor of poor prognosis in ACS patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Jiang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Cognitive impairment and dementia are common in patients with chronic kidney disease, including those undergoing hemodialysis. Since magnesium and phosphate play important roles in brain function and aging, alterations in these and other factors related to bone mineral disorder (MBD) may contribute to low cognitive performance in patients on hemodialysis. This cross-sectional study examined the associations between cognitive function and MBD-related factors among 1207 patients on maintenance hemodialysis. Cognitive function was assessed by the Modified Mini-Mental State examination (3MS). The exposure variables of interest were serum magnesium, phosphate, calcium, calcium-phosphate product, intact parathyroid hormone, fetuin-A, T50 calciprotein crystallization test, use of phosphate binders, use of cinacalcet, and use of vitamin D receptor activators. Multivariable-adjusted linear regression models were used to examine the associations between 3MS and each of the exposure variables independent of 13 potential non-mineral confounders. We found that lower 3MS was associated with lower serum magnesium, lower phosphate, lower calcium-phosphate product, and nonuse of phosphate binders. These results suggest that magnesium and phosphate play potentially protective roles against cognitive impairment in this population.

This study aimed to evaluate the relationship between magnesium (Mg) status, serum vitamin D (VD) concentration and mortality in congestive heart failure (CHF) patients. Data for this study were extracted from the National Health and Nutrition Examination Surveys 2007-2018. Magnesium depletion score (MDS) is a scoring system developed to predict the status of Mg deficiency that considers the pathophysiological factors influencing the reabsorption capability of the kidneys. The primary outcome was all-cause mortality of CHF patients and the secondary outcome was mortality due to cardiovascular disease (CVD). Weighted univariate and multivariate cox proportional hazards models were used to explore the association between Mg status, serum VD concentration and all-cause mortality or mortality due to CVD in CHF patients, using hazard ratios (HRs) and 95 % confidence intervals (CIs). Subgroup analyses based on age, physical activity (PA), course of CHF, race, and body mass index were further assessed with regards to the association analysis. In total, 1022 CHF patients were included, of whom 418 (40.90 %) died by 31st December 2019. After adjusting for all covariates, high MDS (>2 points) was related to a higher risk of all-cause mortality (HR = 1.72, 95 % CI: 1.30-2.29) and mortality due to CVD (HR = 1.71, 95 % CI: 1.29-2.25); a higher serum VD concentration was related to a lower risk of all-cause mortality (HR = 0.78, 95 %CI: 0.62-0.99) and mortality due to CVD (HR = 0.80, 95 % CI: 0.63-0.99). Compared to patients with high serum VD concentration and low MDS, patients with low serum VD concentration and high MDS had a high risk of all-cause mortality (HR = 2.44, 95 % CI: 1.54-3.85, p for trend = 0.043) and mortality due to CVD (HR = 2.41, 95 % CI: 1.32-4.40). Serum VD and Mg status may have a combined effect in improving the prognosis in CHF patients, thus an appropriate level of serum VD and Mg intake may be beneficial to maintain cardiovascular health, thereby improving outcome.

Micronutrient deficiencies are common in inflammatory bowel disease (IBD). The aim of this study was to evaluate micronutrient deficiencies and identify muscular status of patients with IBD. From June 2019 to October 2021, a total of 105 patients with IBD were enrolled prospectively. To obtain objective data, micronutrients were measured in the patients' serum, and body composition analysis was performed using bioelectrical impedance analysis. There were 51 patients with ulcerative colitis (UC) and 54 with Crohn's disease (CD), while the gender ratio (M: F) was 54:51. The average age was 37 ± 18 years, which was significantly lower in patients with CD than UC (29 ± 16 vs. 45 ± 16, p < 0.001). Iron and magnesium were lower in patients with CD compared to UC, respectively (63.3 ± 42.5 vs. 82.8 ± 44.0 µg/dL, p = 0.024, 2.08 ± 0.15 vs. 2.15 ± 0.19 mg/dL, p = 0.036). Vitamin D levels showed insufficiency in patients with UC and deficiency (below 20 ng/mL) in patients with CD (20.1 ± 10.6 vs. 19.0 ± 9.9 ng/mL, p = 0.567). In the UC and CD patient groups, skeletal muscle index (SMI) and adjusted skeletal muscle mass were lower in patients with CD compared to UC (SMI: 32.8 ± 4.7 vs. 35.8 ± 5.5%, p < 0.004, adjusted skeletal muscle: 7.0 ± 1.5 vs. 8.2 ± 1.9 kg/m 2 , p < 0.001). In conclusion, decreased trace elements, specifically iron, magnesium, and vitamin D, as well as skeletal muscle mass were observed to be prominent in patients with CD as compared to UC.

