Molnar Amber O, Biyani Mohan, Hammond Ian, Harmon John Paul, Lavoie Susan, McCormick Brendan, Sood Manish M, Wagner Jessica, Pena Elena, Zimmerman Deborah L
Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Department of Radiology, University of Ottawa, Ottawa, ON, Canada.
BMC Nephrol. 2017 Apr 6;18(1):129. doi: 10.1186/s12882-017-0549-y.
Coronary artery calcification (CAC) is highly prevalent among dialysis patients and is associated with increased cardiovascular and all cause mortality. Magnesium (Mg) inhibits vascular calcification in animal and in-vitro studies but whether the same effect occurs in humans is uncertain.
A single centre cross-sectional study of 80 prevalent peritoneal dialysis (PD) patients; on PD only for a minimum of 3 months. A radiologist blinded to patient status calculated their abdominal aortic calcification (AAC) scores on lateral lumbar spine radiographs, a validated surrogate for CAC.
Eighty patients provided informed consent and underwent lumbar spine radiography. The mean serum Mg was 0.8 mmol/L (standard deviation 0.2) and mean AAC score 8.9 (minimum 0, maximum 24). A higher serum Mg level was associated with a lower AAC score (R = 0.06, unstandardized coefficient [B] = -7.81, p = 0.03), and remained after adjustment for age, serum phosphate, serum parathyroid hormone, low-density lipoprotein cholesterol, smoking history, and diabetes (model adjusted R = 0.36, serum Mg and AAC score B = -11.44, p = 0.00). This translates to a 0.1 mmol/L increase in serum Mg being independently associated with a 1.1-point decrease in AAC score.
Our findings suggest that Mg may inhibit vascular calcification. If this association is replicated across larger studies with serial Mg and vascular calcification measurements, interventions that increase serum Mg and their effect on vascular calcification warrant further investigation in the PD population.
冠状动脉钙化（CAC）在透析患者中非常普遍，并且与心血管疾病及全因死亡率增加相关。在动物和体外研究中，镁（Mg）可抑制血管钙化，但在人类中是否有同样的效果尚不确定。
对80例持续性腹膜透析（PD）患者进行单中心横断面研究；患者仅接受PD治疗至少3个月。一名对患者情况不知情的放射科医生根据腰椎侧位X线片计算其腹主动脉钙化（AAC）评分，这是一种经过验证的CAC替代指标。
80例患者提供了知情同意并接受了腰椎X线摄影。血清镁的平均水平为0.8 mmol/L（标准差0.2），AAC评分平均为8.9（最低0分，最高24分）。较高的血清镁水平与较低的AAC评分相关（R = 0.06，非标准化系数[B] = -7.81，p = 0.03），在对年龄、血清磷酸盐、血清甲状旁腺激素、低密度脂蛋白胆固醇、吸烟史和糖尿病进行校正后该相关性仍然存在（模型校正R = 0.36，血清镁与AAC评分的B = -11.44，p = 0.00）。这意味着血清镁每增加0.1 mmol/L与AAC评分独立降低1.1分相关。
我们的研究结果表明镁可能抑制血管钙化。如果在更多关于连续测量镁和血管钙化的大型研究中重复这种关联，那么提高血清镁的干预措施及其对血管钙化的影响值得在PD人群中进一步研究。
