Diyabetik ve prediabetik hastalarda serum magnezyum ve serum glukoz düzeyleri ile HOMA-IR arasındaki ilişkinin değerlendirilmesi

Öz

Amaç: Bu çalışmada diyabetik ve prediyabetik hastalarda serum magnezyum (Mg) düzeyleri ile yaş, vücut kitle indeksi, HOMA-IR, serum açlık glukoz, HbA1c ve insülin düzeyleri arasındaki ilişkiyi inceledik.

Yöntemler: Bu retrospektif çalışmada, yeni tanı almış prediyabet (Grup PD) (n=63) ve tip 2 diabetes mellitus (Grup D) (n=67) olmak üzere toplam 130 hasta çalışmaya alındı. Hastaların yaşı, vücut kitle indeksi, serum Mg, glukoz ve insülin değerleri, HOMA-IR ve HbA1c kaydedildi. Prediabetes ve tip 2 diyabet tanısı, tanı anında WHO kriterlerine göre yapıldı.

Bulgular: Grup D'de ortalama Mg düzeyi (1,88 ± 0,17 mg/dl), grup PD'den (1,96 ± 0,17 mg/dl) anlamlı derecede düşüktü (p = 0,007). Korelasyon analizi, D grubunda Mg ve glukoz (r = -0,390, p = 0,001) ve HOMA-IR (r = -0,284; p = 0,022) arasında anlamlı negatif korelasyon olduğunu gösterdi. Serum Mg ile insülin, HbA1c, yaş ve vücut kütle indeksi (sırasıyla p = 0,801, 0,087, 0,611 ve 0,691) arasında korelasyon saptanmadı. Grup PD'de serum insülin, HbA1c, glukoz, HOMA-IR, yaş ve vücut kitle indeksi ile serum Mg düzeyleri arasında korelasyon yoktu (sırasıyla p = 0,801, 0,087, 0,939, 0,998, 0,611 ve 0,691).

Sonuçlar: Diyabetik hastalarda magnezyum düzeyleri ile HOMA-IR ve açlık kan glikoz düzeyleri arasında negatif bir ilişki olduğunu, ancak bu ilişkinin prediyabetik hastalarda mevcut olmadığını gösterdik. Çalışma sonuçlarımız serum Mg seviyesinin tip 2 diyabetin metabolik kontrolü ile ilişkili olduğunu ve bu nedenle bu hastalarda göz önüne alınabileceğini düşündürmektedir.

Anahtar Kelimeler

• Magnezyum,diyabet,prediyabet,insülin direnci,açlık glukoz,HOMA-IR

Assessment of relationship between serum magnesium and serum glucose levels and HOMA-IR in diabetic and prediabetic patients

Abstract

Aim: In this study, we aimed to investigate the serum magnesium (Mg) levels in diabetic and prediabetic patients and its correlation with age, body-mass index, HOMA-IR, serum fasting glucose, HbA1c, and insulin levels.

Methods: In this retrospective study, a total of 130 patients consisted of newly diagnosed prediabetes (Group PD) (n=63) and type 2 diabetes mellitus (Group D) (n=67) were included. Patients' age, body mass index, serum Mg, glucose and insulin, HOMA-IR and HbA1c were recorded. The prediabetes and type 2 diabetes diagnoses had been made according to WHO criteria at the time of diagnosis.

Results: In group D, the mean Mg level (1.88 ± 0.17 mg/dl) was significantly lower than group PD (1.96 ± 0.17 mg/dl) (p = 0.007). Correlation analysis showed that there was a significant negative correlation between Mg and glucose (r = -0.390, p = 0.001) and HOMA-IR (r = -0.284; p = 0.022) in the group D. No correlation was found between serum Mg level and serum insulin, HbA1c, age, and body-mass index (p = 0.801, 0.087, 0.611 and 0.691, respectively). In group PD, serum insulin, HbA1c, glucose, HOMA-IR, age, and body-mass index were not corraleted with serum Mg levels (p = 0.801, 0.087, 0.939, 0.998, 0.611 and 0.691, respectively).

Conclusıon: We showed that while there was a negative correlation between magnesium levels and HOMA-IR and fasting blood glucose levels in diabetic patients, but this correlation was not present in prediabetic patients. Our results suggest that serum Mg level is associated with metabolic control of type 2 diabetes and thus it can be considered in these patients.

