Abdullah Mohammed, Abdo Basheer, AlShoaibi Ismaeel, Alzanen Khaled, Alhakamy Mohammed, Al-Namer Mamoon, Almogahed Mohammed, Algaadi Kamal, Al-Shami Marwa, Ahmed Faisal
Department of Internal Medicine, School of Medicine, Ibb University, Ibb, Yemen.
Department of Social Medicine, School of Medicine, Ibb University, Ibb, Yemen.
Medicine (Baltimore). 2025 Aug 8;104(32):e43851. doi: 10.1097/MD.0000000000043851.
Hypomagnesemia is a common comorbidity in patients with type 2 diabetes mellitus (T2DM), adversely affecting metabolic control and increasing cardiovascular risk. This study aimed to determine prevalence and independent predictors of hypomagnesemia among Yemeni adults with T2DM. A retrospective analysis was conducted among 487 adults with T2DM attending Al-Raffa Center in Ibb, Yemen, from 2018 to 2023. Demographic, clinical, and biochemical parameters-including serum magnesium (Mg), HbA1c, and lipid profiles-were evaluated. Hypomagnesemia was defined as serum Mg < 1.6 mg/dL. Univariate and multivariate logistic regression analyses were used to identify independent predictors. The cohort had a mean age of 48.3 ± 15.3 years, with 63.4% female participants. Hypomagnesemia was present in 37.2% of patients. Poor glycemic control (HbA1c ≥7%) and LDL ≥100 mg/dL were observed in 42.3%, and 42.1%, respectively. In univariate analysis, hypomagnesemia was significantly associated with older age, female sex, obesity (BMI ≥25 kg/m2), hypertension, diabetes duration ≥5 years, poor glycemic control, khat chewing, elevated LDL, low HDL, and hypertriglyceridemia (all P < .05). Multivariate regression identified obesity (adjusted OR [aOR] 9.32, 95% CI 4.97-18.06), HbA1c ≥7% (aOR 2.85, 95% CI 1.80-4.52), female sex (aOR 1.85, 95% CI 1.20-2.85), hypertension (aOR 1.58, 95% CI 1.02-2.45), diabetes duration ≥5 years (aOR 1.90, 95% CI 1.20-3.00), and LDL ≥100 mg/dL (aOR 1.60, 95% CI 1.02-2.50) as independent predictors. A significant interaction was observed between obesity and poor glycemic control (aOR 3.25, P < .001). The final model demonstrated excellent discrimination (AUC-ROC = 0.86). Hypomagnesemia is highly prevalent among Yemeni adults with T2DM and is independently associated with female sex, obesity, poor glycemic control, hypertension, longer diabetes duration, and elevated LDL. The synergistic effect of obesity and poor glycemic control identifies a particularly high-risk subgroup. Routine assessment of serum Mg should be considered in diabetes management, especially for women and individuals with coexisting obesity and hyperglycemia in resource-limited settings.
低镁血症是2型糖尿病（T2DM）患者常见的合并症，对代谢控制产生不利影响，并增加心血管疾病风险。本研究旨在确定也门成年T2DM患者中低镁血症的患病率及独立预测因素。对2018年至2023年在也门伊卜省拉菲中心就诊的487例成年T2DM患者进行回顾性分析。评估了人口统计学、临床和生化参数，包括血清镁（Mg）、糖化血红蛋白（HbA1c）和血脂谱。低镁血症定义为血清Mg<1.6mg/dL。采用单因素和多因素逻辑回归分析确定独立预测因素。该队列的平均年龄为48.3±15.3岁，女性参与者占63.4%。37.2%的患者存在低镁血症。血糖控制不佳（HbA1c≥7%）和低密度脂蛋白（LDL）≥100mg/dL的患者分别占42.3%和42.1%。单因素分析显示，低镁血症与年龄较大、女性、肥胖（体重指数[BMI]≥25kg/m2）、高血压、糖尿病病程≥5年、血糖控制不佳、咀嚼卡特叶、LDL升高、高密度脂蛋白（HDL）降低和高甘油三酯血症显著相关（所有P<0.05）。多因素回归分析确定肥胖（调整后比值比[aOR]9.32，95%置信区间[CI]4.97-18.06）、HbA1c≥7%（aOR2.85，95%CI1.80-4.52）、女性（aOR1.85，95%CI1.20-2.85）、高血压（aOR1.58，95%CI1.02-2.45）、糖尿病病程≥5年（aOR1.90，95%CI1.20-3.00）和LDL≥100mg/dL（aOR1.60，95%CI1.02-2.50）为独立预测因素。观察到肥胖与血糖控制不佳之间存在显著交互作用（aOR3.25，P<0.001）。最终模型显示出良好的区分能力（曲线下面积[AUC-ROC]=0.86）。低镁血症在也门成年T2DM患者中非常普遍，并且与女性、肥胖、血糖控制不佳、高血压、糖尿病病程较长和LDL升高独立相关。肥胖与血糖控制不佳的协同作用确定了一个特别高危的亚组。在糖尿病管理中应考虑常规检测血清镁，特别是在资源有限地区的女性以及同时存在肥胖和高血糖的个体中。
