RESUMO
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
BACKGROUND: Preeclampsia is the major cause of maternal morbidity and mortality in developing countries. Magnesium sulfate is considered first-line therapy against eclampsia and magnesium deficiency in pregnancy has been associated with unfavourable perinatal outcomes. However there are doubts if magnesium supplementation during pregnancy can previne preeclampsia especially in population with high nutritional risk. This trial aims to verify the effect of oral magnesium supplmentation on preeclampsia incidence in low income pregnant women. METHODS: This randomized, double-blind, placebo-controlled trial investigated the effect of oral magnesium citrate supplementation for preeclampsia in low-income Brazilian pregnant women, i.e. annual per capita income of US$ 1025 or less. Participants were admitted to the study with gestational age between 12 and 20 weeks. Magnesium serum level was measured pre-randomization and participants with hypermagnesemia were excluded. After randomizationg participants received magnesium citrate capsule (300 mg magnesium citrate) or a daily placebo capsule, until delivery. Intent-to-treat analysis was performed. RESULTS: A total of 416 pregnant women were screened and 318 enrolled according to the inclusion criteria; 159 for each arm. Twenty-eight pregnant women were lost to follow-up. 55/290 (18.9%) of pregnant women developed preeclampsia; 26/143 (18.1%) in magnesium group and 29/147 (19.7%) in the control group; OR 0.90 (CI 95% 0.48-1.69), p = 0.747. No cases of eclampsia were registered. CONCLUSION: Oral magnesium supplementation did not reduce preeclampsia incidence in low-income and low-risk pregnant women. TRIAL REGISTRATION: Registered at ClinicalTrials.gov (Identifier NCT02032186), December 19, 2013.
Assuntos
Deficiência de Magnésio/tratamento farmacológico , Sulfato de Magnésio/uso terapêutico , Pré-Eclâmpsia/tratamento farmacológico , Adulto , Brasil , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Idade Gestacional , Humanos , Pobreza , Gravidez , Adulto JovemRESUMO
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
The objective of the study was to evaluate the efficacy of oral magnesium supplementation in the improvement of metabolic syndrome (MetS) and its components. This is a randomized double-blind, placebo-controlled clinical trial that enrolled 198 individuals with MetS and hypomagnesemia who were randomly allocated to receive either 30 mL of magnesium chloride 5% solution, equivalent to 382 mg of elemental magnesium (n = 100), or placebo solution (n = 98), daily for 16 weeks. Serum magnesium levels <1.8 mg/dL defined hypomagnesemia. At final conditions, a total of 48 (48%) and 76 (77.5%) individuals had MetS in the magnesium and placebo groups (P = 0.01), respectively. At baseline, percent of individuals with 3, 4, and 5 criteria of MetS in the magnesium group were 60.0%, 37.0%, and 3.0%, respectively, and in the control group 55.1%, 35.7%, and 9.2%, respectively. Between basal and final conditions, changes in the components of MetS were significantly higher in the magnesium than placebo groups: -3.6 ± 3.3 mmHg, P = 0.001 for systolic blood pressure; -5.5 ± 1.7 mmHg, P = 0.005 for diastolic blood pressure; -12.4 ± 3.6 mg/dL, P < 0.005 for fasting glucose; -61.2 ± 24 mg/dL, P = 0.003 for triglycerides; and 0.9 ± 0.4 mg/dL, P = 0.06 for high-density lipoprotein cholesterol. Magnesium supplementation improves MetS by reducing blood pressure, hyperglycemia, and hypertriglyceridemia.
Assuntos
Suplementos Nutricionais , Deficiência de Magnésio/tratamento farmacológico , Magnésio/uso terapêutico , Síndrome Metabólica/tratamento farmacológico , Administração Oral , Adulto , Método Duplo-Cego , Esquema de Medicação , Feminino , Seguimentos , Humanos , Deficiência de Magnésio/complicações , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
AIM: This study evaluated the efficacy of oral magnesium supplementation in the reduction of plasma glucose levels in adults with prediabetes and hypomagnesaemia. METHODS: A total of 116 men and non-pregnant women, aged 30 to 65 years with hypomagnesaemia and newly diagnosed with prediabetes, were enrolled into a randomized double-blind placebo-controlled trial to receive either 30 mL of MgCl2 5% solution (equivalent to 382 mg of magnesium) or an inert placebo solution once daily for four months. The primary trial endpoint was the efficacy of magnesium supplementation in reducing plasma glucose levels. RESULTS: At baseline, there were no significant statistical differences in terms of anthropometric and biochemical variables between individuals in the supplement and placebo groups. At the end of follow-up, fasting (86.9 ± 7.9 and 98.3 ± 4.6 mg/dL, respectively; P = 0.004) and post-load glucose (124.7 ± 33.4 and 136.7 ± 23.9 mg/dL, respectively; P = 0.03) levels, HOMA-IR indices (2.85 ± 1.0 and 4.1 ± 2.7, respectively; P = 0.04) and triglycerides (166.4 ± 90.6 and 227.0 ± 89.7, respectively; P = 0.009) were significantly decreased, whereas HDL cholesterol (45.6 ± 10.9 and 46.8 ± 9.2 mg/dL, respectively; P = 0.04) and serum magnesium (1.96 ± 0.27 and 1.60 ± 0.26 mg/dL, respectively; P = 0.005) levels were significantly increased in those taking MgCl2 compared with the controls. A total of 34 (29.4%) people improved their glucose status (50.8% and 7.0% in the magnesium and placebo groups, respectively; P < 0.0005). CONCLUSION: Our results show that magnesium supplementation reduces plasma glucose levels, and improves the glycaemic status of adults with prediabetes and hypomagnesaemia.
