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2 型糖尿病患者低镁血症与蛋白尿的关系。

The relationship between hypomagnesemia and albuminuria in patients with type 2 diabetes mellitus.

机构信息

Department of Internal Medicine, Haseki Research and Training Hospital, Istanbul, Turkey.

出版信息

Clin Endocrinol (Oxf). 2024 Sep;101(3):216-222. doi: 10.1111/cen.15094. Epub 2024 Jun 4.

Abstract

OBJECTIVE

Diabetic nephropathy is a prevalent cause of chronic kidney disease worldwide. Magnesium plays a critical role in insulin resistance, and insulin, in turn, regulates magnesium levels. We aimed to investigate the association between hypomagnesemia and albuminuria in patients with type 2 diabetes mellitus (T2DM).

DESIGN, PATIENTS AND MEASUREMENTS: This retrospective single-centre study encompassed 1178 patients aged 18 and above with T2DM, who attended our outpatient clinic between January 2019 and August 2020. Albuminuria levels were categorised according to Kidney Disease Outcomes Quality Initiative guidelines. In the literature, when examining cut-off values for hypomagnesemia, it is observed that studies typically use hospital normal level as a reference point. Hypomagnesemia, defined as magnesium levels below 1.6 mg/dL, was compared to normomagnesemia (magnesium between 1.6 and 2.4 mg/dL). The primary objective was to explore the impact of magnesium levels on albuminuria, while the secondary objective was to determine the prevalence of hypomagnesemia. The multivariate logistic regression analyses were performed according to age, gender (male), HbA1c, and presence of hypomagnesemia.

RESULTS

The mean age of the participants was 58.7 ± 12.2 years, with 44% being male. Hypomagnesemia was identified in 5.3% of the patients. Advanced age and female gender were more common among patients with hypomagnesemia (p = .001). Magnesium levels exhibited a negative correlation with HbA1c and fasting blood glucose, and a positive correlation with creatinine levels (r = -.117, r = -.131, r = .117, p < .001 for all three variables). Hypomagnesemia was significantly more prevalent in patients with albuminuria (15.9% vs. 4.7%, p < .001). Moreover, participants with the presence of hypomagnesemia were independently associated with a higher risk of albuminuria (odds ratio 3,64 1.76-7.52, p = .001).

CONCLUSION

Albuminuria is more frequently observed in patients with hypomagnesemia.

摘要

目的

糖尿病肾病是全球慢性肾脏病的一个主要病因。镁在胰岛素抵抗中起着关键作用,而胰岛素反过来又调节镁的水平。我们旨在研究 2 型糖尿病(T2DM)患者低镁血症与白蛋白尿之间的关系。

设计、患者和测量方法:本回顾性单中心研究纳入了 2019 年 1 月至 2020 年 8 月期间在我院门诊就诊的年龄在 18 岁及以上的 1178 名 T2DM 患者。白蛋白尿水平根据肾脏病预后质量倡议指南进行分类。在文献中,当检查低镁血症的截止值时,观察到研究通常使用医院正常水平作为参考点。低镁血症定义为镁水平低于 1.6mg/dL,与正常镁血症(镁水平在 1.6 至 2.4mg/dL 之间)进行比较。主要目的是探讨镁水平对白蛋白尿的影响,次要目的是确定低镁血症的患病率。根据年龄、性别(男性)、HbA1c 和低镁血症的存在情况,进行多变量逻辑回归分析。

结果

参与者的平均年龄为 58.7±12.2 岁,其中 44%为男性。5.3%的患者存在低镁血症。低镁血症患者中年龄较大和女性更为常见(p=0.001)。镁水平与 HbA1c 和空腹血糖呈负相关,与肌酐水平呈正相关(r=-0.117,r=-0.131,r=0.117,p<0.001)。低镁血症患者白蛋白尿的发生率明显更高(15.9%比 4.7%,p<0.001)。此外,存在低镁血症的参与者发生白蛋白尿的风险独立升高(优势比 3.64,1.76-7.52,p=0.001)。

结论

低镁血症患者更常出现白蛋白尿。

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