CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Diabetes and Metabolism Research Unit, Endocrinology Department, Universitat Autònoma de Barcelona, Barcelona, Spain.
PLoS One. 2012;7(1):e30599. doi: 10.1371/journal.pone.0030599. Epub 2012 Jan 24.
Type 2 diabetes (T2DM) and obesity are associated with magnesium deficiency. We aimed to determine whether the presence of type 2 diabetes and the degree of metabolic control are related to low serum magnesium levels in obese individuals.
A) Case-control study: 200 obese subjects [50 with T2DM (cases) and 150 without diabetes (controls)] prospectively recruited. B) Interventional study: the effect of bariatric surgery on serum magnesium levels was examined in a subset of 120 obese subjects (40 with type 2 diabetes and 80 without diabetes).
Type 2 diabetic patients showed lower serum magnesium levels [0.75±0.07 vs. 0.81±0.06 mmol/L; mean difference -0.06 (95% CI -0.09 to -0.04); p<0.001] than non-diabetic patients. Forty-eight percent of diabetic subjects, but only 15% of non-diabetic subjects showed a serum magnesium concentration lower than 0.75 mmol/L. Significant negative correlations between magnesium and fasting plasma glucose, HbA1c, HOMA-IR, and BMI were detected. Multiple linear regression analysis showed that fasting plasma glucose and HbA1c independently predicted serum magnesium. After bariatric surgery serum magnesium increased only in those patients in whom diabetes was resolved, but remain unchanged in those who not, without difference in loss weight between groups. Changes in serum magnesium negatively correlated with changes in fasting plasma glucose and HbA1c. Absolute changes in HbA1c independently predicted magnesium changes in the multiple linear regression analysis.
Our results provide evidence that the presence of diabetes and the degree of metabolic control are essential in accounting for the lower levels of magnesium that exist in obese subjects.
2 型糖尿病（T2DM）和肥胖与镁缺乏有关。我们旨在确定 2 型糖尿病的存在和代谢控制程度是否与肥胖个体的低血清镁水平有关。
A）病例对照研究：前瞻性招募 200 名肥胖受试者[50 名患有 2 型糖尿病（病例）和 150 名无糖尿病（对照）]。B）干预研究：在 120 名肥胖受试者（40 名患有 2 型糖尿病和 80 名无糖尿病）中检查减肥手术对血清镁水平的影响。
2 型糖尿病患者的血清镁水平较低[0.75±0.07 与 0.81±0.06 mmol/L；平均差异-0.06（95%置信区间-0.09 至-0.04）；p<0.001]比非糖尿病患者。48%的糖尿病患者，但只有 15%的非糖尿病患者的血清镁浓度低于 0.75 mmol/L。检测到镁与空腹血糖、HbA1c、HOMA-IR 和 BMI 之间存在显著负相关。多元线性回归分析显示，空腹血糖和 HbA1c 独立预测血清镁。减肥手术后，只有糖尿病得到解决的患者血清镁增加，但未解决的患者不变，两组之间的体重减轻无差异。血清镁的变化与空腹血糖和 HbA1c 的变化呈负相关。HbA1c 的绝对变化在多元线性回归分析中独立预测镁的变化。
我们的结果提供了证据，证明糖尿病的存在和代谢控制程度对于解释肥胖个体中存在的低镁水平至关重要。
