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 LaticíniosAssuntos
Humanos , Masculino , Feminino , Idoso , Inibidores da Bomba de Prótons/efeitos adversos , Deficiência de Magnésio/induzido quimicamente , Estudos de Casos e Controles , Prevalência , Estudos Transversais , Fatores de Risco , Corticosteroides/uso terapêutico , Insuficiência Renal Crônica/complicações , Inibidores de Calcineurina/uso terapêutico , Magnésio/uso terapêutico , Deficiência de Magnésio/sangueRESUMO
The objective, with this study, was to investigate the consequences of subclinical hypomagnesemia on the metabolic parameters of dairy cows. Blood samples were collected from 12 animals every two days, between -22 pre and 22 days postpartum, for blood analysis and determining the metabolic profile. The animals were grouped according to magnesium blood concentrations: Hypomagnesemia group (n=5), with blood levels below 1.8 mg/dL in at least two consecutive days, and Control group (n=7), with blood levels above 1.8 mg/dL during the period. The hypomagnesemia group had higher levels of glucagon on days 10, 18 and 20 as well as glucagon/insulin ratio was higher on 6, 8, 10, 12 and 16 days after calving. The blood concentrations of aspartate aminotransferase in the hypomagnesemia group were higher during days 0, 6, 8, 10, 12 and 14 after calving. The results indicate that the low blood levels of magnesium during peripartum may be associated with elevated levels of aspartate amino transferase and glucagon in the blood. In general, subclinical hypomagnesemia does not alter the levels of indicators of energy metabolism, but the results show that cows with hypomagnesemia have a higher rate of glucagon/insulin, demonstrating a greater challenge to maintain glucose blood concentration.(AU)
O objetivo, com este estudo, foi investigar as conseqüências da hipomagnesemia subclínica sobre parâmetros metabólicos de vacas leiteiras. Amostras de sangue foram coletadas de 12 animais, a cada dois dias, entre os dias 22 pré e 22 pós-parto, para a realização de análises sanguíneas e determinação do perfil metabólico. Os animais foram categorizados de acordo com os níveis séricos de magnésio: Grupo Hipomagnesêmicas (n=5), com níveis abaixo de 1,8 mg/dL em ao menos dois dias consecutivos, e o Grupo Controle (n=7), com níveis acima de 1,8 mg/dL em todo o período. O grupo hipomagnesêmicas apresentou níveis de glucagon maiores nos dias 10, 18 e 20, e a taxa Glucagon/Insulina foi maior nos dias 6, 8, 10, 12 e 16 após o parto. As concentrações de aspartato amino transferase foram maiores no grupo hipomagnesêmicas nos dias 0, 6, 8, 10, 12 e 14 pós-parto. Os resultados indicaram que níveis reduzidos de magnésio no periparto podem estar relacionados com níveis elevados de aspartato amino transferase e de glucagon. Em geral, a hipomagnesemia subclínica não altera os níveis dos indicadores do metabolismo energético, mas os resultados demonstraram que as vacas com hipomagnesemia apresentaram maior taxa de glucagon/insulina, demonstrando um maior desafio para manter os níveis glicêmicos.(AU)
Assuntos
Animais , Feminino , Bovinos , Deficiência de Magnésio/sangue , Deficiência de Magnésio/veterinária , Deficiência de Magnésio/metabolismo , Período Periparto , Aspartato AminotransferasesRESUMO
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: Patients with short bowel syndrome have significant fluid and electrolytes loss. OBJECTIVE: Evaluate the mineral and electrolyte status in short bowel syndrome patients receiving intermittent parenteral nutrition or oral feeding. METHODS: Twenty two adults with short bowel syndrome, of whom 11 were parenteral nutrition dependent (PN group), and the 11 remaining had been weaned off parenteral nutrition for at least 1 year and received all nutrients by oral feeding (OF group). The study also included 14 healthy volunteers paired by age and gender (control group). Food ingestion, anthropometry, serum or plasma levels of sodium, potassium, phosphorus, magnesium, calcium, zinc, iron and copper were evaluated. PN group subjects were evaluated before starting a new parenteral nutrition cycle. RESULTS: The levels of sodium, potassium, phosphorus, calcium and zinc were similar between the groups. The magnesium value was lower in the PN group (1.0 ± 0.4 mEq /L) than other groups. Furthermore, this electrolyte was lower in the OF group (1.4 ± 0.3 mEq /L) when compared to the Control group (1.8 ± 0.1 mEq/L). Lower values of copper (69±24 vs 73±26 vs 109±16 µg/dL) were documented, respectively, for the PN and OF groups when compared to the control group. CONCLUSION: Hypomagnesemia and hypocupremia are electrolyte disturbances commonly observed in short bowel syndrome. Patients with massive intestinal resection require monitoring and supplementation in order to prevent magnesium and copper deficiencies.
