Diabetes Metab J.  2024 Nov;48(6):1147-1159. 10.4093/dmj.2023.0401.

Serum Magnesium Levels Are Negatively Associated with Obesity and Abdominal Obesity in Type 2 Diabetes Mellitus: A Real-World Study

• Xu MR
• Wang AP
• Wang YJ
• Lu JX
• Shen L
• Li LX

• KMID: 2561798
• DOI: http://doi.org/10.4093/dmj.2023.0401

Abstract

Background
There remains controversy over the relationship between serum magnesium levels and obesity in type 2 diabetes mellitus (T2DM). Therefore, the aim of this study was to assess whether there is any association of serum magnesium levels with obesity and abdominal obesity in T2DM.
Methods
This cross-sectional, real-world study was conducted in 8,010 patients with T2DM, which were stratified into quintiles according to serum magnesium levels. The clinical characteristics and the prevalence of obesity and abdominal obesity were compared across serum magnesium quintiles in T2DM. Regression analyses were used to evaluate the relationship of serum magnesium with obesity and abdominal obesity in T2DM (clinical trial registration number: ChiCTR1800015893).
Results
After adjustment for age, sex, and duration of diabetes, the prevalence of obesity and abdominal obesity was significantly declined across magnesium quintiles (obesity: 51.3%, 50.8%, 48.9%, 45.3%, and 43.8%, respectively, P<0.001 for trend; abdominal obesity: 71.5%, 70.5%, 68.2%, 66.4%, and 64.5%, respectively, P=0.001 for trend). After controlling for confounders, there were clearly negative associations of serum magnesium levels and quintiles with obesity and abdominal obesity in T2DM. Moreover, C-reactive protein partly mediates the effect of serum magnesium on obesity and abdominal obesity (P=0.016 and P=0.004, respectively).
Conclusion
The significantly negative relationship between serum magnesium and the risk of obesity and abdominal obesity was observed in T2DM. Furthermore, the independently negative association of serum magnesium with obesity may be explained by its anti-inflammatory functions. Serum magnesium levels may be applied to assess the risk of obesity and abdominal obesity in T2DM.

Keyword

Diabetes mellitus, type 2; Magnesium; Obesity; Obesity, abdominal

Figure

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  Fig. 1. Comparisons of serum magnesium levels in different groups. (A) Comparison of serum magnesium levels between men and women with type 2 diabetes mellitus after adjusting for age and duration of diabetes (DD) (P<0.001). (B) Comparison of serum magnesium levels stratified by the degree of obesity after adjusting for age, sex, and DD (P<0.001 for trend). (C) Comparison of serum magnesium levels stratified by the degree of abdominal obesity after adjusting for age, sex, and DD (P<0.001 for trend). (D) Comparison of serum magnesium levels stratified by age after adjusting for DD and sex (P<0.001 for trend). (E) Comparison of serum magnesium levels stratified by DD after adjusting for age and sex (P<0.001 for trend).

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  Fig. 2. Comparisons of the prevalence of obesity and abdominal obesity among serum magnesium quintiles. (A) Comparison of the prevalence of obesity and abdominal obesity stratified by serum magnesium quintiles after adjusting for age, sex, and duration of diabetes (DD) (P<0.001 for trend in obesity, P=0.001 for trend in abdominal obesity). (B) Comparison of the prevalence of obesity and abdominal obesity in low, normal, high serum magnesium group after adjusting for age, sex, and DD (P=0.030 for trend in obesity, P=0.088 for trend in abdominal obesity). (C) Comparison of the prevalence of mild, moderate, and severe obesity across serum magnesium quintiles after adjusting for age, sex, and DD (P<0.001 for trend). (D) Comparison of the prevalence of mild, moderate, and severe abdominal obesity across serum magnesium quintiles after adjusting for age, sex, and DD (P<0.001 for trend).

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  Fig. 3. Role of C-reactive protein (CRP) in the relationship between serum magnesium and obesity/abdominal obesity. (A) Comparison of serum CRP levels between the patients with and without obesity/abdominal obesity after controlling for gender, age, and duration of diabetes (DD) (P<0.001 for trend in obesity and abdominal obesity). (B) Comparison of serum CRP levels in mild, moderate, and severe obesity/abdominal obesity after controlling for gender, age, and DD (P=0.025 for trend in obesity, P<0.001 for trend in abdominal obesity). (C) Comparison of serum CRP levels across serum magnesium quintiles after adjusting for gender, age, and DD (P=0.046 for trend). (D) The mediation effects of CRP on the association between serum magnesium and obesity (P=0.016). (E) The mediation effects of CRP on the association between serum magnesium and abdominal obesity (P=0.004). ACME, average causal mediation effect; ADE, average direct effects.

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