This systematic literature review examines the relationship between psoriasis and trace metals to elucidate the pathogenesis of this condition, and to explore their potential use as a new route of treatment. Searches were primarily conducted in three databases: PubMed, Scopus, and Embase. The initial search resulted in over 100 articles which were manually assessed by the researchers to determine relevancy. Articles were only included if they were published within the last 12 years and were held to the standards of Boote and Biele's Literature Review Rubric to assess their quality. Of the relevant articles included in this study, the following three elements were largely discussed: calcium, magnesium, and zinc. Although not a trace metal, the macromolecule, calcium, was found to regulate the differentiation and proliferation of cells involved in the pathogenesis of psoriasis. Magnesium is thought to have an indirect relationship with psoriasis due to its role in Vitamin D absorption. Additionally, the zinc ion protects against oxidative stress, which is theorized as a mediator of the inflammatory response central to the pathogenesis of psoriasis. Many studies also investigated the serum levels of these elements to see if they were correlated with the severity of the condition. The serum levels of both calcium and zinc were found to have a negative correlation with the amount of surface area involved during a plaque psoriasis flare. These results indicate a potential benefit from evaluating the serum levels of these key modulators in patients. The lab values would indicate any deficiencies or imbalances, which can assist in a physician's ability to determine an individualized and targeted treatment course. Findings from this review consolidate the information currently available, and support the idea that psoriasis is influenced by trace metals. While there is still limited discussion on the evaluation of this relationship, the reviews findings demonstrate that additional comprehensive research would be warranted., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

It is unclear whether blood concentrations of copper (Cu), magnesium (Mg), and calcium (Ca) influence skeletal muscle mass and strength in children. We aimed to explore the associations between plasma Cu, Mg, and Ca and skeletal muscle indicators in Chinese children. A total of 452 children aged 6 to 9 years old were recruited for this cross-sectional study. Whole body lean soft tissue mass (WLSTM), trunk lean soft tissue mass (TLSTM), and appendicular skeletal muscle mass (ASMM) were measured using dual-energy X-ray absorptiometry. Parameters of these indicators divided by Height 2 (Ht 2 ) and Weight (Wt) at the corresponding sites were calculated. Handgrip strength was also measured. Parameters of skeletal muscle indicators and handgrip strength that were below the sex-specific 20th percentile were considered low levels. Plasma concentrations of Cu, Mg, and Ca were measured using ICP-MS. After adjusting for several potential covariates, among the total subjects, for every one standard deviation increase in Cu concentrations, there was a 0.939% decrease in WLSTM/Wt, a 0.415% decrease in TLSTM/Wt, and a 0.47% decrease in ASMM/Wt. For every one standard deviation increase in Cu concentrations, there was a higher odd (OR: 1.36, 95%CI 1.06, 1.75) of low WLSTM/Wt, TLSTM/Wt (OR: 1.33, 95%CI 1.03, 1.71), ASMM/Ht 2 (OR: 1.32, 95%CI 1.02, 1.69), as well as ASMM/Wt (OR: 1.56, 95%CI 1.23, 1.99). No significant associations were found between Mg, Ca, and most skeletal muscle indicators. Higher plasma Cu concentrations were adversely associated with skeletal muscle indicators at multiple sites in Chinese children., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: The relationship between chronic kidney disease-mineral and bone disorder (CKD-MBD) and cognitive function remains largely unknown. This cross-sectional study aimed to explore the association between CKD-MBD and cognitive function in patients on hemodialysis., Methods: Hemodialysis patients aged ≥ 65 years without diagnosed dementia were included. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). CKD-MBD markers, serum magnesium, intact parathyroid hormone (PTH), 25-hydroxyvitamin D (25-OHD), fibroblast growth factor (FGF)-23, and soluble α-klotho were measured., Results: Overall, 390 patients with a median age of 74 (interquartile range, 70-80) years, mean serum magnesium level of 2.4 ± 0.3 mg/dL, and median MoCA and MMSE scores of 25 (22-26) and 28 (26-29), respectively, were analyzed. MoCA and MMSE scores were significantly higher (preserved cognitive function) in the high-magnesium group than in the low-magnesium group according to the unadjusted linear regression analysis (β coefficient [95% confidence interval (CI)] 1.05 [0.19, 1.92], P = 0.017 for MoCA; 1.2 [0.46, 1.94], P = 0.002 for MMSE) and adjusted multivariate analysis with risk factors for dementia (β coefficient [95% CI] 1.12 [0.22, 2.02], P = 0.015 for MoCA; 0.92 [0.19, 1.65], P = 0.014 for MMSE)., Conclusions: Higher serum magnesium levels might be associated with preserved cognitive function in hemodialysis patients. Conversely, significant associations were not observed between cognitive function and intact PTH, 25-OHD, FGF-23, or soluble α-klotho levels., Competing Interests: Declarations Conflicts of interest The authors have declared that no conflict of interest exists. Ethical approval All procedures were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The institutional review board of our hospital (Approval No.: 33–183(10800)) approved the study. Informed consent Informed consent was obtained from all individual participants included in the study., (© 2024. The Author(s), under exclusive licence to Japanese Society of Nephrology.)

