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Shugaa Addin, N. ; Schuppert, C.* ; Full, P.M.* ; Brenner, H.* ; Dörr, M.* ; Keil, T.* ; von Krüchten, R.* ; Meinel, F.G.* ; Niendorf, T.* ; Pischon, T.* ; Schmidt, B.* ; Schulz-Menger, J.* ; Schwichtenberg, J.* ; Völzke, H.* ; Willich, S.N.* ; Bamberg, F.* ; Peters, A. ; Schlett, C.L.* ; Rospleszcz, S.

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

J. Clin. Endocrinol. Metab.:dgaf476 (2025)

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Open Access Green as soon as Postprint is submitted to ZB.

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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 MRI-derived cardiac alterations in a population-based sample. METHODS: We cross-sectionally analyzed N = 9568 participants from the baseline examination of the German National Cohort (NAKO) 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 < 0.001). A 1-SD increase in serum magnesium was associated with lower MetS prevalence (OR 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 LVRI (Estimate 0.012 g/mL [95% CI: 0.008, 0.017]) and decreased left ventricular end-diastolic volume (Estimate -1.132 mL/m2 [95% CI: -1.538, -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.

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Publication type Article: Journal article

Document type Scientific Article

Keywords Magnesium ; Cardiac Function ; Cardiac Morphology ; Magnetic Resonance Imaging ; Metabolic Syndrome; Double-blind; Supplementation; Architecture; Disease

ISSN (print) / ISBN 0021-972X

e-ISSN 1945-7197

Journal Journal of Clinical Endocrinology & Metabolism, The

Quellenangaben Article Number: dgaf476

Publisher Endocrine Society

Publishing Place Bethesda, Md.

Reviewing status Peer reviewed

Institute(s) Institute of Epidemiology (EPI)

Grants Kaltenbach Scholarship of the German Heart Foundation
Hanns-Seidel-Stiftung
Helmholtz Association
Federal states of Germany
Federal Ministry of Education and Research (BMBF)