title: Lower magnesium level associated with new-onset diabetes and pre-diabetes after kidney transplantation.
abstract: BACKGROUND
  Hypomagnesemia is associated with increased peripheral insulin resistance in the general population. It is frequently seen after renal transplantation. We examined its role as a risk factor for new-onset diabetes after transplantation (NODAT) and new-onset pre-diabetes after transplantation (NOPDAT).
  
  
  METHODS
  A retrospective analysis of 138 previously non-diabetic renal transplant recipients was conducted. Cox and logistic regression analyses were performed to examine the associations between 1-month post-transplant serum magnesium level and subsequent diagnoses of NODAT/NOPDAT.
  
  
  RESULTS
  NODAT was diagnosed in 34 (24.6 %) and NOPDAT in 12 (8.7 %) patients. Median time to diagnosis of NODAT/NOPDAT was 20.4 months (interquartile range [IQR] 6.8-34.8). Median follow up for the entire group was 3.5 years (IQR 2.3-5.6). Mean magnesium level at 1 month after transplantation was significantly lower in patients subsequently diagnosed with NODAT/NOPDAT (1.60 ± 0.27 vs. 1.76 ± 0.29 mg/dl, p = 0.002). Cox regression analysis identified a trend towards developing NODAT/NOPDAT with lower baseline magnesium levels (hazard ratio 0.89 per 0.1 mg/dl increment in magnesium level, 95 % confidence interval [CI] = 0.78-1.01, p = 0.07); a stronger relationship between the two variables was seen at logistic regression analysis (odds ratio 0.81 per 0.1 mg/dl increment in serum magnesium (95 % CI 0.67-0.98, p = 0.03).
  
  
  CONCLUSIONS
  A lower magnesium level at 1 month after transplantation may be predictive of a subsequent diagnosis of glucose intolerance or diabetes in renal transplant recipients. Whether replenishing magnesium stores can prevent development of these disorders requires further investigation.
authors.affiliation: Department of Internal Medicine, Boston University Medical Center, Boston, MA, 02118, USA, neetika84@gmail.com.
authors.forename: Neetika
authors.initials: N
authors.lastname: Garg
authors.forename: Janice
authors.initials: J
authors.lastname: Weinberg
authors.forename: Sandeep
authors.initials: S
authors.lastname: Ghai
authors.forename: Gitana
authors.initials: G
authors.lastname: Bradauskaite
authors.forename: Matthew
authors.initials: M
authors.lastname: Nuhn
authors.forename: Amitabh
authors.initials: A
authors.lastname: Gautam
authors.forename: Nilay
authors.initials: N
authors.lastname: Kumar
authors.forename: Jean
authors.initials: J
authors.lastname: Francis
authors.forename: Joline L T
authors.initials: JL
authors.lastname: Chen
mesh_terms: D015415:Biomarkers / Q000097:blood; D001900:Boston; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D015536:Down-Regulation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects*; D016015:Logistic Models; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008274:Magnesium