Serum Magnesium, Prescribed Magnesium Replacement and Cardiovascular Events in Adults with Type 2 Diabetes: A National Cohort Study in U.S. Veterans

作者：Ying Yin, Yan Cheng, Andrew R. Zullo, Yijun Shao, Helen Sheriff, Charles Faselis, Simin Liu, Ali Ahmed, Qing Zeng‐Treitler, Wen‐Chih Wu · 发表于：Nutrients · 年份：2025 · DOI：10.3390/nu17132067 · 被引用次数：3 · 研究领域：Magnesium in Health and Disease、Parathyroid Disorders and Treatments、Potassium and Related Disorders

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....