Backgruound: There remains controversy over the relationship between serum magnesium levels and obesity in type 2 diabetes mellitus (T2DM). Therefore, the aim of this study was to assess whether there is any association of serum magnesium levels with obesity and abdominal obesity in T2DM., Methods: This cross-sectional, real-world study was conducted in 8,010 patients with T2DM, which were stratified into quintiles according to serum magnesium levels. The clinical characteristics and the prevalence of obesity and abdominal obesity were compared across serum magnesium quintiles in T2DM. Regression analyses were used to evaluate the relationship of serum magnesium with obesity and abdominal obesity in T2DM (clinical trial registration number: ChiCTR1800015893)., Results: After adjustment for age, sex, and duration of diabetes, the prevalence of obesity and abdominal obesity was significantly declined across magnesium quintiles (obesity: 51.3%, 50.8%, 48.9%, 45.3%, and 43.8%, respectively, P<0.001 for trend; abdominal obesity: 71.5%, 70.5%, 68.2%, 66.4%, and 64.5%, respectively, P=0.001 for trend). After controlling for confounders, there were clearly negative associations of serum magnesium levels and quintiles with obesity and abdominal obesity in T2DM. Moreover, C-reactive protein partly mediates the effect of serum magnesium on obesity and abdominal obesity (P=0.016 and P=0.004, respectively)., Conclusion: The significantly negative relationship between serum magnesium and the risk of obesity and abdominal obesity was observed in T2DM. Furthermore, the independently negative association of serum magnesium with obesity may be explained by its anti-inflammatory functions. Serum magnesium levels may be applied to assess the risk of obesity and abdominal obesity in T2DM.

Background: Magnesium ion metabolism disorder is pervasive in the chronic kidney disease population, which is affected by many factors. Magnesium ion plays an important role in maintaining vascular functional integrity.. The Magnesium Depletion Score (MDS), serving as a novel metric for the assessment of magnesium deficiency, has not been thoroughly investigated for its association with stroke in patients with chronic kidney disease (CKD). Therefore, this study aims to explore the relationship between the MDS index and stroke in CKD patients., Methods: We conducted a cross-sectional population-based study using data from the National Health and Nutrition Examination Survey 2009-2016 to explore the impact of MDS on the stroke outcome of CKD patients. The primary outcome was the risk of stroke in CKD patients. Sample-weighted multivariate logistic regression was used in our analysis., Results: In this study of 3536 CKD patients from the database, we found an 8.6 % prevalence of stroke with higher stroke risk in older individuals and males. Lower dietary magnesium intake and higher MDS scores were significantly associated with stroke risk. Multivariate logistic regression analysis revealed a dose-dependent relationship between MDS scores and stroke likelihood, independent of demographic and clinical factors. Subgroup analysis confirmed these findings, particularly in those with hypertension, diabetes, and obesity, without significant interactions (all p > 0.05)., Conclusion: Magnesium depletion is independently associated with a heightened stroke risk in chronic kidney disease patients., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier Inc.)