Assuntos
Cobre/deficiência , Deficiência de Magnésio/sangue , Síndrome do Intestino Curto/sangue , Adulto , Cálcio/sangue , Estudos de Casos e Controles , Ingestão de Energia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nutrição Parenteral , Fósforo/sangue , Potássio/sangue , Sódio/sangue , Zinco/sangueRESUMO
Background Patients with short bowel syndrome have significant fluid and electrolytes loss. Objective Evaluate the mineral and electrolyte status in short bowel syndrome patients receiving intermittent parenteral nutrition or oral feeding. Methods Twenty two adults with short bowel syndrome, of whom 11 were parenteral nutrition dependent (PN group), and the 11 remaining had been weaned off parenteral nutrition for at least 1 year and received all nutrients by oral feeding (OF group). The study also included 14 healthy volunteers paired by age and gender (control group). Food ingestion, anthropometry, serum or plasma levels of sodium, potassium, phosphorus, magnesium, calcium, zinc, iron and copper were evaluated. PN group subjects were evaluated before starting a new parenteral nutrition cycle. Results The levels of sodium, potassium, phosphorus, calcium and zinc were similar between the groups. The magnesium value was lower in the PN group (1.0 ± 0.4 mEq /L) than other groups. Furthermore, this electrolyte was lower in the OF group (1.4 ± 0.3 mEq /L) when compared to the Control group (1.8 ± 0.1 mEq/L). Lower values of copper (69±24 vs 73±26 vs 109±16 µg/dL) were documented, respectively, for the PN and OF groups when compared to the control group. Conclusion Hypomagnesemia and hypocupremia are electrolyte disturbances commonly observed in short bowel syndrome. Patients with massive intestinal resection require monitoring and supplementation in order to prevent magnesium and copper deficiencies. .
Contexto Ressecções intestinais extensas resultam em perda de fluídos e eletrólitos. Objetivo Avaliar os níveis séricos de minerais e eletrólitos em pacientes com síndrome do intestino curto, dependentes ou não de nutrição parenteral. Métodos O estudo incluiu 22 adultos com síndrome de intestino curto, sendo 11 dependentes de nutrição parenteral (Grupo NP) e 11 sujeitos que recebiam todo aporte nutricional por via oral (Grupo VO). Foram incluídos 14 voluntários saudáveis, pareados para a idade e o gênero (Grupo Controle). A avaliação da ingestão alimentar, antropometria, níveis sanguíneos de sódio, potássio, fósforo, magnésio, cálcio, zinco, ferro e cobre foram documentados em todos os voluntários. Resultados Os níveis sanguíneos de sódio, potássio, fósforo, cálcio e zinco foram similares entre os grupos de estudo. Os níveis séricos de magnésio foram menores no Grupo NP (1,0±0,4 mEq/L) em relação aos demais grupos. Além disso, a concentração desse eletrólito foi menor no Grupo VO (1,4±0,3 mEq/L) em relação ao Grupo Controle (1,8±0,1 mEq/L). Foram documentados menores valores cobre (69±24 vs 73±26 vs 109±16 µg/dL) nos grupos NP e VO quando comparados com o Grupo Controle, respectivamente. Conclusão Hipomagnesemia e hipocupremia são distúrbios eletrolíticos comumente observados na síndrome de intestino curto. Os pacientes com ressecção intestinal extensa requerem monitorização e suplementação de magnésio e cobre a fim de prevenir deficiências. .
