RESUMO
This study aimed to evaluate the relationship between prepartum subclinical hypomagnesemia (pre-SHMg) and the occurrence of dystocia, metritis, clinical mastitis, lameness, and subclinical hypomagnesemia postpartum (post-SHMg) in pasture-based dairy cows. Also, the difference in means of prepartum magnesium (Mg) concentration by postpartum health events was evaluated. A total of 890 dairy cows from 32 commercial farms located in southern Chile were enrolled. Cows were examined twice, once between 30 and 3 days before and once between 3 and 30 days after calving. Blood samples were collected on both assessments, and cows were considered as having SHMg if serum total Mg < 0.65 mmol/L. On the postpartum visit, cows were evaluated for metritis and lameness. Information about clinical mastitis and dystocia was collected from on-farm records. Data were analyzed using multivariable mixed linear models and multivariable mixed logistic regression models. The overall prevalence of pre-SHMg was 9.9%, and its presence was associated with the occurrence of post-SHMg (odd ratio [OR] = 5.7; P < 0.0001) and metritis (OR = 3.1; P = 0.04). However, we did not detect an association between pre-SHMg and dystocia, clinical mastitis, or lameness after calving. Prepartum serum Mg concentrations were lower in cows that developed post-SHMg than those that did not (LSM ± SE = 0.75 ± 0.02 mmol/L vs. 0.83 ± 0.02 mmol/L; P < 0.0001). In conclusion, pre-SHMg was associated with a higher risk of post-SHMg and metritis in grazing dairy cows but not other postpartum health events.
Assuntos
Doenças dos Bovinos , Magnésio , Período Pós-Parto , Animais , Bovinos , Feminino , Chile/epidemiologia , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/sangue , Gravidez , Magnésio/sangue , Magnésio/análise , Distocia/veterinária , Distocia/epidemiologia , Prevalência , Endometrite/veterinária , Endometrite/epidemiologia , Endometrite/sangue , Deficiência de Magnésio/veterinária , Deficiência de Magnésio/epidemiologia , Deficiência de Magnésio/sangue , Mastite Bovina/epidemiologia , Mastite Bovina/sangue , Coxeadura Animal/epidemiologia , Coxeadura Animal/etiologia , Coxeadura Animal/sangue , Indústria de LaticíniosRESUMO
In dairy farming, cows display important metabolic changes during the transition period, particularly high-production cows, which need nutrients in greater quantity to meet the required demand. The aim of this study was to determine the prevalence of subclinical hypomagnesemia in pre- and post-partum dairy cows inserted in milk-production systems in the Sousa microregion and the district of São João do Rio do Peixe, both in the State of Paraíba, Brazil. As such, visits were made every two weeks to 34 rural properties, where the team collected 357 blood samples by venepuncture, 106 from pre-partum lactating cows and 251 from lactating cows in the post-partum period. It was found that the properties supplied three types of mineral supplement: a single supplement of NaCl, a supplement of NaCl + mineral base, and a commercial supplement. The cows receiving the commercial mineral supplement had the highest prevalence (10.53%) of the disorder, even showing a significant difference (P < .05) between the other types of supplement. In relation to reproductive period, it was found that the post-partum cows had a higher prevalence of subclinical hypomagnesemia (9.96%) than did the pre-partem cows (8.49%); there was, however, no significant difference (P > .05) between the two. Studies such as this are fundamental for alerting rural and technical producers to the occurrence of subclinical hypomagnesemia in the region, in addition to the damage caused by metabolic disorders.(AU)
Na bovinocultura leiteira, as vacas apresentam mudanças metabólicas importantes durante o período de transição, principalmente aquelas de alta produção, que necessitam de nutrientes em maior quantidade para suprir a demanda requerida. Este estudo teve como objetivo determinar a prevalência de hipomagnesemia subclínica no pré e pós-parto em vacas leiteiras inseridas em sistemas de produção de leite na microrregião de Sousa-PB e município de São João do Rio do Peixe-PB. Para isso foram realizadas visitas quinzenais a 34 propriedades rurais, onde a equipe coletou 357 amostras de sangue por meio de punção venosa, sendo 106 provenientes de vacas em lactação que se encontravam no período de pré-parto e 251 de vacas em lactação inseridas no período de pós-parto. Verificou-se que as propriedades forneciam três tipos de suplemento mineral: suplementação exclusiva com NaCl; suplementação com NaCl + núcleo mineral; e suplementação comercial. As vacas que recebiam a suplementação mineral do tipo comercial corresponderam aquelas com maior prevalência (10,53%) de ocorrência do distúrbio, apresentando ainda diferença significativa (P < 0,05) entre as demais formas de suplementação. Em relação ao período reprodutivo em que as vacas se encontravam, notou- se que aquelas do pós-parto apresentaram maior prevalência de hipomagnesemia subclínica (9,96%) em relação às vacas do pré-parto (8,49%). Porém não houve diferença significative (P > 0,05) entre ambas. Estudos como esse tornam-se fundamentais para alertar produtores rurais e técnicos sobre a ocorrência da hipomagnesemia subclínica na região, além dos prejuízos que os distúrbios metabólicos acarretam.(AU)
Assuntos
Animais , Feminino , Bovinos , Deficiência de Magnésio/epidemiologia , Deficiência de Magnésio/etiologia , Deficiência de Magnésio/metabolismo , Deficiência de Magnésio/veterinária , Magnésio , Minerais na Dieta , BrasilRESUMO
INTRODUCTION: In newborns with the diagnosis of hypoxic-ischemic encephalopathy (HIE) treated with hypother mia, metabolic alterations are observed, which are associated with neurological prognosis. Hypo magnesemia has been reported frequently in the literature in these patients, but it is not measured or corrected in all neonatal healthcare centers. OBJECTIVE: To evaluate the frequency of hypomag nesemia and hypocalcemia in newborns with HIE treated with whole-body hypothermia and to evaluate the response to the magnesium sulfate administration. PATIENTS AND METHOD: Prospective, observational and descriptive study in hospitalized newborns with the diagnosis of HIE and trea ted with whole-body hypothermia between the years 2016 and 2017. Serial blood measurement of magnesemia (Mg) and calcemia (Ca) was performed. When presenting an Mg level < 1.8 mg/dl, supplementation with magnesium sulfate was administered to maintain levels between 1.9 and 2.8 mg/dl. The frecuency of hypomagnesemia, hypocalcemia and clinical evolution was registered. A descriptive statistical analysis was performed, with central tendency measures. RESULTS: Sixteen ca ses were included, 13 of them presented hypomagnesemia (81.3%), with early-onset (6-36 hours of life), which was normalized with magnesium sulfate treatment, receiving a second dose 4 patients. Six of 16 patients presented hypocalcemia (37.5 %). CONCLUSIONS: Hypomagnesemia is frequent (80%), similar to that described in the literature, and should be controlled and corrected early, given its physiological role, in the same way that calcium is controlled.
