| Autor: |
Gheorghe AM; PhD Doctoral School, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.; Department of Clinical Endocrinology V, 'C.I. Parhon' National Institute of Endocrinology, 011863 Bucharest, Romania., Ciobica ML; Department of Internal Medicine and Gastroenterology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.; Department of Internal Medicine I and Rheumatology, 'Dr. Carol Davila' Central Military University Emergency Hospital, 010825 Bucharest, Romania., Nistor C; Department 4-Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.; Thoracic Surgery Department, 'Dr. Carol Davila' Central Military University Emergency Hospital, 010242 Bucharest, Romania., Gurzun MM; Cardiology Discipline, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.; Laboratory of Non-Invasive Cardiovascular Exploration, 'Dr. Carol Davila' Central Military University Emergency Hospital, 010242 Bucharest, Romania., Sandulescu BA; PhD Doctoral School, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.; Department of Internal Medicine and Gastroenterology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.; Department of Internal Medicine I and Rheumatology, 'Dr. Carol Davila' Central Military University Emergency Hospital, 010825 Bucharest, Romania., Stanciu M; Department of Endocrinology, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania., Popa FL; Department of Physical Medicine and Rehabilitation, Faculty of Medicine, 'Lucian Blaga' University of Sibiu, 550024 Sibiu, Romania., Carsote M; Department of Clinical Endocrinology V, 'C.I. Parhon' National Institute of Endocrinology, 011863 Bucharest, Romania.; Department of Endocrinology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania. |
| Abstrakt: |
Magnesium (Mg), an essential nutrient with a wide area of physiological roles, stands as a cofactor in over 600 enzymatic reactions involved in the synthesis of proteins and nucleic acids, DNA repair, neuromuscular functions, neuronal transmission, cardiac rhythm regulation, and the modulation of metabolic pathways, as well as acting as a natural blocker for the calcium channels. Our objective was to highlight the most recent clinical data with respect to daily Mg intake (DMI) and metabolic traits, particularly type 2 diabetes mellitus (DM). This was a PubMed-based review of the English-language medical papers across different key terms of search; the time frame was from January 2019 until April 2024. We included (clinically relevant) original studies and excluded cases reports, series, reviews, editorials, opinion, experimental studies, and non-human data as well as studies that did not specifically assessed DMI and only provided assays of serum Mg, studies on patients diagnosed with type 1 or secondary DM. A total of 30 studies were included and we organized the key findings into several sections as follows. Studies investigating DMI in relationship with the adherence to local recommendations in diabetic subjects (n = 2, one transversal and another retrospective cohort; N = 2823) found that most of them had lower DMI. Deficient DMI was correlated with the risk of developing/having DM across five studies (n = 5, one prospective and four of cross-sectional design; N = 47,166). An inverse correlation between DMI and DM prevalence was identified, but these data are presented amid a rather heterogeneous spectrum. Four novel studies (N = 7279) analysed the relationship between DMI and DM control according to various methods (HbA1c, fasting and postprandial glycaemia, and insulin); the association may be linear in diabetic subjects only at certain levels of DMI; additionally, the multifactorial influence on HBA1c should take into consideration this dietary determinant, as well, but there are no homogenous results. Three studies concerning DMI and diabetic complications (one cross-sectional, one prospective, and another case-control study) in terms of retinopathy (n = 1, N = 3794) and nephropathy (n = 2, N = 4805) suggested a lower DMI was associated with a higher risk of such complications. Additionally, two other studies (one prospective and one retrospective cohort) focused on mortality (N = 6744), which, taking only certain mortality indicators into consideration, might be decreased in the subgroups with a higher DMI. Seven studies (N = 30,610) analysed the perspective of DMI in the general population with the endpoint of different features amid glucose profile, particularly, insulin resistance. Concerning HOMA-IR, there were three confirmatory studies and one non-confirmatory, while fasting plasma glucose was highlighted as inversely correlated with a DMI (n = 1). The highest level of evidence regarding Mg supplementation effects on glucose metabolism stands on seven randomised controlled trials (N = 350). However, the sample size was reduced (from 14 to 86 individuals per study, either diabetic or pre-diabetic) and outcomes were rather discordant. These clinical aspects are essential from a multidisciplinary perspective and further trials are mandatory to address the current areas of discordant results. |