Isotretinoin is an effective treatment against acne vulgaris, but it also causes many side effects during and after the treatment. The relationship between the changes in the levels of plasma trace elements of patients with AV after 3 months of isotretinoin treatment and the side effects was investigated in the study. Plasma samples of 35 patients were collected before and after isotretinoin treatment. Samples were analyzed by Inductively Coupled Plasma-Mass Spectrometer. After treatment, the levels of phosphorus, magnesium, and zinc in plasma increased statistically, while the level of potassium decreased (p < 0.05). The treatment had differing effects on zinc levels based on the gender of the individuals. With treatment, the levels of zinc in the plasma of men showed a greater increase compared to women (p = 7.3e-04). Additionally, the correlation matrix analysis revealed a strong correlation (R > 0.8) between magnesium and calcium. According to the study results, the change in phosphorus and potassium levels shows that isotretinoin affects kidney functions. The results suggest that phosphorus, potassium, magnesium, and zinc are associated with fatigue, dry skin and chapped lips, hair loss, and sebum secretion, respectively. Consequently, the study emphasizes the need for a comprehensive pre-treatment assessment, including monitoring of liver and kidney function as well as the levels of phosphorus and potassium in patients., (© 2024. The Author(s).)

In humans, 23 elements have been shown to have biological activity. The purpose of this study was to evaluate the concentrations of iron (Fe), zinc (Zn), sodium (Na), potassium (K), magnesium (Mg), phosphorus (P), and calcium (Ca) in the serum of patients diagnosed with lumbar degenerative stenosis when compared to the concentrations of those elements in the serum of healthy volunteers. The study group consisted of 60 patients who were diagnosed with degenerative stenosis of the lumbosacral spine and who qualified for hemilaminectomy. The control group included 60 healthy volunteers without degenerative spinal stenosis. The clinical specimens studied had sera collected from both groups. The quantitative analysis of the selected elements revealed statistically significant (p < 0.05) lower concentrations of Zn (740 ± 110 µg/L vs. 880 ± 160 µg/L) and Mg (22,091 ± 4256 µg/L vs. 24,100 ± 4210 µg/L) in the serum of the patients from the study group when compared to the controls. By contrast, K (16,230 µg/L ± 1210 µg/L vs. 13,210 µg/L ± 1060 µg/L) and Fe (141.87 µg/L ± 11.22 µg/L vs. 109.1 µg/L ± 26.43 µg/L) levels were significantly higher in the study group compared to the controls (p < 0.05). No statistically significant changes were detected in the concentrations of the assessed micronutrients and macronutrients in both sexes in either the study group, the control group, or those based on body mass index (p > 0.05). In the serum samples from the study group, the strongest correlations were noted between the concentrations. In the study group, we showed a significant relationship between the levels of Fe/Zn (r = 0.41), Fe/Na (r = 0.41), Fe/P (r = 0.55), Zn/P (r = 0.68), Zn/K (r = 0.48), Zn/Ca (r = 0.94), Mg/Ca (r = 0.79), and Na/K (r = 0.67). We showed that only Mg concentration varied statistically significantly with the severity of pain (p < 0.05). These findings suggest that the assessment of Fe, Zn, Mg, and K concentrations can be helpful in predicting the onset of degenerative changes in the spine., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background/Objectives : Hypomagnesemia and hypocalcemia are common conditions among older adults that may contribute to cognitive decline. However, most of the existing research has focused primarily on dietary intake rather than the actual serum levels of these nutrients or examined them separately. This study aims to investigate the relationship between hypomagnesemia, hypocalcemia, and the concurrent presence of both deficiencies in relation to cognitive performance among seniors. Methods : A total of 1220 hospitalized patients aged 60 and older were included in the analysis. The participants were categorized into four groups: those with normal serum levels of magnesium and calcium, those with hypomagnesemia, those with hypocalcemia, and those with both serum magnesium and calcium deficiencies. To evaluate the potential influence of age, sex, common comorbidities, and disturbances in magnesium and calcium levels on cognitive performance, two general linear models were employed, using the Mini-Mental State Examination (MMSE) and Clock-Drawing Test (CDT) as dependent variables. Results : After adjusting for age, sex, body mass index, and comorbidities, the mean values for the MMSE and CDT were 23.33 (95%CI: 22.89-23.79) and 5.56 (95%CI: 5.29-5.83) for the group with normomagnesemia and normocalcemia, 22.59 (95%CI: 21.94-23.24) and 5.16 (95%CI: 4.77-5.54) for the group with hypomagnesemia, 19.53 (95%CI: 18.36-20.70) and 4.52 (95%CI: 3.83-5.21) for the group with hypocalcemia, and 21.14 (95%CI 19.99-22.29) and 4.28 (95%CI 3.61-4.95) for the group with both hypomagnesemia and hypocalcemia, respectively. Magnesium and calcium deficiencies contributed to MMSE and CDT variance in the general linear models. Conclusions : Our findings indicate that in addition to age, body mass index, and chronic heart failure, both hypomagnesemia and hypocalcemia are associated with reduced cognitive performance.