Assuntos
Hipocalcemia/etiologia , Hipotermia Induzida , Hipóxia-Isquemia Encefálica/complicações , Hipóxia-Isquemia Encefálica/terapia , Deficiência de Magnésio/etiologia , Biomarcadores/sangue , Feminino , Humanos , Hipocalcemia/diagnóstico , Hipocalcemia/tratamento farmacológico , Hipocalcemia/epidemiologia , Recém-Nascido , Magnésio/sangue , Deficiência de Magnésio/diagnóstico , Deficiência de Magnésio/tratamento farmacológico , Deficiência de Magnésio/epidemiologia , Sulfato de Magnésio/uso terapêutico , Masculino , Estudos Prospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
In dairy farming, cows display important metabolic changes during the transition period, particularly high-production cows, which need nutrients in greater quantity to meet the required demand. The aim of this study was to determine the prevalence of subclinical hypomagnesemia in pre- and post-partum dairy cows inserted in milk-production systems in the Sousa microregion and the district of São João do Rio do Peixe, both in the State of Paraíba, Brazil. As such, visits were made every two weeks to 34 rural properties, where the team collected 357 blood samples by venepuncture, 106 from pre-partum lactating cows and 251 from lactating cows in the post-partum period. It was found that the properties supplied three types of mineral supplement: a single supplement of NaCl, a supplement of NaCl + mineral base, and a commercial supplement. The cows receiving the commercial mineral supplement had the highest prevalence (10.53%) of the disorder, even showing a significant difference (P .05) between the two. Studies such as this are fundamental for alerting rural and technical producers to the occurrence of subclinical hypomagnesemia in the region, in addition to the damage caused by metabolic disorders.
Na bovinocultura leiteira, as vacas apresentam mudanças metabólicas importantes durante o período de transição, principalmente aquelas de alta produção, que necessitam de nutrientes em maior quantidade para suprir a demanda requerida. Este estudo teve como objetivo determinar a prevalência de hipomagnesemia subclínica no pré e pós-parto em vacas leiteiras inseridas em sistemas de produção de leite na microrregião de Sousa-PB e município de São João do Rio do Peixe-PB. Para isso foram realizadas visitas quinzenais a 34 propriedades rurais, onde a equipe coletou 357 amostras de sangue por meio de punção venosa, sendo 106 provenientes de vacas em lactação que se encontravam no período de pré-parto e 251 de vacas em lactação inseridas no período de pós-parto. Verificou-se que as propriedades forneciam três tipos de suplemento mineral: suplementação exclusiva com NaCl; suplementação com NaCl + núcleo mineral; e suplementação comercial. As vacas que recebiam a suplementação mineral do tipo comercial corresponderam aquelas com maior prevalência (10,53%) de ocorrência do distúrbio, apresentando ainda diferença significativa (P 0,05) entre ambas. Estudos como esse tornam-se fundamentais para alertar produtores rurais e técnicos sobre a ocorrência da hipomagnesemia subclínica na região, além dos prejuízos que os distúrbios metabólicos acarretam.
Assuntos
Feminino , Animais , Bovinos , Deficiência de Magnésio/epidemiologia , Deficiência de Magnésio/etiologia , Deficiência de Magnésio/metabolismo , Deficiência de Magnésio/veterinária , Magnésio , Brasil , Minerais na DietaRESUMO
Resumen: Introducción: En recién nacidos (RN) con encefalopatía hipóxico isquémica (EHI) en hipotermia se describen alte raciones metabólicas que se asocian a pronóstico neurológico. La hipomagnesemia ha sido reportada en la literatura, pero no es medida ni corregida en todos los centros de atención neonatal. Objeti vo: Evaluar la frecuencia de hipomagnesemia e hipocalcemia en RN con EHI en tratamiento con hipotermia corporal total y evaluar la respuesta al aporte de sulfato de magnesio. Pacientes y Méto do: Estudio prospectivo, observational y descriptivo en RN con EHI sometidos a hipotermia corporal total, hospitalizados entre los años 2016-2017. Se realizó medición seriada en sangre de magnesemia (Mg) y calcemia (Ca). Con Mg menor o igual de 1,8 mg/dl se administró suplemento como sulfato de Mg para mantener niveles entre 1,9 y 2,8 mg/dl. Se describió la frecuencia de hipomagnesemia e hipocalcemia y su presentación en el tiempo. Se realizó registro prospectivo de evolución clínica. Se hizo un análisis estadístico descriptivo, con medidas de tendencia central. Resultados: Se incluyeron 16 pacientes. Presentaron hipomagnesemia 13/16 (81,3%), la que fue precoz (6-36 h de vida), nor malizándose con aporte de sulfato de magnesio, requiriendo 2a dosis 4 de ellos. Presentaron hipo- calcemia 6/16 (37,5%). Conclusiones: La hipomagnesemia es frecuente (80%), similar a lo descrito en la literatura. Dado su importancia fisiológica debe controlarse y corregirse, de igual manera que el calcio.
