Düğer Hakan, Uçan Bekir, Çalışkan Mustafa, Bostan Hayri, Demirci Taner, Gül Ümran, Çakal Erman, Kızılgül Muhammed
Health Sciences University, Dışkapı Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Türkiye.
Düzce State Hospital, Department of Endocrinology and Metabolism, Düzce, Türkiye.
Endocrine. 2024 Feb;83(2):466-472. doi: 10.1007/s12020-023-03577-3. Epub 2023 Nov 3.
Magnesium (Mg) homeostasis is closely related to calcium (Ca) metabolism. Hypercalcemia inhibits the reabsorption of Mg from the kidneys, leading to hypomagnesemia. Therefore, patients with primary hyperparathyroidism (PHPT) are predisposed to hypomagnesemia. However, there are few studies on the clinical significance of hypomagnesemia in PHPT. The aim of this study was to retrospectively evaluate the association of hypomagnesemia with the clinical outcomes of PHPT.
A retrospective evaluation was made of the data of 538 consecutive patients (478 females, 60 males) diagnosed with PHPT in our center.
The mean age of the study population was 56.5 ± 11.66 years. The mean serum Mg level was 2 ± 0.26 mg/dl. Asymptomatic disease was present in 241 (44%) patients. Symptomatic patients with osteoporosis, Ca level ≥11.2 mg/dl, and estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m had lower levels of Mg (p < 0.05). Hypomagnesemia was detected in 129 of 538 patients (23.9%). The patients with hypomagnesemia had a higher rate of symptomatic disease (80% vs. 48%, p < 0.0001). The serum parathormone (PTH) level was found to be higher in patients with hypomagnesemia and the lumbar and femur T-scores and serum vitamin D levels were lower (p < 0.05). Patients with hypomagnesemia had higher rates of kidney stones (34% vs. 21%, p = 0.003) and osteoporosis (74% vs. 32%, p < 0.001). Multivariate logistic regression analysis revealed that hypomagnesemia had a significant effect on the development of symptomatic disease (OR:6.88, CI 95%: 5.20-11.27, p < 0.001).
The current study results demonstrate that hypomagnesemia may be associated with a higher risk of osteoporosis and kidney stones in PHPT patients. Routine evaluation of serum Mg may predict the clinical outcomes of PHPT.
镁（Mg）稳态与钙（Ca）代谢密切相关。高钙血症会抑制肾脏对镁的重吸收，导致低镁血症。因此，原发性甲状旁腺功能亢进症（PHPT）患者易患低镁血症。然而，关于PHPT中低镁血症的临床意义的研究较少。本研究的目的是回顾性评估低镁血症与PHPT临床结局的相关性。
对本中心连续诊断为PHPT的538例患者（478例女性，60例男性）的数据进行回顾性评估。
研究人群的平均年龄为56.5±11.66岁。血清镁平均水平为2±0.26mg/dl。241例（44%）患者为无症状性疾病。有骨质疏松症状、血钙水平≥11.2mg/dl且估算肾小球滤过率（eGFR）<60ml/min/1.73m²的患者镁水平较低（p<0.05）。538例患者中有129例（23.9%）检测到低镁血症。低镁血症患者的症状性疾病发生率较高（80%对48%，p<0.0001）。发现低镁血症患者的血清甲状旁腺激素（PTH）水平较高，腰椎和股骨T值以及血清维生素D水平较低（p<0.05）。低镁血症患者的肾结石发生率（34%对21%，p=0.003）和骨质疏松发生率（74%对32%，p<0.001）较高。多因素逻辑回归分析显示，低镁血症对症状性疾病的发生有显著影响（比值比：6.88，95%置信区间：5.20-11.27，p<0.001）。
目前的研究结果表明，低镁血症可能与PHPT患者发生骨质疏松和肾结石的较高风险相关。血清镁的常规评估可能预测PHPT的临床结局。