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cobre/deficiência , Deficiência de Magnésio/sangue , Síndrome do Intestino Curto/sangue , Estudos de Casos e Controles , Cálcio/sangue , Ingestão de Energia , Nutrição Parenteral , Fósforo/sangue , Potássio/sangue , Sódio/sangue , Zinco/sangueRESUMO
En la actualidad, datos epidemiológicos sugieren que, en países occidentales, la ingesta de magnesio no satisface la ingesta recomendada, lo que apoya un riesgo de deficiencia de magnesio latente en estas poblaciones. La evaluación del estado de magnesio sigue siendo un desafío para el laboratorio clínico ya que el magnesio se encuentra distribuido mayoritariamente en el hueso y tejidos blandos. Existe la necesidad de conciliación entre una prueba de fácil acceso, rápida, sensible y representativa del magnesio intracelular. La utilidad de diferentes biomarcadores en sujetos sanos ha sido evaluada; se ha reportado que el magnesio en plasma, eritrocitos y orina parecen ser biomarcadores sensibles a la ingesta dietética y útiles como biomarcadores en la población general. Sin embargo, esto no es concluyente, ya que se resalta que aún se requieren estudios mejor diseñados, que impliquen factores como mayor población empleada, dosis y tiempo de suplementación. El progreso en la genética y la genómica abren perspectivas interesantes en la búsqueda de estos biomarcadores que permitan cuantificar los niveles de magnesio celular así como también las reservas de todo el cuerpo, para poder así establecer recomendaciones dietéticas mejor ajustadas a la población.
Epidemiological studies suggest that dietary magnesium in the Western countries does not meet the recommended intake, supporting a risk of latent magnesium deficiency with Western diet behavior. Assessment of magnesium status remains a major challenge for the clinical laboratory, since, magnesium storage is mostly found in bone and soft tissues. The conciliation between an easy obtained sample, rapid and robust laboratory test, and the parameter representative for intracellular magnesium is extremely difficult to reach. In a current systematic review study, the usefulness of magnesium status biomarkers in healthy subjects has been evaluated. It is proposed that plasma and erythrocyte magnesium, and urinary magnesium excretion which respond to dietary manipulation appear to be useful biomarkers in the general population. However, it is emphasized that well-designed studies of sufficient size with varying doses and duration of magnesium supplementation are still required. The development of specific and sensible biomarkers, making it possible to obtain cell magnesium levels as well as body magnesium pool evaluation, relevant to study individuals, small and large populations, remains a major challenge for the assessment of magnesium status. A progress in genetics and genomics opens new interesting perspectives in the search of these biomarkers.
Na atualidade, dados epidemiológicos sugerem que, nos países ocidentais, a ingestão de magnésio não supre a ingestão recomendada, o que apoia um risco de deficiência de magnésio latente nestas populações. A avaliação do estado do magnésio continua sendo um desafio para o laboratório clínico, visto que o magnésio se encontra distribuído principalmente no osso e nos tecidos moles. Há a necessidade de conciliar evidência facilmente acessível, rápida, sensível e representativa do magnésio intracelular. A utilidade de vários biomarcadores em indivíduos saudáveis foi avaliada, e foi relatado que o magnésio em plasma, eritrócitos e urina parecem ser biomarcadores sensíveis à ingestão dietética e úteis como biomarcadores na população geral. No entanto, esta não é conclusiva, uma vez que se destaca que são requeridos ainda estudos melhor desenhados, envolvendo fatores como utilização de maior população, dosagem e tempo de suplementação. Um avanço na genética e na genômica abre perspectivas interessantes na busca desses biomarcadores para poder quantificar os níveis de magnésio celular bem como as reservas do corpo inteiro, e assim poder estabelecer melhores recomendações na dieta adaptadas à população.