Assuntos
Glicemia/efeitos dos fármacos , Hipoglicemiantes/uso terapêutico , Cloreto de Magnésio/uso terapêutico , Deficiência de Magnésio/tratamento farmacológico , Estado Pré-Diabético/tratamento farmacológico , Adulto , Idoso , Feminino , Humanos , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/farmacologia , Cloreto de Magnésio/administração & dosagem , Cloreto de Magnésio/farmacologia , Deficiência de Magnésio/metabolismo , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/metabolismoRESUMO
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
BACKGROUND AND AIMS: We undertook this study to determine the efficacy of oral magnesium supplementation in the improvement of the metabolic profile and blood pressure in metabolically obese, normal-weight (MONW) individuals. METHODS: A total of 47 MONW individuals with hypomagnesemia were enrolled in clinical a randomized double-blind placebo-controlled trial. Individuals in the intervention group received 30 mL of MgCl2 5% solution (equivalent to 382 mg of magnesium) and individuals in the control group 30 mL of placebo solution, once daily during 4 months. In the absence of obesity or overweight, the presence of fasting glucose levels ≥100 mg/dL, HOMA-IR index ≥3, triglyceride levels ≥150 mg/dL and/or systolic and diastolic blood pressure ≥140 and 90 mmHg defined the presence of the MONW phenotype. Hypomagnesemia was defined by serum magnesium concentration ≤1.8 mg/dL. RESULTS: At basal conditions there were no significant differences between groups. At the end of follow-up, changes in the mean of systolic (-2.1 vs. 3.9% mmHg, p <0.05) and diastolic (-3.8 vs. 7.5% mmHg, p <0.05) blood pressures, HOMA-IR index (-46.5 vs. -5.4%, p <0.0001), fasting glucose (-12.3 vs. -1.8% mg/dL, p <0.05) and triglyceride levels (-47.4% vs. 10.1% mg/dL, p <0.0001) were significantly lower in the subjects who received MgCl2 compared with individuals in the control group. CONCLUSIONS: Oral magnesium supplementation improves the metabolic profile and blood pressure of MONW individuals.
Assuntos
Suplementos Nutricionais , Cloreto de Magnésio/uso terapêutico , Deficiência de Magnésio/tratamento farmacológico , Síndrome Metabólica/tratamento farmacológico , Administração Oral , Adulto , Peso Corporal , Método Duplo-Cego , Esquema de Medicação , Feminino , Seguimentos , Humanos , Análise de Intenção de Tratamento , Deficiência de Magnésio/complicações , Masculino , Síndrome Metabólica/etiologia , Pessoa de Meia-Idade , Obesidade , Resultado do TratamentoRESUMO
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
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 the efficacy and safety of oral magnesium supplementation, with magnesium chloride (MgCl2), in the treatment of newly diagnosed depression in the elderly with type 2 diabetes and hypomagnesemia. Twenty-three elderly patients with type 2 diabetes and hypomagnesemia were enrolled and randomly allocated to receive either 50 mL of MgCl2 5% solution equivalent to 450 mg of elemental magnesium or Imipramine 50 mg daily during 12 weeks. Widowhood or divorce in the last six months, alcoholism, degenerative illnesses of the nervous central system, recent diagnosis of diabetes, previous or current treatment with antidepressants, chronic diarrhea, use of diuretics, and reduced renal function were exclusion criteria. Hypomagnesemia was defined by serum magnesium levels < 1.8 mg/dL and depression by Yasavage and Brink score > or = 11 points. The primary trial end point was the improvement of depression symptoms. At baseline, there were no differences by age (69 +/- 5.9 and 66.4 +/- 6.1 years, p = 0.39), duration of diabetes (11.8 +/- 7.9 and 8.6 +/- 5.7 years, p = 0.33), serum magnesium levels (1.3 +/- 0.04 and 1.4 +/- 0.04 mg/dL, p = 0.09), and Yasavage and Brink Score (17.9 +/- 3.9 and 16.1 +/- 4.5 point, p = 0.34) in the groups with MgCl2 and imipramine, respectively. At end of follow-up, there were no significant differences in the Yasavage and Brink score (11.4 +/- 3.8 and 10.9 +/- 4.3, p = 0.27) between the groups in study; whereas serum magnesium levels were significantly higher in the group with MgCl2 (2.1 +/- 0.08 mg/dL) than in the subjects with imipramine (1.5 +/- 0.07 mg/dL), p < 0.0005. In conclusion, MgCl2 is as effective in the treatment of depressed elderly type 2 diabetics with hypomagnesemia as imipramine 50 mg daily.
