Studies on Serum Magnesium, Phosphorous and Calcium in Cardiovascular Disease Patients Attending Heart Clinic at Enugu State University Teaching Hospital (ESUTH), Enugu, Nigeria
Published: 2024-05-24
Page: 85-93
Issue: 2024 - Volume 7 [Issue 1]
Nkeiruka Chigekwu Mbadiwe
Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria and Department of Medicine, Enugu State University Teaching Hospital, Nigeria.
Jaachi Wilfred Mbachu
Chemical Pathology Unit, Department of Medical Laboratory Science, Imo State University, Owerri, Nigeria.
Chidiebere Ikechukwu Ikaraoha
Chemical Pathology Unit, Department of Medical Laboratory Science, Imo State University, Owerri, Nigeria.
Prince Henry Nnadi *
Chemical Pathology Unit, Department of Medical Laboratory Science, Imo State University, Owerri, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
The aim was achieved by estimating and comparing the concentrations of calcium, phosphorus, and magnesium in individuals with heart disease and those without any history of heart disease. It is well-recognised that certain nutrients influence the onset and course of cardiovascular disorders. These include calcium, phosphorus, and magnesium. These micronutrients have historically been linked to chronic renal disease or bone health, but they may also raise the risk of cardiovascular disease (CVD). This study was carried out to investigate the serum magnesium, phosphorous and calcium in cardiovascular disease patients attending heart clinic at Enugu State University Teaching Hospital (ESUTH) Enugu, Nigeria. Blood samples were obtained by venipuncture from forty (40) patients consisting of ten (10) male cardiovascular disease patient (test subject) and ten (10) male non-cardiovascular disease patients (control subject), ten (10) female cardiovascular disease subject (test subject) and ten (10) female non-cardiovascular disease subject (control subject). Blood sample from each patient was analysed for bone minerals (magnesium, phosphorous and calcium) by spectrophotometric method. Serum Ca was significantly lower (p=0.000) in heart disease patients compared to Controls, while serum phosphorus was significantly higher (p=0.034) in heart disease patients compared to Controls. There was no significant difference (p=0.493) in serum Ca levels of heart disease patients compared to controls. Serum Ca was significantly negatively correlated with P in heart Disease Patients (r= -0.721, p=0.000). There was no significant correlation of serum Ca with Mg in heart Disease Patients (r= 0.074, p=0.755). Hyperphosphatemia and hypomagnesemia are risk factors for cardiovascular diseases, and this study discusses the necessity of increased magnesium and decreased phosphorous levels in maintaining cardiac health.
Keywords: Cardiovascular diseases, heart, calcium, magnesium, phosphorous, cardiovascular disease, coagulability
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References
Mensah GA, Roth GA, Fuster V. The Global Burden of Cardiovascular Diseases and Risk Factors: 2020 and Beyond. J. Am. Coll. Cardiol. 2019; 74:2529–2532.
Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, Barengo NC, Beaton AZ, Benjamin EJ, Benziger CP, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study. J. Am. Coll. Cardiol. 2020;76:982–3021.
Lutsey PL, Alonso A, Michos ED, Loehr LR, Astor BC, Coresh J, Folsom AR. Serum magnesium, phosphorus, and calcium are associated with risk of incident heart failure: the Atherosclerosis Risk in Communities (ARIC) Study. The American Journal of Clinical Nutrition, 100(3), 2014; 756–764.
Foley RN, Collins AJ, Herzog CA, Ishani A, Kalra PA. Serum phosphate and left ventricular hypertrophy in young adults: the Coronary Artery Risk Development in Young Adults Study. Kidney Blood Press Res 2009;32:37–44.
Amann K, Tornig J, Kugel B, Gross M-L, Tyralla K, El-Shakmak A, Szabo A, Ritz E. Hyperphosphatemia aggravates cardiac fibrosis and microvascular disease in experimental uremia. Kidney Int 2003;63:1296–301.