Objectives: Diabetes mellitus is a metabolic condition with hyperglycemia. Literature has shown a correlation between poor sleep quality and duration with an increased incidence of insomnia in diabetic individuals. The goal of this study was to determine the magnesium and potassium supplementation effect among diabetic individuals with insomnia., Methods: A randomized controlled trial (single blind) was conducted on 320 patients with diabetes; after 2 months of follow-up, 290 patients completed the trial. The Insomnia Severity Index (ISI) was used to assess the severity and duration of insomnia, before and after the trial. Tablets containing supplements were prepared: placebo (T1), magnesium (Mg, T2), potassium (K, T3), and a combination of Mg and K (T4). Melatonin and cortisol (sleep hormones) were measured from blood (serum) using an enzyme-linked immunosorbent assay (ELISA), before and after the trial., Results: The study included 93 (32.1%) male and 197 (67.9%) female participants. According to the analysis, there was a significant association between the treatment groups and ISI after the trial (post-trial), p = 0.0001. Analysis showed that there was significant association between pre- and post-serum cortisol levels in treatment groups 2, 3, and 4 (T2, T3, and T4) as p -values are 0.001, 0.001, and 0.001 respectively. Similar findings were observed for serum melatonin., Conclusions: The study revealed that magnesium, potassium, and magnesium and potassium combined had a significant effect on serum cortisol and melatonin levels (sleep hormones). In addition, supplementation significantly decreased the severity of insomnia among patients with diabetes by improving sleep duration., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Khalid, Bashir, Mehboob, Anwar, Ali, Hashim, Waseem and Basharat.)

Chronic Obstructive Pulmonary Disease (COPD) significantly impacts patients' quality of life and burdens healthcare systems. Magnesium is crucial for lung function and reducing respiratory disease risk. This study investigates the association between Magnesium Depletion Score (MDS) and COPD and explores whether inflammatory markers mediate this relationship. A cross-sectional analysis was conducted using data from 30,490 participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. MDS was calculated based on diuretic use, proton pump inhibitors, renal function, and alcohol consumption. Univariable and multivariable logistic regression analyses were performed to assess the association between MDS and COPD, adjusting for potential confounders. Mediation analysis was used to examine the roles of neutrophils, serum albumin, and the Systemic Immune-Inflammation Index (SII). In the univariable logistic model, higher MDS was significantly associated with increased COPD risk. Specifically, compared to MDS = 0, the odds ratios (OR) for COPD were 2.50, 4.12, 6.13, 8.53, and 7.81 for MDS = 1, 2, 3, 4, and 5, respectively (all P < 0.001). In the multivariable model, the ORs were 1.79, 2.25, 2.71, and 3.44 for MDS = 1, 2, 3, and 4, respectively (all P < 0.001). Higher neutrophil levels and SII were positively associated with increased COPD risk, while higher serum albumin levels were inversely associated. Mediation analysis indicated that neutrophils, serum albumin, and SII significantly mediated the MDS-COPD relationship. Higher MDS is significantly associated with increased COPD risk, mediated by systemic inflammation markers. Improving magnesium levels could potentially reduce COPD risk, warranting further research on magnesium supplementation in COPD prevention and management., (© 2024. The Author(s).)

