Impact of serum magnesium and bone mineral density on systemic fractures in chronic hemodialysis patients
Bone mineral density (BMD) measured with dual-energy X-ray absorptiometry (DXA) can be used to predict fractures, but its clinical utility has not been fully established in chronic kidney disease (CKD) patients. Magnesium is an essential trace element. Although magnesium is associated with the risk...
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| creator | Hori, Mayuko Yasuda, Kaoru Takahashi, Hiroshi Yamazaki, Chikao Morozumi, Kunio Maruyama, Shoichi |
| description | Bone mineral density (BMD) measured with dual-energy X-ray absorptiometry (DXA) can be used to predict fractures, but its clinical utility has not been fully established in chronic kidney disease (CKD) patients. Magnesium is an essential trace element. Although magnesium is associated with the risk of fractures in non-CKD populations, the relationship is unknown in CKD patients.
BMD and serum magnesium levels were measured in 358 stable outpatients undergoing maintenance hemodialysis therapy. The primary outcome was fragility fracture. Patients were divided into groups according to the median level of magnesium and the normal threshold value of lumbar spine BMD.
During the median follow-up period of 36 months, 36 (10.0%) fractures occurred. The cumulative incidence rates of fractures were 17.6% and 5.2% [adjusted hazard ratio (aHR) 2.31, 95% confidence interval (CI) 1.03-5.17, P = 0.030] in the lower ( |
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BMD and serum magnesium levels were measured in 358 stable outpatients undergoing maintenance hemodialysis therapy. The primary outcome was fragility fracture. Patients were divided into groups according to the median level of magnesium and the normal threshold value of lumbar spine BMD.
During the median follow-up period of 36 months, 36 (10.0%) fractures occurred. The cumulative incidence rates of fractures were 17.6% and 5.2% [adjusted hazard ratio (aHR) 2.31, 95% confidence interval (CI) 1.03-5.17, P = 0.030] in the lower (<2.6 mg/dL) and higher (≥2.6 mg/dL) magnesium (Mg) groups, respectively, and 21.2% and 7.3% (aHR 2.59, 95% CI 1.09-6.16, P = 0.027) in the low- and high-BMD groups, respectively. The lower-Mg and low-BMD group had a 9.21-fold higher risk of fractures (95% CI; 2.35-47.00; P = 0.0010) than the higher-Mg and high-BMD group. Furthermore, adding both magnesium levels and lumbar spine BMD levels to the established risk factors significantly improved the prediction of fractures (C-index: 0.784 to 0.830, p = 0.041).
The combination of serum magnesium and lumbar spine BMD can be used for fracture risk stratification and synergistically improves the prediction of fractures in CKD patients.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0251912</identifier><identifier>PMID: 34014999</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Albumins ; Alkaline phosphatase ; Binders ; Biology and Life Sciences ; Biomedical materials ; Body mass ; Body mass index ; Body size ; Bone density ; Bone mineral density ; Bones ; C-reactive protein ; Calcium phosphates ; Cardiovascular diseases ; Cerebral infarction ; Chronic kidney failure ; Complications and side effects ; Data analysis ; Demographics ; Demography ; Density ; Dual energy X-ray absorptiometry ; Editing ; Fractures ; Graduate schools ; Graduate studies ; Hazard identification ; Health aspects ; Health risks ; Hemodialysis ; Hemoglobin ; Hemorrhage ; Hospitals ; Magnesium ; Magnesium in the body ; Medicine ; Medicine and Health Sciences ; Methodology ; Morbidity ; Myocardial infarction ; Nephrology ; Osteopenia ; Osteoporosis ; Parathyroid ; Parathyroid hormone ; Parathyroidectomy ; Patients ; Peritoneal dialysis ; Physical Sciences ; Proton pump inhibitors ; Radius ; Risk factors ; Surgical implants ; Urea ; Variables ; Vitamin D</subject><ispartof>PloS one, 2021-05, Vol.16 (5), p.e0251912-e0251912</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Hori et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Hori et al 2021 Hori et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-930c8c9a1b7852fed00fc2832fb67d9d2929e09e56b0a98556cb3e739b1c66383</citedby><cites>FETCH-LOGICAL-c692t-930c8c9a1b7852fed00fc2832fb67d9d2929e09e56b0a98556cb3e739b1c66383</cites><orcidid>0000-0002-6104-0204 ; 0000-0002-0957-2721</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136656/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136656/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34014999$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Blank, Robert Daniel</contributor><creatorcontrib>Hori, Mayuko</creatorcontrib><creatorcontrib>Yasuda, Kaoru</creatorcontrib><creatorcontrib>Takahashi, Hiroshi</creatorcontrib><creatorcontrib>Yamazaki, Chikao</creatorcontrib><creatorcontrib>Morozumi, Kunio</creatorcontrib><creatorcontrib>Maruyama, Shoichi</creatorcontrib><title>Impact of serum magnesium and bone mineral density on systemic fractures in chronic hemodialysis patients</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Bone mineral density (BMD) measured with dual-energy X-ray absorptiometry (DXA) can be used to predict fractures, but its clinical utility has not been fully established in chronic kidney disease (CKD) patients. Magnesium is an essential trace element. Although magnesium is associated with the risk of fractures in non-CKD populations, the relationship is unknown in CKD patients.