Reid IR, Bolland M, Avenell A, Grey A. Cardiovascular effects of calcium supplementation. Osteoporos Int 2011;22:1649–58.
Reid IR, Bolland MJ. Calcium supplements: bad for the heart? Heart 2012;98:895–6.
Taylor JG, Bushinsky DA. Calcium and phosphorus homeostasis. Blood Purif. 2009;27:387–394.
Rubin MR, Rundek T, McMahon DJ, Lee HS, Sacco RL, Silverberg SJ. Carotid artery plaque thickness is associated with increased serum calcium levels: the Northern Manhattan study.Atherosclerosis. 2007;194:426–432.
Tarrass F, Benjelloun M, Zamd M, Medkouri G, Hachim K, Benghanem MG, Ramdani B. Heart valve calcifications in patients with end-stage renal disease: analysis for risk factors. Nephrology (Carlton). 2006;11:494–496.
Shuvy M, Abedat S, Beeri R, Danenberg HD, Planer D, Ben-Dov IZ, Meir K, Sosna J, Lotan C. Uraemic hyperparathyroidism causes a reversible inflammatory process of aortic valve calcification in rats. Cardiovasc Res. 2008;79:492–499.
Shin S, Kim KJ, Chang HJ, Cho I, Kim YJ, Choi BW, Rhee Y, Lim SK, Yang WI, Shim CY, Ha JW, Jang Y, Chung N. Impact of serum calcium and phosphate on coronary atherosclerosis detected by cardiac computed tomography. Eur Heart J. 2012;33:2873–2881.
Sabanayagam C, Shankar A. Serum calcium levels and hypertension among U.S. adults.J Clin Hypertens (Greenwich). 2011;13:716–721.
Ix JH, De Boer IH, Peralta CA, Adeney KL, Duprez DA, Jenny NS, Siscovick DS, Kestenbaum BR. Serum phosphorus concentrations and arterial stiffness among individuals with normal kidney function to moderate kidney disease in MESA. Clin J Am Soc Nephrol. 2009;4:609–615.
Palmer SC, Hayen A, Macaskill P, Pellegrini F, Craig JC, Elder GJ, Strippoli GF. Serum levels of phosphorus, parathyroid hormone, and calcium and risks of death and cardiovascular disease in individuals with chronic kidney disease: a systematic review and meta-analysis. JAMA. 2011;305:1119–1127.
Kwak SM, Jong SK, Choi Y, Chang Y, Kwon MJ, Jung JG, Jeong C, Ahn J, Hyun SK, Shin H, Ryu S. Dietary Intake of Calcium and Phosphorus and Serum Concentration in Relation to the Risk of Coronary Artery Calcification in Asymptomatic Adults. Arteriosclerosis, Thrombosis, and Vascular Biology. 2014; 34(8):1763–1769.
Leifsson BG, Ahrén B. Serum calcium and survival in a large health screening program.J Clin Endocrinol Metab. 1996;81:2149–2153.
Dhingra R, Sullivan LM, Fox CS, Wang TJ, D'Agostino RB, Gaziano JM, Vasan RS. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch Intern Med 2007;167:879–85.
Rude RK. Magnesium. In: Coates PM, Betz JM, Blackman MR, Cragg GM, eds. Encyclopedia of dietary supplements. New York, NY: Informa Healthcare. 2010;527–37.
Qu X, Jin F, Hao Y, Li H, Tang T, Wang H, Yan W, Dai K. Magnesium and the risk of cardiovascular events: A meta-analysis of prospective cohort studies. PLoS ONE. 2013;8:57720.
Rodríguez-Ortiz ME, Gómez-Delgado F, Arenas de Larriva AP, Canalejo A, Gómez-Luna P, Herencia C, López-Moreno J, Rodríguez M, López-Miranda J, Almadén Y. Serum Magnesium is associated with Carotid Atherosclerosis in patients with high cardiovascular risk (CORDIOPREV Study). Sci. Rep. 2019;9:8013.