Assuntos
Humanos , Biomarcadores , Deficiência de Magnésio/sangue , Magnésio/sangue , Técnicas de Laboratório Clínico/métodos , Técnicas de Laboratório Clínico/tendências , MagnésioRESUMO
This study examined changes in the metabolism of magnesium (Mg), and related serum parameters, following treatment with vanadium (V) in streptozotocin-diabetic rats. Over a period of five weeks, four groups were examined: control, diabetic, diabetic-treated with 1 mg V/day or 3 mg V/day. The V was supplied in drinking water as bis(maltolato)oxovanadium(IV). The Mg levels were measured in food, faeces, urine, serum, muscle, kidney, liver, spleen, heart and femur. Albumin, uric acid, urea, total-cholesterol, LDL-cholesterol, triglycerides, aspartate-aminotransferase and alkaline-phosphatase were determined in serum. In the diabetic group, Mg retained and Mg content in serum and femur decreased, while levels of uric acid, urea, total-cholesterol, LDL-cholesterol, triglycerides and alkaline-phosphatase and aspartate-aminotransferase activity increased compared with control rats. In the diabetic group treated with 1 mg V/day, Mg retained, serum levels of Mg, urea and triglycerides, and alkaline-phosphatase activity remained unchanged, while levels of uric acid, total-cholesterol and LDL-cholesterol increased and the Mg content in femur and aspartate-aminotransferase activity decreased compared with the diabetic untreated group. In the diabetic rats treated with 3 mg V/day, food intake and glycaemia were normal. In this group, Mg content in serum, kidney and femur, levels of urea and aspartate-aminotransferase and alkaline-phosphatase activity decreased, whereas LDL-cholesterol increased, uric acid and total-cholesterol levels remained unchanged in comparison with untreated diabetic rats. In conclusion, although treatment with 3 mg V/day normalised the glycaemia, the hypomagnesaemia and tissue depletion of Mg seen in the diabetic rats, caused by the treatment with V, could have partially contributed to the fact that V did not normalise other serum parameters altered by the diabetes.
Assuntos
Diabetes Mellitus Experimental/complicações , Deficiência de Magnésio/complicações , Vanádio/efeitos adversos , Animais , Diabetes Mellitus Experimental/sangue , Magnésio/sangue , Deficiência de Magnésio/sangue , Masculino , Especificidade de Órgãos/efeitos dos fármacos , Ratos , Ratos Wistar , Estreptozocina , Vanádio/sangueRESUMO
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: 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
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
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.
Assuntos
Resistência à Insulina/fisiologia , Deficiência de Magnésio/epidemiologia , Síndrome Metabólica/epidemiologia , Adolescente , Adulto , Glicemia/metabolismo , Doenças Cardiovasculares/etiologia , Estudos Transversais , Complicações do Diabetes/sangue , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/metabolismo , Feminino , Humanos , Espaço Intracelular/metabolismo , Magnésio/sangue , Magnésio/metabolismo , Deficiência de Magnésio/sangue , Deficiência de Magnésio/complicações , Deficiência de Magnésio/metabolismo , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/metabolismo , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto JovemRESUMO
We report a case of severe hypomagnesemia in non-oliguric acute renal failure caused by leptospirosis that required large doses of magnesium replacement during the acute phase of disease. Biochemical studies confirmed kidney-related magnesium wasting and the mechanisms of this defect are discussed. Magnesium imbalance with its attendant clinical complications occurs in leptospirosis and should be monitored and treated aggressively in cases of leptospirosis-induced non-oliguric acute kidney injury.