BMD and serum magnesium levels were measured in 358 stable outpatients undergoing maintenance hemodialysis therapy. The primary outcome was fragility fracture. Patients were divided into groups according to the median level of magnesium and the normal threshold value of lumbar spine BMD.
During the median follow-up period of 36 months, 36 (10.0%) fractures occurred. The cumulative incidence rates of fractures were 17.6% and 5.2% [adjusted hazard ratio (aHR) 2.31, 95% confidence interval (CI) 1.03-5.17, P = 0.030] in the lower (<2.6 mg/dL) and higher (≥2.6 mg/dL) magnesium (Mg) groups, respectively, and 21.2% and 7.3% (aHR 2.59, 95% CI 1.09-6.16, P = 0.027) in the low- and high-BMD groups, respectively. The lower-Mg and low-BMD group had a 9.21-fold higher risk of fractures (95% CI; 2.35-47.00; P = 0.0010) than the higher-Mg and high-BMD group. Furthermore, adding both magnesium levels and lumbar spine BMD levels to the established risk factors significantly improved the prediction of fractures (C-index: 0.784 to 0.830, p = 0.041).
The combination of serum magnesium and lumbar spine BMD can be used for fracture risk stratification and synergistically improves the prediction of fractures in CKD patients.</description><subject>Albumins</subject><subject>Alkaline phosphatase</subject><subject>Binders</subject><subject>Biology and Life Sciences</subject><subject>Biomedical materials</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Bone density</subject><subject>Bone mineral density</subject><subject>Bones</subject><subject>C-reactive protein</subject><subject>Calcium phosphates</subject><subject>Cardiovascular diseases</subject><subject>Cerebral infarction</subject><subject>Chronic kidney failure</subject><subject>Complications and side effects</subject><subject>Data analysis</subject><subject>Demographics</subject><subject>Demography</subject><subject>Density</subject><subject>Dual energy X-ray absorptiometry</subject><subject>Editing</subject><subject>Fractures</subject><subject>Graduate schools</subject><subject>Graduate studies</subject><subject>Hazard identification</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>Hemodialysis</subject><subject>Hemoglobin</subject><subject>Hemorrhage</subject><subject>Hospitals</subject><subject>Magnesium</subject><subject>Magnesium in the body</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Methodology</subject><subject>Morbidity</subject><subject>Myocardial infarction</subject><subject>Nephrology</subject><subject>Osteopenia</subject><subject>Osteoporosis</subject><subject>Parathyroid</subject><subject>Parathyroid hormone</subject><subject>Parathyroidectomy</subject><subject>Patients</subject><subject>Peritoneal dialysis</subject><subject>Physical Sciences</subject><subject>Proton pump inhibitors</subject><subject>Radius</subject><subject>Risk factors</subject><subject>Surgical implants</subject><subject>Urea</subject><subject>Variables</subject><subject>Vitamin 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of serum magnesium and bone mineral density on systemic fractures in chronic hemodialysis patients</title><author>Hori, Mayuko ; Yasuda, Kaoru ; Takahashi, Hiroshi ; Yamazaki, Chikao ; Morozumi, Kunio ; Maruyama, Shoichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-930c8c9a1b7852fed00fc2832fb67d9d2929e09e56b0a98556cb3e739b1c66383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Albumins</topic><topic>Alkaline phosphatase</topic><topic>Binders</topic><topic>Biology and Life Sciences</topic><topic>Biomedical materials</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Bone density</topic><topic>Bone mineral density</topic><topic>Bones</topic><topic>C-reactive protein</topic><topic>Calcium phosphates</topic><topic>Cardiovascular diseases</topic><topic>Cerebral infarction</topic><topic>Chronic kidney 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Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hori, Mayuko</au><au>Yasuda, Kaoru</au><au>Takahashi, Hiroshi</au><au>Yamazaki, Chikao</au><au>Morozumi, Kunio</au><au>Maruyama, Shoichi</au><au>Blank, Robert Daniel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of serum magnesium and bone mineral density on systemic fractures in chronic hemodialysis patients</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-05-20</date><risdate>2021</risdate><volume>16</volume><issue>5</issue><spage>e0251912</spage><epage>e0251912</epage><pages>e0251912-e0251912</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Bone mineral density (BMD) measured with dual-energy X-ray absorptiometry (DXA) can be used to predict fractures, but its clinical utility has not been fully established in chronic kidney disease (CKD) patients. Magnesium is an essential trace element. Although magnesium is associated with the risk of fractures in non-CKD populations, the relationship is unknown in CKD patients.
