Association Between Hypomagnesemia and Severity of Primary Hyperparathyroidism: a Retrospective Study

Abstract

Background: The occurrence of hypomagnesemia in patients with primary hyperparathyroidism (PHPT) has been noted previously; however, the association of hypomagnesemia and severity of primary hyperparathyroidism remains unknown. The present study aimed to evaluate the association of hypomagnesemia with biochemical and clinical manifestations in patients with PHPT.Methods: This was a retrospective study conducted at a tertiary hospital. We obtained data from 307 patients with PHPT from January 2010 through August 2020. Data on demographics, history, laboratory findings, bone densitometry findings, and clinical presentation and complications were collected and were compared in normal magnesium group vs hypomagnesemia group.Results: Among the 307 patients with PHPT included in our study, 77 patients (33/102 [32.4%] males and 44/205 [21.5%] females) had hypomagnesemia. Mean hemoglobin levels in the hypomagnesemia group were significantly lower than those in the normal magnesium group in both males and females. In contrast, patients with hypomagnesemia had a higher mean serum calcium and parathyroid hormone than individuals with normal magnesium. The typical symptoms of PHPT, such as nephrolithiasis, bone pain/fractures, polyuria, or polydipsia, were more common in the hypomagnesemia group. In addition, patients with hypomagnesemia had a higher prevalence of osteoporosis, anemia, and hypercalcemic crisis. Even after adjusting for potential confounders, including age, sex, body mass index, estimated glomerular filtration rate, and parathyroid hormone levels, these associations remained essentially unchanged. Conclusion: Biochemical and clinical evidence indicates that patients with PHPT with hypomagnesemia have more severe hyperparathyroidism than those without hypomagnesemia. Hypomagnesemia is a risk factor for osteoporosis, anemia, and hypercalcemic crisis and may be used as a predictive marker for severity of primary hyperparathyroidism.

Preoperative Low Serum Magnesium Level is a Significant Predictive Factor for Postoperative Hypomagnesemia in Patients Who Underwent Parathyroidectomy for Primary Hyperparathyroidism

“…The severity was minimal at the first day, and gradually restored from the third day. Similar changes have been reported in patients with PHPT after parathyroidectomy 14,16 . They concluded that PTH might influence magnesium metabolism.…”

“…A highly significant negative correlation between serum calcium and magnesium levels in patients with PHPT was reported in a limited number of older studies 13,14 . Nevertheless, the association of serum magnesium, serum calcium, and PTH has been analyzed in patients with secondary hyperparathyroidism 4,6,15,16 . Fang et al 4 studied the effect of PTH on serum magnesium levels in hemodialysis patients with secondary hyperparathyroidism.…”

Protonenpumpenhemmer (PPI): Mikronährstoff-Räuber mit nachhaltigen Nebenwirkungen (Teil 1)

“…Auch die Ausprägung des primären Hyperparathyreoidismus korrelierte mit dem Magnesiummangel. Zudem hatten die Patient*innen mit Magnesiummangel eine höhere Prävalenz an Osteoporose, Anämie und hyperkalzämischen Krisen (Kalzium>3,5 mmol/l) 19 .…”