Assuntos
Leptospirose/complicações , Deficiência de Magnésio/sangue , Deficiência de Magnésio/complicações , Adolescente , Feminino , Humanos , Leptospirose/tratamento farmacológico , Deficiência de Magnésio/tratamento farmacológico , Sulfato de Magnésio/uso terapêutico , Doenças Musculares/sangue , Doenças Musculares/complicações , Fragilidade Osmótica , Penicilina G/uso terapêutico , PotássioRESUMO
To evaluate if hypomagnesemia, at the time of admission in the Intensive care Unit (ICU), is associated with a higher mortality in critically ill patients with type 2 diabetes. Fourteen consecutive critically ill patients with type 2 diabetes admitted in the ICU of a teaching General Hospital serving an inner city population were enrolled in a follow-up study. Parenteral or enteral nutritional support, surgical procedures, malignancy, traumatism or physical injury, pulmonary and/or cardiovascular diseases, chronic renal failure, hepatic cirrhosis, cerebrovascular disease, and disorders of the thyroid gland, were exclusion criteria. Hypomagnesemia was defined by serum magnesium levels < 0.66 mmol/L (1.6 mg/dL). At the time of admission in the ICU, 10 (71.4%) individuals had hypomagnesemia. Mortality rates in the hypomagnesemic and normomagnesemic individuals were 80 and 25%, respectively. Serum magnesium levels were significantly lower in the subjects who died (0.51 [0.41, 0.62] mmol/L) compared with those who survived (0.85 [0.65, 1.11], mmol/L), p = 0.01. The logistic regression model adjusted by APACHE II score and hsCRP levels showed that hypomagnesemia is independently associated with mortality (OR 1.9, CI95% 1.2-14.7). Hypomagnesemia at the time of admission in the ICU seems to be associated with high mortality in critically ill patients with type 2 diabetes.
Assuntos
Diabetes Mellitus Tipo 2 , Deficiência de Magnésio/sangue , Magnésio/sangue , Adulto , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/mortalidade , Seguimentos , Humanos , Unidades de Terapia Intensiva , Deficiência de Magnésio/mortalidade , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To assess the hypothesis that magnesium deficiency is associated with elevated high-sensitivity C-reactive protein (hsCRP) levels. DESIGN: Community-based cross-sectional study. SETTING: 488 apparently healthy children aged 10-13 years were randomly enrolled from Durango, a city in northern Mexico, through two-stage cluster sampling. MAIN OUTCOME MEASURES: Serum magnesium and hsCRP levels, lipid profile, glucose and insulin levels. RESULTS: A total of 109 (22.3%) and 101 (20.7%) children had elevated hsCRP concentrations and low serum magnesium levels; among them, 87.1% exhibited both. Children who had both elevated hsCRP levels (2.45 (10.6) mg/l) and hypomagnesemia (1.3 (0.3) mg/dl) exhibit the highest fasting glucose (96.0 (13.9) mg/dl), insulin (13.6 (7.5) microU/ml) and triglycerides (131.5 (43.5) mg/dl) levels as well as the lowest HDL-cholesterol (46.4 (9.0) mg/dl) levels. Adjusted multivariate logistic regression analysis showed a strong association between low serum magnesium and high hsCRP levels (odds ratio 4.1; 95% confidence interval 1.3 to 10.8). CONCLUSIONS: Magnesium depletion is independently associated with elevated hsCRP levels, suggesting that hypomagnesemia and low-grade inflammation are interactive risk factors.