Tangvoraphonkchai K, Davenport A. Magnesium and Cardiovascular Disease. Adv. Chronic Kidney Dis. 2018;25:251–260.
Yamanaka R, Tabata S, Shindo Y, Hotta K, Suzuki K, Soga T, Oka K. Mitochondrial Mg(2+) homeostasis decides cellular energy metabolism and vulnerability to stress. Sci. Rep. 2016;6:30027.
Liu M, Liu H, Feng F, Xie A, Kang GJ, Zhao Y, Hou CR, Zhou X, Dudley SC. Magnesium Deficiency Causes a Reversible, Metabolic, Diastolic Cardiomyopathy. J. Am. Heart Assoc. 2021;10:020205.
Maier JA, Malpuech-Brugère C, Zimowska W, Rayssiguier Y, Mazur A. Low magnesium promotes endothelial cell dysfunction: Implications for atherosclerosis, inflammation and thrombosis. Biochim. Biophys. Acta. 2004; 1689:13–21.
Fang X, Wang K, Han D, He X, Wei J, Zhao L, Imam MU, Ping Z, Li Y, Xu Y, et al. Dietary magnesium intake and the risk of cardiovascular disease, type 2 diabetes, and all-cause mortality: A dose-response meta-analysis of prospective cohort studies. BMC Med. 2016;14:210.
Taveira TH, Ouellette D, Gulum A, Choudhary G, Eaton CB, Liu S, Wu WC. Relation of Magnesium Intake With Cardiac Function and Heart Failure Hospitalizations in Black Adults: The Jackson Heart Study. Circ. Heart Fail. 2016;9:002698.
Wu WC, Huang M, Taveira TH, Roberts MB, Martin LW, Wellenius GA, Johnson KC, Manson JE, Liu S, Eaton CB. Relationship between Dietary Magnesium Intake and Incident Heart Failure Among Older Women: The WHI. J. Am. Heart Assoc. 2020;9:013570.
Leo GM. Direct Colorimetric Determination of Serum Calcium with o -Cresolphthalein Complexon. American Journal of Clinical Pathology. 1974; 61(1):114-117
Lieboff SL. A colorimetric method for determination of blood inorganic phosphorous. Journal of Biological Chemistry. 1928;79:611-619
Faulkner WR. Selected method for the small clinical chemistry laboratory. Magnesium in biological fluid. AACC Washington, D.C. 1982; pp. 277
Tietz NW. Fundamentals of Clinical Chemistry. W.B Saunders Co. Philadelphia. 1976; p.919.
Jee SH, Miller ER, Guallar E, Singh VK, Appel LJ, Klag MJ. The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials. Am J Hypertens. 2002;15:691–6.
He K, Liu K, Daviglus ML, Morris SJ, Loria CM, Van Horn L, Jacobs DR, Savage PJ. Magnesium intake and incidence of metabolic syndrome among young adults. Circulation. 2006;113:1675–82.
Song Y, He K, Levitan EB, Manson JE, Liu S. Effects of oral magnesium supplementation on glycaemic control in type 2 diabetes: a meta-analysis of randomized double-blind controlled trials. Diabetes Med. 2006;23:1050–6.
Ohira T, Peacock JM, Iso H, Chambless LE, Rosamond WD, Folsom AR. Serum and dietary magnesium and risk of ischemic stroke. Am J Epidemiol. 2009; 169:1437–44.
Liao F, Folsom AR, Brancati FL. Is low magnesium concentration a risk factor for coronary heart disease? The Atherosclerosis Risk in Communities (ARIC) Study. Am Heart J 1998;136:480–90.
Peacock JM, Ohira T, Post W, Sotoodehnia N, Rosamond W, Folsom AR. Serum magnesium and risk of sudden cardiac death in the Atherosclerosis Risk in Communities (ARIC) Study. Am Heart J. 2010;160:464–70.
Chakraborti S, Chakraborti T, Mandal M, Mandal A, Das S, Ghosh S. Protective role of magnesium in cardiovascular diseases: a review. Mol Cell Biochem. 2002;238:163–79.
