Biochemical Variations of Serum Magnesium with Lipid Analytes in Different Clinical Groups of Type 1 and Type 2 Diabetes Mellitus: A Hospital-based Cross-sectional Study
Shashi Ranjan, Himani Rathi, Raman Kumar, Shilpa Puluturu, Bela Goyal, Swati Rajput, Satyavati Rana, Senkadhirdasan Dakshinamurthy, Anissa A Mirza
Hypercholesterolemia, Hypertriacylglycerolemia, Hypomagnesemia, Type 1 and type 2 diabetes mellitus
Citation Information :
Ranjan S, Rathi H, Kumar R, Puluturu S, Goyal B, Rajput S, Rana S, Dakshinamurthy S, Mirza AA. Biochemical Variations of Serum Magnesium with Lipid Analytes in Different Clinical Groups of Type 1 and Type 2 Diabetes Mellitus: A Hospital-based Cross-sectional Study. Indian J Med Biochem 2020; 24 (3):119-124.
Objective: Hypomagnesemia associated with dyslipidemia in type 2 diabetes mellitus (T2DM) has been well documented globally by various researchers, as there found a paucity in related data for type 1 diabetes mellitus (T1DM), present observational hospital-based cross-sectional study was planned to estimate, correlate serum magnesium with lipid analytes in different clinical groups of both T1DM and T2DM, and validate its diagnostic significance.
Materials and methods: The study comprised 250 subjects with random inclusion of 200 of both T1DM, T2DM, and 50 normoglycemic healthy controls. Based on medical history and clinical records of 52 T1DM and 148 T2DM clinical cases, they were subgrouped into group I—newly diagnosed, group II—stabilized controlled, and group III—with long course, uncontrolled with associated complications. Biochemical analyses of plasma glucose, serum total magnesium, total cholesterol, and triacylglycerol were analyzed, compared, and correlated statistically with each group and healthy controls.
Results: Comparison and correlations of studied analytes in T1DM and T2DM groups of subgroups with healthy controls, clearly depicted biochemical variations of hypomagnesemia in overt hyperglycemic-hyperlipidemic clinical cases. Hypomagnesemia was inversely correlated with hypertriacylglycerolemia and hypercholesterolemia in hyperglycemic of both T1DM and T2DM with varied statistical significances in different clinical groups with (p < 0.001) in group III, (p < 0.01) in group I, and (p > 0.05) non-significant in group II. However, no statistical significance (p > 0.05) for analytes was noted between type 1 and type 2 of all subgroups.
Conclusion: As biochemical variations of hypomagnesemia in overt hyperglycemic-hyperlipidemic type 1 and type 2 clinical cases of diabetes mellitus was depicted and correlated, it is recommended for clinicians to prescribe serum magnesium as a routine investigation of diabetes diagnostic profile for early screening, periodic monitoring, and better management with its supplementation to prevent long-standing critical diabetes complications.
American Diabetes Association. 2. Classification and diagnosis of diabetes. Dia Care 2017;40(Suppl. 1):S11–S24. DOI: 10.2337/dc17-S005.
WHO [Internet]. Available from: https://www.who.int/health-topics/diabetes#tab=tab_1.
Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. Australas Med J 2014;7(1):45–48. DOI: 10.4066/AMJ.2014.1979.
Tabish SA. Is diabetes becoming the biggest epidemic of the twenty-first century? Int J Health Sci (Qassim) 2007;1(2):V–VIII.
Shahid SM, Rafique R, Mahboob T. Electrolytes and sodium transport mechanism in diabetes mellitus. Pak J Pharm Sci 2005;18(2):6–10.
Marschner H. Mineral nutrition of higher plants. 2nd ed., [5. print.], San Diego: Academic Press; 2002. p. 889.
Zhang Y, Li Q, Xin Y, et al. Association between serum magnesium and common complications of diabetes mellitus. Gómez C, Schwarzacher SP, Zhou H, ed. THC 2018;26:379–387. DOI: 10.3233/THC-174702.
Rodríguez-Morán M, Simental Mendía LE, Zambrano Galván G, et al. The role of magnesium in type 2 diabetes: a brief based-clinical review. Magnes Res 2011;24(4):156–162. DOI: 10.1684/mrh.2011.0299.
