Low serum magnesium levels are associated with increased risk of fractures: a long-term prospective cohort study

Abstract

Magnesium, which is an essential trace element that plays a key role in several cellular processes, is a major component of bone; however, its relationship with risk of major bone fractures is uncertain. We aimed to investigate the association of baseline serum magnesium concentrations with risk of incident fractures. We analyzed data on 2245 men aged 42–61 years in the Kuopio Ischemic Heart Disease prospective cohort study, with the assessment of serum magnesium measurements and dietary intakes made at baseline. Hazard ratios [95% confidence intervals (CI)] for incident total (femoral, humeral, and forearm) and femoral fractures were assessed. During a median follow-up of 25.6 years, 123 total fractures were recorded. Serum magnesium was non-linearly associated with risk of total fractures. In age-adjusted Cox regression analysis, the hazard ratio (HR) (95% CIs) for total fractures in a comparison of the bottom quartile versus top quartile of magnesium concentrations was 2.10 (1.30–3.41), which persisted on adjustment for several established risk factors 1.99 (1.23–3.24). The association remained consistent on further adjustment for renal function, socioeconomic status, total energy intake, and several trace elements 1.80 (1.10–2.94). The corresponding adjusted HRs for femoral fractures were 2.56 (1.38–4.76), 2.43 (1.30–4.53) and 2.13 (1.13–3.99) respectively. There was no evidence of an association of dietary magnesium intake with risk of any fractures. In middle-aged Caucasian men, low serum magnesium is strongly and independently associated with an increased risk of fractures. Further research is needed to assess the potential relevance of serum magnesium in the prevention of fractures.Electronic supplementary materialThe online version of this article (doi:10.1007/s10654-017-0242-2) contains supplementary material, which is available to authorized users.

Validity and reproducibility of a semi-quantitative multiple-choice food frequency questionnaire in adults living in central Iran

“…It is proposed that measuring the dietary intakes using multiple DRs that are not dependent on memory and has a great specificity in describing foods is a suitable choice to be used as a reference method in validation studies [4,23]. Biochemical markers are also used in epidemiological studies to measure the participants' status regarding specific nutrients or dietary compounds [24,25]. Previous studies indicate high correlations between dietary intake and some biochemical markers [26,27].…”

The level of microelements and heterogeneity of joint hypermobility as an endophenotype of undifferentiated connective tissue dysplasia

“…Bones loses its quality characteristics according to reduced concentrations of this trace element, which leads to the development of osteoporosis [15]. In a long-term prospective study, which included 2,245 men aged 42 to 61 years, an association of decreased serum magnesium concentration with fractures of the peripheral skeleton was revealed [16]. In a study of chondrocalcinosis in the Chinese population, Zeng et al found that patients with lower serum magnesium levels, even within the normal range, had a higher prevalence of chondrocalcinosis of knee [17].…”

Reporting the methods used in public health research and practice

“…For matched cohort studies, reporting should include the matching criteria used and the number of participants exposed and unexposed to the hypothesized cause of the outcome; in this case, the methods section also should describe how loss to follow-up was addressed. An example of reporting according to STROBE guidelines for cohort studies is available in Kunutsor et al ’s investigation of the association of baseline serum magnesium concentrations associated with a risk for incident fractures (31). …”