Abstract: Introduction: In newborns with the diagnosis of hypoxic-ischemic encephalopathy (HIE) treated with hypother mia, metabolic alterations are observed, which are associated with neurological prognosis. Hypo magnesemia has been reported frequently in the literature in these patients, but it is not measured or corrected in all neonatal healthcare centers. Objective: To evaluate the frequency of hypomag nesemia and hypocalcemia in newborns with HIE treated with whole-body hypothermia and to evaluate the response to the magnesium sulfate administration. Patients and Method: Prospective, observational and descriptive study in hospitalized newborns with the diagnosis of HIE and trea ted with whole-body hypothermia between the years 2016 and 2017. Serial blood measurement of magnesemia (Mg) and calcemia (Ca) was performed. When presenting an Mg level < 1.8 mg/dl, supplementation with magnesium sulfate was administered to maintain levels between 1.9 and 2.8 mg/dl. The frecuency of hypomagnesemia, hypocalcemia and clinical evolution was registered. A descriptive statistical analysis was performed, with central tendency measures. Results: Sixteen ca ses were included, 13 of them presented hypomagnesemia (81.3%), with early-onset (6-36 hours of life), which was normalized with magnesium sulfate treatment, receiving a second dose 4 patients. Six of 16 patients presented hypocalcemia (37.5 %). Conclusions: Hypomagnesemia is frequent (80%), similar to that described in the literature, and should be controlled and corrected early, given its physiological role, in the same way that calcium is controlled.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Hipóxia-Isquemia Encefálica/complicações , Hipóxia-Isquemia Encefálica/terapia , Hipocalcemia/etiologia , Hipotermia Induzida , Deficiência de Magnésio/etiologia , Biomarcadores/sangue , Estudos Prospectivos , Fatores de Risco , Resultado do Tratamento , Hipocalcemia/diagnóstico , Hipocalcemia/tratamento farmacológico , Hipocalcemia/epidemiologia , Magnésio/sangue , Deficiência de Magnésio/diagnóstico , Deficiência de Magnésio/tratamento farmacológico , Deficiência de Magnésio/epidemiologia , Sulfato de Magnésio/uso terapêuticoRESUMO
BACKGROUND: Whether low serum magnesium is an epiphenomenon related with obesity or, whether obesity per se is cause of hypomagnesemia, remains to be clarified. OBJECTIVE: To examine the relationship between body weight status and hypomagnesemia in apparently healthy subjects. METHODS: A total of 681 healthy individuals aged 30 to 65years were enrolled in A cross-sectional study. Extreme exercise, chronic diarrhea, alcohol intake, use of diuretics, smoking, oral magnesium supplementation, diabetes, malnutrition, hypertension, liver disease, thyroid disorders, and renal damage were exclusion criteria. Based in the Body Mass Index (BMI), body weight status was defined as follows: normal weight (BMI <25kg/m2); overweight (BMI ≥25<30 BMIkg/m2); and obesity (BMI ≥30kg/m2). Hypomagnesemia was defined by serum magnesium concentration ≤0.74mmol/L. A multiple logistic regression analysis was used to compute the odds ratio (OR) between body weight status (independent variables) and hypomagnesemia (dependent variable). RESULTS: The multivariate logistic regression analysis showed that dietary magnesium intake (OR 2.11; 95%CI 1.4-5.7) but no obesity (OR 1.53; 95%CI 0.9-2.5), overweight (OR 1.40; 95%CI 0.8-2.4), and normal weight (OR 0.78; 95%CI 0.6-2.09) were associated with hypomagnesemia. A subsequent logistic regression analysis adjusted by body mass index, waist circumference, total body fat, systolic and diastolic blood pressure, and triglycerides levels showed that hyperglycemia (2.19; 95%CI 1.1-7.0) and dietary magnesium intake (2.21; 95%CI 1.1-8.9) remained associated with hypomagnesemia. CONCLUSIONS: Our results show that body weight status is not associated with hypomagnesemia and that, irrespective of obesity, hyperglycemia is cause of hypomagnesemia in non-diabetic individuals.
Assuntos
Hiperglicemia/sangue , Deficiência de Magnésio/epidemiologia , Magnésio/sangue , Obesidade/sangue , Adulto , Pressão Sanguínea , Índice de Massa Corporal , Estudos Transversais , Exercício Físico , Feminino , Voluntários Saudáveis , Humanos , Hipertensão/etiologia , Modelos Logísticos , Masculino , México , Pessoa de Meia-Idade , Análise Multivariada , Obesidade/complicações , Fatores de Risco , Circunferência da CinturaRESUMO
BACKGROUND: Hypophosphatemia, hypomagnesemia, and hypokalemia occur in patients receiving parenteral nutrition (PN), mainly when the body's stores are depleted due to fasting or inflammation. Although these disorders are potentially fatal, few studies have reported the incidence in the pediatric population. METHODS: This study evaluated, in a historical cohort of pediatric patients, the prevalence of hypophosphatemia, hypokalemia, and hypomagnesaemia until 48 hours before initiation of PN infusion (P1) and from days 1-4 (P2) and days 5-7 (P3) of PN infusion and investigated if malnutrition, calories, and protein infusion were correlated to these disorders. RESULTS: Malnutrition was present in 32.8% (n = 119) of the subjects; 66.4% of the patients were in the pediatric intensive care unit. Survival rate was 86.6%. P1 had the highest prevalence of mineral disorders, with 54 events (58.1%; P2, n = 35, 37.6%; P3, n = 4, 4.3%). Hypokalemia events were related to malnutrition (odds ratio, 2.79; 95% confidence interval, 1.09-7.14; P = .045). In the first 7 days, infused calories were below the amount recommended by current guidelines in up to 84.9% of patients, and protein infused was adequate in up to 75.7%. Protein infused above the recommendation in the first 4 days was related to hypomagnesaemia (odds ratio, 5.66; 95% confidence interval, 1.24-25.79; P = .033). CONCLUSION: Hypophosphatemia, hypokalemia, and hypomagnesemia were frequent in hospitalized pediatric patients before and during the first 4 days of PN infusion. Patients with malnutrition had more chances of having hypokalemia, and those who received high protein infusion had an increased chance of developing hypomagnesemia.