Barbagallo M. Magnesium and type 2 diabetes. WJD 2015;6(10):1152. DOI: 10.4239/wjd.v6.i10.1152.
Erasmus RT, Olukoga AO, Alanamu RA, et al. Plasma magnesium and retinopathy in black African diabetics. Trop Geogr Med 1989;41(3):234–237.
Kao WHL, Folsom AR, Nieto FJ, et al. Serum and dietary magnesium and the risk for type 2 diabetes mellitus: the atherosclerosis risk in communities study. Arch Intern Med 1999;159(18):2151. DOI: 10.1001/archinte.159.18.2151.
Djurhuus MS, Skøtt P, Hother-Nielsen O, et al. Insulin increases renal magnesium excretion: a possible cause of magnesium depletion in hyperinsulinaemic states. Diabet Med 1995;12(8):664–669. DOI: 10.1111/j.1464-5491.1995.tb00566.x.
Nasri H. Consequences of hypomagnesemia in type 2 diabetes mellitus patients. consequences of hypomagnesemia in type 2 diabetes mellitus patients [Internet]. J Renal Inj Prev 2014;3(4):99–100. DOI: 10.12861/jrip.2014.28.
Grafton G, Bunce CM, Sheppard MC, et al. Effect of Mg2+ on Na+-dependent inositol transport: role for Mg2+ in etiology of diabetic complications. Diabetes 1992;41(1):35–39. DOI: 10.2337/diab.41.1.35.
de Valk HW, Hardus PL, van Rijn HJ, et al. Plasma magnesium concentration and progression of retinopathy. Diabetes Care 1999;22(5):864–865. DOI: 10.2337/diacare.22.5.864.
Gröber U, Schmidt J, Kisters K. Magnesium in prevention and therapy. Nutrients 2015;7(9):8199–8226. DOI: 10.3390/nu7095388.
Velayutharaj A, Saraswathi R, Shivakumar R, et al. Association of serum magnesium with glycemic control and insulin resistance in patients with type 2 diabetes mellitus. Int J Curr Res Rev 2016;8(13):17.
Sajjan N, Shamsuddin M. A study of serum magnesium and dyslipidemia in type 2 diabetes mellitus patients. Inter J Clin Bio Res 2016;3(1):36. DOI: 10.5958/2394-6377.2016.00007.1.
Yu L, Zhang J, Wang L, et al. Association between serum magnesium and blood lipids: influence of type 2 diabetes and central obesity. Br J Nutr 2018;120(3):250–258. DOI: 10.1017/S0007114518000685.
Khan LA, Alam AM, Ali L, et al. Serum and urinary magnesium in young diabetic subjects in Bangladesh. Am J Clin Nutr 1999;69(1):70–73. DOI: 10.1093/ajcn/69.1.70.
Sales CH, Pedrosa L, de FC. Magnesium and diabetes mellitus: their relation. Clin Nutr 2006;25(4):554–562. DOI: 10.1016/j.clnu.2006.03.003.
Tosiello L. Hypomagnesemia and diabetes mellitus. A review of clinical implications. Arch Intern Med 1996;156(11):1143–1148. DOI: 10.1001/archinte.1996.00440100029005.
Seyoum B, Siraj ES, Saenz C, et al. Hypomagnesemia in ethiopians with diabetes mellitus. Ethn Dis 2008;18(2):147–151.
Gupta NK, Sharma S, Kaushik G, et al., Association Between Indexes of Insulin Sensitivity/Resistance and Serum Magnesium Levels in Overweight Diabetic Subjects. :6.
Jamali AA, Jamali GM, Jamali NH, et al. Assessment of serum magnesium level in type 2 diabetes mellitus with diabetic foot ulcers (grade I and II) at Nawabshah, Pakistan. IJCM 2018;09(02):104–116. DOI: 10.4236/ijcm.2018.92011.
Shahbah D, Hassan T, Morsy S, et al. Oral magnesium supplementation improves glycemic control and lipid profile in children with type 1 diabetes and hypomagnesaemia. Medicine 2017;96(11):e6352. DOI: 10.1097/MD.0000000000006352.
Arpaci D, Tocoglu AG, Ergenc H, et al. Associations of serum magnesium levels with diabetes and diabetic complications. EJEA [Internet] 2015. DOI: 10.1530/endoabs.37.EP490Available from: http://www.endocrine-abstracts.org/ea/0037/ea0037EP490.htm.
