Fu-Chou Cheng

Purpose Serum magnesium is the most frequently used laboratory test for evaluating clinical magnesium status. Hypomagnesemia (low magnesium status), which is associated with many chronic diseases, is diagnosed using the serum magnesium reference range. Currently, no international consensus for a magnesemia normal range exists. Two independent groups designated 0.85 mmol/L (2.07 mg/dL; 1.7 mEq/L) as the low cut-off point defining hypomagnesemia. MaGNet discussions revealed differences in serum magnesium reference ranges used by members’ hospitals and laboratories, presenting an urgent need for standardization. Methods We gathered and compared serum magnesium reference range values from our institutions, hospitals, and colleagues worldwide. Results Serum magnesium levels designating “hypomagnesemia” differ widely. Of 43 collected values, only 2 met 0.85 mmol/L as the low cut-off point to define hypomagnesemia. The remainder had lower cut-off values, which may underestimate hypomagnesemia diagnosis in hospital, clinical, and research assessments. Current serum magnesium reference ranges stem from “normal” populations, which unknowingly include persons with chronic latent magnesium deficit (CLMD). Serum magnesium levels of patients with CLMD fall within widely used “normal” ranges, but their magnesium status is too low for long-term health. The lower serum magnesium reference (0.85 mmol/L) proposed specifically prevents the inclusion of patients with CLMD. Conclusions Widely varying serum magnesium reference ranges render our use of this important medical tool imprecise, minimizing impacts of low magnesium status or hypomagnesemia as a marker of disease risk. To appropriately diagnose, increase awareness of, and manage magnesium status, it is critical to standardize lower reference values for serum magnesium at 0.85 mmol/L (2.07 mg/dL; 1.7 mEq/L).

We investigated the effects of dietary calcium (Ca) and magnesium (Mg) intakes on cardiovascular disease risks in older patients with diabetes. In this cross-sectional study, 197 patients with type 2 diabetes aged 65 years and above were recruited. The 24-h dietary recalls and 1-week self-reported typical dietary intake patterns were collected. The Ca and Mg intakes of 100% of RDA were defined as low, moderate, and high Ca and Mg intakes, respectively. Anthropometric measurements were determined and biochemical analysis of blood and urine was performed. Our data indicated that 60.9% and 87.3% of our patients were Ca and Mg intakes below RDA, respectively. Patients whose Ca intake was high or low (81.2%) had significantly higher C-reactive protein (CRP) than those whose Ca intake was moderate (p = 0.043). Furthermore, patients whose Mg intake was low (87.3%) had significantly higher CRP than that of those who took adequate Mg (p = 0.025). The dietary Ca:Mg intake ratios were highly correlated with CRP, platelet counts, and red blood cell distribution (p < 0.05). A dietary Ca:Mg intake ratio of 2.0–2.5 was significantly correlated to lower CRP levels (p = 0.013). High or low calcium intake increases cardiovascular disease risks. We suggest that “moderate” intake of 402–600 mg Ca/day (approximately 67%–100% of Taiwan RDA for Ca) and adequate Mg intake (or meeting RDA for Mg) with Ca:Mg intake ratio of 2.0–2.5 are important for reducing cardiovascular disease risks in older patients with diabetes.

Serum magnesium (Mg) levels are closely controlled through a variety of Mg transporters and ionic channels during physiological conditions. These levels have been shown to increase during exercise. However, the effect of Mg transporter expression during exercise remains to be determined. The purpose of this study was to examine the gene expression of SLC41A1, a Na+/Mg2+ exchanger, during exercise. In the present study, male C57BL/6JNarl mice (n=16, 8 weeks old) were subjected to 3 h forced exercise on a treadmill. The mice in the control and Mg groups were injected with saline and Mg (MgSO4, 90 mg/kg, intraperitoneal), respectively. Blood samples were obtained at three time points: prior to, following and 24 h after exercise. The gene expression levels of SLC41A1 were significantly downregulated to 23.6±4.6 and 12.6±10.2% following exercise in the control and Mg groups, respectively. The expression levels returned to the basal levels 24 h after exercise in the two groups and there was no significant difference found between the two groups. The downregulated role of SLC41A1 expression and its interaction with the Mg status in exercise requires further investigation.

Repeated blood sampling in rodents is often necessary and difficult. Magnesium has been touted as an agent for enhancing physical activity. An auto-blood-sampling device coupled with a microdialysis analyzer was developed to determine blood glucose and lactate concentrations in rats subjected to treadmill exercise. The effects of magnesium on exercise performance and blood energy metabolism were also evaluated. Sprague–Dawley rats fed a magnesium-adequate diet were randomly assigned to 2 experimental groups. Exercise performance was evaluated at 3 treadmill speeds (10, 15, and 20 m·min^–1) with or without magnesium administration (90 mg·kg^–1, intraperitoneal) in the first experiment. In the other experiment, each rat was fitted with a catheter in the jugular vein for collection of blood samples during the treadmill exercise at a speed of 20 m·min^–1. Exercise performance was significantly higher at the lower speed of 10 m·min^–1 in the control group. In addition, exercise performance was significantly enhanced only at 20 m·min^–1 in the magnesium-sulfate-treated group when compared with the control group. Blood samples were collected every 15 min. Glucose concentrations increased significantly and then declined immediately after completion of the exercise task at 20 m·min^–1 in both groups. However, glucose concentrations increased immediately after administration of magnesium and increased further during exercise when compared with those of the control group. Findings from a repeated blood-sampling assay suggest that increased blood glucose contributes to enhanced exercise performance by rats injected intraperitoneally with magnesium.