Zhou Zhengxi, Yao Xiaotian
Department of Urology, Ningbo Mingzhou Hospital, Zhejiang, China.
The Division of Nephrology, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Diabetol Metab Syndr. 2025 Jan 29;17(1):38. doi: 10.1186/s13098-025-01598-8.
The kidney reabsorption is essential for maintaining magnesium homeostasis. This study aims to explore the relationship between kidney reabsorption-related magnesium depletion score (MDS) and the occurrence of cardiovascular disease (CVD) and prognosis in diabetic disease kidney (DKD) patients.
We included 3199 DKD patients from the National Health and Nutrition Examination Survey (NHANES) database, including 1072 CVD patients. Weighted logistic regression analysis was used to explore the relationship between MDS and the occurrence of CVD. Weighted COX proportional hazards regression was used to explore the relationship between MDS and mortality. Stratified analysis was used to further validate. Finally, we assessed the predictive accuracy of MDS on survival outcomes in DKD patients using time-dependent receiver operating characteristic (ROC) curve analysis.
Survey-weighted multiple logistic regression analysis revealed that MDS ≥ 3, the incidence of CVD increased by 371%. During the follow-up period (median of 87 months), 1373 all-cause deaths (497 cardiovascular deaths) were recorded. In DKD patients, MDS ≥ 3, all-cause mortality increased 78% (P < 0.001) and cardiac mortality 76% (P = 0.08). Consistent results were also shown when stratified by age, sex, race, marital status, magnesium intake. The area under the curve (AUC) values for predicting 1-,2-,3-,4-, and 5-year mortality using MDS were 0.86, 0.66, 0.59, 0.57, and 0.55, for all-cause mortality and 0.9, 0.67, 0.62, 0.58, and 0.56 for cardiovascular mortality.
MDS, kidney reabsorption-related, is positively correlated with the incidence of CVD and longitudinal mortality in DKD patients.
肾脏重吸收对于维持镁稳态至关重要。本研究旨在探讨与肾脏重吸收相关的镁缺乏评分（MDS）与糖尿病肾病（DKD）患者心血管疾病（CVD）发生及预后之间的关系。
我们纳入了来自美国国家健康与营养检查调查（NHANES）数据库的3199例DKD患者，其中包括1072例CVD患者。采用加权逻辑回归分析来探讨MDS与CVD发生之间的关系。采用加权COX比例风险回归来探讨MDS与死亡率之间的关系。采用分层分析进行进一步验证。最后，我们使用时间依赖性受试者工作特征（ROC）曲线分析评估MDS对DKD患者生存结局的预测准确性。
调查加权多元逻辑回归分析显示，MDS≥3时，CVD发病率增加371%。在随访期间（中位时间87个月），记录了1373例全因死亡（497例心血管死亡）。在DKD患者中，MDS≥3时，全因死亡率增加78%（P<0.001），心脏死亡率增加76%（P=0.08）。按年龄、性别、种族、婚姻状况、镁摄入量分层时也显示出一致的结果。使用MDS预测1年、2年、3年、4年和5年死亡率的曲线下面积（AUC）值，全因死亡率分别为0.86、0.66、0.59、0.57和0.55，心血管死亡率分别为0.9、0.67、0.62、0.58和0.56。
与肾脏重吸收相关的MDS与DKD患者CVD发病率和纵向死亡率呈正相关。
