Serum ionized magnesium levels and ionized calcium‐to‐magnesium ratios in adult patients with sickle cell anemia

Abstract

Low levels of total magnesium in sickle cell erythrocytes have been linked to increased sickling due to cell dehydration. We tested the null hypothesis that adult sickle cell anemia (SCA) patients have the same serum level of ionized Mg (Mg 2+ ) and Ca 2+ /Mg 2+ ratio as healthy African Americans (AA) and healthy Caucasians (CAUC). We measured serum Mg 2+ and ionized calcium (Ca 2+ ) with ion-selective electrodes and calculated the serum Ca 2+ /Mg 2+ ratios in patients with SCA and control groups (AA and CAUC). Seventyfour SCA patients and 61 controls were compared. SCA patients had significantly (P < 0.001) lower levels of serum Mg 2+ (0.52 ± 0.05) compared to healthy AA (0.57 ± 0.04) and CAUC (0.62 ± 0.03). Eighty-six percent of the adult SCA patients had serum Mg 2+ levels below the mean for the AA group, and 96% of SCA patients were above the AA group's mean serum Ca 2+ /Mg 2+ . Of the SCA patients studied, 25.6% (95% CI, 16.2-37.2%) had serum Mg 2+ levels below the racially adjusted lower limit of normal and 50% (95% CI, 38.1-61.9%) were above the upper limit of serum Ca 2+ /Mg 2+ for AA controls. By measuring serum Mg 2+ and Ca 2+ , we were able to define a subset of SCA patients with hypomagnesemia and elevated Ca 2+ /Mg 2+ ratios, who may benefit from magnesium supplementation. Am.

The Role of Nutrition in Sickle Cell Disease

“…Some studies have measured normal circulating levels74,83 while others are reported to be low 84. Low levels of total Mg in sickle cell erythrocytes have been associated with increased sickling due to propensity for red cell dehydration and hence, increased HbS polymerization 7,85.…”

“…They reported that the participants with HbSS had significantly lower levels of serum Mg 2+ (0.52 ± 0.05) compared with healthy ethnicity matched controls (0.57 ± 0.04) and Caucasian controls (0.62 ± 0.03), P < 0.001. By measuring serum Mg 2+ and Ca 2+ , they were able to define a subset of HbSS patients with hypomagnesemia and elevated Ca 2+ /Mg 2+ ratios, who might benefit from magnesium supplementation 84. In another study, Brousseu et al reported a decrease in the length of hospital stay from approximately 5 days to an average of 3 days ( P < 0.01) in children admitted to the hospital for painful crisis, who were given IV Mg 86.…”

Precipitating factors and targeted therapies in combating the perils of sickle cell disease--- A special nutritional consideration

“…Zinc supplementation not only improved growth and weight of SCD children, but also gave a boost to their immunity by offering antibacterial protection, thereby making its supplementation essential. Besides zinc, magnesium was found to protect against losses of water and potassium in SCD patients [ 39 , 40 ]. Magnesium deficiency was found to increase episodes of sickling by causing cell dehydration in sickled erythrocytes [ 40 ].…”

“…Besides zinc, magnesium was found to protect against losses of water and potassium in SCD patients [ 39 , 40 ]. Magnesium deficiency was found to increase episodes of sickling by causing cell dehydration in sickled erythrocytes [ 40 ]. In SCD patients It has been found that magnesium supplementation reduced the number of dense erythrocytes and also improved the erythrocyte membrane transport abnormalities of patients with SCD [ 41 ].…”

Phytomedicines and Nutraceuticals: Alternative Therapeutics for Sickle Cell Anemia

“…Zinc deficiency is a common nutritional problem in sickle cell disease, so supplements may be important. Magnesium protects against potassium and water loss in sickle cells [19, 72, 73]. In view of these findings, it can be concluded that Ciklavit may cause a reduction in bone pains (painful crises) and may ameliorate the adverse effect of sickle cell anemia on the liver.…”