Assuntos
Hipopotassemia/epidemiologia , Hipofosfatemia/epidemiologia , Deficiência de Magnésio/epidemiologia , Desnutrição/epidemiologia , Nutrição Parenteral/efeitos adversos , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Ingestão de Energia , Feminino , Hospitalização , Humanos , Hipopotassemia/sangue , Hipopotassemia/etiologia , Hipofosfatemia/sangue , Hipofosfatemia/etiologia , Incidência , Lactente , Unidades de Terapia Intensiva Pediátrica , Deficiência de Magnésio/sangue , Deficiência de Magnésio/etiologia , Masculino , Desnutrição/sangue , Desnutrição/etiologia , Micronutrientes/administração & dosagem , Micronutrientes/sangue , Estado Nutricional , Prevalência , Adulto JovemRESUMO
BACKGROUND: In the search for answers that contribute to the metabolic control of patients with diabetes and the primary prevention of the disease, we performed a review of the evidence from cohort studies on the relationship between serum and/or magnesium intake with the risk of developing type 2 diabetes as well as of clinical trials on the efficacy of oral magnesium salts on reducing glycemia. METHODS: An electronic search using the databases MEDLINE, EMBASE, and Cochrane Controlled Trials Register, updated to September 30, 2013, was performed. RESULTS: A total of seven cohort studies (24,388 persons/year) show unequivocally that magnesium intake is associated with decreased risk of developing type 2 diabetes; two studies (13,076 persons/year) indicate that low magnesium intake is not associated with the risk of diabetes; one study (8,735 persons/year) shows that hypomagnesemia is associated with the development of impaired glucose metabolism. A total of 11 randomized controlled trials were identified; five show the effectiveness of oral magnesium salts in reducing glycemia in high-risk subjects and six studies carried out in patients with type 2 diabetes show inconsistent results. CONCLUSIONS: Magnesium intake in the customary diet of subjects of the general population and the high-risk groups and/or oral magnesium supplementation is recommended for the prevention of diabetes. The efficacy of oral magnesium supplementation in the reduction of glucose levels in type 2 diabetic patients is inconsistent.
Antecedentes: ante la repercusión de la diabetes tipo 2 en la calidad de vida y los altos costos de su tratamiento, es urgente la búsqueda de alternativas para el control metabólico y la prevención primaria de esta enfermedad. Objetivo: revisar la evidencia derivada de estudios de cohortes acerca de la relación entre las concentraciones séricas y la ingesta de magnesio con el riesgo de diabetes tipo 2, y de ensayos clínicos de la eficacia de las sales orales de magnesio en la reducción de la glucemia. Material y métodos: estudio retrospectivo, efectuado con base en la búsqueda de estudios de cohorte mayores de 10 años en MEDLINE, EMBASE, y Cochrane Controlled Trials Register, actualizada al 30 de septiembre del 2013. Resultados: se encontraron siete estudios de cohorte (24,388 personas/ año) que muestran que la ingesta de magnesio disminuye el riesgo de diabetes tipo 2; dos estudios (13,076 personas/año) indican que la baja ingesta de magnesio en la dieta no parece asociarse con el riesgo de diabetes; 1 estudio (8,735 personas/año) demuestra que la hipomagnesemia se asocia con alteraciones del metabolismo de la glucosa. De 11 ensayos clínicos con asignación al azar, 5 estudios en sujetos de riesgo muestran que las sales orales de magnesio reducen la glucemia, y 6 estudios en pacientes con diabetes tipo 2 muestran resultados inconsistentes. Conclusiones: la ingesta de magnesio en la dieta habitual o de sales orales de magnesio es recomendable en la prevención de diabetes. La eficacia de las sales de magnesio en la reducción de la glucemia de pacientes con diabetes tipo 2, es inconsistente.
Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Magnésio/uso terapêutico , Administração Oral , Glicemia/análise , Estudos de Coortes , Efeitos Psicossociais da Doença , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/economia , Diabetes Mellitus Tipo 2/epidemiologia , Dieta , Suplementos Nutricionais , Saúde Global , Humanos , Magnésio/administração & dosagem , Deficiência de Magnésio/complicações , Deficiência de Magnésio/tratamento farmacológico , Deficiência de Magnésio/epidemiologia , México/epidemiologia , Prevalência , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: To describe the prevalence of serum iron and zinc deficiencies and low serum concentrations (LSC) of copper and magnesium in Mexican adults. MATERIALS AND METHODS: Blood samples from subjects (≥20 years, both genders) participating in the 2006 National Health and Nutrition Survey were used to measure the serum concentrations of s-ferritin, soluble- transferrin-receptor (s-TfR), zinc, copper, and magnesium. RESULTS: The prevalence of s-ferritin≤12 ug/L was 18.1 and 3.6% while s-TfR>6 mg/L was 9.5 and 4.4%, for females and males, respectively. The prevalence of zinc deficiency was 33.8% females and 42.6% males; LSC of copper were 16.8 and 18.2%, and 36.3 and 31.0% for magnesium, for females and males, respectively. CONCLUSIONS: The prevalence of deficiencies in iron (in females), and zinc are still high in the adult population. LSC of copper and magnesium are published for the first time and show significant prevalence of deficiencies. Corrective actions are necessary in order to diminish these nutritional deficits in the Mexican population.
