Effects of magnesium supplementation on carotid intima–media thickness and metabolic profiles in diabetic haemodialysis patients: a randomised, double-blind, placebo-controlled trial

Abstract

This study evaluated the effects of Mg administration on carotid intima–media thickness (CIMT), glycaemic control and markers of cardio-metabolic risk in diabetic haemodialysis (HD) patients. This randomised, double-blind, placebo-controlled clinical trial was conducted in fifty-four diabetic HD patients. Participants were randomly divided into two groups to take either 250 mg/d Mg as magnesium oxide (n 27) or placebo (n 27) for 24 weeks. Mg supplementation resulted in a significant reduction in mean (P<0·001) and maximum levels of left CIMT (P=0·02) and mean levels of right CIMT (P=0·004) compared with the placebo. In addition, taking Mg supplements significantly reduced serum insulin levels (β=–9·42 pmol/l; 95% CI –14·94, –3·90; P=0·001), homoeostasis model of assessment-insulin resistance (β=–0·56; 95 % CI –0·89, –0·24; P=0·001) and HbA1c (β=–0·74 %; 95 % CI –1·10, –0·39; P<0·001) and significantly increased the quantitative insulin sensitivity check index (β=0·008; 95 % CI 0·002, 0·01; P=0·002) compared with the placebo. In addition, Mg administration led to a significant reduction in serum total cholesterol (β=–0·30 mmol/l; 95% CI –0·56, –0·04; P=0·02), LDL-cholesterol (β=–0·29 mmol/l; 95% CI –0·52, –0·05; P=0·01), high-sensitivity C-reactive protein (hs-CRP) (P<0·001) and plasma malondialdehyde (MDA) (P=0·04) and a significant rise in plasma total antioxidant capacity (TAC) levels (P<0·001) compared with the placebo. Overall, we found that taking Mg for 24 weeks by diabetic HD patients significantly improved mean and maximum levels of left and mean levels of right CIMT, insulin metabolism, HbA1c, total cholesterol and LDL-cholesterol, hs-CRP, TAC and MDA levels.

The effect of magnesium supplementation on anthropometric indices: a systematic review and dose–response meta-analysis of clinical trials

“…All studies had parallel design. Out of twenty-eight included studies, four studies performed in Europe (34,39,41,43) , ten in America (26,28,(30)(31)(32)35,37,38,44,45) and fourteen studies in Asia (21)(22)(23)(24)27,29,33,36,40,42,46,47,52) . The intervention period ranged between 4 and 48 weeks.…”

“…All of included studies were conducted on both sexes except six studies that were conducted in women (35,36,41,45,47,52) and one study on men (39) . Included studies were carried out in cases with hypertension (28,41) , diabetes and prediabetes (21,(23)(24)(25)27,30,32,37,38,(42)(43)(44) , obesity (22,33,34,52) , the metabolic syndrome (26,45,47), nonalcoholic fatty liver disease (46) , insulin resistance (34,37 ), depression (29) and healthy volunteers (36,40) . Detailed characteristics of included trial were presented in Table 1.…”

“…Totally, sixteen eligible studies (21,(23)(24)(25)27,30,33,36,(38)(39)(40)(41)(45)(46)(47)52) with eighteen treatment arms, including a total of 1079 participants, examined the effect of Mg supplementation on BW. Combining their findings based on random-effects model, data Subgroup analysis based on the median dose of intervention (>360 and ≤360 mg/d), duration of supplementation (>12 and ≤12 weeks), mean BMI of subjects (BMI > 28 and ≤28 kg/m 2 ), mean age of participants (age of >50 and ≤50 years) and sex (men, women and both) effect remained non-significant in all of subgroup analysis as outlined in Table 3.…”

“…The pooled estimation from the random-effects model that performed on twenty-five studies (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(42)(43)(44)(45)(46)(47)52) Subgroup analysis based on the median dose of supplementation (>360 and ≤360 mg/d), mean duration of intervention (>12 and ≤12 weeks), mean BMI (BMI > 30 and ≤30 kg/m 2 ), mean age (>50 and ≤50 years) and sex (women and both) showed non-significant effect of Mg supplementation on BMI as outlined in Table 3.…”

Cardiovascular Features of Chronic Inflammation and Endothelial Dysfunction in Patients with Diabetic Nephropathy on Programmed Hemodialysis

“…Moreover, CRP reduces the production/expression of eNOS and can directly lead to ED[31,32]. Interestingly, magnesium deficiency is associated with NF-κβ activation, decreased NO bioavailability, cytokine aggression, and progression of atherosclerosclerotic damage[33,34,35]. Hyperfibrinogenemia in case of CKD may be associated with inflammation, fibrin formation, increased blood viscosity, increased platelet aggregation, thrombophilia, and stimulation of smooth muscle cell proliferation[8, 9].…”