Articular Orthopaedics, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China.
Suzhou Medical College, Soochow University, Suzhou, 215000, Jiangsu, China.
Clin Rheumatol. 2024 Dec;43(12):3973-3982. doi: 10.1007/s10067-024-07203-z. Epub 2024 Oct 25.
The magnesium depletion score (MDS) is a scoring system developed to predict magnesium deficiency based on pathophysiological factors that affect renal reabsorption. The relationship between systemic magnesium status and arthritis is unclear. The purpose of this study was to determine the association between the MDS and rheumatoid arthritis (RA) as well as osteoarthritis (OA).
This study was conducted through a cross-sectional survey of 20,513 adults aged ≥ 20 years who participated in NHANES from 2007 to 2018. The four dimensions of the MDS included diuretics, proton pump inhibitors, glomerular filtration rate, and excessive alcohol consumption. Univariate and multivariable-weighted logistic regression were used to assess the associations between MDS and RA/OA, and a test for trend was performed to analyze the presence of a dose-response relationship. Subgroup analyses and interaction tests were performed according to confounders.
After adjustment for all covariates, we found a graded dose-response relationship between MDS and RA or OA. When MDS was considered as a continuous variable, each onefold increase in MDS was associated with a 1.21-fold increase in the odds of having RA (OR = 1.21, 1.10, 1.33) and a 1.12-fold increase in the odds of having OA (OR = 1.12, 1.04, 1.21). There was an interaction of sex in the effect of MDS on RA (P = 0.004) and age in the effect of MDS on OA (P = 0.006). In addition, these associations were further confirmed in sensitivity and subgroup analyses.
Our study identified significant dose-response associations between MDS and both RA and OA. More biological mechanisms are needed in the future to validate and clarify the results of this study.
镁耗竭评分（MDS）是一种基于影响肾脏重吸收的病理生理因素来预测镁缺乏的评分系统。全身镁状态与关节炎的关系尚不清楚。本研究旨在确定 MDS 与类风湿关节炎（RA）和骨关节炎（OA）之间的关系。
本研究通过对 2007 年至 2018 年参加 NHANES 的 20,513 名≥20 岁成年人进行横断面调查。MDS 的四个维度包括利尿剂、质子泵抑制剂、肾小球滤过率和过量饮酒。采用单变量和多变量加权逻辑回归评估 MDS 与 RA/OA 的相关性，并进行趋势检验以分析剂量-反应关系的存在。根据混杂因素进行亚组分析和交互检验。
在调整所有协变量后，我们发现 MDS 与 RA 或 OA 之间存在分级剂量-反应关系。当 MDS 被视为连续变量时，MDS 每增加一倍，患 RA 的几率增加 1.21 倍（OR=1.21，1.10，1.33），患 OA 的几率增加 1.12 倍（OR=1.12，1.04，1.21）。MDS 对 RA 的影响存在性别交互作用（P=0.004），MDS 对 OA 的影响存在年龄交互作用（P=0.006）。此外，这些关联在敏感性和亚组分析中得到了进一步证实。
本研究确定了 MDS 与 RA 和 OA 之间存在显著的剂量-反应关联。未来需要更多的生物学机制来验证和阐明本研究的结果。