The relationship between magnesium deficiency and metabolic dysfunction associated steatotic liver disease (MASLD) remains unclear. This study aimed to examine the association between the magnesium depletion score (MDS) and the risk of MASLD, as well as explore potential underlying mechanisms. Data from 12,024 participants from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 were analyzed. MDS was calculated based on the use of diuretics and proton pump inhibitors, kidney function, and alcohol consumption. MASLD was defined using the fatty liver index. Logistic regression, restricted cubic spline analysis, and mediation analyses were conducted to evaluate the association between MDS and MASLD and to identify potential mediators. A higher MDS was significantly associated with an increased risk of MASLD (OR = 2.00, 95% CI [1.47, 2.74] for MDS 3 vs. 0). A dose-response relationship between MDS and MASLD risk was observed. Neutrophils, albumin, and white blood cells partially were identified as partial mediators of the association, with albumin exhibiting the highest mediating effect (14.05%). Elevated MDS is significantly associated with an increased risk of MASLD in U.S. adults. Inflammation and albumin may serve as potential mediators of this relationship. These findings underscore the importance of addressing magnesium deficiency in the prevention and management of MASLD., (© 2024. The Author(s).)

Background: China's plasmapheresis donation policy differs from that of Western countries. The association between regular plasmapheresis donation and donor health in China is still unknown., Objectives: To investigate the association of regular plasmapheresis donation with serum protein and electrolyte levels and provide scientific evidence for policy improvement., Design: Multicentre cross-sectional study., Setting and Participants: A total of 767 regular and 726 new donors from the provinces of Sichuan, Hunan, Henan and Yunnan were recruited from September 2021 to October 2022., Primary and Secondary Outcome Measures: Our primary outcome focused on measuring the levels of serum protein and electrolyte levels, including total serum protein (TSP), IgG, albumin (Alb), haemoglobin (Hb), calcium, potassium (K + ) and magnesium (Mg 2+ ). The secondary outcome assessed their abnormal rates., Results: Male and female donors in the high donation frequency group (>16 donations per year) exhibited lower IgG levels compared with new donors (p=0.008 for male donors and p=0.007 for female donors). Additionally, female donors with high donation frequency and a high total number of lifetime donations (>100 donations) had significantly lower Hb concentrations than new donors. However, no significant changes were observed in TSP, Alb, calcium, K + and Mg 2+ levels. There were also no statistically significant differences in the rates of abnormal protein and electrolyte values below the respective threshold levels between new and regular donors., Conclusions: Plasmapheresis donation is not associated with an increased risk of abnormalities in the analysed parameters. However, the results provide preliminary evidence supporting the routine inclusion of IgG screening for donors, as plasmapheresis donation is associated with a decrease in IgG levels. Particular attention should be paid to the Hb levels of female donors, especially those who donate frequently. Testing of TSP at each donation may not be necessary., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Recent studies suggested that the combination of tobacco smoke exposure (TSE) and dietary nutrients intake may be related to a higher or lower risk of hypertension. However, the relationship between dietary magnesium (Mg) intake, TSE and the odds of hypertension remain unclear. This study aimed to evaluate the association of TSE, dietary Mg intake and the odds of hypertension among children and adolescents., Method: Data of this study were extracted from the National Health and Nutrition Examination Surveys (NHANES) 2007-2018. Dietary Mg intake was calculated as the average of two days of dietary and supplementations intake. Serum cotinine concertation ≥ 0.05 µg/L or at least one-person smoking in the household was considered as exposing to the tobacco smoke. The weighted univariate and multivariate logistic regression models were utilized to explore the associations of dietary Mg intake, TSE and the odds of hypertension among children and adolescents with the evaluation index of odds ratio (ORs) and 95% confidence intervals (CIs). Subgroup analyses based on different age, gender and overweight were further assessed these associations., Results: A total of 7,122 children and adolescents aged 8-17 years old and with the blood pressure measurement were included. Of which, 948 (13.31%) had hypertension. After adjusting all covariates, we observed children and adolescents exposed to tobacco smoke was related to higher odds of hypertension (OR = 1.34, 95%CI: 1.01-1.78); children and adolescents not reached the dietary Mg references intakes was related to higher odds of hypertension (OR = 1.48, (95%CI: 1.11-1.97); compared to children and adolescents non-TSE and reached the DRIs of Mg, those not reached the DRIs of Mg and exposed to tobacco smoke have the highest odds of hypertension (OR = 1.94, 95%CI: 1.30-2.89, P for trend = 0.002). These associations of dietary Mg intake, TSE and hypertension remain robust after the stratified analysis based on age, gender and overweight was conducted., Conclusion: Our findings suggested there were a robust association between dietary Mg intake, TSE and hypertension in children and adolescents. Those children and adolescents with deficiency dietary Mg intake and exposed to tobacco smoke may have the high odds of hypertension. More restrictions on smoking as well as Mg supplementation in the prevention and treatment of hypertension among children and adolescents might be justified., (© 2024. The Author(s).)

