Correlation of Magnesium Intake with Metabolic Parameters

Background

Type 2 diabetes mellitus is a major global public health problem in the worldwide and is increasing in aging populations. Magnesium intake may be one of the most important factors for diabetes prevention and management. Low magnesium intake may exacerbate metabolic abnormalities. In this study, the relationships of magnesium intake with metabolic parameters, depression and physical activity in elderly patients with type 2 diabetes were investigated.

Methods

This cross-sectional study involved 210 type 2 diabetes patients aged 65 years and above. Participants were interviewed to obtain information on lifestyle and 24-hour dietary recall. Assessment of depression was based on DSM-IV criteria. Clinical variables measured included anthropometric measurements, blood pressure, and biochemical determinations of blood and urine samples. Linear regression was applied to determine the relationships of magnesium intake with nutritional variables and metabolic parameters.

Results

Among all patients, 88.6% had magnesium intake which was less than the dietary reference intake, and 37.1% had hypomagnesaemia. Metabolic syndromes and depression were associated with lower magnesium intake (p < 0.05). A positive relationship was found between magnesium intake and HDL-cholesterol (p = 0.005). Magnesium intake was inversely correlated with triglyceride, waist circumference, body fat percent and body mass index (p < 0.005). After controlling confounding factor, HDL-cholesterol was significantly higher with increasing quartile of magnesium intake (p for trend = 0005). Waist circumference, body fat percentage, and body mass index were significantly lower with increase quartile of magnesium intake (p for trend < 0.001). The odds of depression, central obesity, high body fat percentage, and high body mass index were significantly lower with increasing quartile of magnesium intake (p for trend < 0.05). In addition, magnesium intake was related to high physical activity level and demonstrated lower serum magnesium levels. Serum magnesium was not significantly associated with metabolic parameters.

Conclusions

The majority of elderly type 2 diabetes who have low magnesium intake may compound this deficiency with metabolic abnormalities and depression. Future studies should determine the effects of increased magnesium intake or magnesium supplementation on metabolic control and depression in elderly people with type 2 diabetes.

1. Wild S, Roglic G, Green A, Sicree R, King H: Global prevalence of diabetes: estimates for the year 2000 and projections for 2030.

   Diabetes Care 2004, 27(5):1047-1053. PubMed Abstract | Publisher Full Text

2. Meneilly GS, Tessier D: Diabetes in elderly adults.

   J Gerontol A Biol Sci Med Sci 2001, 56(1):M5-M13. PubMed Abstract | Publisher Full Text

3. Huang ES, Liu JY, Moffet HH, John PM, Karter AJ: Glycemic control, complications, and death in older diabetic patients the diabetes and aging study.

   Diabetes Care 2011, 34(6):1329-1336. PubMed Abstract | Publisher Full Text |PubMed Central Full Text

4. de Boer IH, Katz R, Cao JJ, Fried LF, Kestenbaum B, Mukamal K, et al.: Cystatin C, albuminuria, and mortality among older adults with diabetes.

   Diabetes Care 2009, 32(10):1833-1838. PubMed Abstract | Publisher Full Text |PubMed Central Full Text

5. Moran A, Palmas W, Field L, Bhattarai J, Schwartz JE, Weinstock RS, et al.: Cardiovascular autonomic neuropathy is associated with microalbuminuria in older patients with type 2 diabetes.

   Diabetes Care 2004, 27(4):972-977. PubMed Abstract | Publisher Full Text

6. Rizvi AA: Management of diabetes in older adults.

   Am J Med Sci 2007, 333(1):35-47. PubMed Abstract | Publisher Full Text

7. Rodriguez-Moran M, Guerrero-Romero F: Oral magnesium supplementation improves insulin sensitivity and metabolic control in type 2 diabetic subjects: a randomized double-blind controlled trial.

   Diabetes Care 2003, 26(4):1147-1152. PubMed Abstract | Publisher Full Text

8. Dong JY, Xun P, He K, Qin LQ: Magnesium intake and risk of type 2 diabetes: meta-analysis of prospective cohort studies.

   Diabetes Care 2011, 34(9):2116-2122. PubMed Abstract | Publisher Full Text |PubMed Central Full Text

9. Swaminathan R: Magnesium metabolism and its disorders.

   Clin Biochem Rev 2003, 24(2):47-66. PubMed Abstract | PubMed Central Full Text

10. Nadler JL, Buchanan T, Natarajan R, Antonipillai I, Bergman R, Rude R: Magnesium deficiency produces insulin resistance and increased thromboxane synthesis.

    Hypertension 1993, 21:1024-1029. PubMed Abstract | Publisher Full Text

11. Bohl CH, Volpe SL: Magnesium and exercise.

    Crit Rev Food Sci Nutr 2002, 42(6):533-563. PubMed Abstract | Publisher Full Text

12. Nielsen FH, Milne DB, Klevay LM, Gallagher S, Johnson L: Dietary magnesium deficiency induces heart rhythm changes, impairs glucose tolerance, and decreases serum cholesterol in post menopausal women.

    J Am Coll Nut 2007, 26(2):121-132.

