What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Type 2 diabetes and obesity (n=750). Intervention: Serum magnesium > 0.70 mmol/L vs. Serum magnesium ≤ 0.70 mmol/L (hypomagnesemia). Primary outcome: Prevalence of premature ventricular complexes (PVC) (OR 0.24, 95% CI 0.06-0.98, p=0.046).

January 1, 2012Cardiovascular Diabetology69 citationsOpen Access

Low serum magnesium concentrations are associated with a high prevalence of premature ventricular complexes in obese adults with type 2 diabetes

LGLiana C. Del GobboStanford University YSYiqing SongBrigham and Women's Hospital PPPaul PoirierPreventive Cardiology

Key Result

Serum magnesium concentrations > 0.70 mmol/L were associated with a significantly lower odds of premature ventricular complexes (OR 0.24) compared to hypomagnesemia in adults with type 2 diabetes.

Study Design

Type

Cross-Sectional (n=750)

Multicenter

Yes

Structured PICO

Is higher serum magnesium (>0.70 mmol/L) associated with a reduced prevalence of premature ventricular complexes compared to hypomagnesemia in adults with type 2 diabetes?

Population

750 Cree adults, aged > 18 yrs, participating in an age-stratified, cross-sectional health survey in Quebec, Canada.

Intervention

Serum magnesium (sMg) > 0.70 mmol/L

Comparator

Hypomagnesemia (sMg ≤ 0.70 mmol/L)

Outcome

Prevalence of premature ventricular complexes (PVC) recorded by Holter electrocardiograms for two consecutive hourssurrogate

Main Result

Effect estimate: OR 0.24 (95% CI 0.06-0.98)

Absolute Event Rate: 21% vs 50%

p-value: p=0.046

Limitations

Use of total serum magnesium instead of ionized magnesium as a biomarker
Uncertain prognostic significance of PVC endpoints selected in this high-risk population
Use of short-term (2 hr) Holter monitoring on a single occasion
Unknown left ventricular ejection fraction
Ethnic homogeneity of the sample (Cree descent)

Abstract

BACKGROUND: Premature ventricular complexes (PVC) predict cardiovascular mortality among several adult populations. Increased arrhythmia prevalence has been reported during controlled magnesium (Mg) depletion studies in adults. We thus hypothesized that serum magnesium (sMg) concentrations are inversely associated with the prevalence of PVC in adults at high cardiovascular risk. METHODS: Anthropometric, demographic and lifestyle characteristics were assessed in 750 Cree adults, aged > 18 yrs, who participated in an age-stratified, cross-sectional health survey in Quebec, Canada. Holter electrocardiograms recorded heart rate variability and cardiac arrhythmias for two consecutive hours. Multivariate logistic regression was used to evaluate the associations between sMg and PVC. RESULTS: PVC prevalence in adults with hypomagnesemia (sMg ≤ 0.70 mmol/L) was more than twice that of adults without hypomagnesemia (50% vs. 21%, p = 0.015); results were similar when adults with cardiovascular disease history were excluded. All hypomagnesemic adults with PVC had type 2 diabetes (T2DM). Prevalence of PVC declined across the sMg concentration gradient in adults with T2DM only (p 0.70 mmol/L was 0.24 (95% CI: 0.06-0.98) p = 0.046 compared to those with sMg ≤ 0.70 mmol/L. CONCLUSIONS: sMg concentrations were inversely associated with the prevalence of PVC in patients with T2DM in a dose response manner, indicating that suboptimal sMg may be a contributor to arrhythmias among patients with T2DM.

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