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补充镁对血液透析患者颈动脉内膜中层厚度和血流介导的扩张的影响:一项双盲、随机、安慰剂对照试验。

Effect of magnesium supplementation on carotid intima-media thickness and flow-mediated dilatation among hemodialysis patients: a double-blind, randomized, placebo-controlled trial.

机构信息

Isfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Eur Neurol. 2013;69(5):309-16. doi: 10.1159/000346427. Epub 2013 Mar 14.

Abstract

OBJECTIVES

The aim of the present study was to determine the efficacy of oral magnesium (Mg) supplementation on endothelial function through evaluation of carotid intima-media thickness (cIMT), brachial artery flow-mediated dilatation (FMD), and C-reactive protein (CRP) among hemodialysis (HD) patients.

METHODS

This randomized, controlled, double-blind clinical trial consisted of 54 patients on HD. One group was treated orally with 440 mg of Mg oxide 3 times per week for 6 months (n = 29). The control group (n = 25) was given placebo using the same administration protocol. cIMT, FMD, serum calcium levels, phosphorus, lipid, CRP, and bicarbonate were measured at baseline and at 6 months in both groups.

RESULTS

At 6 months, cIMT was significantly decreased in the Mg group (0.84 ± 0.13 mm at baseline and 0.76 ± 0.13 mm at 6 months, p = 0.001). However, in the placebo group, cIMT was significantly increased (0.73 ± 0.13 and 0.79 ± 0.12 mm, respectively, p = 0.003). When hypertension, diabetes mellitus, smoking, hyperlipidemia, and systemic lupus erythematosus were controlled for in the analysis, the effect of Mg remained significant in both groups (p = 0.000).

CONCLUSION

Our results indicate that Mg might not improve endothelial function (CRP level and FMD) and that a decreased cIMT as a marker of atherosclerosis may be due to the inhibition of calcification through the regulation parathormone, calcium, and phosphorus.

摘要

目的

本研究旨在通过评估颈内动脉内膜中层厚度(cIMT)、肱动脉血流介导的舒张功能(FMD)和 C 反应蛋白(CRP),来确定口服镁(Mg)补充对血液透析(HD)患者内皮功能的疗效。

方法

这是一项随机、对照、双盲临床试验,共纳入 54 名 HD 患者。一组患者每周口服 440mg 氧化镁 3 次,持续 6 个月(n=29)。对照组(n=25)采用相同的给药方案给予安慰剂。在基线和 6 个月时,两组均测量 cIMT、FMD、血清钙水平、磷、脂质、CRP 和碳酸氢盐。

结果

6 个月时,Mg 组 cIMT 显著降低(基线时为 0.84±0.13mm,6 个月时为 0.76±0.13mm,p=0.001)。然而,安慰剂组 cIMT 显著增加(分别为 0.73±0.13 和 0.79±0.12mm,p=0.003)。在分析中控制高血压、糖尿病、吸烟、高脂血症和系统性红斑狼疮等因素后,Mg 在两组中的作用仍然显著(p=0.000)。

结论

我们的结果表明,Mg 可能不会改善内皮功能(CRP 水平和 FMD),而作为动脉粥样硬化标志物的 cIMT 降低可能是由于甲状旁腺激素、钙和磷的调节抑制了钙化。

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