Assuntos
Índice de Massa Corporal , Proteína C-Reativa/metabolismo , Deficiência de Magnésio/sangue , Obesidade/sangue , Adolescente , Glicemia/metabolismo , Criança , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Magnésio/sangue , Masculino , México , Sobrepeso/sangue , Estatística como Assunto , Triglicerídeos/sangueRESUMO
PURPOSE: To study the effects on the water, electrolyte, and acid-base balances in rabbits submitted to antegrade enema with different solutions through appendicostomy. METHODS: Forty male New Zealand rabbits were submitted to appendicostomy, and distributed in 4 groups, according to the antegrade enema solution: PEG group, polyethylene glycol electrolyte solution (n=10); ISS group, isotonic saline solution (n=10); GS group, glycerin solution (n=10); SPS group, sodium phosphate solution (n=10). After being weighed, arterial blood gas analysis, red blood count, creatinine and electrolytes were measured at 4 times: preoperatively (T1); day 6 postop, before enema (T2); 4h after enema (T3); and 24h after T3 (T4). RESULTS: In PEG group occurred Na retention after 4h, causing alkalemia, sustained for 24h with HCO3 retention. In ISS group occurred isotonic water retention and hyperchloremic acidosis after 4h, which was partially compensated in 24h. GS group showed metabolic acidosis after 4h, compensated in 24h. In SPS group occurred hypernatremic dehydration, metabolic acidosis in 4h, and hypokalemia, hypocalcemia, hypomagnesemia, and metabolic alkalosis with partially compensated dehydration in 24h. CONCLUSIONS: All solutions used in this study caused minor alterations on water, electrolyte or acid-base balances. The most intense ones were caused by hypertonic sodium phosphate solution (SPS) and isotonic saline solution (ISS) and the least by polyethyleneglycol electrolyte solution (PEG) and glycerin solution 12% (GS).
Assuntos
Equilíbrio Ácido-Base/efeitos dos fármacos , Enema/métodos , Glicerol/efeitos adversos , Fosfatos/efeitos adversos , Polietilenoglicóis/efeitos adversos , Equilíbrio Hidroeletrolítico/efeitos dos fármacos , Desequilíbrio Ácido-Base/sangue , Desequilíbrio Ácido-Base/etiologia , Animais , Apêndice/cirurgia , Catárticos/administração & dosagem , Catárticos/efeitos adversos , Enema/efeitos adversos , Glicerol/administração & dosagem , Soluções Isotônicas/administração & dosagem , Soluções Isotônicas/efeitos adversos , Deficiência de Magnésio/sangue , Deficiência de Magnésio/etiologia , Masculino , Modelos Animais , Fosfatos/administração & dosagem , Polietilenoglicóis/administração & dosagem , Coelhos , Fatores de Tempo , Desequilíbrio Hidroeletrolítico/sangue , Desequilíbrio Hidroeletrolítico/etiologiaRESUMO
PURPOSE: To study the effects on the water, electrolyte, and acid-base balances in rabbits submitted to antegrade enema with different solutions through appendicostomy. METHODS: Forty male New Zealand rabbits were submitted to appendicostomy, and distributed in 4 groups, according to the antegrade enema solution: PEG group, polyethylene glycol electrolyte solution (n=10); ISS group, isotonic saline solution (n=10); GS group, glycerin solution (n=10); SPS group, sodium phosphate solution (n=10). After being weighed, arterial blood gas analysis, red blood count, creatinine and electrolytes were measured at 4 times: preoperatively (T1); day 6 postop, before enema (T2); 4h after enema (T3); and 24h after T3 (T4). RESULTS: In PEG group occurred Na retention after 4h, causing alkalemia, sustained for 24h with HCO3 retention. In ISS group occurred isotonic water retention and hyperchloremic acidosis after 4h, which was partially compensated in 24h. GS group showed metabolic acidosis after 4h, compensated in 24h. In SPS group occurred hypernatremic dehydration, metabolic acidosis in 4h, and hypokalemia, hypocalcemia, hypomagnesemia, and metabolic alkalosis with partially compensated dehydration in 24h. CONCLUSIONS: All solutions used in this study caused minor alterations on water, electrolyte or acid-base balances. The most intense ones were caused by hypertonic sodium phosphate solution (SPS) and isotonic saline solution (ISS) and the least by polyethyleneglycol electrolyte solution (PEG) and glycerin solution 12 percent (GS).