13. Barragan-Rodriguez L, Rodriguez-Moran M, Guerrero-Romero F: Depressive symptoms and hypomagnesemia in older diabetic subjects.

    Arch Med Res 2007, 38(7):752-756. PubMed Abstract | Publisher Full Text

14. McKeown NM, Jacques PF, Zhang XL, Juan W, Sahyoun NR: Dietary magnesium intake is related to metabolic syndrome in older Americans.

    Eur J Nutr 2008, 47(4):210-216. PubMed Abstract | Publisher Full Text

15. Corica F, Corsonello A, Ientile R, Cucinotta D, Di Benedetto A, Perticone F, et al.: Serum ionized magnesium levels in relation to metabolic syndrome in type 2 diabetic patients.

    J Am Coll Nut 2006, 25(3):210-215.

16. Guerrero-Romero F, Rodriguez-Moran M: Hypomagnesemia is linked to low serum HDL-cholesterol irrespective of serum glucose values.

    J Diabetes Complicat 2000, 14(5):272-276. PubMed Abstract | Publisher Full Text

17. Corica F, Allegra A, Di Benedetto A, Giacobbe MS, Romano G, Cucinotta D, et al.: Effects of oral magnesium supplementation on plasma lipid concentrations in patients with non-insulin-dependent diabetes mellitus.

    Magnes Res 1994, 7(1):43-47. PubMed Abstract

18. Motoyama T, Sano H, Fukuzaki H: Oral magnesium supplementation in patients with essential hypertension.

    Hypertension 1989, 13(3):227-232. PubMed Abstract | Publisher Full Text

19. Finstad EW, Newhouse IJ, Lukaski HC, McAuliffe JE, Stewart CR: The effects of magnesium supplementation on exercise performance.

    Med Sci Sports Exerc 2001, 33(3):493-498. PubMed Abstract | Publisher Full Text

20. Barragan-Rodriguez L, Rodriguez-Moran M, Guerrero-Romero F: Efficacy and safety of oral magnesium supplementation in the treatment of depression in the elderly with type 2 diabetes: a randomized, equivalent trial.

    Magnes Res 2008, 21(4):218-223. PubMed Abstract | Publisher Full Text

21. Ismail Y, Ismail AA, Ismail AAA: The underestimated problem of using serum magnesium measurements to exclude magnesium deficiency in adults; a health warning is needed for “normal” results.

    Clin Chem Lab Med 2010, 48(3):323-327. PubMed Abstract

22. Arnaud MJ: Update on the assessment of magnesium status.

    Br J Nutr 2008, 99(Suppl 3):S24-S36. PubMed Abstract | Publisher Full Text

23. Sales CH, Pedrosa LF, Lima JG, Lemos TM, Colli C: Influence of magnesium status and magnesium intake on the blood glucose control in patients with type 2 diabetes.

    Clin Nutr 2011, 30(3):359-364. PubMed Abstract | Publisher Full Text

24. Thompson FE, Byers T: Dietary assessment resource manual.

    J Nutr 1994, 124(11 Suppl):2245S-2317S. PubMed Abstract | Publisher Full Text

25. Volpe SL: Magnesium, the metabolic syndrome, insulin resistance, and type 2 diabetes mellitus.

    Crit Rev Food Sci Nutr 2008, 48(3):293-300. PubMed Abstract | Publisher Full Text

26. American Diabetes Association: Report of the expert committee on the diagnosis and classification of diabetes mellitus.

    Diabetes Care 1997, 20:1183-1197. PubMed Abstract

27. American Diabetes Association: Standards of medical care in diabetes–2010.

    Diabetes Care 2010, 33(Suppl 1):11S-61S.

28. Kurukulasuriya LR, Sowers JR: Therapies for type 2 diabetes: lowering HbA1c and associated cardiovascular risk factors.

    Cardiovasc Diabetol 2010, 9:45. PubMed Abstract | BioMed Central Full Text |PubMed Central Full Text

29. Grundy SM, Cleeman JI, Merz CN, Brewer HB, Clark LT, Hunninghake DB, et al.: Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines.

    Circulation 2004, 110:227-239. PubMed Abstract | Publisher Full Text

30. Xu J, Eilat-Adar S, Loria CM, Howard BV, Fabsitz RR, Begum M, et al.: Macronutrient intake and glycemic control in a population-based sample of American Indians with diabetes: the Strong Heart Study.

    Am J Clin Nutr 2007, 86(2):480-487. PubMed Abstract | Publisher Full Text

31. Posner BM, Smigelski C, Duggal A, Morgan IL, Cobb I, Cupples LA: Validation of two-dimensional models for estimation of portion size in nutrition research.

    J Am Diet Assoc 1992, 92:738-741. PubMed Abstract

32. Huang MC, Hsu CC, Wang HS, Shin SJ: Prospective randomized controlled trial to evaluate effectiveness of registered dietitian-led diabetes management on glycemic and diet control in a primary care setting in Taiwan.

    Diabetes Care 2010, 33(2):233-239. PubMed Abstract | Publisher Full Text |PubMed Central Full Text

33. Institute of Medicine, Food and Nutrition Board: Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D and fluoride. National Academy Press, Washington, D.C; 1997:71-145.
34. Evans WJ: Protein nutrition, exercise and aging.

