Serum Magnesium Useful for Early Detection and Progression of Type 2 Diabetes Mellitus and Nephropathy

Abstract

Introduction: : Magnesium, Insulin, urinary ACR, eGFR, play various roles in the pathophysiology of type 2 diabetes mellitus and nephropathy. This study aimed at determining whether serum magnesium, insulin, urinary ACR and eGFR are significantly altered during normo albuminuria of type 2 diabetes patients that subsequently develop micro and macro albuminuria and whether such changes are useful in predicting the disease early.

Objectives: To estimate serum magnesium and corelate with clinical markers of nephropathy in patients with type 2 diabetes mellitus. Additionally, the serum magnesium can serve has a early diagnostic and prognostic marker for nephropathy.

Methods: This was a cross sectional study which compared biochemical, clinical parameters in 40 type 2 diabetes mellitus with normo albuminuria, 40 type 2 diabetes mellitus with micro albuminuria, 40 type 2 diabetes mellitus with macro albuminuria and 40 age, gender and BMI matched healthy controls. Blood sugars, glycated haemoglobin, renal function tests, serum insulin, magnesium, eGFR and urinary ACR were analysed.

Results: There were significant differences in serum magnesium, insulin, urinary ACR, and eGFR among different stages of type 2 diabetes mellitus patients when compared to controls. Additionally, the serum magnesium negatively correlated with BMI, blood sugars, glycated haemoglobin, urea, creatinine, insulin, urinary ACR and positively correlated with eGFR (P=0.001**). Furthermore, the receiver operating characteristic curve analysis area uncer the curve for serum magnesium, urinary ACR and eGFR were; 0.989, 0.573 and 0.565 respectively. Decreased serum magnesium (specificity: 100; sensitivity; 95; CI=0.935 to 1.000; p=0.0001) were associated with T2DM and nephropathy.

Conclusions: Hypomagnesemia precede type 2 diabetes mellitus and can serve as early predictive and prognostic indices for type 2 diabetic nephropathy.