Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration with Arterial Calcification and Stiffness in Incident Hemodialysis Patients

Wei Chen, Jessica Fitzpatrick, Jose M. Monroy-Trujillo, Stephen M. Sozio, Bernard G. Jaar, Michelle M. Estrella, Tong Tong Wu, Michal L. Melamed, Rulan S. Parekh, David A. Bushinsky

Research output: Contribution to journalArticle

Abstract

Introduction: Magnesium (Mg) may protect against arterial calcification. We tested the hypotheses that a higher serum Mg concentration is associated with less arterial calcification and stiffness in patients on hemodialysis (HD) and that these associations are modified by diabetes mellitus. Methods: We performed cross-sectional analyses of 367 incident HD patients from the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) cohort. Measures of arterial calcification and stiffness included coronary arterial calcification (CAC) and thoracic aortic calcification (TAC) scores, ankle brachial index (ABI; high ABI: >1.4 or incompressible vessels), pulse wave velocity (PWV), and pulse pressure. Results: Mean Mg was 1.8 ± 0.2 mEq/l and 58% had diabetes. Among nondiabetic individuals, per 0.1 mEq/l higher Mg, non-zero CAC score was lower (% difference: −15.4%; 95% confidence interval [CI]: −28% to −0.55%; P = 0.03), the odds of having TAC score >0 and the odds of having high ABI were lower (odds ratio [OR]: 0.66; 95% CI 0.47–0.93; P = 0.02, and 0.23; 95% CI: 0.06–0.83, P = 0.03, respectively) while adjusting for demographics, comorbidities, markers of mineral metabolism, and dialysis clearance. Among diabetic individuals, per 0.1 mEq/l higher Mg, the odds of having TAC score >0 was higher (OR: 1.57; 95% CI: 1.09–2.26; P = 0.02). Mg was not associated with CAC or high ABI among diabetic individuals. Mg was not associated with PWV or pulse pressure regardless of diabetes status. Conclusion: Diabetes modified the associations of serum Mg with arterial calcification and stiffness in incident HD patients. Higher Mg was associated with less arterial calcification and less peripheral arterial stiffness among nondiabetic individuals, but Mg was only associated with TAC among diabetic individuals with higher Mg being associated with higher likelihood of having TAC score >0.

Original languageEnglish (US)
JournalKidney International Reports
DOIs
StatePublished - Jan 1 2019

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Vascular Stiffness
Magnesium
Renal Dialysis
Diabetes Mellitus
Serum
Thorax
Confidence Intervals
Pulse Wave Analysis
Odds Ratio
Blood Pressure
Ankle Brachial Index
Chronic Kidney Failure
Minerals
Comorbidity
Dialysis
Cross-Sectional Studies
Demography

Keywords

  • arterial calcification
  • arterial stiffness
  • diabetes mellitus
  • magnesium
  • mineral metabolism

ASJC Scopus subject areas

  • Nephrology

Cite this

Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration with Arterial Calcification and Stiffness in Incident Hemodialysis Patients. / Chen, Wei; Fitzpatrick, Jessica; Monroy-Trujillo, Jose M.; Sozio, Stephen M.; Jaar, Bernard G.; Estrella, Michelle M.; Wu, Tong Tong; Melamed, Michal L.; Parekh, Rulan S.; Bushinsky, David A.

In: Kidney International Reports, 01.01.2019.

Research output: Contribution to journalArticle

Chen, Wei ; Fitzpatrick, Jessica ; Monroy-Trujillo, Jose M. ; Sozio, Stephen M. ; Jaar, Bernard G. ; Estrella, Michelle M. ; Wu, Tong Tong ; Melamed, Michal L. ; Parekh, Rulan S. ; Bushinsky, David A. / Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration with Arterial Calcification and Stiffness in Incident Hemodialysis Patients. In: Kidney International Reports. 2019.
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abstract = "Introduction: Magnesium (Mg) may protect against arterial calcification. We tested the hypotheses that a higher serum Mg concentration is associated with less arterial calcification and stiffness in patients on hemodialysis (HD) and that these associations are modified by diabetes mellitus. Methods: We performed cross-sectional analyses of 367 incident HD patients from the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) cohort. Measures of arterial calcification and stiffness included coronary arterial calcification (CAC) and thoracic aortic calcification (TAC) scores, ankle brachial index (ABI; high ABI: >1.4 or incompressible vessels), pulse wave velocity (PWV), and pulse pressure. Results: Mean Mg was 1.8 ± 0.2 mEq/l and 58{\%} had diabetes. Among nondiabetic individuals, per 0.1 mEq/l higher Mg, non-zero CAC score was lower ({\%} difference: −15.4{\%}; 95{\%} confidence interval [CI]: −28{\%} to −0.55{\%}; P = 0.03), the odds of having TAC score >0 and the odds of having high ABI were lower (odds ratio [OR]: 0.66; 95{\%} CI 0.47–0.93; P = 0.02, and 0.23; 95{\%} CI: 0.06–0.83, P = 0.03, respectively) while adjusting for demographics, comorbidities, markers of mineral metabolism, and dialysis clearance. Among diabetic individuals, per 0.1 mEq/l higher Mg, the odds of having TAC score >0 was higher (OR: 1.57; 95{\%} CI: 1.09–2.26; P = 0.02). Mg was not associated with CAC or high ABI among diabetic individuals. Mg was not associated with PWV or pulse pressure regardless of diabetes status. Conclusion: Diabetes modified the associations of serum Mg with arterial calcification and stiffness in incident HD patients. Higher Mg was associated with less arterial calcification and less peripheral arterial stiffness among nondiabetic individuals, but Mg was only associated with TAC among diabetic individuals with higher Mg being associated with higher likelihood of having TAC score >0.",
keywords = "arterial calcification, arterial stiffness, diabetes mellitus, magnesium, mineral metabolism",
author = "Wei Chen and Jessica Fitzpatrick and Monroy-Trujillo, {Jose M.} and Sozio, {Stephen M.} and Jaar, {Bernard G.} and Estrella, {Michelle M.} and Wu, {Tong Tong} and Melamed, {Michal L.} and Parekh, {Rulan S.} and Bushinsky, {David A.}",
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T1 - Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration with Arterial Calcification and Stiffness in Incident Hemodialysis Patients