    J Am Coll Nutr 2004, 23(6 Suppl):601S-609S. PubMed Abstract

35. Hu G, Jousilahti P, Barengo NC, Qiao Q, Lakka TA, Tuomilehto J: Physical activity, cardiovascular risk factors, and mortality among Finnish adults with diabetes.

    Diabetes Care 2005, 28(4):799-805. PubMed Abstract | Publisher Full Text

36. Sahota PK, Knowler WC, Looker HC: Depression, diabetes, and glycemic control in an American Indian community.

    J Clin Psychiatry 2008, 69(5):800-809. PubMed Abstract | Publisher Full Text |PubMed Central Full Text

37. Hwang LC, Chen SC, Tjung JJ, Chiou HY, Chen CJ, Tsai CH: Body mass index as a predictor of mortality in older people in Taiwan.

    International Journal of Gerontology 2009, 3(1):39-46. Publisher Full Text

38. Monami M, Lamanna C, Balzi D, Bartalucci F, Melani C, Masotti G, et al.: Metabolic syndrome and cardiovascular mortality in older type 2 diabetic patients: a longitudinal study.

    J Gerontol A Biol Sci Med Sci 2008, 63(6):646-649. PubMed Abstract | Publisher Full Text

39. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, Criqui M, Alexander RW, Anderson JL, Cannon RO, Criqui M, et al.: Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association.

    Circulation 2003, 107(3):499-511. PubMed Abstract | Publisher Full Text

40. Levin A, Hemmelgarn B, Culleton B, Tobe S, McFarlane P, Ruzicka M, et al.: Guidelines for the management of chronic kidney disease.

    CMAJ 2008, 179(11):1154-1162. PubMed Abstract | Publisher Full Text |PubMed Central Full Text

41. Wang JL, Weng YL, Pan WH, Kao MD: Trends and nutritional status for magnesium in Taiwan from NAHSIT 1993 to 2008.

    Asia Pac J Clin Nutr 2011, 20(2):266-274. PubMed Abstract

42. Moshfegh AJ, Goldman JD, Ahuja JK, Rhodes DG, LaComb RP: What We Eat in America, NHANES 2005–2006: Usual nutrient intakes from food and water compared to 1997 dietary reference intakes for vitamin D, calcium, phosphorus, and magnesium (24-page report). Agricultural Research Service, US Department of Agriculture; 2009. PubMed Abstract |Publisher Full Text
43. Mirmiran P, Shab-Bidar S, Hosseini-Esfahani F, Asghari G, Hosseinpour-Niazi S, Azizi F:Magnesium intake and prevalence of metabolic syndrome in adults: tehran lipid and glucose study.

    Public Health Nutr 2012, 15(4):693-701. PubMed Abstract | Publisher Full Text

44. Ustun TB, Ayuso-Mateos JL, Chatterji S, Mathers C, Murray CJ: Global burden of depressive disorders in the year 2000.

    Br J Psychiatry 2004, 184:386-392. PubMed Abstract | Publisher Full Text

45. Katon W, Schulberg H: Epidemiology of depression in primary care.

    Gen Hosp Psychiatry 1992, 14(4):237-247. PubMed Abstract | Publisher Full Text

46. Ali S, Stone MA, Peters JL, Davies MJ, Khunti K: The prevalence of co-morbid depression in adults with Type 2 diabetes: a systematic review and meta-analysis.

    Diabet Med 2006, 23(11):1165-1173. PubMed Abstract | Publisher Full Text

47. Black SA: Increased health burden associated with comorbid depression in older diabetic Mexican Americans. Results from the hispanic established population for the epidemiologic study of the elderly survey.

    Diabetes Care 1999, 22(1):56-64. PubMed Abstract | Publisher Full Text

48. Pham PC, Pham PM, Pham SV, Miller JM, Pham PT: Hypomagnesemia in patients with type 2 diabetes.

    Clin J Am Soc Nephrol 2007, 2(2):366-373. PubMed Abstract | Publisher Full Text

49. Nasri H, Baradaran HR: Lipids in association with serum magnesium in diabetes mellitus patients.

    Bratislava Medical Journal-Bratislavske Lekarske Listy 2008, 109(7):302-306.

50. Dominguez LJ, Barbagallo M, Lauretani F, Bandinelli S, Bos A, Corsi AM, et al.: Magnesium and muscle performance in older persons: the InCHIANTI study.

    Am J Clin Nutr 2006, 84(2):419-426. PubMed Abstract | Publisher Full Text |PubMed Central Full Text

51. Nielsen FH, Lukaski HC: Update on the relationship between magnesium and exercise.

    Magnesium Res 2006, 19(3):180-189.

52. Rayssiguier Y, Guezennec CY, Durlach J: New experimental and clinical data on the relationship between magnesium and sport.

    Magnes Res 1990, 3(2):93-102. PubMed Abstract

53. McDonald R, Keen CL: Iron, zinc and magnesium nutrition and athletic performance.

    Sports Med 1988, 5(3):171-184. PubMed Abstract | Publisher Full Text