Shahbah D, El Naga AA, Hassan T, et al. Status of serum magnesium in Egyptian children with type 1 diabetes and its correlation to glycemic control and lipid profile. Medicine 2016;95(47):e5166. DOI: 10.1097/MD.0000000000005166.
Khubchandani AS, Sanghani H, Study of Serum Magnesium and HbA1C in Diabetic Patients along with Changes in their Lipid Profiles. :3.
Ramadass S, Basu S, Srinivasan AR. SERUM magnesium levels as an indicator of status of diabetes mellitus type 2. Diabetes Metab Syndr 2015;9(1):42–45. DOI: 10.1016/j.dsx.2014.04.024.
Manonmani M, Manimekalai K. A study of serum magnesium level in type 2 diabetes mellitus patients. JDM 2018;08(02):20–26. DOI: 10.4236/jdm.2018.82003.
Pokharel DR, Khadka D, Sigdel M, et al. Association of serum magnesium level with poor glycemic control and renal functions in Nepalese patients with type 2 diabetes mellitus. Diabetes Metabol Syndr 2017;11:S417–S423. DOI: 10.1016/j.dsx.2017.03.028.
Srinivasan AR, Niranjan G, Kuzhandai Velu V, et al. Status of serum magnesium in type 2 diabetes mellitus with particular reference to serum triacylglycerol levels. Diabetes Metabol Syndr 2012;6(4):187–189. DOI: 10.1016/j.dsx.2012.09.001.
Sendhav SS, Kakaiya A, Chatterjee B. Evaluation of serum magnesium level along with lipid profile in a Gujarati population diagnosed with diabetes mellitus. Indian J Med Biochem 2017;21(2):112–116. DOI: 10.5005/jp-journals-10054-0032.
Dineshbabu S, Tonk RS. Study of relation between serum magnesium levels and vascular complications in patients of type 2 diabetes mellitus. IJMSCI 2019;6(09):4574–4591. DOI: 10.18535/ijmsci/v6i9.03.
Rodriguez-Moran M, Guerrero-Romero F. Oral magnesium supplementation improves insulin sensitivity and metabolic control in type 2 diabetic subjects: a randomized double-blind controlled trial. Diabetes Care 2003;26(4):1147–1152. DOI: 10.2337/diacare.26.4.1147.
Rodrigues AK, Melo AE, Domingueti CP. Association between reduced serum levels of magnesium and the presence of poor glycemic control and complications in type 1 diabetes mellitus: a systematic review and meta-analysis. Diabetes Metabol Syndr 2020;14(2):127–134. DOI: 10.1016/j.dsx.2020.01.015.
Gommers LMM, Hoenderop JGJ, Bindels RJM, et al. Hypomagnesemia in type 2 diabetes: a vicious circle? Diabetes 2016;65(1):3–13. DOI: 10.2337/db15-1028.
Djurhuus MS, Henriksen JE, Klitgaard NA, et al. Effect of moderate improvement in metabolic control on magnesium and lipid concentrations in patients with type 1 diabetes. Diabetes Care 1999;22(4):546–554. DOI: 10.2337/diacare.22.4.546.
Rodríguez M, Guerrero-Romero F. Low serum magnesium levels and foot ulcers in subjects with type 2 diabetes. Arch Med Res 2001;32(4):300–303. DOI: 10.1016/S0188-4409(01)00298-3.
Lal J, Vasudev K, Kela AK, et al. Effect of oral magnesium supplementation on the lipid profile and blood glucose of patients with type 2 diabetes mellitus. J Assoc Physicians India 2003;51:37–42.
Sasaki S, Oshima T, Matsuura H, et al. Abnormal magnesium status in patients with cardiovascular diseases. Clin Sci 2000;98(2):175–181. DOI: 10.1042/cs0980175.
Ma J, Folsom AR, Melnick SL, et al. Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: the ARIC study. J Clin Epidemiol 1995;48(7):927–940.
Song Y, He K, Levitan EB, et al. Effects of oral magnesium supplementation on glycaemic control in type 2 diabetes: a meta-analysis of randomized double-blind controlled trials. Diabet Med 2006;23(10):1050–1056.