title: Dose-Response Relationship between Dietary Magnesium Intake and Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Regression Analysis of Prospective Cohort Studies.
abstract: The epidemiological evidence for a dose-response relationship between magnesium intake and risk of type 2 diabetes mellitus (T2D) is sparse. The aim of the study was to summarize the evidence for the association of dietary magnesium intake with risk of T2D and evaluate the dose-response relationship. We conducted a systematic review and meta-analysis of prospective cohort studies that reported dietary magnesium intake and risk of incident T2D. We identified relevant studies by searching major scientific literature databases and grey literature resources from their inception to February 2016. We included cohort studies that provided risk ratios, i.e., relative risks (RRs), odds ratios (ORs) or hazard ratios (HRs), for T2D. Linear dose-response relationships were assessed using random-effects meta-regression. Potential nonlinear associations were evaluated using restricted cubic splines. A total of 25 studies met the eligibility criteria. These studies comprised 637,922 individuals including 26,828 with a T2D diagnosis. Compared with the lowest magnesium consumption group in the population, the risk of T2D was reduced by 17% across all the studies; 19% in women and 16% in men. A statistically significant linear dose-response relationship was found between incremental magnesium intake and T2D risk. After adjusting for age and body mass index, the risk of T2D incidence was reduced by 8%-13% for per 100 mg/day increment in dietary magnesium intake. There was no evidence to support a nonlinear dose-response relationship between dietary magnesium intake and T2D risk. The combined data supports a role for magnesium in reducing risk of T2D, with a statistically significant linear dose-response pattern within the reference dose range of dietary intake among Asian and US populations. The evidence from Europe and black people is limited and more prospective studies are needed for the two subgroups.
authors.affiliation: Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden. xin.fang@ki.se.
authors.forename: Xin
authors.initials: X
authors.lastname: Fang
authors.affiliation: Department of Health Statistics, Second Military Medical University, Shanghai 200433, China. he_dong1102@126.com.
authors.forename: Hedong
authors.initials: H
authors.lastname: Han
authors.affiliation: Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. happyxiaoant@126.com.
authors.forename: Mei
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. chunliangliang@hotmail.com.
authors.forename: Chun
authors.initials: C
authors.lastname: Liang
authors.affiliation: Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China. Fan@pumch.cn.
authors.forename: Zhongjie
authors.initials: Z
authors.lastname: Fan
authors.affiliation: Faculty of Public Health, Hedmark University of Applied Sciences, Elverum 2411, Norway. jaol-aas@online.no.|Innlandet Hospital Trust, Kongsvinger Hospital Division, Kongsvinger 2226, Norway. jaol-aas@online.no.
authors.forename: Jan
authors.initials: J
authors.lastname: Aaseth
authors.affiliation: Department of Health Statistics, Second Military Medical University, Shanghai 200433, China. hejia63@yeah.net.
authors.forename: Jia
authors.initials: J
authors.lastname: He
authors.affiliation: Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro 70182, Sweden. scott.montgomery@regionorebrolan.se.|Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm 17177, Sweden. scott.montgomery@regionorebrolan.se.|Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK. scott.montgomery@regionorebrolan.se.
authors.forename: Scott
authors.initials: S
authors.lastname: Montgomery
authors.affiliation: Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden. yang.cao@ki.se.|Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro 70182, Sweden. yang.cao@ki.se.
authors.forename: Yang
authors.initials: Y
authors.lastname: Cao
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D004032:Diet; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008274:Magnesium / Q000008:administration & dosage*; D008275:Magnesium Deficiency / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D017711:Nonlinear Dynamics; D016017:Odds Ratio; D011446:Prospective Studies; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D008274:Magnesium
keywords: cohort study; dietary intake; magnesium; meta-analysis; prospective study; type 2 diabetes