Magnesium depletion, metabolic impairment, and cardiac alterations: the NAKO-MRI study with mendelian randomization

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Item Type:	Article
Title:	Magnesium depletion, metabolic impairment, and cardiac alterations: the NAKO-MRI study with mendelian randomization
Creators Name:	Shugaa Addin, Nuha, Schuppert, Christopher, Full, Peter M., Brenner, Hermann, Dörr, Marcus, Keil, Thomas, von Krüchten, Ricarda, Meinel, Felix G., Niendorf, Thoralf, Pischon, Tobias, Schmidt, Börge, Schulz-Menger, Jeanette, Schwichtenberg, Julia, Völzke, Henry, Willich, Stefan N., Bamberg, Fabian, Peters, Annette, Schlett, Christopher L. and Rospleszcz, Susanne
Abstract:	CONTEXT: Magnesium deficiency may contribute to subclinical cardiac changes, particularly metabolic diastolic cardiomyopathy. OBJECTIVE: To investigate the association between magnesium depletion, metabolic syndrome (MetS), and magnetic resonance imaging (MRI)-derived cardiac alterations in a population-based sample. METHODS: We cross-sectionally analyzed participants (N = 9568) from the baseline examination of the German National Cohort who underwent whole-body MRI. Associations of serum magnesium and magnesium depletion score (MDS) with MetS and cardiac alterations were assessed using multivariable logistic and linear regression, respectively. Two-sample Mendelian Randomization was performed to evaluate the potential causal relationship between serum magnesium and MRI-derived cardiac parameters. RESULTS: Our analysis revealed no correlation between serum magnesium and MDS (Spearman's rho = 0.065; P < .001). A 1-SD increase in serum magnesium was associated with lower MetS prevalence (odds ratio, 0.93 [95% CI, 0.88-0.99]) and reduced left and right ventricular systolic and diastolic volumes. Higher MDS, indicating magnesium deficiency, was linked to increased MetS prevalence (OR per 1 unit, 1.32 [95% CI, 1.23-1.41]) and its individual components. Furthermore, higher MDS was associated with increased left ventricular remodeling index (estimate, 0.012 g/mL [95% CI, 0.008-0.017]) and decreased left ventricular end-diastolic volume (estimate, −1.132 mL/m(2) [95% CI, −1.538 to −0.727]), indicating concentric hypertrophy. Two-sample Mendelian Randomization suggested no causal relationship between serum magnesium and MRI-derived cardiac markers. CONCLUSION: Magnesium depletion may serve as an early indicator of cardiac impairment. However, Mendelian Randomization results do not support a causal role of serum magnesium on cardiac structure and morphology.
Keywords:	Magnesium, Metabolic Syndrome, Cardiac Function, Cardiac Morphology, Magnetic Resonance Imaging
Source:	Journal of Clinical Endocrinology and Metabolism
ISSN:	0021-972X
Publisher:	Oxford University Press / Endocrine Society
Page Range:	dgaf476
Date:	16 September 2025
Official Publication:	https://doi.org/10.1210/clinem/dgaf476
PubMed:	View item in PubMed

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