Öz
Aim: Although mild hypomagnesemia is frequently asymptomatic, given it’s widespread physiological roles through the body system hypomagnesemia may be associated with crucial patient outcomes in elderly, whose body systems are more prone to disease states. In this study, we have evaluated association of hypomagnesemia with geriatric syndromes and mortality among subjects with an age of 65 years or more.
Material and Methods: Electronic medical records of subjects who were evaluated in geriatrics clinic were reviewed retrospectively. A serum magnesium level of <1.6 mg/dl was considered as hypomagnesemia. Hypomagnesemia and normomagnesemia groups were compared for demographic and clinical characteristics. Logistic regression analysis was performed for the association of hypomagnesemia with each of the geriatric syndromes and mortality.
Results: Of the 888 patients included, 48 had hypomagnesemia (5.4%). Patients with hypomagnesemia were older, more commonly had diabetes mellitus and chronic kidney disease, exposed to higher number of drugs, and had lower median hemoglobin, serum vitamin B12 and folic acid levels. Hypomagnesemia was independently associated with dynapenia (per 1 mg/dL, OR 2.27, 95% CI 0.97-5.29, p=0.057) and geriatric depression (OR 2.91, 95% CI 1.44-5.89, p=0.003) in multivariate regression models. Between serum magnesium levels of 1.2 through 2.3 mg/dL, an increase of 0.1 mg/dL was associated with a 10% decrease in the risk of dynapenia (95% CI 0.83-0.98, p=0.018) and a 9% decrease in the risk of depression (95% CI 0.85-0.98, p=0.009). A higher serum magnesium level (per 0.1 mg/dL, OR 0.90, 95% CI 0.83-0.98, p=0.018) wes associated with a lower mortality risk.
Conclusions: Hypomagnesemia is independently associated with dynapenia, depression, and mortality in elderly outpatients.
Anahtar Kelimeler
Kaynakça
- 1. Pham PC, Pham PA, Pham SV, et al. Hypomagnesemia: a clinical perspective. Int J Nephrol Renovasc Dis. 2014; 7:219-30.
- 2. Al Alawi AM, Majoni SW, Falhammar H. Magnesium and Human Health: Perspectives and Research Directions. Int J Endocrinol. 2018; 2018:9041694.
- 3. Cheungpasitporn W, Thongprayoon C, Chewcharat A, et al. Hospital-Acquired Dysmagnesemia and In-Hospital Mortality. Med Sci (Basel). 2020 Sep 1; 8(3).
- 4. Malinowska J, Malecka M, Ciepiela O. Variations in Magnesium Concentration Are Associated with Increased Mortality: Study in an Unselected Population of Hospitalized Patients. Nutrients. 2020 Jun 19; 12(6).
- 5. Pham PC, Pham PM, Pham SV, et al. Hypomagnesemia in patients with type 2 diabetes. Clin J Am Soc Nephrol. 2007 Mar;2 (2):366-73.
- 6. Earl H, Rudolph DO, Joyce MG. Disorders of Magnesium Metabolism Ed: Edgar L, Nissenson A. Nephrology Secrets 3rd ed, Philadelphia, Mosby; 2012, 560-570.
- 7. Association AP. 5th ed. Washington, DC2013. (Diagnostic and Statistical Manual of Mental Disorders).
- 8. Durmaz B, Soysal P, Ellidokuz H, et al. Validity and reliability of geriatric depression scale-15 (short form) in Turkish older adults. North Clin Istanb. 2018 Sep; 5(3):216-220.
- 9. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jul 1; 48(4):601.
- 10. Unutmaz GD, Soysal P, Tuven B, et al. Costs of medication in older patients: before and after comprehensive geriatric assessment. Clin Interv Aging. 2018; 13:607-613.
- 11. Dutoglu E, Soysal P, Smith L, et al. Nocturia and its clinical implications in older women. Arch Gerontol Geriatr. 2019 Nov - Dec; 85:103917.
- 12. Eby GA, Eby KL. Magnesium for treatment-resistant depression: a review and hypothesis. Med Hypotheses. 2010 Apr; 74(4):649-60.
Öz
Amaç: Hafif hipomagnezemi sıklıkla asemptomatik olmasına rağmen vücutta önemli olan çok sayıda sistem üzerindeki kofaktör rolü nedeniyle bu sistemleri daha duyarlı yaşlı bireylerde hipomagnezemi ciddi hasta sonlanımlarıyla birlikte olabilir. Ayaktan geriatri polikliniğinde değerlendirilen 65 yaş ve üzeri bireylerde hipomagnezeminin geriatrik sendromlar ve mortalite ile ilişkisini değerlendirmeyi hedefledik.
