医学
内科学
心力衰竭
心肌梗塞
内分泌学
2型糖尿病
血糖性
肾脏疾病
糖尿病
作者
Lynette J. Oost,Amber A.W.A. van der Heijden,Emma A. Vermeulen,Caro Bos,Petra J.M. Elders,Roderick C. Slieker,Steef Kurstjens,Miranda van Berkel,Joost G.J. Hoenderop,Cees J. Tack,Joline W.J. Beulens,Jeroen H.F. de Baaij
标识
DOI:10.2337/figshare.14573631
摘要
<p><b>Objective</b></p> <p>We investigated whether serum magnesium (Mg<sup>2+</sup>) was prospectively associated with macro- or microvascular complications and mediated by glycemic control (Hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>)), in T2D.</p> <p> </p> <p><b>Research Design and Methods</b></p> <p>We analyzed in 4,348 participants the association of serum Mg<sup>2+</sup> with macrovascular disease and mortality (acute myocardial infarction (AMI), coronary heart disease (CHD), heart failure (HF), cerebrovascular accident (CVA), peripheral arterial disease (PAD)), atrial fibrillation (AF) and microvascular complications (chronic kidney disease (CKD), diabetic retinopathy and diabetic foot) using Cox regression, adjusted for confounders. Mediation analysis was performed to assess whether HbA<sub>1c</sub> mediated these associations.</p> <p> </p> <p><b>Results</b></p> <p>The average baseline serum Mg<sup>2+</sup> concentration was 0.80 ± 0.08 mmol/L. Serum Mg<sup>2+</sup> was during 6.1 years of follow-up inversely associated with major macrovascular 0.87 (95% CI: 0.76; 1.00), HF 0.76 (95% CI: 0.62; 0.93) and AF 0.59 (95% CI: 0.49; 0.72). Serum Mg<sup>2+</sup> was not associated with AMI, CHD, CVA and PAD. Serum Mg<sup>2+</sup> was during 5.1 years of follow-up inversely associated with<sup> </sup>overall microvascular events 0.85 (95% CI: 0.78; 0.91), 0.89 (95% CI: 0.82; 0.96) for CKD, 0.77 (95% CI: 0.61; 0.98) for diabetic retinopathy and 0.85 (95% CI: 0.78; 0.92) for diabetic foot. HbA<sub>1c</sub> mediated the associations of serum Mg<sup>2+ </sup>with HF, overall microvascular events, diabetic retinopathy and diabetic foot.</p> <p> </p> <p><b>Conclusions</b></p> <p>Serum Mg<sup>2+</sup> concentration is inversely associated with the risk to develop HF, AF and with the occurrence of CKD, diabetic retinopathy and foot complications, in T2D. Glycemic control partially mediated the association of serum Mg<sup>2+</sup> with HF and microvascular complications. </p>
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