ASSOCIATION OF HYPOMAGNESEMIA WITH HYPERGLYCEMIA AND ITS RENAL COMPLICATION IN OUTPATIENTS
Renal Complication of Hypomagnesemia With Hyperglycemia
Keywords:Albumin creatinine ratio, Fasting plasma glucose, Hyperglycemia, Hypomagnesemia, Type 2 diabetes mellitus
Objective: To evaluate the association of hypomagnesemia with hyperglycemia and its renal complication in outpatients.
Study Design: Case control study.
Place and Duration of Study: Department of chemical pathology & endocrinology, Armed Forces Institute of Pathology, Rawalpindi, from October 2014 to July 2015.
Material and Methods: Adults of either gender aged 20 years and above comprising 63 subjects with hyperglycemia and 63 controls with normoglycemia were consecutively inducted in the study. Patients with malabsorption, thyroid dysfunction or adrenal dysfunction, renal impairment, taking mineral supplement, pregnancy, lactation and any acute illness were excluded from the study. Fasting plasma glucose (FPG) and serum magnesium (Mg) level were measured on ADVIA 1800 siemens clinical chemistry auto-analyzer with hexokinase and xylidyl blue methods, respectively. Urine albumin was analyzed by Immunoturbidimetric method and urine creatinine was measured by the Jaffé kinetic assay on same analyzer. Albumin/creatinine ratio (ACR) was calculated. Pearson correlation coefficient “r” was calculated for serum Mg with FPG and ACR. Mean serum Mg levels in hyperglycemic and normoglycemic groups were compared using in dependent sample “t” test. Frequency of hypomagnesemia (serum magnesium ≤0.66 mmol/L) was also calculated in hyperglycemic subjects with type 2 diabetes mellitus (T2DM). A p-value <0.05 was considered statistically significant.
Results: Serum Mg has significant inverse correlation with FPG (r=-0.543, p=0.001) and ACR (r=-0.474; p=0.001).Mean serum Mg was 0.78 mmol/l in hyperglycemics and 0.88 mmol/l in normoglycemics (p=0.001). The frequency of hypomagnesemia in subjects with type 2 Diabetes Mellitus (T2DM) was found to be 18.8% while no subject with pre-diabetes and normoglycemia had hypomagnesemia.
Conclusion: Subjects with hyperglycemia had significantly lower mean serum Mg levels compared with healthy counterparts. Hypomagnesemia was also associated with poor glycemic control and diabetic nephropathy.