Magnesium Deficiency: A Cause of Heterogenous Disease in Humans

Rude, Robert K.

doi:10.1359/jbmr.1998.13.4.749

Cited by 303 publications

(225 citation statements)

References 130 publications

(157 reference statements)

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“…Bone and nutrition in elderly women JZ Ilich et al cular hyperexcitability, probably due to the impaired PTH secretion (Rude, 1998). Although the national and other surveys consistently show low Mg intakes among females of all age groups (FASEB, 1995;Ilich et al, 1999), its role in osteoporosis is poorly understood, probably because of the lack of well-controlled clinical trials.…”

Section: Multiple Regression Resultsmentioning

confidence: 99%

Bone and nutrition in elderly women: protein, energy, and calcium as main determinants of bone mineral density

2003

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Objective: Nutrition is an important factor in the prevention and treatment of osteoporosis. Our goal was to examine the relationship between various nutrients and bone mass of several skeletal sites in elderly women, taking into account possible confounding variables. Design/methods: A cross-sectional study in 136 healthy Caucasian, postmenopausal women, free of medications known to affect bone was carried out. Bone mineral density (BMD) and body composition (lean and fat tissue) were measured by dual X-ray absorptiometry using specialized software for different skeletal sites. Parathyroid hormone (PTH) and vitamin D, 25(OH)D, as possible confounders, were determined in serum samples. Dietary intake, including all supplements, was assessed by 3-day dietary record and analyzed using Food Processor 1 . Past physical activity and present walking were examined as well and accounted for as potential confounders. Simple and multiple regression models were created to assess the relationships between nutrients and BMD. To examine the co-linear variables and their possible independent association with bone, subgroup analyses were performed. Results: Showed independent influence of calcium, energy, and protein, examined separately and in multiple regression models on BMD of several skeletal sites. Magnesium, zinc and vitamin C were significantly related to BMD of several skeletal sites in multiple regression models (controlled for age, fat and lean tissue, physical activity and energy intake), each contributing more than 1% of variance. Serum PTH and 25(OH)D did not show significant association with bone mass. Conclusions: Despite the cross-sectional nature of our study we were able to show a significant relationship between BMD and several critical nutrients: energy, protein, calcium, magnesium, zinc and vitamin C. The exact involvement of these nutrients and their clinical significance in bone health need to be further elucidated in humans and conclusions about the effects of a single nutrient on bone mass must be given cautiously, taking into account its interaction and co-linearity with others. Understanding relationships among nutrients, not just limited to calcium and vitamin D, but others that have not been investigated to such extent, is an important step toward identifying preventive measures for bone loss and prevention of osteoporosis.

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Section: Multiple Regression Resultsmentioning

confidence: 99%

Bone and nutrition in elderly women: protein, energy, and calcium as main determinants of bone mineral density

2003

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“…Family members affected with primary hypomagnesemia due to renal Mg wasting inherited in an autosomal dominant manner have been reported to demonstrate significant reductions in serum and lymphocyte Mg concentrations as well as decreased BMD values at the lumbar spine and proximal femur [17]. Taken together, these findings suggest that Mg deficiency might also act as a risk factor for osteoporosis [18,19]. However, other studies have failed to find the association between Mg deficiency and osteoporosis [20][21][22], and there are still controversies about this issue.…”

Section: Discussionmentioning

confidence: 93%

“…In addition, Mg deficiency could inhibit the synthesis of 1,25-dihydroxy vitamin D (1,25(OH) 2 D) [9][10][11] as well as its action on bone [11]. Accumulating data have shown that a long-term Mg deficiency and resulting hypomagnesemia could cause osteoporosis and bone fractures through these dysfunctions of PTH and vitamin D action [12,[13][14][15][16][17][18][19]. However, other studies have shown no relationship between Mg deficiency and osteoporosis [20][21][22], and it still seems to be controversial whether or not Mg deficiency could cause osteoporosis.…”

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confidence: 99%

A Case of Magnesium Deficiency Associated with Insufficient Parathyroid Hormone Action and Severe Osteoporosis

