Xiang Xiaoli, Ji Zijia, Jiang Tingwang, Huang Zhengru, Yan Jing
Department of Ophthalmology, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, China.
Department of Ultrasonography, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, China.
Front Med (Lausanne). 2022 Sep 20;9:923282. doi: 10.3389/fmed.2022.923282. eCollection 2022.
Serum magnesium levels have been reported to reflect the risk of diabetic retinopathy (DR); however, the effect of serum magnesium level on diabetic macular edema (DME) remains unclear. Here, we investigated the association between the serum magnesium levels and DME in patients with DR. Patients with DR were recruited between January 2018 and June 2021. A total of 519 such patients were included in this study. All patients underwent a standardized clinical ophthalmic examination by an experienced ophthalmologist, and an assay was conducted to determine the serum magnesium concentration. Compared with the non-DME group, the DME group had a higher proportion of insulin use and a higher level of serum ischemia-modified albumin and fasting plasma glucose. The serum magnesium and calcium levels were lower in the DME group than in the non-DME group ( < 0.05). Higher magnesium levels were negatively associated with DME after adjustment for relevant covariates. Compared with the participants in the lowest magnesium quartile, those in the fourth quartile showed a significantly lower risk of DME after adjustment [odds ratio (OR), 0.294; 95% confidence interval, 0.153-0.566; < 0.0001]. Considering the potentially different effects of serum magnesium on the development of DME in patients with DR based on age, DR staging and insulin use, stratified analysis was performed by considering these factors. Among insulin-using patients with non-proliferative DR who were < 66 years of age, those in the third and fourth quartile of serum magnesium were less likely to develop DME than those in the lowest quartile of serum magnesium [OR (95% CI), 0.095 (0.014-0.620), 0.057 (0.011-0.305); = 0.014, 0.001]. Overall, a higher serum magnesium level was associated with a lower risk of DME in patients with DR. Furthermore, patients with DR who used insulin were more likely to develop DME. Long-term studies on oral magnesium supplements are needed to determine whether maintaining the serum magnesium levels in a higher physiological range can reduce the risk of DME in patients with DR.
据报道，血清镁水平可反映糖尿病视网膜病变（DR）的风险；然而，血清镁水平对糖尿病性黄斑水肿（DME）的影响仍不清楚。在此，我们调查了DR患者血清镁水平与DME之间的关联。2018年1月至2021年6月招募了DR患者。本研究共纳入519例此类患者。所有患者均由经验丰富的眼科医生进行标准化临床眼科检查，并进行检测以确定血清镁浓度。与非DME组相比，DME组胰岛素使用比例更高，血清缺血修饰白蛋白和空腹血糖水平更高。DME组的血清镁和钙水平低于非DME组（<0.05）。在调整相关协变量后，较高的镁水平与DME呈负相关。与镁水平最低四分位数的参与者相比，处于第四四分位数的参与者在调整后发生DME的风险显著降低[比值比（OR），0.294；95%置信区间，0.153 - 0.566；<0.0001]。考虑到血清镁对不同年龄、DR分期和胰岛素使用情况的DR患者发生DME可能有不同影响，基于这些因素进行了分层分析。在年龄<66岁、使用胰岛素的非增殖性DR患者中，血清镁处于第三和第四四分位数的患者比血清镁处于最低四分位数的患者发生DME的可能性更小[OR（95%CI），0.095（0.014 - 0.620），0.057（0.011 - 0.305）；=0.014，0.001]。总体而言，较高的血清镁水平与DR患者发生DME的风险较低相关。此外，使用胰岛素的DR患者更易发生DME。需要对口服镁补充剂进行长期研究，以确定将血清镁水平维持在较高生理范围内是否可降低DR患者发生DME的风险。