AU - Chen, Wei

AU - Fitzpatrick, Jessica

AU - Monroy-Trujillo, Jose M.

AU - Sozio, Stephen M.

AU - Jaar, Bernard G.

AU - Estrella, Michelle M.

AU - Wu, Tong Tong

AU - Melamed, Michal L.

AU - Parekh, Rulan S.

AU - Bushinsky, David A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: Magnesium (Mg) may protect against arterial calcification. We tested the hypotheses that a higher serum Mg concentration is associated with less arterial calcification and stiffness in patients on hemodialysis (HD) and that these associations are modified by diabetes mellitus. Methods: We performed cross-sectional analyses of 367 incident HD patients from the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) cohort. Measures of arterial calcification and stiffness included coronary arterial calcification (CAC) and thoracic aortic calcification (TAC) scores, ankle brachial index (ABI; high ABI: >1.4 or incompressible vessels), pulse wave velocity (PWV), and pulse pressure. Results: Mean Mg was 1.8 ± 0.2 mEq/l and 58% had diabetes. Among nondiabetic individuals, per 0.1 mEq/l higher Mg, non-zero CAC score was lower (% difference: −15.4%; 95% confidence interval [CI]: −28% to −0.55%; P = 0.03), the odds of having TAC score >0 and the odds of having high ABI were lower (odds ratio [OR]: 0.66; 95% CI 0.47–0.93; P = 0.02, and 0.23; 95% CI: 0.06–0.83, P = 0.03, respectively) while adjusting for demographics, comorbidities, markers of mineral metabolism, and dialysis clearance. Among diabetic individuals, per 0.1 mEq/l higher Mg, the odds of having TAC score >0 was higher (OR: 1.57; 95% CI: 1.09–2.26; P = 0.02). Mg was not associated with CAC or high ABI among diabetic individuals. Mg was not associated with PWV or pulse pressure regardless of diabetes status. Conclusion: Diabetes modified the associations of serum Mg with arterial calcification and stiffness in incident HD patients. Higher Mg was associated with less arterial calcification and less peripheral arterial stiffness among nondiabetic individuals, but Mg was only associated with TAC among diabetic individuals with higher Mg being associated with higher likelihood of having TAC score >0.

AB - Introduction: Magnesium (Mg) may protect against arterial calcification. We tested the hypotheses that a higher serum Mg concentration is associated with less arterial calcification and stiffness in patients on hemodialysis (HD) and that these associations are modified by diabetes mellitus. Methods: We performed cross-sectional analyses of 367 incident HD patients from the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) cohort. Measures of arterial calcification and stiffness included coronary arterial calcification (CAC) and thoracic aortic calcification (TAC) scores, ankle brachial index (ABI; high ABI: >1.4 or incompressible vessels), pulse wave velocity (PWV), and pulse pressure. Results: Mean Mg was 1.8 ± 0.2 mEq/l and 58% had diabetes. Among nondiabetic individuals, per 0.1 mEq/l higher Mg, non-zero CAC score was lower (% difference: −15.4%; 95% confidence interval [CI]: −28% to −0.55%; P = 0.03), the odds of having TAC score >0 and the odds of having high ABI were lower (odds ratio [OR]: 0.66; 95% CI 0.47–0.93; P = 0.02, and 0.23; 95% CI: 0.06–0.83, P = 0.03, respectively) while adjusting for demographics, comorbidities, markers of mineral metabolism, and dialysis clearance. Among diabetic individuals, per 0.1 mEq/l higher Mg, the odds of having TAC score >0 was higher (OR: 1.57; 95% CI: 1.09–2.26; P = 0.02). Mg was not associated with CAC or high ABI among diabetic individuals. Mg was not associated with PWV or pulse pressure regardless of diabetes status. Conclusion: Diabetes modified the associations of serum Mg with arterial calcification and stiffness in incident HD patients. Higher Mg was associated with less arterial calcification and less peripheral arterial stiffness among nondiabetic individuals, but Mg was only associated with TAC among diabetic individuals with higher Mg being associated with higher likelihood of having TAC score >0.

KW - arterial calcification

KW - arterial stiffness

KW - diabetes mellitus

KW - magnesium

KW - mineral metabolism

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