Serum Magnesium, Prescribed Magnesium Replacement and Cardiovascular Events in Adults with Type 2 Diabetes: A National Cohort Study in U.S. Veterans
Yin Y, Cheng Y, Zullo AR, Shao Y, Sheriff HM, Faselis C, Liu S, Ahmed A, Zeng-Treitler Q, Wu WC
Nutrients · 3 citations
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Independent funding
- Government
- Office of Research and Development, Health Services Research and Development
- Government
- the Washington DC VA Medical Center
- Government
- National Health Lung and Blood Institute of the NIH Office
- Government
- National Health Lung and Blood Institute of the NIH
Based on 4 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2025-06-21 · Nutrients · vol. 17 · issue 13 · p. 2067
- Publisher
- Multidisciplinary Digital Publishing Institute
- Cited
- 3 citations · more than 81% of similar papers · 1.5× the field average
- References
- 52 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Magnesium in Health and Disease · Parathyroid Disorders and Treatments · Potassium and Related Disorders
- Keywords
- Magnesium, Type 2 diabetes, Medicine, Cohort, Diabetes mellitus, Cohort study, Internal medicine, Endocrinology, Chemistry
- MeSH
- humans, cardiovascular diseases, diabetes mellitus, type 2, magnesium deficiency, magnesium, retrospective studies, cohort studies, aged, middle aged, veterans, united states, female, male
10 authors
From US
- Ying YinGeorge Washington University; Veterans Health Administration
- Yan ChengGeorge Washington University; Veterans Health Administration
- Andrew R. ZulloProvidence College; Brown University; Veterans Health Administration
- Yijun ShaoGeorge Washington University; Veterans Health Administration
- Helen M. SheriffGeorge Washington University; Veterans Health Administration
- Charles J. FaselisUniformed Services University of the Health Sciences; George Washington University; Veterans Health Administration
Abstract
Objectives
To investigate the relationship between serum magnesium levels, prescribed oral magnesium replacement, and major adverse cardiovascular events (MACE) in type-2 diabetes mellitus (T2D).
Research design and methods
This nationwide retrospective study analyzed 1,284,940 US Veterans (≥18 years) with T2D who had outpatient serum magnesium testing between 1999-2021 in the Veterans Health Administration. The relationship between serum magnesium levels and MACE (hospitalizations for acute myocardial infarction, heart failure, ischemic stroke, or all-cause mortality) was determined using multivariable-adjusted Cox-regression models. Using a new-user-design and propensity-score-matching approach, we further related the use of prescribed oral magnesium and MACE among patients with hypomagnesemia (serum magnesium <1.8 mg/dL) and normomagnesemia (serum magnesium 1.8-2.3 mg/dL).
Results
Of 1,284,940 patients with T2D, 229,210 (17.8%) patients had hypomagnesemia, and 117,674 (9.2%) patients had hypermagnesemia (serum magnesium >2.3 mg/dL). Compared to patients with normomagnesemia (serum magnesium 1.8-2.3 mg/dL), those with either hypomagnesemia or hypermagnesemia had elevated hazards for MACE. The risk increased with the severity of serum magnesium abnormalities in both directions-low (hazard ratios [HRs] 1.11-1.20) and high (HRs 1.04-1.39)-in a parabolic pattern. Oral magnesium was prescribed to 9.7% and 0.7% of patients with hypomagnesemia and normomagnesemia, respectively. After propensity-score-matching balanced across 64 baseline characteristics, oral magnesium was associated with a lower MACE risk in 40,766 matched patients with hypomagnesemia (HR 0.89; 95% confidence interval [CI], 0.84-0.93), especially those on proton-pump-inhibitors or thiazides. Oral magnesium was not related to MACE in 11,838 matched patients with normomagnesemia (HR 1.07; 95% CI, 0.97-1.17).
Conclusions
In patients with T2D, both hypomagnesemia and hypermagnesemia were associated with higher one-year MACE risks compared to normomagnesemia. Prescribed oral magnesium was associated with a reduced MACE risk in hypomagnesemia but not in normomagnesemia.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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