Assuntos
Cobre/deficiência , Deficiências de Ferro , Deficiência de Magnésio/epidemiologia , Zinco/deficiência , Adulto , Idoso , Deficiências Nutricionais/epidemiologia , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência , Adulto JovemRESUMO
Magnesium has been implicated in the pathogenesis of hypertension, but the role of its intracellular levels in cardiovascular diseases is not clear yet. We investigated the relationships of low concentrations of serum magnesium (sMg) and intracellular Mg (iMg) with clinical and vascular parameters. Thiazide-treated hypertensive women were separated into two groups according to lower (<2.0 mg/dL) or normal (≥2.0 mg/dL) sMg concentrations. The same patients were later divided according to lower (<3.75 mg/dL erythrocytes) and normal (≥3.75 mg/dL erythrocytes) iMg concentrations. Carotid ultrasound, radial applanation, and peripheral arterial tonometry were performed in all patients. Low sMg levels were associated with increased Framingham Risk Score (16% ± 3% vs 11% ± 1%; P = .024), higher systolic (148 ± 7 vs 135 ± 3 mm Hg; P = .049) and diastolic (91 ± 3 vs 84 ± 2 mm Hg; P = .042) blood pressure, and carotid intima-media thickness (0.92 ± 0.09 vs 0.76 ± 0.02 mm; P = .023). Low concentrations of iMg were related to wave reflection parameters such as increased augmentation pressure (20 ± 2 vs 15 ± 1 mm Hg; P = .032) and augmentation index (43% ± 2% vs 33% ± 2%; P = .004). In conclusion, in these diuretic-treated hypertensive women, low sMg was associated with higher blood pressure values, and more intense wave reflection were closely linked to iMg depletion, processes that might contribute to hypertension and other cardiovascular risk factors.
Assuntos
Hipertensão/tratamento farmacológico , Deficiência de Magnésio/tratamento farmacológico , Magnésio/uso terapêutico , Inibidores de Simportadores de Cloreto de Sódio/uso terapêutico , Doenças Vasculares/tratamento farmacológico , Adulto , Idoso , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/fisiologia , Estudos Transversais , Método Duplo-Cego , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/metabolismo , Magnésio/sangue , Deficiência de Magnésio/sangue , Deficiência de Magnésio/epidemiologia , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Doenças Vasculares/epidemiologia , Doenças Vasculares/metabolismo , Rigidez Vascular/fisiologiaRESUMO
OBJECTIVE: The aim of this study was to evaluate the association of serum magnesium levels with proton pump inhibitors (PPIs) use and other factors. METHODS: This was a cross-sectional study of 151 patients admitted with acute diseases in the Internal Medicine Division of the Hospital de Clinicas de Porto Alegre, after the exclusion of conditions that are commonly associated with hypomagnesemia: diarrhea; vomiting; chronic alcohol use; severely uncompensated diabetes mellitus; and chronic use of laxatives, diuretics or other drugs causing magnesium deficiency. RESULTS: All patients had normal serum magnesium levels. Serum albumin and creatinine levels were positively associated with serum magnesium levels, after adjusting for confounders. There was no difference between mean serum magnesium levels of PPI users and non-users, nor between men and women; there was also no correlation among age, serum phosphorus, and potassium levels with serum magnesium levels. Limitations of this study include the absence of an instrument for measuring adherence to PPI use and the sample size. CONCLUSION: The association of PPI use and hypomagnesemia is uncommon. Congenital defects in the metabolism of magnesium may be responsible for hypomagnesemia in some patients using this drug class.
OBJETIVO: O objetivo desse estudo foi verificar a associação do nível sérico do magnésio com o uso de inibidores de bomba de prótons (IBP) e outros fatores. MÉTODOS: Realizou-se estudo transversal com 151 pacientes admitidos com doenças agudas no serviço de medicina interna do Hospital de Clínicas de Porto Alegre. Foram excluídos aqueles pacientes com condições usualmente relacionadas à hipomagnesemia: diarréia; vômitos; diabéticos agudamente descompensados; uso crônico de laxantes, álcool, diuréticos ou outros fármacos relacionados. RESULTADOS: Todos os pacientes apresentaram níveis normais de magnésio. Albumina e creatinina sérica se associaram positivamente com os níveis de magnésio sérico, após ajuste para fatores confundidores. Não houve diferença no nível sérico de magnésio em usuários ou não-usuários de IBP ou entre homens e mulheres. Não houve correlação com idade, nível sérico de fósforo e potássio. As principais limitações desse estudo foram a ausência de instrumento para medir a adesão aos IBPs e o tamanho da amostra. CONCLUSÃO: A associação do uso de IBP e hipomagnesemia é rara. Defeitos congênitos no metabolismo do magnésio devem ser responsáveis pelo surgimento de hipomagnesemia em usuários de dessa classe de fármacos.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Deficiência de Magnésio/induzido quimicamente , Deficiência de Magnésio/epidemiologia , Magnésio/sangue , Inibidores da Bomba de Prótons/efeitos adversos , Creatinina/sangue , Métodos Epidemiológicos , Deficiência de Magnésio/sangue , Deficiência de Magnésio/diagnóstico , Albumina Sérica/análiseRESUMO
OBJECTIVE: To describe the prevalence of serum iron and zinc deficiencies and low serum concentrations (LSC) of copper and magnesium in Mexican adults. MATERIALS AND METHODS: Blood samples from subjects (>20 years, both genders) participating in the 2006 National Health and Nutrition Survey were used to measure the serum concentrations of s-ferritin, soluble- transferrin-receptor (s-TfR), zinc, copper, and magnesium. RESULTS: The prevalence of s-ferritin<12ug/L was 18.1 and 3.6% while s-TfR>6mg/L was 9.5 and 4.4%, for females and males, respectively. The prevalence of zinc deficiency was 33.8% females and 42.6% males; LSC of copper were 16.8 and 18.2%, and 36.3 and 31.0% for magnesium, for females and males, respectively. CONCLUSIONS: The prevalence of deficiencies in iron (in females), and zinc are still high in the adult population. LSC of copper and magnesium are published for the first time and show significant prevalence of deficiencies. Corrective actions are necessary in order to diminish these nutritional deficits in the Mexican population.