Keywords

• Magnesium,Diabetes,Prediabetes,Insulin resistance,Fasting glucose,HOMA-IR

Kaynakça

1. 1. Barbagallo M. Magnesium and type 2 diabetes. World J Diabetes. 2015;6:1152-7.
2. 2. Jahnen-Dechent W, Ketteler M. Magnesium basics. Clin Kidney J. 2012;5:i3-i14.
3. 3. Simmons D, Joshi S, Shaw J. Hypomagnesaemia is associated with diabetes: Not pre-diabetes, obesity or the metabolic syndrome. Diabetes Res Clin Pract. 2010;87:261-6.
4. 4. Ma J, Folsom AR, Melnick SL, Eckfeldt JH, Sharrett AR, Nabulsi AA, et al. Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: the ARIC study. Atherosclerosis Risk in Communities Study. J Clin Epidemiol. 1995;48:927-40.
5. 5. Pham PC, Pham PM, Pham PA, Pham SV, Pham HV, Miller JM, et al. Lower serum magnesium levels are associated with more rapid decline of renal function in patients with diabetes mellitus type 2. Clin Nephrol. 2005;63:429-36.
6. 6. Mather HM, Nisbet JA, Burton GH, Poston GJ, Bland JM, Bailey PA, et al. Hypomagnesaemia in diabetes. Clin Chim Acta. 1979;95:235-42.
7. 7. de Lordes Lima M, Cruz T, Pousada JC, Rodrigues LE, Barbosa K, Cangucu V. The effect of magnesium supplementation in increasing doses on the control of type 2 diabetes. Diabetes Care. 1998;21:682-6.
8. 8. Walti MK, Zimmermann MB, Spinas GA, Hurrell RF. Low plasma magnesium in type 2 diabetes. Swiss Med Wkly. 2003;133:289-92.

9. 9. Mooren FC. Magnesium and disturbances in carbohydrate metabolism. Diabetes Obes Metab. 2015;17:813-23.
10. 10. Tosiello L. Hypomagnesemia and diabetes mellitus. A review of clinical implications. Arch Intern Med. 1996;156:1143-8.
11. 11. Nichols GA, Hillier TA, Brown JB. Progression From Newly Acquired Impaired Fasting Glusose to Type 2 Diabetes. Diabetes Care. 2007;30:228-33.
12. 12. Fang C, Wang X, Wu W, Gu X, Ye T, Deng H, et al. Association of Serum Magnesium Level with Odds of Prediabetes and Diabetes in a Southern Chinese Population: a Prospective Nested Case-Control Study. Biol Trace Elem Res. 2015;172:307-14.
13. 13. World Health Organization. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia - Report of a WHO/IDF Consultation: WHO Press, World Health Organization, Geneva, Switzerland 2006 [cited 2018 June, 1st]. Available from: http://www.who.int/diabetes/publications/Definition and diagnosis of diabetes_new.pdf.
14. 14. Liamis G, Rodenburg EM, Hofman A, Zietse R, Stricker BH, Hoorn EJ. Electrolyte disorders in community subjects: prevalence and risk factors. Am J Med. 2013;126:256-63.
15. 15. Palmer BF, Clegg DJ. Electrolyte and Acid-Base Disturbances in Patients with Diabetes Mellitus. N Engl J Med. 2015;373:548-59.
16. 16. Song Y, Manson JE, Buring JE, Liu S. Dietary magnesium intake in relation to plasma insulin levels and risk of type 2 diabetes in women. Diabetes Care. 2004;27:59-65.
17. 17. Odusan OO, Familoni OB, Odewabi AO, Idowu AO, Adekolade AS. Patterns and Correlates of Serum Magnesium Levels in Subsets of Type 2 Diabetes Mellitus Patients in Nigeria. Indian J Endocrinol Metab. 2017;21:439-42.
18. 18. Arpaci D, Tocoglu AG, Ergenc H, Korkmaz S, Ucar A, Tamer A. Associations of serum Magnesium levels with diabetes mellitus and diabetic complications. Hippokratia. 2015;19:153-7.
19. 19. Dasgupta A, Sarma D, Saikia UK. Hypomagnesemia in type 2 diabetes mellitus. Indian J Endocrinol Metab. 2012;16:1000-3.
20. 20. Guerrero-Romero F, Simental-Mendia LE, Hernandez-Ronquillo G, Rodriguez-Moran M. Oral magnesium supplementation improves glycaemic status in subjects with prediabetes and hypomagnesaemia: A double-blind placebo-controlled randomized trial. Diabetes Metab. 2015;41:202-7.
21. 21. Morakinyo AO, Samuel TA, Adekunbi DA. Magnesium upregulates insulin receptor and glucose transporter-4 in streptozotocin-nicotinamide-induced type-2 diabetic rats. Endocr Regul. 2018;52:6-16.
22. 22. Liamis G, Liberopoulos E, Barkas F, Elisaf M. Diabetes mellitus and electrolyte disorders. World J Clin Cases. 2014;2:488-96.
23. 23. Pham PC, Pham PM, Pham SV, Miller JM, Pham PT. Hypomagnesemia in patients with type 2 diabetes. Clin J Am Soc Nephrol. 2007;2:366-73.
24. 24. Özsan M, Yaprak M, Özcan O, Kiriktir E, Turgut F. Tip 2 Diyabetli Hastalarda Elektrolit Bozuklukları. Turkish Nephrology Dialysis Transplantation. 2017;26:285-9.