BMD and serum magnesium levels were measured in 358 stable outpatients undergoing maintenance hemodialysis therapy. The primary outcome was fragility fracture. Patients were divided into groups according to the median level of magnesium and the normal threshold value of lumbar spine BMD.
During the median follow-up period of 36 months, 36 (10.0%) fractures occurred. The cumulative incidence rates of fractures were 17.6% and 5.2% [adjusted hazard ratio (aHR) 2.31, 95% confidence interval (CI) 1.03-5.17, P = 0.030] in the lower (<2.6 mg/dL) and higher (≥2.6 mg/dL) magnesium (Mg) groups, respectively, and 21.2% and 7.3% (aHR 2.59, 95% CI 1.09-6.16, P = 0.027) in the low- and high-BMD groups, respectively. The lower-Mg and low-BMD group had a 9.21-fold higher risk of fractures (95% CI; 2.35-47.00; P = 0.0010) than the higher-Mg and high-BMD group. Furthermore, adding both magnesium levels and lumbar spine BMD levels to the established risk factors significantly improved the prediction of fractures (C-index: 0.784 to 0.830, p = 0.041).
The combination of serum magnesium and lumbar spine BMD can be used for fracture risk stratification and synergistically improves the prediction of fractures in CKD patients.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34014999</pmid><doi>10.1371/journal.pone.0251912</doi><tpages>e0251912</tpages><orcidid>https://orcid.org/0000-0002-6104-0204</orcidid><orcidid>https://orcid.org/0000-0002-0957-2721</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-05, Vol.16 (5), p.e0251912-e0251912 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2529909130 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Albumins Alkaline phosphatase Binders Biology and Life Sciences Biomedical materials Body mass Body mass index Body size Bone density Bone mineral density Bones C-reactive protein Calcium phosphates Cardiovascular diseases Cerebral infarction Chronic kidney failure Complications and side effects Data analysis Demographics Demography Density Dual energy X-ray absorptiometry Editing Fractures Graduate schools Graduate studies Hazard identification Health aspects Health risks Hemodialysis Hemoglobin Hemorrhage Hospitals Magnesium Magnesium in the body Medicine Medicine and Health Sciences Methodology Morbidity Myocardial infarction Nephrology Osteopenia Osteoporosis Parathyroid Parathyroid hormone Parathyroidectomy Patients Peritoneal dialysis Physical Sciences Proton pump inhibitors Radius Risk factors Surgical implants Urea Variables Vitamin D |
| title | Impact of serum magnesium and bone mineral density on systemic fractures in chronic hemodialysis patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T22%3A17%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20serum%20magnesium%20and%20bone%20mineral%20density%20on%20systemic%20fractures%20in%20chronic%20hemodialysis%20patients&rft.jtitle=PloS%20one&rft.au=Hori,%20Mayuko&rft.date=2021-05-20&rft.volume=16&rft.issue=5&rft.spage=e0251912&rft.epage=e0251912&rft.pages=e0251912-e0251912&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0251912&rft_dat=%3Cgale_plos_%3EA662418854%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2529909130&rft_id=info:pmid/34014999&rft_galeid=A662418854&rft_doaj_id=oai_doaj_org_article_a42cb69e8262498aadc9c90bf348fece&rfr_iscdi=true |