Ionized Mg (iMg) may offer a more reliable indicator of Mg status during acute illness than total Mg (tMg) concentrations. This study aimed to determine the prevalence of dysmagnesemia and their relationship using iMg and tMg. The clinical and biochemical characteristics as well as health outcomes and their association with iMg and tMg were also assessed. A prospective study including all eligible adult patients (≥18 years) who were hospitalized in the General Internal Medicine unit at Sultan Qaboos University Hospital (SQUH) for 3.5 months in 2023. The iMg and tMg concentrations were collected on all at the admission. In total 500 patients were included (females 49.2%) with a median age of 64.5 years (IQR: 48-77). The prevalence of hypomagnesemia and hypermagnesemia by iMg concentrations was 3.4% and 26.6%, respectively, while by tMg concentrations 13.2% and 11.0%, respectively. The agreement between both measurements was strong (r=0.665, p<0.01). An increased tMg concentration was independently associated with high dependency units' admission (adjusted odds ratio (aOR): 4.34, 95%CI: 1.24-15.06, p=0.02) and cardiac arrest (aOR: 14.64, 95%CI: 3.04-70.57, p<0.01), and 6-month all-cause mortality (aOR: 11.44, 95%CI: 2.46-53.17, p<0.01). During follow-up hypermagnesemia using tMg had a higher mortality compared to other groups (hazard ratio (HR): 1.82, 95%CI: 1.11-3.01, p=0.02) while no significant findings were demonstrated using iMg concentrations. iMg and tMg concentrations had a strong correlation that might be supporting the potential use of point-of-care devices. Multivariant regression analysis showed that hypermagnesemia by tMg was associated with adverse outcomes. However, the generalizability of the study findings should be taken with caution and the difference in the associations with outcomes highlight the importance of further research to examine the complex associations and impacts of dysmagnesemia in various clinical settings., (© 2024. The Author(s).)

Rationale: Hypomagnesemia is associated with multiple electrolyte disturbances such as hypokalemia, hypocalcemia and hypoparathyroidism. Proton pump inhibitors (PPIs) are widely used in gastrointestinal disorders and are generally considered safe by clinicians. However, it is unusual side effect of hypomagnesemia is potentially under-recognized. Delirium is usually thought to be a clue of cerebrovascular disease, and the association between delirium and hypomagnesemia is unexpected. We describe a patient used PPI with hypomagnesemia showed normal parathyroid hormone (PTH) despite hypocalcemia and reversible delirium. To enhance clinicians' vigilance, we performed a literature review on cerebellar syndromes due to hypomagnesemia., Patient Concerns: A 74-year-old woman was admitted to our hospital with intermittent nausea, vomiting, hand tremors, and delirium., Diagnosis: Laboratory analysis showed hypokalemia, hypomagnesemia, and normal parathyroid hormone despite hypocalcemia, physical examination showed horizontal nystagmus and the brain MRI was negative. Surprising, detailed medical history revealed that the etiology was the usage of omeprazole., Interventions: Omeprazole was discontinued and oral supplementation with magnesium, calcium, and potassium was administered., Outcomes: Delirium quickly disappeared and the serum potassium, magnesium, and calcium levels gradually normalized; at discharge, nystagmus gradually disappeared, and plasma electrolyte levels were stable at follow-up., Lessons: Hypomagnesemia is associated with a variety of neurological symptoms up to life-threatening conditions if left untreated; as Mg is not present in routine electrolyte panels, hypoparathyroidism, hypokalemia, and delirium may be a clue, and physicians must be alert to consider PPI as a potential cause of unexplained hypomagnesemia, and timely treatment to avoid sequelae., Competing Interests: The authors declare that they have no conflict of interests., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Higher magnesium intake was linked to a lower risk of hepatocellular carcinoma (HCC). However, the relationship between blood magnesium level and HCC has not been fully characterized, especially among patients with liver cirrhosis who are at a higher risk for HCC., Methods: In the Mass General Brigham Biobank, we developed a new prospective cohort of 1,430 patients with liver cirrhosis without liver cancer history using the validated International Classification of Diseases codes. We used Cox proportional hazards models to generate hazard ratios (HRs) with 95% confidence intervals (CI) for incident HCC and used generalized estimating equations to compare changes in liver biomarkers according to baseline blood magnesium, adjusting for age, sex, race, lifestyles, body mass index, type 2 diabetes, model for end-stage liver disease score, and hepatitis infection., Results: During a median follow-up period of 4.26 years, 109 patients developed HCC. Magnesium deficiency (<1.70 mg/dL; N = 158) was associated with a higher risk of HCC (HR = 1.93; 95% CI, 1.12-3.30) compared with magnesium sufficiency (≥1.70 mg/dL; N = 1282). This association remained robust in the 1-year lag analysis (HR = 2.18; 95% CI, 1.11-4.28) and in sensitivity analysis excluding patients with alcoholic liver disease (HR = 2.41; 95% CI, 1.23-4.74). Magnesium in the lowest quartile was associated with a faster increase in alanine transaminase (β = 4.35; 95% CI, 1.06-7.63), aspartate aminotransferase (β = 6.46; 95% CI, 0.28-12.6), direct bilirubin (β = 0.18; 95% CI, 0.01-0.35), and total bilirubin (β = 0.21; 95% CI, 0.03-0.39), compared with the highest quartile., Conclusions: Lower blood magnesium level is associated with higher HCC risk and unfavorable liver biomarker changes., Impact: If confirmed, our findings may potentially enable better identification of high-risk patients for HCC and inform better management strategies for liver cirrhosis., (©2024 American Association for Cancer Research.)

