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

European Journal of Epidemiology

Volumn 32, Issue 7, 2017, Pages 593-603

  Kunutsor, Setor Kwadzo ^a   Whitehouse, Michael Richard ^a   Blom, Ashley William ^a   Laukkanen, Jari Antero ^b,c  

^a SOUTHMEAD HOSPITAL   (United Kingdom)

^b UNIVERSITY OF EASTERN FINLAND   (Finland)

^c Central Finland Central Hospital   (Finland)

Author keywords

Cohort study; Fracture; Magnesium; Risk factor

Indexed keywords

CALCIUM ION; CHOLESTEROL; CREATININE; GLUCOSE; MAGNESIUM; POTASSIUM; TRIACYLGLYCEROL; ZINC;

ADULT; ALCOHOL CONSUMPTION; ARTICLE; CALCIUM BLOOD LEVEL; CALORIC INTAKE; CAUCASIAN; CHOLESTEROL BLOOD LEVEL; COHORT ANALYSIS; CREATININE BLOOD LEVEL; DIETARY INTAKE; ESTIMATED GLOMERULAR FILTRATION RATE; FEMUR FRACTURE; FINLAND; FOLLOW UP; FOREARM FRACTURE; GLUCOSE BLOOD LEVEL; HUMAN; HUMERUS FRACTURE; HYPOMAGNESEMIA; KIDNEY FUNCTION; MAGNESIUM BLOOD LEVEL; MAGNESIUM INTAKE; MAJOR CLINICAL STUDY; MALE; OBSERVATIONAL STUDY; POTASSIUM BLOOD LEVEL; PROSPECTIVE STUDY; RISK FACTOR; SOCIAL STATUS; TRIACYLGLYCEROL BLOOD LEVEL; ZINC BLOOD LEVEL; BLOOD; CROSS-SECTIONAL STUDY; FEMALE; FRACTURE; MIDDLE AGED; PROPORTIONAL HAZARDS MODEL;

ADULT; CROSS-SECTIONAL STUDIES; FEMALE; FINLAND; FRACTURES, BONE; HUMANS; MAGNESIUM; MALE; MIDDLE AGED; PROPORTIONAL HAZARDS MODELS; PROSPECTIVE STUDIES; RISK FACTORS;

EID: 85017424138     PISSN: 03932990     EISSN: 15737284     Source Type: Journal    
DOI: 10.1007/s10654-017-0242-2     Document Type: Article

References (48)

