Parenteral magnesium load evaluation of malnourished Thai children

Caddell, Joan L.; Suskind, Robert M.; Sillup, Helen; Olson, Robert E.

doi:10.1016/s0022-3476(73)80334-8

Cited by 34 publications

(6 citation statements)

References 5 publications

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“…Such tests have been utilized for the assessment of tissue magnesium stores [18,24,[28][29][30][31][32]]. Although we are not able to obtain control magnesium retention data from normal children, because of the pain at the injection site caused by intramuscular injection of MgS0 4 , we noted that all but five of the children with IDDM retained more than 40% of the load, with a high mean retention of Mg (58.7 + 5.1).…”

Section: Discussionmentioning

confidence: 93%

“…Although a decreased urinary excretion of magnesium has been considered a reliable index of tissue magnesium deficiency [24,25], this homeostatic mechanism may be lost during osmotic diuresis. Also, glucose or sucrose loads have caused substantial magnesiuresis in normal subjects [26], because glucose interferes with renal tubular reabsorption of magnesium [27].…”

Section: Discussionmentioning

confidence: 99%

“…The increased retention of this ion possibly is indicative of tissue depletion. It should be noted that retention of more than 20% of an Mg load is considered suggestive of magnesium deficiency in adults [28][29][30] and that retention of 40% or more of an intramuscular load has been associated with magnesium deficiency in infants and young children [18,24,29,32].…”

Section: Discussionmentioning

confidence: 99%

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Magnesium status in children with insulin-dependent diabetes mellitus.

Fort¹,

Lifshitz²

1986

Journal of the American College of Nutrition

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We assessed the magnesium status in 67 children with insulin-dependent diabetes mellitus (IDDM) in various degrees of diabetic control and its changes during the evolution of the disease. This was done by measuring fasting serum magnesium and 24-hr urinary magnesium clearances when patients were first studied, as well as subsequently on follow-up. In 23 of these patients the retention of intramuscular magnesium was also assessed in relation to the degree of diabetic control and the duration of the illness. The mean +/- SD serum magnesium levels were significantly lower in diabetic children as compared to nondiabetic controls (1.91 +/- 0.22 vs 2.12 +/- 0.26 mg/dl, p less than 0.001). Serum magnesium in diabetic children correlated with glycosylated hemoglobins (r = -0.358, p less than 0.001), but not with 24-hr glycosuria (r = -0.296). On follow-up of patients, serum magnesium significantly increased when IDDM control improved and decreased when the control worsened. Diabetic patients had increased urinary magnesium clearances compared to nondiabetic subjects (5.26 +/- 3.58 vs 3.60 +/- 1.36 cc/min, p less than 0.05). All but five of the 23 patients given the magnesium load retained more than 40% of the dose, with a mean +/- SD retention of 58.7 +/- 5.1%. There was no correlation between the amount of retained magnesium and the duration of the illness, degree of diabetic control, amount of glycosuria, magnesuria, magnesemia, glycosylated hemoglobins, or serum lipids. The data confirm that lower than control serum magnesium levels occur frequently among children with poorly controlled IDDM. Moreover, there might be magnesium deficiency in IDDM, as indicated by the high retention of magnesium when given intramuscularly. The deficiency of this ion may or may not be accompanied by decreased serum magnesium levels and may result from increased urinary magnesium losses in children with IDDM.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Magnesium status in children with insulin-dependent diabetes mellitus.

Fort¹,

Lifshitz²

1986

Journal of the American College of Nutrition

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“…[30][31][32][33][34][35] Flasma values of magnesium are helpful when low,26,35 but magnesium deficient patients may have normal plasma levels. 35,38 Muscle values may be diminished when expressed on the basis of weight of tissue in magnesium-deficient animals or patients, 26,30,34 but intracellular magnesium concentration is not significantly different from controls. Because intracellular space decreases and interstitial space increases in the malnutrition that accompanies prolonged magnesium depletion, 36,37 the concentration/gm of tissue may decrease: connective tissue is magnesiumpoor.…”

Section: Diagnosismentioning

confidence: 99%

“…There are three precautions: 1) Renal function must be good since almost all absorbed magnesium is excreted by the kidney,1.2 2) Good hydration should be achieved and maintained, 3) As soon as possible, the therapeutic regimen should include all essential nutrients, including calcium; magnesium increases the urinary excretion of calcium. 2,38 In an emergency or in severe illness the parenteral route is the route of choice, since intestinal absorption is slow and variable. The intramuscular and intravenous doses are the same: 0.4 to 0.5 mEq/kg of body weight per day (0.1 to 0,12 ml of 50 per cent MgS04'7H20/kg of body weight per day.…”

Section: Course and Prognosismentioning

confidence: 99%

Magnesium in the Nutrition of the Child

Caddell

1974

Clin Pediatr (Phila)