Assuntos
Antidepressivos/uso terapêutico , Depressão/complicações , Depressão/tratamento farmacológico , Diabetes Mellitus Tipo 2/complicações , Cloreto de Magnésio/uso terapêutico , Deficiência de Magnésio/tratamento farmacológico , Idoso , Antidepressivos/administração & dosagem , Humanos , Imipramina/uso terapêutico , Magnésio/sangue , Cloreto de Magnésio/administração & dosagem , Resultado do TratamentoRESUMO
OBJECTIVES: Neonatal hypomagnesemia is defined as total magnesium (TMg) < or = 0.65 mmol/L (1.6 mg/dl). However, magnesium (Mg) deficiency and sufficiency overlap at serum values of 0.57 to 0.74 mmol/L (1.4 to 1.8 mg/dl). We hypothesized that (1) some infants with TMg < or = 0.65 mmol/L (1.6 mg/dl) have normal ionized Mg values (normal neonatal range 0.40 to 0.56 mmol/L (0.97 to 1.36 mg/dl)); (2) the dose (6.0 mg of elemental Mg/kg) used to correct hypomagnesemia does not lead to elevation of ionized Mg; (3) after intravenous magnesium sulfate infusion, ionized calcium increases in patients with low baseline ionized Mg and decreases in patients with normal baseline ionized Mg. STUDY DESIGN: We recruited 22 neonates with TMg < or = 1.6 mg/dl. They received intravenous sulfate (6 mg elemental Mg/kg) over a 1-hour period. Serum TMg, ionized Mg, and ionized Ca were measured before and after magnesium sulfate infusion. An ion-selective electrode was used to allow direct measurement of ionized Mg and ionized Ca. RESULTS: Thirteen (59%) of 22 neonates with TMg < or = 0.65 mmol/L (1.6 mg/dl) had normal IMg. In 7 (31%) of 22 cases ionized Mg increased slightly above 0.56 mmol/L (1.36 mg/dl); the maximum value was 0.61 mmol/L (1.48 mg/dl). The change in ionized Ca concentrations and the baseline ionized Mg value were inversely correlated (r = -0.79; p < 0.0001). CONCLUSIONS: (1) Measurement of ionized Mg should prevent overdiagnosis and treatment of hypomagnesemia. (2) The dose used in this study is safe. (3) Ionized Mg concentrations are inversely correlated to the response of ionized Ca concentrations to an Mg load.
Assuntos
Deficiência de Magnésio/tratamento farmacológico , Sulfato de Magnésio/uso terapêutico , Magnésio/sangue , Cálcio/sangue , Feminino , Humanos , Recém-Nascido , Infusões Intravenosas , Deficiência de Magnésio/sangue , Deficiência de Magnésio/diagnóstico , Sulfato de Magnésio/administração & dosagem , Masculino , Valores de ReferênciaRESUMO
This report describes the unusual case of 46-year-old white European woman who presented spontaneous keratoconus. This case suggests a new association: keratoconus-tetany-menopause. This can be explained by Thalasselis' syndrome, a syndrome showing a relation between keratoconus, magnesium (Mg) deficiency, type A behavior, and allergy. Furthermore, Thalasselis' syndrome integrates old and new theories. This report also suggests that the alteration induced by severe but reversible Mg deficiency at the intra- and extracellular levels, associated with metabolic and hormonal imbalances, may trigger the development of keratoconus. Clinical data which support this thesis are reported.
Assuntos
Ceratocone/complicações , Menopausa , Tetania/complicações , Administração Oral , Cálcio/uso terapêutico , Feminino , Humanos , Magnésio/uso terapêutico , Deficiência de Magnésio/complicações , Deficiência de Magnésio/tratamento farmacológico , Pessoa de Meia-Idade , Tetania/tratamento farmacológico , Acuidade VisualRESUMO
Because insulin-dependent diabetes mellitus is associated with altered electrolyte metabolism and a derangement of the parathyroid hormone (PTH)-vitamin D endocrine system, we studied 23 children with diabetes (age 9.4 +/- 2.5 years) and found lower serum values for total and ionized calcium, magnesium, intact PTH, calcitriol, and osteocalcin than in age- and sex-matched control subjects. All patients were given magnesium orally (6 mg/kg daily of elemental magnesium) for up to 60 days. During treatment, serum magnesium, total and ionized calcium, intact PTH, calcitriol, and osteocalcin concentrations significantly increased, reaching control values. After a 3-day low-calcium diet, the patients had a significantly reduced delta-increment of PTH and calcitriol in comparison with values obtained during hypomagnesemia. After magnesium repletion, the delta-increments of both PTH and calcitriol, in response to the low-calcium diet, were not significantly different from control values. These data suggest that magnesium deficiency plays a pivotal role in altering mineral homeostasis in insulin-dependent diabetes mellitus.