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2型糖尿病患者的低镁血症与死亡率

Hypomagnesemia and mortality in patients with type 2 diabetes.

作者信息

Curiel-García José A, Rodríguez-Morán Martha, Guerrero-Romero Fernando

机构信息

General Hospital of the Mexican Social Security Institute at Durango, Av. Normal y Predio Canoas S/N; 34067, Durango, Dgo., Mexico.

出版信息

Magnes Res. 2008 Sep;21(3):163-6.

Abstract

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.

摘要

为评估在重症监护病房(ICU)入院时低镁血症是否与2型糖尿病重症患者的较高死亡率相关。一家为市中心人口服务的教学综合医院的ICU收治的14例连续的2型糖尿病重症患者被纳入一项随访研究。肠外或肠内营养支持、外科手术、恶性肿瘤、创伤或身体损伤、肺部和/或心血管疾病、慢性肾衰竭、肝硬化、脑血管疾病以及甲状腺疾病均为排除标准。低镁血症定义为血清镁水平<0.66 mmol/L(1.6 mg/dL)。在ICU入院时,10例(71.4%)患者存在低镁血症。低镁血症患者和正常镁血症患者的死亡率分别为80%和25%。死亡患者的血清镁水平(0.51[0.41, 0.62] mmol/L)显著低于存活患者(0.85[0.65, 1.11] mmol/L),p = 0.01。经APACHE II评分和hsCRP水平调整的逻辑回归模型显示,低镁血症与死亡率独立相关(OR 1.9,CI95% 1.2 - 14.7)。在ICU入院时的低镁血症似乎与2型糖尿病重症患者的高死亡率相关。

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