Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.
Internal Medicine Residency Training Program, Oman Medical Specialty B, Muscat, Oman.
Sci Rep. 2024 Oct 10;14(1):23668. doi: 10.1038/s41598-024-74920-5.
Ionized Mg (iMg) may offer a more reliable indicator of Mg status during acute illness than total Mg (tMg) concentrations. This study aimed to determine the prevalence of dysmagnesemia and their relationship using iMg and tMg. The clinical and biochemical characteristics as well as health outcomes and their association with iMg and tMg were also assessed. A prospective study including all eligible adult patients (≥18 years) who were hospitalized in the General Internal Medicine unit at Sultan Qaboos University Hospital (SQUH) for 3.5 months in 2023. The iMg and tMg concentrations were collected on all at the admission. In total 500 patients were included (females 49.2%) with a median age of 64.5 years (IQR: 48-77). The prevalence of hypomagnesemia and hypermagnesemia by iMg concentrations was 3.4% and 26.6%, respectively, while by tMg concentrations 13.2% and 11.0%, respectively. The agreement between both measurements was strong (r=0.665, p<0.01). An increased tMg concentration was independently associated with high dependency units' admission (adjusted odds ratio (aOR): 4.34, 95%CI: 1.24-15.06, p=0.02) and cardiac arrest (aOR: 14.64, 95%CI: 3.04-70.57, p<0.01), and 6-month all-cause mortality (aOR: 11.44, 95%CI: 2.46-53.17, p<0.01). During follow-up hypermagnesemia using tMg had a higher mortality compared to other groups (hazard ratio (HR): 1.82, 95%CI: 1.11-3.01, p=0.02) while no significant findings were demonstrated using iMg concentrations. iMg and tMg concentrations had a strong correlation that might be supporting the potential use of point-of-care devices. Multivariant regression analysis showed that hypermagnesemia by tMg was associated with adverse outcomes. However, the generalizability of the study findings should be taken with caution and the difference in the associations with outcomes highlight the importance of further research to examine the complex associations and impacts of dysmagnesemia in various clinical settings.
离子化镁 (iMg) 可能比总镁 (tMg) 浓度更能可靠地反映急性疾病期间镁的状态。本研究旨在确定使用 iMg 和 tMg 时低镁血症和高镁血症的患病率及其相关性。还评估了临床和生化特征以及健康结果及其与 iMg 和 tMg 的关系。一项前瞻性研究，纳入了 2023 年在苏丹卡布斯大学医院（SQUH）综合内科住院的所有符合条件的成年患者（≥18 岁），共 500 例（女性 49.2%），中位年龄为 64.5 岁（IQR：48-77）。根据 iMg 浓度，低镁血症和高镁血症的患病率分别为 3.4%和 26.6%，而根据 tMg 浓度，低镁血症和高镁血症的患病率分别为 13.2%和 11.0%。两种测量方法之间的一致性很强（r=0.665，p<0.01）。tMg 浓度升高与高依赖单位入院（调整优势比 (aOR)：4.34，95%CI：1.24-15.06，p=0.02）和心搏骤停（aOR：14.64，95%CI：3.04-70.57，p<0.01）独立相关，与 6 个月全因死亡率（aOR：11.44，95%CI：2.46-53.17，p<0.01）相关。在随访中，与其他组相比，tMg 高镁血症的死亡率更高（风险比 (HR)：1.82，95%CI：1.11-3.01，p=0.02），而使用 iMg 浓度则没有显著发现。iMg 和 tMg 浓度之间具有很强的相关性，这可能支持使用即时检测设备。多变量回归分析显示，tMg 高镁血症与不良结局相关。然而，应该谨慎考虑研究结果的普遍性，并且与结局的关联差异突出了进一步研究的重要性，以检查各种临床环境中低镁血症和高镁血症的复杂关联和影响。
