Chen Taoran, Sun Miao, Zhou Qi, Xu Jiancheng
Department of Laboratory Medicine, First Hospital of Jilin University, Changchun, China.
Department of Pediatrics, First Hospital of Jilin University, Changchun, China.
Front Endocrinol (Lausanne). 2025 Aug 13;16:1603150. doi: 10.3389/fendo.2025.1603150. eCollection 2025.
Hyperglycemia in Diabetic Kidney Disease (DKD) induces excessive accumulation of reactive oxygen species (ROS) through various pathways, leading to oxidative stress, ferroptosis, and mitochondrial dysfunction, which collectively contribute to kidney damage. Currently, the treatment of DKD remains a significant challenge. Magnesium, an essential mineral, has emerged as a promising therapeutic agent for DKD due to its anti-inflammatory and antioxidant properties. Magnesium has been shown to alleviate renal fibrosis, maintain tubular integrity and function, improve endothelial cell function, and regulate renal hemodynamics. As a cofactor of antioxidant enzymes, Magnesium directly scavenges ROS and enhances the expression of antioxidant proteins. This review explores the relationship between Magnesium and DKD, examining how Magnesium mitigates oxidative stress through the PI3K/AKT/FoxO3a pathway, inhibits ferroptosis in renal tubular epithelial cells via the AMPK/FoxO3a/Nrf2 pathway, and reduces autophagy and apoptosis, thereby delaying DKD progression. The review further discusses how Magnesium regulates the pivotal FoxO3a protein, a transcription factor with antioxidant properties, leading to the prevention of DKD, and proposes Magnesium supplementation as a potential clinical strategy for alleviating DKD, offering a new therapeutic approach for its treatment.
糖尿病肾病(DKD)中的高血糖通过多种途径诱导活性氧(ROS)过度积累,导致氧化应激、铁死亡和线粒体功能障碍,这些共同导致肾脏损伤。目前,DKD的治疗仍然是一项重大挑战。镁作为一种必需矿物质,因其抗炎和抗氧化特性,已成为DKD的一种有前景的治疗药物。镁已被证明可减轻肾纤维化、维持肾小管完整性和功能、改善内皮细胞功能并调节肾血流动力学。作为抗氧化酶的辅助因子,镁直接清除ROS并增强抗氧化蛋白的表达。本综述探讨了镁与DKD之间的关系,研究了镁如何通过PI3K/AKT/FoxO3a途径减轻氧化应激,通过AMPK/FoxO3a/Nrf2途径抑制肾小管上皮细胞中的铁死亡,并减少自噬和凋亡,从而延缓DKD进展。该综述进一步讨论了镁如何调节具有抗氧化特性的关键转录因子FoxO3a蛋白,从而预防DKD,并提出补充镁作为缓解DKD的潜在临床策略,为其治疗提供了一种新的治疗方法。
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