Magnesium in Disease: a Review with Special Emphasis on the Serum Ionized Magnesium
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Gerard T. Sanders
Abstract
This review deals with the six main clinical situations related to magnesium or one of its fractions, including ionized magnesium: renal disease, hypertension, preeclampsia, diabetes mellitus, cardiac disease, and the administration of therapeutic drugs. Issues addressed are the physiological role of magnesium, eventual changes in its levels, and how these best can be monitored.
In renal disease mostly moderate hypermagnesemia is seen; measuring ionized magnesium offers minimal advantage. In hypertension magnesium might be lowered but its measurement does not seem relevant. In the prediction of severe pre-eclampsia, elevated ionized magnesium concentration may play a role, but no unequivocal picture emerges. Low magnesium in blood may be cause for, or consequence of, diabetes mellitus. No special fraction clearly indicates magnesium deficiency leading to insulin resistance. Cardiac diseases are related to diminished magnesium levels. During myocardial infarction, serum magnesium drops. Total magnesium concentration in cardiac cells can be predicted from levels in sublingual or skeletal muscle cells. Most therapeutic drugs (diuretics, chemotherapeutics, immunosuppressive agents, antibiotics) cause hypomagnesemia due to increased urinary loss.
It is concluded that most of the clinical situations studied show hypomagnesemia due to renal loss, with exception of renal disease. Keeping in mind that only 1% of the total body magnesium pool is extracellular, no simple measurement of the real intracellular situation has emerged; measuring ionized magnesium in serum has little added value at present.
Copyright © 1999 by Walter de Gruyter GmbH & Co. KG
Articles in the same Issue
- Author Index
- Contents
- Subject Index
- Strategies for Cardiac Marker Measurement
- Statistical Techniques for Evaluating the Diagnostic Utility of Laboratory Tests
- Magnesium in Disease: a Review with Special Emphasis on the Serum Ionized Magnesium
- Methods for Improving Clinical Trials
- Infrared Analysis of Urinary Stones: a Trial of Automated Identification
- Evaluation of a Direct α-Amylase Assay Using 2-Chloro-4-nitrophenyl-α-D-maltotrioside
- Accurate Platelet Counting in an Insidious Case of Pseudothrombocytopenia
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- The Sensitivity of Cardiac Markers: an Evidence-based Approach
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- Cardiac Markers: Centralized or Decentralized Testing?
- EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry. Version 2 – 1999
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- Reference Intervals: Are Interlaboratory Differences Appropriate?
- Lipoprotein Protocols. By J.M. Ordovas, editor
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Articles in the same Issue
- Author Index
- Contents
- Subject Index
- Strategies for Cardiac Marker Measurement
- Statistical Techniques for Evaluating the Diagnostic Utility of Laboratory Tests
- Magnesium in Disease: a Review with Special Emphasis on the Serum Ionized Magnesium
- Methods for Improving Clinical Trials
- Infrared Analysis of Urinary Stones: a Trial of Automated Identification
- Evaluation of a Direct α-Amylase Assay Using 2-Chloro-4-nitrophenyl-α-D-maltotrioside
- Accurate Platelet Counting in an Insidious Case of Pseudothrombocytopenia
- A New Liquid Homogeneous Assay for HDL Cholesterol Determination Evaluated in Seven Laboratories in Europe and the United States
- Tissue Release of Cardiac Markers: from Physiology to Clinical Applications
- The Specificity of Biochemical Markers of Cardiac Damage: a Problem Solved
- Biochemical Factors Influencing Measurement of Cardiac Troponin I in Serum
- The Sensitivity of Cardiac Markers: an Evidence-based Approach
- Risk Stratification and Therapeutic Decision Making in Patients with Acute Coronary Syndromes the Role of Cardiac Troponin T
- Cardiac Markers: Centralized or Decentralized Testing?
- EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry. Version 2 – 1999
- Plasma Malondialdehyde and Obesity: Is there a Relationship?
- Reference Intervals: Are Interlaboratory Differences Appropriate?
- Lipoprotein Protocols. By J.M. Ordovas, editor
- Tietz Textbook of Clinical Chemistry. By C.A. Burtis and E.R. Ashwood, editors