Modern hemodialysis employs weak acids as buffers to prevent bicarbonate precipitation with calcium or magnesium. Acetate, the most used acid, is linked to chronic inflammation and poor dialysis tolerance. Citrate has emerged as a potential alternative, though its effect on dialysis efficiency is not clear. This study aims to compare the efficacy of acetate- and citrate-based dialysates, focusing on protein-bound uremic toxins and dialysis doses. This single-center prospective crossover study includes prevalent patients participating in a thrice-weekly online hemodiafiltration program. Four dialysates were tested: two acetate-based (1.25 and 1.5 mmol/L calcium) and two citrate-based (1.5 mmol/L calcium with 0.5 and 0.75 mmol/L magnesium). Pre- and post-dialysis blood samples of eighteen patients were analyzed for urea, creatinine, p-cresyl sulfate, indoxyl sulfate, and albumin. Statistical significance was assessed using paired t -tests and repeated measures of ANOVA. There were no significant differences in dialysis dose (Kt), urea, creatinine, or indoxyl sulfate reduction ratios between acetate- and citrate-based dialysates. However, a significant decrease in the reduction ratio of p-cresyl sulfate was observed with the acetate dialysate containing 1.25 mmol/L calcium and the citrate dialysate with 0.5 mmol/L magnesium compared to the acetate dialysate containing 1.5 mmol/L calcium and the citrate dialysate with 0.75 mmol/L magnesium (51.56 ± 4.75 and 53.02 ± 4.52 vs. 65.25 ± 3.38 and 58.66 ± 4.16, p 0.007). No differences in dialysis dose were found between acetate- and citrate-based dialysates. However, citrate dialysates with lower calcium and magnesium concentrations may reduce the albumin displacement of p-cresyl sulfate. Further studies are needed to understand the observed differences and optimize the dialysate composition for the better clearance of protein-bound uremic toxins.

Magnesium plays a vast role in the nervous system. In particular, high magnesium in cerebrospinal fluid appears to enhance the neural functions, while low magnesium induces neuronal diseases. The aim of the study was to find out the relation of serum magnesium with idiopathic generalized epilepsy attending in a tertiary care hospital. This cross-sectional comparative study was conducted in the department of Neurology at Mymensingh Medical College and Hospital, Bangladesh from January 2019 to June 2020 following ethical approval. Total 110 purposively selected participants (55 with idiopathic generalized epilepsy and 55 non epileptic apparently healthy individuals) were enrolled in this study. Serum total Mg was measured by EMP-168 Biochemical Analyzer. Average age of epileptic individuals was 33.13±9.5 years and majority was female (60.0%). Mean serum magnesium level was lower in epileptic patients than controls (1.80±0.041 vs. 2.02±0.19 mg/dl; p<0.001). Patients with higher seizure attack (>3 per month) had significantly lower mean serum magnesium level than the patients with seizure attack three or less per month. Serum magnesium levels are reduced in epileptic patients compared to healthy age and gender matched controls. Studies involving larger numbers of patients are needed to confirm these results.