Severn and Wessex Deanery, Bristol, Avon, UK.
Clin Chem Lab Med. 2010 Mar;48(3):323-7. doi: 10.1515/CCLM.2010.077.
A major use of serum magnesium measurements in clinical practice is to identify patients with deficiency. However, numerous studies have shown that magnesium deficiency is common and may be present in over 10% of hospitalized patients, as well as in the general population. An important cause for under diagnosis of deficiency is that serum magnesium, the most commonly used test, can be normal despite negative body stores. This article focuses on the limitations of "normal" magnesium results and highlights the importance of lifestyle or "modus vivendi" as a pragmatic means of identifying those individuals potentially at risk for negative body magnesium stores.
Researched peer reviewed articles on magnesium published between 1990 and 2008 in MEDLINE and EMBASE, using database keywords "magnesium, deficiency, diagnosis, treatment and hypomagnesaemia". Bibliographies of retrieved articles have been searched and followed. We have also performed a manual search of each individual issue in which most of these reports have appeared.
In 183 peer reviewed studies published from 1990 to 2008, magnesium deficiency was associated with increased prevalence and risk in 11 major conditions. Similarly, in 68 studies performed over the same period, magnesium deficiency was found to predict adverse events and a decreased risk of pathology was noted when supplementation or treatment was instituted.
The perception that "normal" serum magnesium excludes deficiency is common among clinicians. This perception is probably enforced by the common laboratory practice of highlighting only abnormal results. A health warning is therefore warranted regarding potential misuse of "normal" serum magnesium because restoration of magnesium stores in deficient patients is simple, tolerable, inexpensive and can be clinically beneficial.
在临床实践中，血清镁测量的主要用途是识别缺乏症患者。然而，许多研究表明，镁缺乏症很常见，可能在 10%以上的住院患者以及普通人群中存在。导致缺乏症诊断不足的一个重要原因是，血清镁是最常用的检测方法，尽管体内储存量为负，但检测结果可能仍为正常。本文重点介绍“正常”镁结果的局限性，并强调生活方式或“生活方式”作为识别那些体内镁储存量可能存在风险的个体的实用方法的重要性。
在 MEDLINE 和 EMBASE 中检索了 1990 年至 2008 年期间发表的有关镁的同行评审文章，使用数据库关键字“镁、缺乏症、诊断、治疗和低镁血症”。检索文章的参考文献已被搜索和跟踪。我们还对这些报告大部分出现的每个问题进行了手动搜索。
在 1990 年至 2008 年期间发表的 183 篇同行评审研究中，镁缺乏症与 11 种主要疾病的患病率和风险增加有关。同样，在同期进行的 68 项研究中，发现镁缺乏症可预测不良事件，并且当进行补充或治疗时，镁缺乏症可降低发病风险。
“正常”血清镁排除缺乏症的观念在临床医生中很普遍。这种观念可能是由于实验室普遍存在只强调异常结果的做法而加强的。因此，需要对潜在的“正常”血清镁的不当使用发出警告，因为恢复缺乏症患者的镁储存量既简单、耐受、便宜，又具有临床益处。
