Mg status in inflammation, insulin resistance, and associated conditions

Magnesium (Mg), an essential ion for the human body, is involved in various enzymatic reactions, particularly those related to energy transfer, storage, and transport. Longitudinal studies show that hypomagnesaemia (Mg serum concentration <0.75 mmol/L) and Mg dietary inadequacy (daily intake < EAR (Estimated Average Requirement) for age/gender) are conditions related to metabolic disorders of the immune and cardiovascular system and often occur in obese and diabetic individuals. Poor eating habits, reduced Mg content in food and water are the main causes of the decrease in Mg intake by the general population. In clinical practice, the serum concentration of this mineral is the most widely used marker for diagnosing deficiency. However, the serum concentration does not reflect the nutritional Mg status since it can be maintained by mobilization of body storage, mainly the bone. Thus, the use of serum concentration as the only routine biomarker of Mg status may hinder the diagnosis of Mg deficiency. In clinical and experimental research, different methods for Mg status assessment are proposed (plasma, erythrocyte, urine), but they are seldom used in clinical routine. In some countries (such as USA and Brazil) the average daily Mg dietary ingestion of more than 60% of the adult population is lower than the Estimated Average Requirement for age and gender, and these data are not too different for individuals with chronic non-communicable diseases. It is unclear whether it is an actual reduction of Mg consumption or if the recommendations are overestimated. If we assume that the recommendations are correct, the question is if this condition constitutes a risk factor for chronic diseases or the hypomagnesemia described in some diseases is a consequence of physiopathological changes. This review has the latest information of human and animal studies about Mg status evaluated from plasma, erythrocyte and urine, dietary inadequacy, and its relation to inflammation and to components of metabolic syndrome.