Serum Magnesium Level in Children With Bronchial Asthma in Duhok City

Abstract

Background
 Asthma is an increasingly common disease over the last century. It is caused by chronic inflammation of lung airways with increased airway responsiveness and airflow obstruction. Magnesium is the fourth most common cation in the body and the major intracellular divalent cation. Mg+2 in extracellular fluid is crucial for normal neuromuscular activities. Magnesium deficiency is associated with increased contractility of smooth muscle cells including bronchiolar resulting in bronchospasm.
 Objectives
 To detect the prevalence of hypomagnesemia among asthmatic children and to find out any significant correlation of hypomagnesemia with asthma in children.
 Patients and Methods
 A case control study conducted in Duhok, North of Iraq in the period between January the 1st 2014 and January the 1st 2015. One hundred asthmatic patients aged between 1 and 15 years were examined. All patients had acute asthmatic attacks with features of respiratory distress for which they were admitted to Heevi Pediatric Teaching Hospital. Those with fever, dehydration, localized wheezing, pneumonia, cardiac, renal, or hepatic dysfunction were excluded. They were all studied in terms of age, gender, duration of asthma, drugs used for treatment, severity of asthma and the patients’ growth as measured by Body Mass index. Control group included 100 children who were healthy non asthmatic and visited the hospital with their parents. Samples of blood were taken to measure serum magnesium level.Statistical analysis were performed by using the SPSS 19 where P<0.05 is significant.
 Results
 The mean serum magnesium in patients group was 1.91± 0.33 mg/dl while in the control group it was 2.03± 0.33 mg/dl. Serum magnesium levels were lower in the asthmatic patients than controls P= 0.01. Male gender predominated in both groups (68% , 61%) and the most common age among cases was 1- < 3 years and controls 5- <10 years. Serum magnesium level indirectly correlated with duration of asthma but not significantly (P=0.1). Serum magnesium level was not significantly related to body mass index P=0.3.Serum magnesium level decreased with increasing severity of asthma symptoms P= 0.05. Serum level is slightly lower in asthmatics on steroids and bronchodilators than those who were not P=0.7, P=0.9 respectively. 
 Conclusion
 Serum magnesium level is significantly lower in asthmatic children as compared to the control group. Serum Mg+2 level decreases as the duration of asthma is longer but not significantly. There is an inverse relation between serum Mg+2 and the severity of asthma. No significant change in serum Mg+2 develops when steroids and bronchodilators are used.