A multi-center study on the association between serum magnesium levels and allostatic load in hemodialysis patients.

Serum magnesium (Mg) levels are associated with insulin resistance, hypertension, lipid abnormalities, and inflammation. However, limited studies have indicated the relationship between Mg and multiple system indexes. The purpose of this study was to investigate the association between Mg and allostatic load (AL) in hemodialysis patients. A cross-sectional survey was conducted on hemodialysis patients from different centers in Anhui Province, China, between January and December 2020. A total of 3,025 hemodialysis patients were recruited. Their clinical data were measured before hemodialysis. Information was collected by an online self-reported questionnaire and medical record. Serum Mg was divided into three groups by tertiles. A score of AL greater than or equal to 3 was defined as high AL. A binary logistic regression model was applied to examine the relationship between serum Mg and AL. A total of 1,222 patients undergoing hemodialysis were included, 60% of whom were males (733/1,222). The mean (standard deviation) age of patients was 55.90 (12.75). The median level of serum Mg was 1.22 mmol/L. The rate of high AL levels was 23.4%. Serum Mg was negatively correlated with body mass index, fasting blood glucose (Glu), and C-reactive protein and positively correlated with high-density lipoprotein, low-density lipoprotein, total cholesterol, diastolic blood pressure (DBP), and serum phosphorus. After adjusting for gender, anxiety, diabetes, family residence, lipid-lowering agents, antihypertensive medications, albumin, and Glu, the binary logistic regression model showed that patients with lower levels of serum Mg were more likely have high AL ( for the T1 group of serum Mg:1.945, 95% : 1.365-2.773, and for the T2 group of serum Mg:1.556, 95% : 1.099-2.201). Our data support the hypothesis that higher serum Mg concentrations may contribute to lower health risk in hemodialysis populations. Further randomized controlled trials and cohort studies are warranted to verify whether Mg supplementation could be part of routine examinations in hemodialysis populations.