et al. 2007

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Abstract. The relationship between osteoporosis and magnesium (Mg) deficiency is still controversial. Here we report a case of an 82-year-old woman with a giant adenomatous goiter and severe osteoporosis with multiple vertebral fractures, whose clinical course indicated that her osteoporosis was probably due to Mg deficiency. She visited our hospital for treatments of tetany. Laboratory data showed the existence of hypomagnesemia, hypocalcemia, hypokalemia, vitamin D deficiency, and slightly elevated intact PTH. Intravenous administration of Mg not only improved these electrolyte abnormalities but also increased serum levels of intact PTH, bone formation markers, 1,25-dihydroxyvitamin D, as well as bone resorption markers in the urine, and lowered urinary phosphate reabsorption. Hypomagnesemia on admission seemed to arise from long-lasting poor food intake and malnutrition, because it improved after the disappearance of dysphagia with a goiter resection. After the operation, BMD values at the lumbar spine and femoral neck obviously increased during 6 months of Mg supplementation without any specific therapies for osteoporosis. Mg deficiency in this case seemed to cause impaired secretion of PTH from the parathyroid and the refractoriness of bone and kidney to the hormone, which led to the suppression of both bone remodeling and renal vitamin D production. These processes were probably linked to her severe osteoporosis, which was reversed by Mg supplementation. SERUM calcium levels are normally regulated within a relatively narrow range by the parathyroid gland through a negative feedback mechanism: Increased secretion of parathyroid hormone (PTH) by a fall in blood calcium levels enhances the mobilization of calcium, mainly by bone resorption, and then calcium levels are rapidly restored. Chronic magnesium (Mg) deficiency would result in hypocalcemia [1, 2], because of the impairment of PTH secretion [3][4][5][6][7] and/ or resistance of target organ to PTH action [4,6,8].Previous studies have demonstrated that serum PTH concentration was suppressed in patients with hypomagnesemia [4,5], and Mg substitution therapy enhanced PTH secretion and reversed PTH target-organ resistance, and thus serum calcium concentration returned to normal within several days [4,7]. In addition, Mg deficiency could inhibit the synthesis of 1,25-dihydroxy vitamin D (1,25(OH) 2 D) [9][10][11] as well as its action on bone [11]. Accumulating data have shown that a long-term Mg deficiency and resulting hypomagnesemia could cause osteoporosis and bone fractures through these dysfunctions of PTH and vitamin D action [12,[13][14][15][16][17][18][19]. However, other studies have shown no relationship between Mg deficiency and osteoporosis [20][21][22], and it still seems to be controversial whether or not Mg deficiency could cause osteoporosis. Here we report a patient with a giant adenomatous goiter and severe osteoporosis exhibiting hypomagnesemic hypocalcemia, whose osteoporosis was reversed by Mg supplementation with chronological improv...

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“…The recommended daily estimated average requirement for magnesium is 265 and 350 mg for adult females and males, respectively (6). This suggests that the average North American diet is only adequate for maintenance of body magnesium levels (7). Moreover, magnesium requirements increase was rapid growth in infancy and adolescence and during pregnancy and lactation.…”

Section: Introductionmentioning

confidence: 99%

Epithelial magnesium transport and regulation by the kidney

C²

2000

Front Biosci

102

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Magnesium is the fourth most abundant cation in the body and the second most common cation in the intracellular fluid. It is the kidney that provides the most sensitive control for magnesium balance. About a 80% of the total serum magnesium is ultrafilterable through the glomerular membrane. In all of the mammalian species studied to date, the proximal tubule of the adult animal reabsorbs only a small fraction, 10-15%, of the filtered magnesium. Unlike the adult proximal convoluted tubule that of young rats (aged 13-15 days) reabsorbs 50-60% of filtered magnesium along the proximal tubule together with sodium, calcium, and water. Micropuncture experiments, in every species studied to date, indicates that a large part (approximately 60%) of the filtered magnesium is reabsorbed in the loop of Henle. Magnesium reabsorption in the loop occurs within the cortical thick ascending limb (cTAL) by passive means driven by the transepithelial voltage through the paracellular pathway. Micropuncture experiments have clearly showed that the superficial distal tubule reabsorbs significant amounts of magnesium. Unlike the thick ascending limb of the loop of Henle, magnesium reabsorption in the distal tubule is transcellular and active in nature. Many hormones and nonhormonal factors influence renal magnesium reabsorption to variable extent in the cTAL and distal tubule. Moreover, nonhormonal factors may have important implications on hormonal controls of renal magnesium conservation. Dietary magnesium restriction leads to renal magnesium conservation with diminished urinary magnesium excretion. Adaptation of magnesium transport with dietary magnesium restriction occurs in both the cTAL and distal tubule. Elevation of plasma magnesium or calcium concentration inhibits magnesium and calcium reabsorption leading to hypermagnesiuria and hypercalciuria. The

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Magnesium Deficiency: A Cause of Heterogenous Disease in Humans

Cited by 303 publications

References 130 publications

Bone and nutrition in elderly women: protein, energy, and calcium as main determinants of bone mineral density

Bone and nutrition in elderly women: protein, energy, and calcium as main determinants of bone mineral density

A Case of Magnesium Deficiency Associated with Insufficient Parathyroid Hormone Action and Severe Osteoporosis

Epithelial magnesium transport and regulation by the kidney

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