Gereç ve Yöntemler: Geriatri polikliniğinde değerlendirilen tüm bireylerin (≥65 yaş) elektronik tıbbi kayıtları geriye dönük incelendi. Serum magnezyum düzeyi <1,6 mg/dl olan bireyler hipomagnezemi grubuna dahil edildi. Hipomagnezemi ile normomagnezemi olan bireylerin demografik ve klinik verileri kıyaslandı. Hipomagnezeminin her bir geriatrik sendrom ve mortalite ile ilişkisinin değerlendirilmesi için lojistik regresyon analizi uygulandı.
Bulgular: Araştırmaya dahil edilen 888 hastanın 48’inde (%5,4) hipomagnezemi saptandı. Hipomagnezemi olan bireylerin daha yaşlı olduğu, daha sıklıkla diyabetes mellitus ve kronik böbrek yetmezliği ile birliktelik gösterdiği, daha fazla ilaç kullandığı, ve daha düşük hemoglobin, serum B12 ve folik asit düzeylerine sahip olduğu görüldü. Çok değişkenli analizlerdede hipomagnezeminin dinapeni (her 1 mg/dl için OR 2,27, %95 GA 0,97-5,29, p=0,057) ve geriatrik depresyon (OR 2,91, %95 GA 1,44-5,89, p=0,003) için bağımsız bir risk faktörü olduğu, serum magnezyum düzeyindeki her 1 mg/dl artışın dinapeni riskinde %10 (%95 GA 0,83-0,98, p=0,018), geriatrik depresyon riskinde %9 (%95 GA 0,85-0,98, p=0,009) azalma ile birlikte olduğu görüldü. Magnezyum düzeyinin arttıkça mortalite riskinin azaldığı (her 1 mg/dl için OR 0,90, %95 GA 0,83-0,98, p=0,018) belirlendi.
Sonuç: Hipomagnezeminin ayaktan başvuran geriatrik yaş grubu bireylerde dinapeni, depresyon ve mortalite ile bağımsız birlikteliği gösterilmiştir.
Anahtar Kelimeler
Kaynakça
- 1. Pham PC, Pham PA, Pham SV, et al. Hypomagnesemia: a clinical perspective. Int J Nephrol Renovasc Dis. 2014; 7:219-30.
- 2. Al Alawi AM, Majoni SW, Falhammar H. Magnesium and Human Health: Perspectives and Research Directions. Int J Endocrinol. 2018; 2018:9041694.
- 3. Cheungpasitporn W, Thongprayoon C, Chewcharat A, et al. Hospital-Acquired Dysmagnesemia and In-Hospital Mortality. Med Sci (Basel). 2020 Sep 1; 8(3).
- 4. Malinowska J, Malecka M, Ciepiela O. Variations in Magnesium Concentration Are Associated with Increased Mortality: Study in an Unselected Population of Hospitalized Patients. Nutrients. 2020 Jun 19; 12(6).
- 5. Pham PC, Pham PM, Pham SV, et al. Hypomagnesemia in patients with type 2 diabetes. Clin J Am Soc Nephrol. 2007 Mar;2 (2):366-73.
- 6. Earl H, Rudolph DO, Joyce MG. Disorders of Magnesium Metabolism Ed: Edgar L, Nissenson A. Nephrology Secrets 3rd ed, Philadelphia, Mosby; 2012, 560-570.
- 7. Association AP. 5th ed. Washington, DC2013. (Diagnostic and Statistical Manual of Mental Disorders).
- 8. Durmaz B, Soysal P, Ellidokuz H, et al. Validity and reliability of geriatric depression scale-15 (short form) in Turkish older adults. North Clin Istanb. 2018 Sep; 5(3):216-220.
- 9. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jul 1; 48(4):601.
- 10. Unutmaz GD, Soysal P, Tuven B, et al. Costs of medication in older patients: before and after comprehensive geriatric assessment. Clin Interv Aging. 2018; 13:607-613.
- 11. Dutoglu E, Soysal P, Smith L, et al. Nocturia and its clinical implications in older women. Arch Gerontol Geriatr. 2019 Nov - Dec; 85:103917.
- 12. Eby GA, Eby KL. Magnesium for treatment-resistant depression: a review and hypothesis. Med Hypotheses. 2010 Apr; 74(4):649-60.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2020 |
| Gönderilme Tarihi | 4 Kasım 2020 |
| Kabul Tarihi | 24 Aralık 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 3 Sayı: 3 |
Kaynak Göster
Bu dergide yayınlanan makaleler Creative Commons Atıf-GayriTicari-AynıLisanslaPaylaş 4.0 Uluslararası Lisansı ile lisanslanmıştır.
Geriatrik Bilimler Dergisi, Türkiye Atıf Dizini, Türk MEDLINE, Asos İndeks, Scilit, EuroPub ve Eylül 2022 tarihinden itibaren Index Copernicus International - Journals Master List'te indekslenmektedir.
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