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补充镁对糖尿病血液透析患者颈动脉内膜中层厚度和代谢特征的影响:一项随机、双盲、安慰剂对照试验。

Effects of magnesium supplementation on carotid intima-media thickness and metabolic profiles in diabetic haemodialysis patients: a randomised, double-blind, placebo-controlled trial.

机构信息

1Department of Radiology,Kashan University of Medical Sciences,Kashan,PO Box 87159-81151,Iran.

2Department of Internal Medicine,Kashan University of Medical Sciences,Kashan,PO Box 87159-81151,Iran.

出版信息

Br J Nutr. 2019 Apr;121(7):809-817. doi: 10.1017/S0007114519000163. Epub 2019 Feb 11.

DOI:10.1017/S0007114519000163
PMID:30739626
Abstract

This study evaluated the effects of Mg administration on carotid intima-media thickness (CIMT), glycaemic control and markers of cardio-metabolic risk in diabetic haemodialysis (HD) patients. This randomised, double-blind, placebo-controlled clinical trial was conducted in fifty-four diabetic HD patients. Participants were randomly divided into two groups to take either 250 mg/d Mg as magnesium oxide (n 27) or placebo (n 27) for 24 weeks. Mg supplementation resulted in a significant reduction in mean (P<0·001) and maximum levels of left CIMT (P=0·02) and mean levels of right CIMT (P=0·004) compared with the placebo. In addition, taking Mg supplements significantly reduced serum insulin levels (β=-9·42 pmol/l; 95% CI -14·94, -3·90; P=0·001), homoeostasis model of assessment-insulin resistance (β=-0·56; 95 % CI -0·89, -0·24; P=0·001) and HbA1c (β=-0·74 %; 95 % CI -1·10, -0·39; P<0·001) and significantly increased the quantitative insulin sensitivity check index (β=0·008; 95 % CI 0·002, 0·01; P=0·002) compared with the placebo. In addition, Mg administration led to a significant reduction in serum total cholesterol (β=-0·30 mmol/l; 95% CI -0·56, -0·04; P=0·02), LDL-cholesterol (β=-0·29 mmol/l; 95% CI -0·52, -0·05; P=0·01), high-sensitivity C-reactive protein (hs-CRP) (P<0·001) and plasma malondialdehyde (MDA) (P=0·04) and a significant rise in plasma total antioxidant capacity (TAC) levels (P<0·001) compared with the placebo. Overall, we found that taking Mg for 24 weeks by diabetic HD patients significantly improved mean and maximum levels of left and mean levels of right CIMT, insulin metabolism, HbA1c, total cholesterol and LDL-cholesterol, hs-CRP, TAC and MDA levels.

摘要

这项研究评估了镁剂治疗对糖尿病血液透析(HD)患者颈动脉内膜中层厚度(CIMT)、血糖控制和心血管代谢风险标志物的影响。这是一项随机、双盲、安慰剂对照的临床试验,共纳入了 54 名糖尿病 HD 患者。参与者被随机分为两组,分别服用 250mg/d 氧化镁(n=27)或安慰剂(n=27),疗程为 24 周。与安慰剂相比,镁补充剂显著降低了左 CIMT 的平均(P<0·001)和最大水平(P=0·02)以及右 CIMT 的平均水平(P=0·004)。此外,服用镁补充剂还显著降低了血清胰岛素水平(β=-9·42 pmol/l;95%CI-14·94,-3·90;P=0·001)、稳态模型评估的胰岛素抵抗(β=-0·56;95%CI-0·89,-0·24;P=0·001)和糖化血红蛋白(HbA1c)(β=-0·74%;95%CI-1·10,-0·39;P<0·001),并显著提高了定量胰岛素敏感性检查指数(β=0·008;95%CI 0·002,0·01;P=0·002)。此外,与安慰剂相比,镁剂治疗还显著降低了血清总胆固醇(β=-0·30mmol/l;95%CI-0·56,-0·04;P=0·02)、LDL-胆固醇(β=-0·29mmol/l;95%CI-0·52,-0·05;P=0·01)、高敏 C 反应蛋白(hs-CRP)(P<0·001)和血浆丙二醛(MDA)(P=0·04)水平,同时显著升高了血浆总抗氧化能力(TAC)水平(P<0·001)。总之,我们发现,糖尿病血液透析患者服用镁剂 24 周可显著改善左 CIMT 的平均和最大水平、右 CIMT 的平均水平、胰岛素代谢、HbA1c、总胆固醇和 LDL-胆固醇、hs-CRP、TAC 和 MDA 水平。

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