Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain.
Department of Biochemistry and Molecular Biology, Universidad Miguel Hernandez, San Juan de Alicante, Spain.
Clin Chem Lab Med. 2023 Jul 31;62(2):234-248. doi: 10.1515/cclm-2023-0537. Print 2024 Jan 26.
Magnesium is one of the most abundant cations in the body and acts as a cofactor in more than 600 biochemical reactions. Hypomagnesemia is a highly prevalent condition, especially in subjects with comorbid conditions, but has received less attention than other electrolyte disturbances. This review will discuss magnesium physiology, absorption, storage, distribution across the body, and kidney excretion. After reviewing the regulation of magnesium homeostasis, we will focus on the etiology and clinical presentation of hypomagnesemia. The role of laboratory medicine in hypomagnesemia will be the main purpose of this review, and we will discuss the laboratory tests and different samples and methods for its measurement. Although free magnesium is physiologically active, total serum magnesium is the most commonly used measurement in laboratory medicine and is apt for clinical purposes; however, it is not appropriately used, and many patients with hypomagnesemia remain undiagnosed and not treated. Using information technologies, laboratory medicine can largely improve the diagnosis and treatment of hypomagnesemia through the design and establishment of automatic demand management and result management interventions by acting in the first and last steps of the laboratory cycle, test requests, and actions taken after test results, to unmask patients with hypomagnesemia and improve the number of patients undergoing treatment.
镁是体内含量最丰富的阳离子之一，作为 600 多种生化反应的辅助因子。低镁血症是一种非常普遍的病症，特别是在合并症患者中，但它受到的关注不如其他电解质紊乱多。这篇综述将讨论镁的生理学、吸收、储存、在体内的分布和肾脏排泄。在回顾镁稳态的调节后，我们将重点讨论低镁血症的病因和临床表现。本文主要目的是探讨实验室医学在低镁血症中的作用，并讨论实验室检测以及不同样本和方法的测量。尽管游离镁在生理上具有活性，但血清总镁是实验室医学中最常用的测量指标，适用于临床目的；然而，它的使用并不恰当，许多低镁血症患者仍未得到诊断和治疗。通过在实验室周期的第一步和最后一步、检测请求以及检测结果后的行动中设计和建立自动需求管理和结果管理干预措施，利用信息技术，实验室医学可以在很大程度上改善低镁血症的诊断和治疗，以发现低镁血症患者并增加接受治疗的患者数量。