1. Wu L, Luthringer BJ, Feyerabend F, Schilling AF, Willumeit R. Effects of extracellular magnesium on the differentiation and function of human osteoclasts. Acta Biomater. 2014;10(6):2843–54. doi:10.1016/j.actbio.2014.02.010.
2. Martini LA. Magnesium supplementation and bone turnover. Nutr Rev. 1999;57(7):227–9.
3. Rude RK, Singer FR, Gruber HE. Skeletal and hormonal effects of magnesium deficiency. J Am Coll Nutr. 2009;28(2):131–41.
4. Rude RK, Gruber HE, Norton HJ, Wei LY, Frausto A, Kilburn J. Dietary magnesium reduction to 25% of nutrient requirement disrupts bone and mineral metabolism in the rat. Bone. 2005;37(2):211–9. doi:10.1016/j.bone.2005.04.005.
5. Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients. 2013;5(8):3022–33. doi:10.3390/nu5083022.
6. Orchard TS, Larson JC, Alghothani N, et al. Magnesium intake, bone mineral density, and fractures: results from the Women’s Health Initiative Observational Study. Am J Clin Nutr. 2014;99(4):926–33. doi:10.3945/ajcn.113.067488.
7. Tucker KL, Hannan MT, Chen H, Cupples LA, Wilson PW, Kiel DP. Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr. 1999;69(4):727–36.
8. Ryder KM, Shorr RI, Bush AJ, et al. Magnesium intake from food and supplements is associated with bone mineral density in healthy older white subjects. J Am Geriatr Soc. 2005;53(11):1875–80. doi:10.1111/j.1532-5415.2005.53561.x.
9. Aydin H, Deyneli O, Yavuz D, et al. Short-term oral magnesium supplementation suppresses bone turnover in postmenopausal osteoporotic women. Biol Trace Elem Res. 2010;133(2):136–43. doi:10.1007/s12011-009-8416-8.
10. Dahl C, Sogaard AJ, Tell GS, et al. Nationwide data on municipal drinking water and hip fracture: could calcium and magnesium be protective? A NOREPOS study. Bone. 2013;57(1):84–91. doi:10.1016/j.bone.2013.06.017.
11. Farsinejad-Marj M, Saneei P, Esmaillzadeh A. Dietary magnesium intake, bone mineral density and risk of fracture: a systematic review and meta-analysis. Osteoporos Int. 2016;27(4):1389–99. doi:10.1007/s00198-015-3400-y.
12. Saris NE, Mervaala E, Karppanen H, Khawaja JA, Lewenstam A. Magnesium. An update on physiological, clinical and analytical aspects. Clin Chim Acta. 2000;294(1–2):1–26.
13. Marier JR. Magnesium content of the food supply in the modern-day world. Magnesium. 1986;5(1):1–8.
14. Hayhoe RP, Lentjes MA, Luben RN, Khaw KT, Welch AA. Dietary magnesium and potassium intakes and circulating magnesium are associated with heel bone ultrasound attenuation and osteoporotic fracture risk in the EPIC-Norfolk cohort study. Am J Clin Nutr. 2015;102(2):376–84. doi:10.3945/ajcn.114.102723.
15. Rachner TD, Khosla S, Hofbauer LC. Osteoporosis: now and the future. Lancet. 2011;377(9773):1276–87. doi:10.1016/S0140-6736(10)62349-5.
16. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9. doi:10.1016/j.jclinepi.2007.11.008.
17. Salonen JT. Is there a continuing need for longitudinal epidemiologic research? The Kuopio Ischaemic Heart Disease Risk Factor Study. Ann Clin Res. 1988;20(1–2):46–50.
18. Kunutsor SK, Kurl S, Zaccardi F, Laukkanen JA. Baseline and long-term fibrinogen levels and risk of sudden cardiac death: a new prospective study and meta-analysis. Atherosclerosis. 2016;245:171–80. doi:10.1016/j.atherosclerosis.2015.12.020.
19. Kunutsor SK, Laukkanen JA. Serum zinc concentrations and incident hypertension: new findings from a population-based cohort study. J Hypertens. 2016. doi:10.1097/HJH.0000000000000923.
20. Karppi J, Kurl S, Makikallio TH, Ronkainen K, Laukkanen JA. Serum beta-carotene concentrations and the risk of congestive heart failure in men: a population-based study. Int J Cardiol. 2013. doi:10.1016/j.ijcard.2012.12.072.
21. Salonen JT, Nyyssonen K, Korpela H, Tuomilehto J, Seppanen R, Salonen R. High stored iron levels are associated with excess risk of myocardial infarction in eastern Finnish men. Circulation. 1992;86(3):803–11.
22. Saaranen M, Suistomaa U, Kantola M, Saarikoski S, Vanha-Perttula T. Lead, magnesium, selenium and zinc in human seminal fluid: comparison with semen parameters and fertility. Hum Reprod. 1987;2(6):475–9.
23. Laukkanen JA, Laaksonen D, Lakka TA, et al. Determinants of cardiorespiratory fitness in men aged 42–60 years with and without cardiovascular disease. Am J Cardiol. 2009;103(11):1598–604. doi:10.1016/j.amjcard.2009.01.371.