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Grand Boulevard, St. Louis, Mo. 63104. M AGNESIUM IS the second most abundant intracellular cation. This element is essential for the production and transfer of energy, for protein synthesis, for contractility in muscle and excitability in nerve, and as an essential cofactor in numerous enzyme systems related to other functions. ~.2 Of 75 neonates with convulsions caused by mineral imbalance, Cockburn et al. found 53 per cent to be hypomagnesemic.~ Since convulsions are only one of many symptoms' of magnesium deficiency in the young child, magnesium deficiency must often go undiagnosed. Magnesium Reserves in the Developing Fetus and in the NewbornThe nutritional requirements of the human fetus for magnesium increase as gestation progresses. At term, an infant weighs 20 times as much as a 20-week-old fetus, yet has 32 times as much magnesium.5 Therefore, one would expect that any infant born prematurely would have poor magnesium reserves, regardless of the magnesium status of the mother.In animal studies, magnesium deficiency during pregnancy affects the offspring more than it does the mother. Wang et al. 6 showed that rats fed a low magnesium diet during pregnancy had prolonged labor, a high incidence of stillbirths, and over 90 per cent mortality of live offspring during the first week postpartum. In addition, the body weights and magnesium content of serum and carcass of the offspring were significantly reduced. Also, the milk samples from the deficient dams on day 21 of lactation were low in magnesium. In another study of magnesium deprivation in rats, Dancis et c~l.' 7 found some fetal parasitism, but in the inevitable competition between mother and offspring, magnesium was retained by the mother at the expense of the fetus. At term, the mothers looked healthy, despite some magnesium depletion, but the surviving fetuses were small, pale, weak, and at times edematous.Blizzard' postulated that the stunting found in the growth of magnesium-deficient embryos of Rana pipiens was related to the requirement for adequate magnesium for ribosome synthesis. Although magnesiumdeficient embryos continued to synthesize ribosomal RNA, ribosomes were not made or maintained. Tsang and C~h's~ report of decreased serum magnesium levels in infants of low birth weight is of particular pertinence in this regard. Pertinence to Feeding of the NeonateIt is been established that protein, calcium, and phosphorus all increase the metabolic requirement for magnesium.1° Therefore, some of the practices of current infant feeding merit review. Cow's milk, the basis for most of the artificial formulas fed to infants, 1 1 has higher protein and calcium concentrations than human breast milk, and a phosphorus to magnesium ratio that is about six times greater. 12 Infants fed cow's milk have at The University of Auckland Library on March 29, 2015 cpj.sagepub.com Downloaded from 264 greater gains in weight and length than breast-fed infants. 11 I Several reasons may obtain for the present trend towards larger infants. Reports from both the Un...

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Magnesium Metabolism Studies in Children with Chronic Inflammatory Disease of the Bowel

LaSala,

Lifshitz,

Silverberg

et al. 1985

J. pediatr. gastroenterol. nutr.

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Magnesium metabolism was studied in seven patients with severe chronic inflammatory disease of the bowel (CIDB), and in 20 children without intestinal pathology. Four of the CIDB patients had ulcerative colitis and three had granulomatous disease of the bowel. All had diarrhea as well as other gastrointestinal complaints for 1 to 6 years prior to the study. All were being treated with sulfasalazine and were also receiving corticosteroids intermittently. All but one had had intestinal surgery. Basal plasma and urine were obtained in all patients and, if surgery was performed, a piece of muscle was excised. The CIDB patients received an intravenous magnesium infusion of 2 mEq/kg/day for 4 days, 2 days postsurgery. Electrocardiograms were recorded throughout the study. The mean basal plasma magnesium levels were reduced in CIDB patients as compared with controls. Mild hypomagnesemia was observed in six of seven CIDB patients. The mean basal urine excretion of magnesium was also reduced in CIDB patients, but the muscle concentrations of this element were similar to controls. Basal hypomagnesuria was present in only two of the three patients with granulomatous disease and in one patient with ulcerative colitis. The three patients with granulomatous disease excreted minimal amounts of magnesium in the urine during intravenous administration of this ion. A positive magnesium balance persisted throughout the 4‐day period of infusion. In contrast, only two of the four patients with ulcerative colitis had magnesium retention during the first day of intravenous administration, and all four had negative magnesium balances thereafter. The data suggest that hypomagnesemia in CIDB patients may occur with or without magnesium deficiency. However, the excretion of magnesium in urine after a parenteral magnesium load was the best index of magnesium deficiency. In three CIDB patients, with involvement of small bowel, magnesium depletion was found.

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Parenteral magnesium load evaluation of malnourished Thai children

Cited by 34 publications

References 5 publications

Magnesium status in children with insulin-dependent diabetes mellitus.

Magnesium status in children with insulin-dependent diabetes mellitus.

Magnesium in the Nutrition of the Child

Magnesium Metabolism Studies in Children with Chronic Inflammatory Disease of the Bowel

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