Galli-Tsinopoulou Assimina, Maggana Ioanna, Kyrgios Ioannis, Mouzaki Konstantina, Grammatikopoulou Maria G, Stylianou Charilaos, Karavanaki Kyriaki
4th Department of Pediatrics, Faculty of Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
J Diabetes. 2014 Jul;6(4):369-77. doi: 10.1111/1753-0407.12118. Epub 2014 Feb 24.
Magnesium levels may be decreased in patients with type 1 diabetes mellitus (T1DM), influencing disease control. Relevant studies concern mainly adults and there are few data from the pediatric population. The aim of the present study was to evaluate magnesium levels and examine their possible association with glycemic control in youths with T1DM.
In all, 138 children and adolescents with T1DM aged between 1.9 and 20.3 years were recruited to the study. Using a cross-sectional design, we measured anthropometric parameters, HbA1c, serum magnesium, ionized and total calcium, phosphorus, potassium, sodium, and urinary albumin (UA). Estimated glomerular filtration rate (eGFR), based on serum creatinine concentrations, was also calculated.
Lower levels of magnesium were found in subjects with poor versus good glycemic control (0.79 ± 0.09 vs 0.82 ± 0.09 mmol/L, respectively; P = 0.002). Serum magnesium levels were negatively correlated with HbA1c (P < 0.001) and positively correlated with UA, calcium, phosphorus, and potassium levels (P < 0.05). After adjustment for confounding factors, only magnesium levels remained significantly associated with HbA1c (adjusted r(2) = 0.172; P = 0.004). The odds ratio for poor glycemic control, indicated by HbA1c >7.5%, between the highest and lowest magnesium concentration quartiles was 0.190 and amounted to a decrease of 1.7% in the HbA1c level.
The present study shows that low serum magnesium levels in children and adolescents with T1DM are associated with an increased risk of poor glycemic control, potentially contributing to the early development of cardiovascular complications.
1型糖尿病(T1DM)患者的镁水平可能降低,这会影响疾病控制。相关研究主要关注成年人,儿科人群的数据较少。本研究的目的是评估T1DM青少年的镁水平,并检查其与血糖控制的可能关联。
总共招募了138名年龄在1.9至20.3岁之间的T1DM儿童和青少年参与本研究。采用横断面设计,我们测量了人体测量参数、糖化血红蛋白(HbA1c)、血清镁、离子钙和总钙、磷、钾、钠以及尿白蛋白(UA)。还根据血清肌酐浓度计算了估算肾小球滤过率(eGFR)。
血糖控制差的受试者的镁水平低于血糖控制良好的受试者(分别为0.79±0.09 vs 0.82±0.09 mmol/L;P = 0.002)。血清镁水平与HbA1c呈负相关(P < 0.001),与UA、钙、磷和钾水平呈正相关(P < 0.05)。在对混杂因素进行调整后,只有镁水平仍与HbA1c显著相关(调整后的r(2) = 0.172;P = 0.004)。HbA1c>7.5%表明血糖控制差,在最高和最低镁浓度四分位数之间的比值比为0.190,相当于HbA1c水平降低了1.7%。
本研究表明,T1DM儿童和青少年的低血清镁水平与血糖控制不佳的风险增加有关,可能会促使心血管并发症的早期发展。