OBJETIVO: Estudar os efeitos no equilíbrio hídrico, eletrolítico e ácido-base, do enema anterógrado com diferentes soluções em coelhos através de apendicostomia. MÉTODOS: 40 coelhos Nova Zelândia, machos, submetidos a apendicostomia, distribuídos em quatro grupos segundo a solução de enema: grupo PEG (n = 10) solução de polietilenoglicol com eletrólitos; grupo SF (n = 10) solução fisiológica; grupo SG (n = 10) solução glicerinada; grupo FS (n = 10) solução de fosfato de sódio. Realizou-se pesagem, gasometria arterial, série vermelha, creatinina e ionograma, em quatro tempos: TI (pré-operatório); T2 (6o PO antes do enema); T3 (4h após enema); T4 (24h após T3). RESULTADOS: No PEG ocorreu retenção de Na em 4h, com alcalemia por retenção de HCO3, mantida por 24h. No SF ocorreu retenção hídrica isotônica e acidose hiperclorêmica em 4h, resolvidos parcialmente com 24h. No SG ocorreu acidose metabólica hiperclorêmica em 4h, compensada com 24h. No FS ocorreu desidratação hipenatrêmica, acidose metabólica com ânion gap elevado em 4h, hipopotassemia, hipocalcemia, hipomagnesemia e alcalose metabólica com recuperação parcial da desidratação em 24h. CONCLUSÕES: Todas as soluções empregadas neste estudo causam alterações de pouca intensidade no equilíbrio hídrico, eletrolítico ou ácido-base. As mais intensas foram causadas pela solução de fosfato de sódio e solução fisiológica, e as menos intensas pela solução de polietilenoglicol com eletrólitos e solução glicerinada.
Assuntos
Animais , Masculino , Coelhos , Equilíbrio Ácido-Base/efeitos dos fármacos , Enema/métodos , Glicerol/efeitos adversos , Fosfatos/efeitos adversos , Polietilenoglicóis/efeitos adversos , Equilíbrio Hidroeletrolítico/efeitos dos fármacos , Desequilíbrio Ácido-Base/sangue , Desequilíbrio Ácido-Base/etiologia , Apêndice/cirurgia , Catárticos/administração & dosagem , Catárticos/efeitos adversos , Enema/efeitos adversos , Glicerol/administração & dosagem , Soluções Isotônicas/administração & dosagem , Soluções Isotônicas/efeitos adversos , Modelos Animais , Deficiência de Magnésio/sangue , Deficiência de Magnésio/etiologia , Fosfatos/administração & dosagem , Polietilenoglicóis/administração & dosagem , Fatores de Tempo , Desequilíbrio Hidroeletrolítico/sangue , Desequilíbrio Hidroeletrolítico/etiologiaRESUMO
The aim of this review was to elaborate a synthesis about the discussions on magnesium and diabetes mellitus, in the last 14 years. The magnesium deficiency has been associated with chronic diseases, amongst them, diabetes mellitus. Epidemiological studies had shown low levels of magnesium ingestion in the general population, as well as a relation between the ingestion of food rich in magnesium and the reduction of diabetes installation and its complications. Hypomagnesemia is frequently present in diabetic patients, however there is not an exact elucidation of the mechanism of magnesium deficiency in diabetes mellitus. On the other hand, in the presence of this illness, it is observed that inadequate metabolic control can affect the corporal concentrations of magnesium, developing hypomagnesemia, which may be still directly related with some micro and macrovascular complications observed in diabetes, as cardiovascular disease, retinopathy and neuropathy. This way, the chronic complications of diabetes can appear precociously. Based on this, the supplementation with magnesium has been suggested in patients with diabetes mellitus who have proven hypomagnesemia and the presence of its complications.