OBJETIVO: Describir la prevalencia de deficiencias de hierro y zinc y valores bajos (VB) de cobre y magnesio en adultos mexicanos. MATERIAL Y MÉTODOS: Se utilizaron muestras de sangre de individuos (>20 años, ambos sexos) de la Encuesta Nacional de Salud y Nutrición 2006 para medir concentraciones séricas de s-ferritina, receptor soluble de transferrina (s-TfR), zinc, cobre y magnesio. RESULTADOS: La prevalencia de s-ferritina<12ug/L fue de 18.1 y 3.6%, s-TfR>6mg/L de 9.5 y 4.4% para mujeres y hombres, respectivamente. Para zinc fue de 33.8% mujeres y 42.6% hombres. Para VB de cobre fue 16.8 y 18.2%; y magnesio 36.3 y 31.0% en mujeres y hombres, respectivamente. CONCLUSIONES: Las prevalencias de deficiencia de hierro (mujeres) y zinc aún son altas en la población adulta. VB de cobre y magnesio se publican por primera vez en una muestra representativa de adultos y muestran prevalencias importantes. Son necesarias medidas correctivas para combatir estos problemas en la población mexicana.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Cobre/deficiência , Ferro/deficiência , Deficiência de Magnésio/epidemiologia , Zinco/deficiência , Deficiências Nutricionais/epidemiologia , México/epidemiologia , Inquéritos Nutricionais , PrevalênciaRESUMO
OBJECTIVE: The aim of this study was to evaluate the association of serum magnesium levels with proton pump inhibitors (PPIs) use and other factors. METHODS: This was a cross-sectional study of 151 patients admitted with acute diseases in the Internal Medicine Division of the Hospital de Clinicas de Porto Alegre, after the exclusion of conditions that are commonly associated with hypomagnesemia: diarrhea; vomiting; chronic alcohol use; severely uncompensated diabetes mellitus; and chronic use of laxatives, diuretics or other drugs causing magnesium deficiency. RESULTS: All patients had normal serum magnesium levels. Serum albumin and creatinine levels were positively associated with serum magnesium levels, after adjusting for confounders. There was no difference between mean serum magnesium levels of PPI users and non-users, nor between men and women; there was also no correlation among age, serum phosphorus, and potassium levels with serum magnesium levels. Limitations of this study include the absence of an instrument for measuring adherence to PPI use and the sample size. CONCLUSION: The association of PPI use and hypomagnesemia is uncommon. Congenital defects in the metabolism of magnesium may be responsible for hypomagnesemia in some patients using this drug class.
Assuntos
Deficiência de Magnésio/induzido quimicamente , Deficiência de Magnésio/epidemiologia , Magnésio/sangue , Inibidores da Bomba de Prótons/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Creatinina/sangue , Métodos Epidemiológicos , Feminino , Humanos , Deficiência de Magnésio/sangue , Deficiência de Magnésio/diagnóstico , Masculino , Pessoa de Meia-Idade , Albumina Sérica/análise , Adulto JovemRESUMO
Deficiencies in calcium (Ca) and magnesium (Mg) are associated with various complications during pregnancy. To test the hypothesis that the status of these minerals is inadequate in pregnancy, a cross-sectional study was conducted of the dietary intake and status of Ca and Mg in pregnant women (n = 50) attending a general public university hospital in Brazil. Dietary intake was assessed from 4-day food records; levels of plasma Mg, erythrocyte Mg, and urinary Ca and Mg excretion were determined by flame atomic absorption spectroscopy; and type I collagen C-telopeptides were evaluated by enzyme-linked immunosorbent assay. Probabilities of inadequate Ca and Mg intake were exhibited by 58 and 98% of the study population, respectively. The mean levels of urinary Ca and Mg excretion were 8.55 and 3.77 mmol/L, respectively. Plasma C-telopeptides, plasma Mg, and erythrocyte Mg were within normal levels. Multiple linear regression analysis revealed positive relationships among urinary Ca excretion, Ca intake (P = .002) and urinary Mg excretion (P < .001) and between erythrocyte Mg and Mg intake (P = .023). It is concluded that the Ca and Mg status of participants was adequate even though the intake of Ca and Mg was lower than the recommended level.
Assuntos
Cálcio/sangue , Deficiência de Magnésio/fisiopatologia , Magnésio/sangue , Desnutrição/fisiopatologia , Complicações na Gravidez/fisiopatologia , Adulto , Brasil/epidemiologia , Cálcio/deficiência , Cálcio/urina , Colágeno Tipo I/sangue , Estudos Transversais , Ingestão de Energia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Modelos Lineares , Magnésio/urina , Deficiência de Magnésio/epidemiologia , Desnutrição/complicações , Desnutrição/epidemiologia , Estado Nutricional , Peptídeos/sangue , Gravidez , Complicações na Gravidez/epidemiologia , Adulto JovemRESUMO
OBJETIVOS: Verificar a frequência de hipomagnesemia em pacientes pediátricos submetidos a artrodese de coluna, avaliando se há queda significativa nas dosagens de magnésio sérico nos períodos pré e pós-operatório, quais suas possíveis causas e quais as consequências clínicas para os pacientes. MÉTODOS: Estudo retrospectivo e descritivo dos pacientes admitidos em uma Unidade de Terapia Intensiva pediátrica no pós-operatório de artrodese de coluna, no período de 1º de março a 31 de agosto de 2011. Foram comparados os níveis de magnésio, fósforo, cálcio total e ionizado no pré-operatório com os valores encontrados após a admissão na Unidade de Terapia Intensiva. RESULTADOS: Foram incluídos 45 pacientes, com idade média de 13,1 anos. No pré-operatório, o valor médio do magnésio foi de 1,8±0,2 mg/dL, e no pós-operatório, de 1,4±0,2 mg/dL, o que demonstra uma queda significativa entre os dois períodos (p < 0,001). A frequência de hipomagnesemia foi de somente um paciente (2%) no pré-operatório para 31 (68%) no pós-operatório. Houve também queda significativa nos níveis de fósforo (p < 0,001) e cálcio total (p < 0,001). Houve correlação significativa entre a queda do magnésio e o volume de fluido recebido durante a cirurgia (p = 0,03), volume de transfusão sanguínea (p < 0,001) e número de vértebras fixadas (p < 0,05). Dos 31 pacientes com hipomagnesemia, sete (22%) apresentaram sintomas. CONCLUSÃO: Existe uma elevada frequência de hipomagnesemia em pacientes submetidos a artrodese de coluna. Ao realizar a dosagem do magnésio sérico no momento da admissão na Unidade de Terapia Intensiva, a reposição adequada pode ser prontamente iniciada, minimizando o risco de complicações.
