Tzanakis Ioannis, Virvidakis Kyriakos, Tsomi Aggeliki, Mantakas Emmanouel, Girousis Nikolaos, Karefyllakis Nektarios, Papadaki Antonia, Kallivretakis Nikolaos, Mountokalakis Theodoros
Department of Nephrology, General Hospital of Chania, Chania, Greece.
Magnes Res. 2004 Jun;17(2):102-8.
Traditional risk factors do not adequately explain the high prevalence of cardiovascular disease in patients with chronic renal insufficiency. Currently, there is a lot of evidence that hypomagnesaemia may play a significant role in the pathogenesis of cardiovascular diseases in general population. The aim of this study was to test the hypothesis that magnesium status in haemodialysis patients is related to the degree of atheromatosis of carotid arteries, as assessed by B-mode ultrasound. Intima-media thickness of both common carotids was assessed by B-mode ultrasound in 93 stable chronic haemodialysis patients and in 182 age- and sex-matched healthy controls. Intracellular magnesium as well as serum magnesium levels were obtained in the haemodialysis patients. Intracellular magnesium was estimated by determination of this ion in isolated peripheral lymphocytes. Haemodialysis patients had also a significantly higher mean common carotid intima-media thickness than controls (0.87+/-0.16 vs 0.76+/-0.13 mm, p < 0.001). Multivariate analysis revealed that in haemodialysis patients both serum magnesium and intracellular magnesium were negatively associated with common carotid intima-media thickness (p = 0.001 and p = 0.003 respectively). Significant associations between the age of the haemodialysis patients, the existence of diabetes mellitus as well as the serum calcium x serum phosphate product with common carotid intima-media thickness of haemodialysis patients were also observed. A strong negative association of both extracellular and intracellular magnesium with common carotid intima-media thickness exists in haemodialysis patients. The above finding suggests that magnesium may play an important protective role in the development and/or acceleration of arterial atherosclerosis in patients with chronic renal insufficiency.
传统危险因素并不能充分解释慢性肾功能不全患者心血管疾病的高患病率。目前，有大量证据表明低镁血症可能在普通人群心血管疾病的发病机制中起重要作用。本研究的目的是检验以下假设：通过B超评估，血液透析患者的镁状态与颈动脉粥样硬化程度相关。采用B超对93例稳定的慢性血液透析患者和182例年龄及性别匹配的健康对照者双侧颈总动脉的内膜中层厚度进行了评估。测定了血液透析患者的细胞内镁以及血清镁水平。通过测定分离的外周淋巴细胞中的该离子来估算细胞内镁。血液透析患者的平均颈总动脉内膜中层厚度也显著高于对照组（0.87±0.16对0.76±0.13mm，p<0.001）。多因素分析显示，在血液透析患者中，血清镁和细胞内镁均与颈总动脉内膜中层厚度呈负相关（分别为p = 0.001和p = 0.003）。还观察到血液透析患者的年龄、糖尿病的存在以及血清钙×血清磷乘积与血液透析患者颈总动脉内膜中层厚度之间存在显著关联。血液透析患者的细胞外和细胞内镁与颈总动脉内膜中层厚度均存在强烈的负相关。上述发现表明，镁可能在慢性肾功能不全患者动脉粥样硬化的发生和/或进展中起重要的保护作用。
