Relationship between magnesium / phosphate ratio and endothelial function in coronary artery disease, a prospective study
Öz
Aim: The pathogenesis of atherosclerotic changes and endothelial dysfunction is complex and multifactorial. Magnesium and phosphate minerals, are important blood minerals in the pathophysiology of atherogenesis and endothelial dysfunction. Flow mediated vasodilation test is accepted as the most accurate test in evaluation endothelial functions. In our study, we aimed to evaluate the relationship between magnesium / phosphate ratio and endothelial functions in patients with coronary artery disease.
Materials and Methods: Sixty-one patients who had had coronary angiography and diagnosed with coronary artery disease were consecutively included. Endothelial functions were evaluated by flow-mediated vasodilation (FMD) test on the radial artery during outpatient visit. IBM SPSS Statistics 25.0 Program was used for statistical analysis. Spearman correlation analysis was used to evaluate the correlation between the Mg / P ratio and the AAD percentile change.
Results: The mean age of 61 patients included in the study was 61.2 ± 10.1 years, and 72% of the patients were male and the mean body mass index was 27.8 ± 5.4 kg / m2. In the FMD test, the mean radial artery basal diameter was 0.25 ± 0.03 cm, and the mean radial artery diameter after FMD was 0.28 ± 0.03 cm. A positive correlation was observed between magnesium / phosphate ratio and the percentage change in artery diameter implying endothelial functions (r = 0.268, p = 0.037).
Conclusion: In patients with coronary artery disease, magnesium / phosphate ratios can be used as a parameter reflecting endothelial function.
Anahtar Kelimeler
Coronary artery disease endothelial function magnesium phosphate
Kaynakça
- Widlansky ME, Gokce N, Keaney JF, et al. The clinical implications of endothelial dysfunction, J Am Coll Cardiol. 2003; 42 (7): 1149-60.
- Ross R. Atherosclerosis—an inflammatory disease. N Engl J Med. 1999; 340: 115–26.
- Volpe SL. Magnesium, the metabolic syndrome, insulin resistance, and type 2 diabetes mellitus. Crit Rev Food Sci Nutr. 2008; 48: 293–300.
- Kolte D, Vijayaraghavan K, Khera S, et al. Role of magnesium in cardiovascular diseases. Cardiol Rev. 2014; 22: 182–92.
- Del Gobbo LC, Imamura F, Wu JH, 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: 160–73.
- Fang X, Liang C, Li M, et al. Dose-response relationship between dietary magnesium intake and cardiovascular mortality: a systematic review and dose-based meta-regression analysis of prospective studies. J Trace Elem Med Biol. 2016; 38: 64–73.
- Maier JA, Malpuech-Brugère C, Zimowska W, et al. Low magnesium promotes endothelial cell dysfunction: implications for atherosclerosis, inflammation and thrombosis. Biochim Biophys Acta. 2004;1689(1):13-21.
- Tonelli M, Sacks F, Pfeffer M, et al. Cholesterol And Recurrent Events Trial Investigators. Relation between serum phosphate level and cardiovascular event rate in people with coronary disease. Circulation. 2005; 112 (17): 2627-33.
- Dhingra R, Sullivan LM, Fox CS, et al. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch Intern Med. 2007; 167: 879–85.
- Ganesh SK, Stack AG, Levin NW, et al. Association of elevated serum PO(4), Ca x PO(4) product, and parathyroid hormone with cardiac mortality risk in chronic hemodialysis patients. J Am Soc Nephrol. 2001; 12: 2131–8.
- Vogel RA. Coronary risk factors, endothelial function, and atherosclerosis: a review. Clin Cardiol. 1997; 20: 426–32.
- Anderson TJ, Meredith IT, Yeung AC, et al. The effects of cholesterol lowering and antioxidant therapy on endothelium-dependent coronary vasomotion. N Engl J Med. 1995; 332: 488–93.
- Raitakari OT, Celermajer DS. Flow-mediated dilatation. Br J Clin Pharmacol. 2000; 50: 397-404.
- Verma S, Anderson TJ. Fundamentals of endothelial function for the clinical cardiologist. Circulation. 2002; 105: 546-9.
- McLenachan JM, Williams JK, Fish RD, et al. Loss of flow-mediated endothelium-dependent dilation occurs early in the development of atherosclerosis. Circulation. 1991; 84: 1273-8.
- Celermajer DS, Sorensen KE, Bull C, et al. Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol. 1994; 24: 1468-74.
- Altura BM, Altura BT. New perspectives on the role of magnesium in the pathophysiology of the cardiovascular system. I. Clinical aspects. Magnesium. 1985; 4: 226-44.
- Northcott CA, Watts SW. Low [Mg2+]e enhances arterial spontaneous tone via phosphatidylinositol 3-kinase in DOCA-salt hypertension. Hypertension. 2004; 43: 125-9. 82 Ege Tıp Dergisi / Ege Journal of Medicine
- Zheltova AA, Kharitonova MV, Iezhitsa IN, et al. Magnesium deficiency and oxidative stress: an update. Biomedicine (Taipei). 2016; 6: 20.