OBJECTIVES: To determine the frequency of hypomagnesaemia in pediatric patients after spinal fusion, to verify whether postoperative magnesium levels were lower than preoperative levels and, if so, to identify possible causes and assess the clinical repercussions for patients. METHODS: This was a retrospective descriptive study of pediatric patients admitted to a pediatric intensive care unit (ICU) after spine fusion surgery, between March 1 and August 31, 2011. Preoperative magnesium, phosphorus and total and ionized calcium concentrations were compared with the results of tests conducted during the first 24 hours after admission to the ICU. RESULTS: A total of 45 patients were enrolled on the study. Median age was 13.1 years. Preoperative mean serum magnesium was 1.8±0.2 mg/dL and postoperative serum magnesium was 1.4±0.2 mg/dL, which was a significant reduction between the two periods (p < 0.001). The frequency of hypomagnesaemia rose from 1 patient (2%) in the preoperative period to 31 patients (68%) during the postoperative period. There were also significant reductions in concentrations of phosphorus (p < 0.001) and total calcium (p < 0.001). There was a significant correlation between magnesium reductions and the volume of fluids administered during the surgery (p = 0.03), transfused blood volume (p < 0.001) and number of vertebrae fused (p < 0.05). Seven of the 31 patients with hypomagnesemia exhibited symptoms (22%). CONCLUSION: There was an elevated frequency of hypomagnesemia in patients who underwent spinal fusion. Serum magnesium should be assayed when patients are admitted to the pediatric ICU, so appropriate supplementation can be initiated immediately, minimizing the risk of complications.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Deficiência de Magnésio/etiologia , Magnésio/sangue , Fusão Vertebral/efeitos adversos , Brasil/epidemiologia , Cálcio/sangue , Unidades de Terapia Intensiva Pediátrica , Deficiência de Magnésio/sangue , Deficiência de Magnésio/epidemiologia , Fósforo/sangue , Estudos Retrospectivos , Estatísticas não Paramétricas , Escoliose/cirurgiaRESUMO
OBJECTIVES: To determine the frequency of hypomagnesemia in pediatric patients after spinal fusion, to verify whether postoperative magnesium levels were lower than preoperative levels and, if so, to identify possible causes and assess the clinical repercussions for patients. METHODS: This was a retrospective descriptive study of pediatric patients admitted to a pediatric intensive care unit (ICU) after spine fusion surgery, between March 1 and August 31, 2011. Preoperative magnesium, phosphorus and total and ionized calcium concentrations were compared with the results of tests conducted during the first 24 hours after admission to the ICU. RESULTS: A total of 45 patients were enrolled on the study. Median age was 13.1 years. Preoperative mean serum magnesium was 1.8 ± 0.2 mg/dL and postoperative serum magnesium was 1.4 ± 0.2 mg/dL, which was a significant reduction between the two periods (p < 0.001). The frequency of hypomagnesemia rose from 1 patient (2%) in the preoperative period to 31 patients (68%) during the postoperative period. There were also significant reductions in concentrations of phosphorus (p < 0.001) and total calcium (p < 0.001). There was a significant correlation between magnesium reductions and the volume of fluids administered during the surgery (p = 0.03), transfused blood volume (p < 0.001) and number of vertebrae fused (p < 0.05). Seven of the 31 patients with hypomagnesemia exhibited symptoms (22%). CONCLUSION: There was an elevated frequency of hypomagnesemia in patients who underwent spinal fusion. Serum magnesium should be assayed when patients are admitted to the pediatric ICU, so that appropriate supplementation can be initiated immediately, minimizing the risk of complications.
Assuntos
Deficiência de Magnésio/etiologia , Magnésio/sangue , Fusão Vertebral/efeitos adversos , Adolescente , Brasil/epidemiologia , Cálcio/sangue , Criança , Feminino , Humanos , Unidades de Terapia Intensiva Pediátrica , Deficiência de Magnésio/sangue , Deficiência de Magnésio/epidemiologia , Masculino , Fósforo/sangue , Estudos Retrospectivos , Escoliose/cirurgia , Estatísticas não ParamétricasRESUMO
OBJECTIVE: To describe the frequency of anemia and iron, zinc, copper and magnesium deficiencies among Mexican adolescents in the probabilistic survey ENSANUT 2006. MATERIALS AND METHODS: The sample included 2447 adolescents aged 12 to 19 y. Capillary hemoglobin and venous blood samples were collected to measure the concentrations of ferritin, sTFR, CRP, zinc, iron, copper and magnesium. Logistic regression models were constructed to assess the risk for mineral deficiencies. RESULTS: The overall prevalence of anemia was 11.8 and 4.6%, body iron deficiency 18.2 and 7.9% for females and males, respectively. Overall prevalence of tissue iron deficiency was 6.9%, low serum copper were 14.4 and 12.25%; zinc 28.4 and 24.5%, magnesium 40 and 35.3%; for females and males, respectively. CONCLUSIONS: There is a high prevalence of mineral deficiency in Mexican adolescents; females were more prone to have more mineral deficiencies. Nutritional interventions are necessaries in order to reduce and control them.
Assuntos
Anemia/epidemiologia , Cobre/deficiência , Deficiências de Ferro , Deficiência de Magnésio/epidemiologia , Zinco/deficiência , Adolescente , Criança , Deficiências Nutricionais/epidemiologia , Feminino , Humanos , Masculino , México/epidemiologia , Inquéritos Nutricionais , Prevalência , Adulto JovemRESUMO
OBJETIVE: To describe the frequency of anemia and iron, zinc, copper and magnesium deficiencies among Mexican adolescents in the probabilistic survey ENSANUT 2006. MATERIALS AND METHODS: The sample included 2447 adolescents aged 12 to 19 y. Capillary hemoglobin and venous blood samples were collected to measure the concentrations of ferritin, sTFR, CRP, zinc, iron, copper and magnesium. Logistic regression models were constructed to assess the risk for mineral deficiencies. RESULTS: The overall prevalence of anemia was 11.8 and 4.6%, body iron deficiency 18.2 and 7.9% for females and males, respectively. Overall prevalence of tissue iron deficiency was 6.9%, low serum copper were14.4 and 12.25%; zinc 28.4 and 24.5%, magnesium 40 and 35.3%; for females and males, respectively. CONCLUSIONS: There is a high prevalence of mineral deficiency in Mexican adolescents; females were more prone to have more mineral deficiencies. Nutritional interventions are necessaries in order to reduce and control them.