Eisenberg MJ. Magnesium deficiency and sudden death. Am Heart J 1992;124:544–9.
Misialek JR, Lopez FL, Lutsey PL, Huxley RR, Peacock JM, Chen LY, Soliman EZ, Agarwal SK, Alonso A. Serum and dietary magnesium and incidence of atrial fibrillation in whites and in African Americans; Atherosclerosis Risk in Communities (ARIC) Study. Circ J. 2013;77:323–9.
Witte KKA, Nikitin NP, Parker AC, von Haehling S, Volk H-D, Anker SD, Clark AL, Cleland JGF. The effect of micronutrient supplementation on quality-of-life and left ventricular function in elderly patients with chronic heart failure. Eur Heart J. 2005;26:2238–44.
Almoznino-Sarafian D, Sarafian G, Berman S, Shteinshnaider M, Tzur I, Cohen N, Gorelik O. Magnesium administration may improve heart rate variability in patients with heart failure. Nutr Metab Cardiovasc Dis. 2009;19:641–5.
Larsson SC, Orsini N, Wolk A. Dietary magnesium intake and risk of stroke: a meta-analysis of prospective studies. Am J Clin Nutr. 2012;95:362–366.
Del Gobbo LC, Imamura F, Wu JH, de Oliveira Otto MC, Chiuve SE, et al. Circulating and dietary magnesium and risk of cardiovascular disease: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr. 2013;98:160–173.
Ranjani G. Estimation of serum calcium and serum phosphorus levels in newly detected essential hypertensive patients. International Archives of Integrated Medicine. 2017;4(9):47-53
Foley RN, Collins AJ, Ishani A, Kalra PA. Calcium-phosphate levels and cardiovascular disease in community-dwelling adults: the Atherosclerosis Risk in Communities (ARIC) Study. Am Heart J. 2008;156:556–63.
Lind L, Skarfors E, Berglund L, Lithell H, Ljunghall S. Serum calcium: a new, independent, prospective risk factor for myocardial infarction in middle-aged men followed for 18 years. J Clin Epidemiol. 1997;50:967–73.
Jorde R, Sundsfjord J, Fitzgerald P, Bønaa KH. Serum calcium and cardiovascular risk factors and diseases: the Tromsø Study. Hypertension. 1999;34:484–90.
McGovern AP, De Lusignan S, Van Vlymen J, Liyanage H, Tomson CR, Gallagher H, et al. Serum Phosphate as a Risk Factor for Cardiovascular Events in People with and without Chronic Kidney Disease: A Large Community Based Cohort Study. PLoS ONE. 2013; 8(9):74996.
Mathew S, Tustison KS, Sugatani T, Chaudhary LR, Rifas L, et al. The mechanism of phosphorus as a cardiovascular risk factor in CKD. Journal of the American Society of Nephrology. 2008;19:1092–1105.
Lau WL, Pai A, Moe SM, Giachelli CM. Direct Effects of Phosphate on Vascular Cell Function. Advanced Chronic Kidney Disesease. 2011;18: 105–112.
Jono S, McKee MD, Murry CE, Shioi A, Nishizawa Y, et al. Phosphate regulation of vascular smooth muscle cell calcification. Circulation Research. 2000;87: E10–17.
Amann K, Tornig J, Kugel B, Gross ML, Tyralla K, et al. Hyperphosphatemia aggravates cardiac fibrosis and microvascular disease in experimental uremia. Kidney international. 2003;63: 1296–1301.
Chue CD, Townend JN, Steeds RP, Ferro CJ. Arterial stiffness in chronic kidney disease: causes and consequences. Heart. 2010;96: 817–823.
Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral metabolism, mortality, and morbidity in hemodialysis patients. Journal of American Society of Nephrology. 2004;15:2208–2218.
Oh J, Wunsch R, Turzer M, et al. Advanced coronary and carotid arteriopathy in young adults with childhood-onset chronic renal failure. Circulation. 2002;106: 100-105.