24. Kunutsor SK, Khan H, Laukkanen JA. Serum albumin concentration and incident type 2 diabetes risk: new findings from a population-based cohort study. Diabetologia. 2015;58(5):961–7. doi:10.1007/s00125-015-3520-0.
25. Voutilainen S, Rissanen TH, Virtanen J, Lakka TA, Salonen JT. Kuopio Ischemic heart disease risk factor S. Low dietary folate intake is associated with an excess incidence of acute coronary events: the Kuopio Ischemic Heart Disease Risk Factor Study. Circulation. 2001;103(22):2674–80.
26. Therneau TM, Grambsch PM. Modeling survival data: extending the cox model. New York: Springer; 2000.
27. Easton DF, Peto J, Babiker AG. Floating absolute risk: an alternative to relative risk in survival and case-control analysis avoiding an arbitrary reference group. Stat Med. 1991;10(7):1025–35.
28. Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Int Med. 2009;150(9):604–12.
29. Groenwold RH, Klungel OH, Grobbee DE, Hoes AW. Selection of confounding variables should not be based on observed associations with exposure. Eur J Epidemiol. 2011;26(8):589–93. doi:10.1007/s10654-011-9606-1.
30. Lazo M, Selvin E, Clark JM. Brief communication: clinical implications of short-term variability in liver function test results. Ann Int Med. 2008;148(5):348–52.
31. Drueke TB, Lacour B. Magnesium homeostasis and disorders of magnesium metabolism. In: Feehally J, Floege J, Johnson RJ, editors. Comprehensive clinical nephrology. 3rd ed. Philadelphia: Mosby; 2007. p. 136–8.
32. Griffin TP, Murphy M, Coulter J, Murphy MS. Symptomatic hypocalcaemia secondary to PTH resistance associated with hypomagnesaemia after elective embolisation of uterine fibroid. BMJ Case Rep. 2013. doi:10.1136/bcr-2013-008708.
33. Rude RK, Gruber HE, Norton HJ, Wei LY, Frausto A, Mills BG. Bone loss induced by dietary magnesium reduction to 10% of the nutrient requirement in rats is associated with increased release of substance P and tumor necrosis factor-alpha. J Nutr. 2004;134(1):79–85.
34. Welsh JJ, Weaver VM. Adaptation to low dietary calcium in magnesium-deficient rats. J Nutr. 1988;118(6):729–34.
35. Blumenthal NC, Betts F, Posner AS. Stabilization of amorphous calcium phosphate by Mg and ATP. Calcif Tissue Res. 1977;23(3):245–50.
36. Bigi A, Foresti E, Gregorini R, Ripamonti A, Roveri N, Shah JS. The role of magnesium on the structure of biological apatites. Calcif Tissue Int. 1992;50(5):439–44.
37. Vallee BL, Wacker WE, Ulmer DD. The magnesium-deficiency tetany syndrome in man. N Engl J Med. 1960;262:155–61. doi:10.1056/NEJM196001282620401.
38. Assadi F. Hypomagnesemia: an evidence-based approach to clinical cases. Iran J Kidney Dis. 2010;4(1):13–9.
39. Ayuk J, Gittoes NJ. Contemporary view of the clinical relevance of magnesium homeostasis. Ann Clin Biochem. 2014;51(Pt 2):179–88. doi:10.1177/0004563213517628.
40. Gamez C, Artacho R, Ruiz-Lopez MD, Navarro M, Puerta A, Lopez MC. Serum concentration and dietary intake of Mg and Ca in institutionalized elderly people. Sci Total Environ. 1997;203(3):245–51.
41. Hardwick LL, Jones MR, Brautbar N, Lee DB. Magnesium absorption: mechanisms and the influence of vitamin D, calcium and phosphate. J Nutr. 1991;121(1):13–23.
42. Watkins DW, Jahangeer S, Floor MK, Alabaster O. Magnesium and calcium absorption in Fischer-344 rats influenced by changes in dietary fibre (wheat bran), fat and calcium. Magnes Res. 1992;5(1):15–21.
43. Vaquero MP. Magnesium and trace elements in the elderly: intake, status and recommendations. J Nutr Health Aging. 2002;6(2):147–53.
44. Mouw DR, Latessa RA, Hickner J. Clinical inquiries. What are the causes of hypomagnesemia? J Fam Pract. 2005;54(2):174–6.
45. Agus ZS. Hypomagnesemia. J Am Soc Nephrol. 1999;10(7):1616–22.
46. Sojka JE, Weaver CM. Magnesium supplementation and osteoporosis. Nutr Rev. 1995;53(3):71–4.
47. Jahnen-Dechent W, Ketteler M. Magnesium basics. Clin Kidney J. 2012;5(Suppl 1):i3–14. doi:10.1093/ndtplus/sfr163.
48. Huijgen HJ, Sanders R, van Olden RW, Klous MG, Gaffar FR, Sanders GT. Intracellular and extracellular blood magnesium fractions in hemodialysis patients; is the ionized fraction a measure of magnesium excess? Clin Chem. 1998;44(3):639–48.