National Research Council, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128, Padova, Italy.
Research Hospital, National Institute of Gastroenterlogy, IRCCS De Bellis, Castellana Grotte, BA, Italy.
Eur J Nutr. 2020 Feb;59(1):263-272. doi: 10.1007/s00394-019-01905-w. Epub 2019 Jan 25.
To map and grade all health outcomes associated with magnesium (Mg) intake and supplementation using an umbrella review.
Umbrella review of systematic reviews with meta-analyses of observational studies and randomized controlled trials (RCTs) using placebo/no intervention as control group. We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values, 95% prediction intervals, heterogeneity, small-study effects and excess significance. For meta-analyses of RCTs, outcomes with a random-effect p value < 0.005 and a high-GRADE assessment were classified as strong evidence.
From 2048 abstracts, 16 meta-analyses and 55 independent outcomes were included (36 in RCTs and 19 in observational studies). In RCTs of Mg versus placebo/no active treatment, 12 over 36 outcomes reported significant results (p < 0.05). A strong evidence for decreased need for hospitalization in pregnancy and for decreased risk of frequency and intensity of migraine relapses in people with migraine was observed using the GRADE assessment. In observational studies, 9/19 outcomes were significant (p < 0.05). However, only one outcome presented highly suggestive evidence (lower incidence of type 2 diabetes in people with higher Mg intake at baseline) and one suggestive (lower incidence of stroke associated with higher Mg intake at baseline).
Strong evidence according to the GRADE suggests that Mg supplementation can decrease the risk of hospitalization in pregnant women and reduce the intensity/frequency of migraine. Higher Mg intake is associated with a decreased risk of type 2 diabetes and stroke with highly suggestive and suggestive evidence, respectively, in observational studies.
采用伞式综述方法绘制并评估与镁（Mg）摄入和补充相关的所有健康结局。
对观察性研究和随机对照试验（RCT）的系统综述进行伞式综述，使用安慰剂/无干预作为对照组。我们评估了基于随机效应汇总效应大小及其 p 值、95%预测区间、异质性、小样本效应和过度显著性的观察性研究荟萃分析。对于 RCT 的荟萃分析，具有随机效应 p 值 < 0.005 和高 GRADE 评估的结局被归类为强证据。
从 2048 篇摘要中，纳入了 16 项荟萃分析和 55 项独立结局（36 项 RCT 和 19 项观察性研究）。在 Mg 与安慰剂/无活性治疗的 RCT 中，12 项 36 项结局报告了显著结果（p < 0.05）。使用 GRADE 评估观察到妊娠住院需求降低以及偏头痛患者偏头痛复发频率和强度降低的强烈证据。在观察性研究中，9/19 项结局具有统计学意义（p < 0.05）。然而，只有一项结局具有高度提示性证据（基线时 Mg 摄入量较高的人 2 型糖尿病发病率较低）和一项提示性证据（基线时 Mg 摄入量较高与中风风险降低相关）。
根据 GRADE 的评估，Mg 补充可以降低孕妇住院风险，降低偏头痛的强度/频率，具有强证据。在观察性研究中，具有高度提示性和提示性证据分别表明，较高的 Mg 摄入与 2 型糖尿病和中风的风险降低相关。