- Kisters K, Gröber U. Magnesium in health and disease. Plant Soil. 2013; 368, 155–65.
- Ma J, Folsom AR, Melnick SL, et al. Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: the ARIC study. J Clin Epidemiol. 1995; 48: 927-40.
- 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.
- Li Q, Chen Q, Zhang H, et al. Associations of Serum Magnesium Levels and Calcium-Magnesium Ratios With Mortality in Patients With Coronary Artery Disease. Diabetes Metab. 2019; 1262-3636: 30189-2.
- Shechter M. The role of magnesium as antithrombotic therapy. Wien Med Wochenschr. 2000; 150: 343–7.
- Shechter M, Sharir M, Labrador MJ, et al. Oral magnesium therapy improves endothelial function in patients with coronary artery disease. Circulation. 2000; 102: 2353-8.
- Dickens BF, Weglicki WB, Li YS, et al. Magnesium deficiency in vitro enhances free radical-induced intracellular oxidation and cytotoxicity in endothelial cells. FEBS Lett. 1992; 311:187-91.
- Cunha AR, D'El-Rei J, Medeiros F, et al. Oral magnesium supplementation improves endothelial function and attenuates subclinical atherosclerosis in thiazide-treated hypertensive women. J Hypertens. 2017; 35: 89–97.
- Lee S, Ryu JH, Kim SJ, et al. The Relationship between Magnesium and Endothelial Function in End-Stage Renal Disease Patients on Hemodialysis. Yonsei Med J. 2016 Nov 1; 57 (6): 1446–53.
- Onufrak SJ, Bellasi A, Shaw LJ, et al. Phosphorus levels are associated with subclinical atherosclerosis in the general population. Atherosclerosis. 2008; 199: 424–31.
- Stevens KK, Denby L, Patel RK, et al. Deleterious effects of phosphate on vascular and endothelial function via disruption to the nitric oxide pathway. Nephrol Dial Transplant. 2017; 32: 1617–27.
- Shuto E, Taketani Y, Tanaka R, et al. Dietary Phosphorus Acutely Impairs Endothelial Function. J Am Soc Nephrol. 2009 Jul; 20: 1504–12.
- Peng A, Wu T, Zeng C, et al. Adverse effects of simulated hyper- and hypo-phosphatemia on endothelial cell function and viability. PLoS One2011; 6: e23268.
Koroner arter hastalığında magnezyum/fosfat oranı ile endotel fonksiyonları arasındaki ilişki: Bir prospektif çalışma
Öz
Amaç: Aterosklerotik değişikliklerin ve endotel disfonksiyonunun patogenezi karmaşık ve çok faktörlüdür. Kandaki elektrolitlerden magnezyum ve fosfat mineralleri aterogenez ve endotel fonksiyon bozukluğunun patofizyolojisinde yer alan önemli minerallerdir. Endotel fonksiyonu değerlendirmede en çok kabul görmüş akım aracılı vazodilatasyon testidir. Çalışmamızda, koroner arter hastalığı olan hastalarda magnezyum/fosfat oranı ile endotel fonksiyonları arasındaki ilişkinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Koroner anjiyografi ile belgelenmiş koroner arter hastalığı olan ardışık 61 hasta çalışmaya dahil edildi. Radial arterden akım aracılı vazodilatasyon testi ile endotel fonksiyonları poliklinik kontrolünde incelendi. Magnezyum/fosfat oranı ile akım aracılı vazodilatasyon yüzdelik değişimi arasındaki korelasyonu değerlendirmek için Spearman korelasyon analizi kullanıldı.
Bulgular: Hastaların ortalama yaşı 61,2±10,1 yıl olup hastaların %72’si erkek ve ortalama vücut kitle indeksi 27,8±5,4 kg/m2’dir. AAD testinde ortalama radial arter bazal çapı 0,25±0,03 cm, test sonrası ortalama radial arter çapı 0,28±0,03 cm olarak saptandı. Magnezyum/fosfat oranları ile endotel fonksiyonlarını gösteren arter çapındaki yüzdelik değişim arasında pozitif yönde bir ilişki saptandı (r = 0,268, p = 0,037).
Sonuç: Koroner arter hastalığı olan hastalarda, magnezyum/fosfat oranı endotel fonksiyonlarının bir göstergesi olarak kullanılabilir.
Anahtar Kelimeler
Kaynakça
- Widlansky ME, Gokce N, Keaney JF, et al. The clinical implications of endothelial dysfunction, J Am Coll Cardiol. 2003; 42 (7): 1149-60.
- Ross R. Atherosclerosis—an inflammatory disease. N Engl J Med. 1999; 340: 115–26.
- Volpe SL. Magnesium, the metabolic syndrome, insulin resistance, and type 2 diabetes mellitus. Crit Rev Food Sci Nutr. 2008; 48: 293–300.
- Kolte D, Vijayaraghavan K, Khera S, et al. Role of magnesium in cardiovascular diseases. Cardiol Rev. 2014; 22: 182–92.
- Del Gobbo LC, Imamura F, Wu JH, 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: 160–73.
