title: Dose-response relationship between dietary magnesium intake and cardiovascular mortality: A systematic review and dose-based meta-regression analysis of prospective studies.
abstract: BACKGROUND
  Although epidemiology studies have reported the relationship, including a dose-response relationship, between dietary magnesium intake and risk of cardiovascular disease (CVD), the risk for CVD mortality is inconclusive and the evidence for a dose-response relationship has not been summarized.
  
  
  OBJECTIVE
  We conducted a systematic review and meta-analysis of prospective studies to summarize the evidence regarding the association of dietary magnesium intake with risk of CVD mortality and describe their dose-response relationship.
  
  
  METHODS
  We identified relevant studies by searching major scientific literature databases and grey literature resources from their inception to August 2015, and reviewed references lists of retrieved articles. We included population-based studies that reported mortality risks, i.e. relative risks (RRs), odds ratios (ORs) or hazard ratios (HRs) of CVD mortality or cause-specific CVD death. Linear dose-response relationships were assessed using random-effects meta-regression. Potential nonlinear associations were evaluated using restricted cubic splines.
  
  
  RESULTS
  Out of 3002 articles, 9 articles from 8 independent studies met the eligibility criteria. These studies comprised 449,748 individuals and 10,313 CVD deaths. Compared with the lowest dietary magnesium consumption group in the population, the risk of CVD mortality was reduced by 16% in women and 8% in men. No significant linear dose-response relationship was found between increment in dietary magnesium intake and CVD mortality across all the studies. After adjusting for age and BMI, the risk of CVD mortality was reduced by 24-25% per 100mg/d increment in dietary magnesium intake in women of all the participants and in all the US participants.
  
  
  CONCLUSIONS
  Although the combined data confirm the role of dietary magnesium intake in reducing CVD mortality, the dose-response relationship was only found among women and in US population.
authors.affiliation: Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden.
authors.forename: Xin
authors.initials: X
authors.lastname: Fang
authors.affiliation: Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, 200003 Shanghai, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Liang
authors.affiliation: Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, 200003 Shanghai, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Li
authors.affiliation: Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden; Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, 17177 Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, WC1E 6BT, UK.
authors.forename: Scott
authors.initials: S
authors.lastname: Montgomery
authors.affiliation: Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden; Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, 17177 Stockholm, Sweden.
authors.forename: Katja
authors.initials: K
authors.lastname: Fall
authors.affiliation: Faculty of Public Health, Hedmark University College, 2411 Elverum, Norway; Innlandet Hospital Trust, Kongsvinger Hospital Division, 2226 Kongsvinger, Norway.
authors.forename: Jan
authors.initials: J
authors.lastname: Aaseth
authors.affiliation: Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden. Electronic address: yang.cao@ki.se.
authors.forename: Yang
authors.initials: Y
authors.lastname: Cao
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality*; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008274:Magnesium / Q000008:administration & dosage* / Q000494:pharmacology*; D012727:Sex Characteristics; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology
chemical_list: D008274:Magnesium
keywords: Cardiovascular mortality; Dietary intake; Magnesium; Meta-analysis; Meta-regression; Prospective study