OBJETIVO: Describir la prevalencia de anemia y deficiencia de hierro, zinc, cobre y magnesio en adolescentes mexicanos en la encuesta probabilística ENSANUT 2006. MATERIAL Y MÉTODOS: La muestra incluyó 2447 adolescentes de 12 a 19 años de edad. Se tomó hemoglobina capilar y muestras de sangre venosa para medir las concentraciones séricas de ferritina, sTFR, CRP, zinc, hierro, cobre y magnesio. Se construyeron modelos de regresión logística para evaluar el riesgo de deficiencia de minerales. RESULTADOS: La prevalencia de anemia fue de 11.8% en mujeres y 4.6% en hombres. Las deficiencias de hierro fueron de 18.2 y 7.9% La deficiencia tisular de hierro fue 6.9%; la baja concentración de cobre fue de 14.4 y 12.25% la de zinc de 28.4 y 24.5%, la de magnesio fue 40 y 35.3% en mujeres y hombres, respectivamente. CONCLUSIONES: Existe una alta prevalencia de deficiencia de minerales en los adolescentes; las mujeres tuvieron mayor riesgo. Son necesarias intervenciones nutricionales para reducir o controlar estas deficiencias.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Adulto Jovem , Anemia/epidemiologia , Cobre/deficiência , Ferro/deficiência , Deficiência de Magnésio/epidemiologia , Zinco/deficiência , Deficiências Nutricionais/epidemiologia , México/epidemiologia , Inquéritos Nutricionais , PrevalênciaRESUMO
BACKGROUND & AIMS: This study was undertaken to assess magnesium intake and magnesium status in patients with type 2 diabetes, and to identify the parameters that best predict alterations in fasting glucose and plasma magnesium. METHODS: A cross-sectional study was carried out in patients with type 2 diabetes (n = 51; 53.6 ± 10.5 y) selected within the inclusion factors, at the University Hospital Onofre Lopes. Magnesium intake was assessed by three 24-h recalls. Urine, plasma and erythrocytes magnesium, fasting and 2-h postprandial glucose, HbA1, microalbuminuria, proteinuria, and serum and urine creatinine were measured. RESULTS: Mean magnesium intake (9.37 ± 1.76 mmol/d), urine magnesium (2.80 ± 1.51 mmol/d), plasma magnesium (0.71 ± 0.08 mmol/L) and erythrocyte magnesium (1.92 ± 0.23 mmol/L) levels were low. Seventy-seven percent of participants presented one or more magnesium status parameters below the cut-off points of 3.00 mmol/L for urine, 0.75 mmol/L for plasma and 1.65 mmol/L for erythrocytes. Subjects presented poor blood glucose control with fasting glucose of 8.1 ± 3.7 mmol/L, 2-h postprandial glucose of 11.1 ± 5.1 mmol/L, and HbA1 of 11.4 ± 3.0%. The parameters that influenced fasting glucose were urine, plasma and dietary magnesium, while plasma magnesium was influenced by creatinine clearance. CONCLUSIONS: Magnesium status was influenced by kidney depuration and was altered in patients with type 2 diabetes, and magnesium showed to play an important role in blood glucose control.
Assuntos
Glicemia , Diabetes Mellitus Tipo 2/dietoterapia , Dieta , Deficiência de Magnésio/complicações , Magnésio/administração & dosagem , Adulto , Idoso , Índice de Massa Corporal , Brasil/epidemiologia , Creatinina/sangue , Creatinina/urina , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/fisiopatologia , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/fisiopatologia , Nefropatias Diabéticas/prevenção & controle , Eritrócitos/química , Hemoglobinas Glicadas/análise , Humanos , Hiperglicemia/prevenção & controle , Incidência , Magnésio/sangue , Magnésio/urina , Deficiência de Magnésio/epidemiologia , Deficiência de Magnésio/prevenção & controle , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Obesidade/complicações , Proteinúria/prevenção & controleRESUMO
This cross sectional study evaluated serum (SMg) and intramononuclear (MMg) magnesium in patients with metabolic syndrome without diabetes and correlated them with cardiovascular risk factors. 72 patients and 57 controls (blood donors) were studied. Hypomagnesemia (SMg<1.7 mg/dL) was seen in 23.2% and intracellular depletion in 36.1% of the patients. SMg and MMg means were significantly lower in patients than in controls: 1.80+/-0.18 mg/dL vs. 2.43+/-0.43 mg/dL and 0.98+/-0.55 microg/mg vs. 1.67+/-0.64 microg/mg of protein (P<0.001). Inverse correlation was observed between, SMg and MMg with BMI; SMg with systolic blood pressure and waist circumference in women. Patients with acanthosis nigricans had lower SMg (1.75+/-0.18 mg/dL vs. 1.85+/- 0.18 mg/dL, P<0.05). Non-white people had lower SMg (1.78+/-0.16 mg/dL vs. 1.92+/-0.24 mg/dL, P=0.007) and MMg (0.95+/-0.59 microg/mg vs. 1.13+/-0.42 microg/mg, P=0.03). Patients with IR showed lower MgM means (0.84+/-0.33 microg/mg vs. 1.14+/-0.69 microg/mg, P<0.05). The same occurred in patients with low HDL-c levels (0.92+/-0.46 microg/mg vs. 1.20+/-0.70 microg/mg, P=0.03), and those with moderate and severe hepatic steatosis (0.77+/-0.29 microg/mg vs. 1.21+/-0.80 microg/mg, P<0.05). In conclusion, magnesium depletion in serum and mononuclear cells is common in obese people with metabolic syndrome, and it is more evident in non-white people with insulin resistance. This depletion may contribute to a post-receptor insulin resistance.