- Fang X, Liang C, Li M, et al. Dose-response relationship between dietary magnesium intake and cardiovascular mortality: a systematic review and dose-based meta-regression analysis of prospective studies. J Trace Elem Med Biol. 2016; 38: 64–73.
- Maier JA, Malpuech-Brugère C, Zimowska W, et al. Low magnesium promotes endothelial cell dysfunction: implications for atherosclerosis, inflammation and thrombosis. Biochim Biophys Acta. 2004;1689(1):13-21.
- Tonelli M, Sacks F, Pfeffer M, et al. Cholesterol And Recurrent Events Trial Investigators. Relation between serum phosphate level and cardiovascular event rate in people with coronary disease. Circulation. 2005; 112 (17): 2627-33.
- Dhingra R, Sullivan LM, Fox CS, et al. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch Intern Med. 2007; 167: 879–85.
- Ganesh SK, Stack AG, Levin NW, et al. Association of elevated serum PO(4), Ca x PO(4) product, and parathyroid hormone with cardiac mortality risk in chronic hemodialysis patients. J Am Soc Nephrol. 2001; 12: 2131–8.
- Vogel RA. Coronary risk factors, endothelial function, and atherosclerosis: a review. Clin Cardiol. 1997; 20: 426–32.
- Anderson TJ, Meredith IT, Yeung AC, et al. The effects of cholesterol lowering and antioxidant therapy on endothelium-dependent coronary vasomotion. N Engl J Med. 1995; 332: 488–93.
- Raitakari OT, Celermajer DS. Flow-mediated dilatation. Br J Clin Pharmacol. 2000; 50: 397-404.
- Verma S, Anderson TJ. Fundamentals of endothelial function for the clinical cardiologist. Circulation. 2002; 105: 546-9.
- McLenachan JM, Williams JK, Fish RD, et al. Loss of flow-mediated endothelium-dependent dilation occurs early in the development of atherosclerosis. Circulation. 1991; 84: 1273-8.
- Celermajer DS, Sorensen KE, Bull C, et al. Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol. 1994; 24: 1468-74.
- Altura BM, Altura BT. New perspectives on the role of magnesium in the pathophysiology of the cardiovascular system. I. Clinical aspects. Magnesium. 1985; 4: 226-44.
- Northcott CA, Watts SW. Low [Mg2+]e enhances arterial spontaneous tone via phosphatidylinositol 3-kinase in DOCA-salt hypertension. Hypertension. 2004; 43: 125-9. 82 Ege Tıp Dergisi / Ege Journal of Medicine
- Zheltova AA, Kharitonova MV, Iezhitsa IN, et al. Magnesium deficiency and oxidative stress: an update. Biomedicine (Taipei). 2016; 6: 20.
- Kisters K, Gröber U. Magnesium in health and disease. Plant Soil. 2013; 368, 155–65.
- Ma J, Folsom AR, Melnick SL, et al. Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: the ARIC study. J Clin Epidemiol. 1995; 48: 927-40.
- 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.
- Li Q, Chen Q, Zhang H, et al. Associations of Serum Magnesium Levels and Calcium-Magnesium Ratios With Mortality in Patients With Coronary Artery Disease. Diabetes Metab. 2019; 1262-3636: 30189-2.
- Shechter M. The role of magnesium as antithrombotic therapy. Wien Med Wochenschr. 2000; 150: 343–7.
- Shechter M, Sharir M, Labrador MJ, et al. Oral magnesium therapy improves endothelial function in patients with coronary artery disease. Circulation. 2000; 102: 2353-8.
- Dickens BF, Weglicki WB, Li YS, et al. Magnesium deficiency in vitro enhances free radical-induced intracellular oxidation and cytotoxicity in endothelial cells. FEBS Lett. 1992; 311:187-91.
- Cunha AR, D'El-Rei J, Medeiros F, et al. Oral magnesium supplementation improves endothelial function and attenuates subclinical atherosclerosis in thiazide-treated hypertensive women. J Hypertens. 2017; 35: 89–97.
- Lee S, Ryu JH, Kim SJ, et al. The Relationship between Magnesium and Endothelial Function in End-Stage Renal Disease Patients on Hemodialysis. Yonsei Med J. 2016 Nov 1; 57 (6): 1446–53.
- Onufrak SJ, Bellasi A, Shaw LJ, et al. Phosphorus levels are associated with subclinical atherosclerosis in the general population. Atherosclerosis. 2008; 199: 424–31.
- Stevens KK, Denby L, Patel RK, et al. Deleterious effects of phosphate on vascular and endothelial function via disruption to the nitric oxide pathway. Nephrol Dial Transplant. 2017; 32: 1617–27.
- Shuto E, Taketani Y, Tanaka R, et al. Dietary Phosphorus Acutely Impairs Endothelial Function. J Am Soc Nephrol. 2009 Jul; 20: 1504–12.
- Peng A, Wu T, Zeng C, et al. Adverse effects of simulated hyper- and hypo-phosphatemia on endothelial cell function and viability. PLoS One2011; 6: e23268.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Mart 2021 |
| Gönderilme Tarihi | 11 Ocak 2021 |
| Yayımlandığı Sayı | Yıl 2021 |