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Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration With Arterial Calcification and Stiffness in Incident Hemodialysis Patients
INTRODUCTION: Magnesium (Mg) may protect against arterial calcification. We tested the hypotheses that a higher serum Mg concentration is associated with less arterial calcification and stiffness in patients on hemodialysis (HD) and that these associations are modified by diabetes mellitus. METHODS:...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6551514/ https://www.ncbi.nlm.nih.gov/pubmed/31194171 http://dx.doi.org/10.1016/j.ekir.2019.03.003 |
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author | Chen, Wei Fitzpatrick, Jessica Monroy-Trujillo, Jose M. Sozio, Stephen M. Jaar, Bernard G. Estrella, Michelle M. Wu, Tong Tong Melamed, Michal L. Parekh, Rulan S. Bushinsky, David A. |
author_facet | Chen, Wei Fitzpatrick, Jessica Monroy-Trujillo, Jose M. Sozio, Stephen M. Jaar, Bernard G. Estrella, Michelle M. Wu, Tong Tong Melamed, Michal L. Parekh, Rulan S. Bushinsky, David A. |
author_sort | Chen, Wei |
collection | PubMed |
description | INTRODUCTION: Magnesium (Mg) may protect against arterial calcification. We tested the hypotheses that a higher serum Mg concentration is associated with less arterial calcification and stiffness in patients on hemodialysis (HD) and that these associations are modified by diabetes mellitus. METHODS: We performed cross-sectional analyses of 367 incident HD patients from the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) cohort. Measures of arterial calcification and stiffness included coronary arterial calcification (CAC) and thoracic aortic calcification (TAC) scores, ankle brachial index (ABI; high ABI: >1.4 or incompressible vessels), pulse wave velocity (PWV), and pulse pressure. RESULTS: Mean Mg was 1.8 ± 0.2 mEq/l and 58% had diabetes. Among nondiabetic individuals, per 0.1 mEq/l higher Mg, non-zero CAC score was lower (% difference: −15.4%; 95% confidence interval [CI]: −28% to −0.55%; P = 0.03), the odds of having TAC score >0 and the odds of having high ABI were lower (odds ratio [OR]: 0.66; 95% CI 0.47–0.93; P = 0.02, and 0.23; 95% CI: 0.06–0.83, P = 0.03, respectively) while adjusting for demographics, comorbidities, markers of mineral metabolism, and dialysis clearance. Among diabetic individuals, per 0.1 mEq/l higher Mg, the odds of having TAC score >0 was higher (OR: 1.57; 95% CI: 1.09–2.26; P = 0.02). Mg was not associated with CAC or high ABI among diabetic individuals. Mg was not associated with PWV or pulse pressure regardless of diabetes status. CONCLUSION: Diabetes modified the associations of serum Mg with arterial calcification and stiffness in incident HD patients. Higher Mg was associated with less arterial calcification and less peripheral arterial stiffness among nondiabetic individuals, but Mg was only associated with TAC among diabetic individuals with higher Mg being associated with higher likelihood of having TAC score >0. |
format | Online Article Text |
id | pubmed-6551514 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-65515142019-06-10 Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration With Arterial Calcification and Stiffness in Incident Hemodialysis Patients Chen, Wei Fitzpatrick, Jessica Monroy-Trujillo, Jose M. Sozio, Stephen M. Jaar, Bernard G. Estrella, Michelle M. Wu, Tong Tong Melamed, Michal L. Parekh, Rulan S. Bushinsky, David A. Kidney Int Rep Clinical Research INTRODUCTION: Magnesium (Mg) may protect against arterial calcification. We tested the hypotheses that a higher serum Mg concentration is associated with less arterial calcification and stiffness in patients on hemodialysis (HD) and that these associations are modified by diabetes mellitus. METHODS: We performed cross-sectional analyses of 367 incident HD patients from the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) cohort. Measures of arterial calcification and stiffness included coronary arterial calcification (CAC) and thoracic aortic calcification (TAC) scores, ankle brachial index (ABI; high ABI: >1.4 or incompressible vessels), pulse wave velocity (PWV), and pulse pressure. RESULTS: Mean Mg was 1.8 ± 0.2 mEq/l and 58% had diabetes. Among nondiabetic individuals, per 0.1 mEq/l higher Mg, non-zero CAC score was lower (% difference: −15.4%; 95% confidence interval [CI]: −28% to −0.55%; P = 0.03), the odds of having TAC score >0 and the odds of having high ABI were lower (odds ratio [OR]: 0.66; 95% CI 0.47–0.93; P = 0.02, and 0.23; 95% CI: 0.06–0.83, P = 0.03, respectively) while adjusting for demographics, comorbidities, markers of mineral metabolism, and dialysis clearance. Among diabetic individuals, per 0.1 mEq/l higher Mg, the odds of having TAC score >0 was higher (OR: 1.57; 95% CI: 1.09–2.26; P = 0.02). Mg was not associated with CAC or high ABI among diabetic individuals. Mg was not associated with PWV or pulse pressure regardless of diabetes status. CONCLUSION: Diabetes modified the associations of serum Mg with arterial calcification and stiffness in incident HD patients. Higher Mg was associated with less arterial calcification and less peripheral arterial stiffness among nondiabetic individuals, but Mg was only associated with TAC among diabetic individuals with higher Mg being associated with higher likelihood of having TAC score >0. Elsevier 2019-03-13 /pmc/articles/PMC6551514/ /pubmed/31194171 http://dx.doi.org/10.1016/j.ekir.2019.03.003 Text en © 2019 International Society of Nephrology. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Clinical Research Chen, Wei Fitzpatrick, Jessica Monroy-Trujillo, Jose M. Sozio, Stephen M. Jaar, Bernard G. Estrella, Michelle M. Wu, Tong Tong Melamed, Michal L. Parekh, Rulan S. Bushinsky, David A. Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration With Arterial Calcification and Stiffness in Incident Hemodialysis Patients |
title | Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration With Arterial Calcification and Stiffness in Incident Hemodialysis Patients |
title_full | Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration With Arterial Calcification and Stiffness in Incident Hemodialysis Patients |
title_fullStr | Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration With Arterial Calcification and Stiffness in Incident Hemodialysis Patients |
title_full_unstemmed | Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration With Arterial Calcification and Stiffness in Incident Hemodialysis Patients |
title_short | Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration With Arterial Calcification and Stiffness in Incident Hemodialysis Patients |
title_sort | diabetes mellitus modifies the associations of serum magnesium concentration with arterial calcification and stiffness in incident hemodialysis patients |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6551514/ https://www.ncbi.nlm.nih.gov/pubmed/31194171 http://dx.doi.org/10.1016/j.ekir.2019.03.003 |
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