Dey Ritwik, Rajappa Medha, Parameswaran Sreejith, Revathy G
Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantari Nagar, Puducherry, 605006, India.
Clin Exp Nephrol. 2015 Dec;19(6):1054-61. doi: 10.1007/s10157-015-1097-z. Epub 2015 Feb 20.
Recent reports suggest that 40-70 % chronic kidney disease (CKD) patients receiving dialysis have significant coronary artery disease. Magnesium depletion is being considered as the missing link between the cardiovascular risk factors and atherosclerosis in CKD. The present work aimed to study the association between magnesium status and lipid alterations in pre-dialysis CKD patients attending the Nephrology Clinic in a tertiary care hospital in South India.
90 cases of CKD and 90 age and gender matched healthy controls were included in the study. Framingham risk scoring was done and presence of metabolic syndrome was assessed. Lipid profile, serum and urine magnesium, blood glucose, calcium, phosphorus, urea and creatinine levels were assayed in all study subjects.
In this study we observed a significantly lower serum magnesium levels and dyslipidemic alterations, a significantly raised total cholesterol and low-density lipoprotein and non-HDL in patients with CKD. We also observed a significant correlation between the lowered serum magnesium concentrations and atherogenic dyslipidemia, suggesting a link to increased cardiovascular risk in CKD patients. CKD patients had higher risk of cardiovascular disease (according to their Framingham risk score), which also showed significant correlation with the hypomagnesaemia.
Our results suggest a strong association of hypomagnesemia and atherogenic dyslipidemia in patients with CKD. This gains particular importance in the high cardiovascular risk-borne CKD patients, as supplementing magnesium would go a long way in reducing the risk of cardiovascular morbidity and mortality in CKD.
最近的报告表明，40%-70%接受透析的慢性肾脏病（CKD）患者患有严重的冠状动脉疾病。镁缺乏被认为是CKD中心血管危险因素与动脉粥样硬化之间缺失的环节。本研究旨在探讨印度南部一家三级护理医院肾病科门诊的透析前CKD患者的镁状态与脂质改变之间的关联。
本研究纳入了90例CKD患者以及90名年龄和性别匹配的健康对照。进行了弗雷明汉风险评分，并评估代谢综合征的存在情况。对所有研究对象测定血脂谱、血清和尿液镁、血糖、钙、磷、尿素和肌酐水平。
在本研究中，我们观察到CKD患者的血清镁水平显著降低以及血脂异常改变，总胆固醇、低密度脂蛋白和非高密度脂蛋白显著升高。我们还观察到血清镁浓度降低与致动脉粥样硬化性血脂异常之间存在显著相关性，这表明与CKD患者心血管风险增加有关。CKD患者有更高的心血管疾病风险（根据他们的弗雷明汉风险评分），这也与低镁血症显著相关。
我们的结果表明，CKD患者中低镁血症与致动脉粥样硬化性血脂异常密切相关。这在心血管风险高的CKD患者中尤为重要，因为补充镁对降低CKD患者心血管发病和死亡风险大有帮助。
