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Effect of magnesium supplements on insulin secretion after kidney transplantation : a randomized controlled trial

(2017) ANNALS OF TRANSPLANTATION. 22. p.524-531
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Abstract
Background: Hypomagnesemia is associated with a disturbed glucose metabolism. Insulin hypo-secretion predicts diabetes in the general population and in transplant recipients. We aimed to assess whether magnesium improves insulin secretion and glycemic control after transplantation in prevalent hypomagnesemic kidney transplant recipients. Material/Methods: We conducted an open-label, randomized, parallel-group study. Eligible participants were adults more than 4 months after kidney transplantation on tacrolimus with persisting serum magnesium concentrations <1.8 mg/dL randomized to magnesium oxide supplementation up to a maximum of 3 times 450 mg daily (N=26) or no supplements (N=26). Insulin secretion was assessed by OGTT-derived, first-phase insulin secretion (FPIR). The primary endpoint was the mean difference in FPIR between baseline and 6 months after randomization. Secondary endpoints were differences in HbA1c and insulin resistance, measured by HOMA. Dietary magnesium was assessed by a food-frequency questionnaire. All analyses were done on an intention-to-treat basis. Results: Magnesium with a mean daily dose of 688 +/- 237mg in the treatment group failed to lead to significant differences between the 2 groups in FPIR, fasting glucose, HbA1c, or HOMA-IR. Persisting hypomagnesemia was very common and associated with more insulin hypo-secretion, glucose intolerance, and lower dietary magnesium intake (142 +/- 56 versus 202 +/- 90 mg; p=0.015) as compared to patients with a rise in serum magnesium over 6 months. Conclusions: Magnesium supplementation does not improve insulin secretion in stable hypomagnesemic kidney transplant recipients on tacrolimus. Persisting hypomagnesemia is associated with impaired glucose tolerance, insulin hypo-secretion, and dietary factors.
Keywords
DEPENDENT DIABETES-MELLITUS, GLUCOSE-TOLERANCE, DOUBLE-BLIND, HYPOMAGNESEMIA, RISK, TACROLIMUS, RECIPIENTS, POSTTRANSPLANTATION, SENSITIVITY, RESISTANCE, Glucose Metabolism Disorders, Insulin, Kidney Transplantation, Magnesium

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Chicago
Van Laecke, Steven, Rogier Caluwe, Inge Huybrechts, Evi Nagler, Raymond Vanholder, Patrick Peeters, Bruno Van Vlem, and Wim Van Biesen. 2017. “Effect of Magnesium Supplements on Insulin Secretion After Kidney Transplantation : a Randomized Controlled Trial.” Annals of Transplantation 22: 524–531.
APA
Van Laecke, S., Caluwe, R., Huybrechts, I., Nagler, E., Vanholder, R., Peeters, P., Van Vlem, B., et al. (2017). Effect of magnesium supplements on insulin secretion after kidney transplantation : a randomized controlled trial. ANNALS OF TRANSPLANTATION, 22, 524–531.
Vancouver
1.
Van Laecke S, Caluwe R, Huybrechts I, Nagler E, Vanholder R, Peeters P, et al. Effect of magnesium supplements on insulin secretion after kidney transplantation : a randomized controlled trial. ANNALS OF TRANSPLANTATION. 2017;22:524–31.
MLA
Van Laecke, Steven et al. “Effect of Magnesium Supplements on Insulin Secretion After Kidney Transplantation : a Randomized Controlled Trial.” ANNALS OF TRANSPLANTATION 22 (2017): 524–531. Print.
@article{8542649,
  abstract     = {Background: Hypomagnesemia is associated with a disturbed glucose metabolism. Insulin hypo-secretion predicts diabetes in the general population and in transplant recipients. We aimed to assess whether magnesium improves insulin secretion and glycemic control after transplantation in prevalent hypomagnesemic kidney transplant recipients. 
Material/Methods: We conducted an open-label, randomized, parallel-group study. Eligible participants were adults more than 4 months after kidney transplantation on tacrolimus with persisting serum magnesium concentrations {\textlangle}1.8 mg/dL randomized to magnesium oxide supplementation up to a maximum of 3 times 450 mg daily (N=26) or no supplements (N=26). Insulin secretion was assessed by OGTT-derived, first-phase insulin secretion (FPIR). The primary endpoint was the mean difference in FPIR between baseline and 6 months after randomization. Secondary endpoints were differences in HbA1c and insulin resistance, measured by HOMA. Dietary magnesium was assessed by a food-frequency questionnaire. All analyses were done on an intention-to-treat basis. 
Results: Magnesium with a mean daily dose of 688 +/- 237mg in the treatment group failed to lead to significant differences between the 2 groups in FPIR, fasting glucose, HbA1c, or HOMA-IR. Persisting hypomagnesemia was very common and associated with more insulin hypo-secretion, glucose intolerance, and lower dietary magnesium intake (142 +/- 56 versus 202 +/- 90 mg; p=0.015) as compared to patients with a rise in serum magnesium over 6 months. 
Conclusions: Magnesium supplementation does not improve insulin secretion in stable hypomagnesemic kidney transplant recipients on tacrolimus. Persisting hypomagnesemia is associated with impaired glucose tolerance, insulin hypo-secretion, and dietary factors.},
  author       = {Van Laecke, Steven and Caluwe, Rogier and Huybrechts, Inge and Nagler, Evi and Vanholder, Raymond and Peeters, Patrick and Van Vlem, Bruno and Van Biesen, Wim},
  issn         = {1425-9524},
  journal      = {ANNALS OF TRANSPLANTATION},
  language     = {eng},
  pages        = {524--531},
  title        = {Effect of magnesium supplements on insulin secretion after kidney transplantation : a randomized controlled trial},
  url          = {http://dx.doi.org/10.12659/AOT.903439},
  volume       = {22},
  year         = {2017},
}

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