Mooren Frank C
Department of Sports Medicine, Institute of Sports Sciences, Justus-Liebig-University, Giessen, Germany.
Diabetes Obes Metab. 2015 Sep;17(9):813-23. doi: 10.1111/dom.12492. Epub 2015 Jun 23.
Magnesium is actively involved in a number of metabolic reactions as an important co-factor, with special emphasis on carbohydrate metabolism. After a brief overview of the regulation of intra- and extracellular magnesium, the present review first describes the regulatory role of magnesium in important metabolic pathways involved in energy metabolism and glycaemic control. Next the clinical significance of hypomagnesaemic conditions with regard to the management of glucose in prediabetic stages, such as insulin resistance/impaired glucose tolerance and in type 2 diabetes mellitus are characterized. Cross-sectional as well as longitudinal studies suggest that a reduced dietary magnesium intake serves as a risk factor for the incidence of both impaired glucose regulation and type 2 diabetes. Mechanisms that might be responsible for diabetes-associated hypomagnesaemia are discussed. Furthermore, the role of hypomagnesaemia in the development and progression of chronic diabetic complications are addressed. Finally, the available literature on the effects of magnesium supplementation on glycaemic control parameters during prediabetic conditions (preventive approach) as well as type 2 diabetes mellitus (therapeutic approach) are reviewed systematically. There is considerable evidence that chronic magnesium supplementation may delay the progression from impaired glucose regulation to type 2 diabetes; however, the effects of oral magnesium supplementation as an adjunct therapy for type 2 diabetes are quite heterogeneous with respect to the various measures of glycaemic control. The results of this review suggest a requirement for critical consideration of the pros and cons of magnesium replacement therapy, based on variables such as magnesium status, stage of disease and glycaemic control.
镁作为一种重要的辅助因子，积极参与多种代谢反应，尤其在碳水化合物代谢方面。在简要概述细胞内和细胞外镁的调节之后，本综述首先描述了镁在参与能量代谢和血糖控制的重要代谢途径中的调节作用。接下来，阐述了低镁血症在糖尿病前期阶段（如胰岛素抵抗/糖耐量受损）和2型糖尿病患者血糖管理方面的临床意义。横断面研究和纵向研究均表明，饮食中镁摄入量减少是葡萄糖调节受损和2型糖尿病发病的危险因素。文中讨论了可能导致糖尿病相关低镁血症的机制。此外，还探讨了低镁血症在慢性糖尿病并发症发生和发展中的作用。最后，系统回顾了关于补充镁对糖尿病前期（预防方法）和2型糖尿病（治疗方法）血糖控制参数影响的现有文献。有大量证据表明，长期补充镁可能会延缓从葡萄糖调节受损发展为2型糖尿病的进程；然而，口服补充镁作为2型糖尿病辅助治疗的效果在各种血糖控制指标方面差异很大。本综述结果表明，基于镁状态、疾病阶段和血糖控制等变量，需要审慎考虑镁替代疗法的利弊。
