Magnezyum ve Formları
Özet
Magnezyum, insan vücudunda potasyumdan sonra en bol bulunan ikinci intraselüler katyon olup enerji üretimi, protein sentezi ve kas-sinir fonksiyonları gibi yüzlerce metabolik süreçte kritik roller üstlenir. Yetişkin bir bireyde ortalama 20-28 gram miktarında bulunur ve bu deposunun %99'u kemik ile kaslarda yer alırken, sadece %1'i kanda ölçülebilir. Günlük alım gereksinimi cinsiyete göre 300-400 mg arasında değişmekle birlikte gebelik ve stres gibi durumlarda ihtiyaç artar. Vücuttaki magnezyum dengesi böbrekler, bağırsaklar ve kemikler aracılığıyla hassas bir şekilde yönetilir; ancak rutin kan testleri dokulardaki gerçek eksikliği her zaman yansıtmaz. Magnezyum eksikliği; insülin direnci, tip 2 diyabet, hipertansiyon, migren ve fibromiyalji gibi pek çok kronik hastalıkla ilişkilidir. Tedavide kullanılan magnezyum formlarının biyoyararlanımı farklılık gösterir; magnezyum sitrat kabızlık ve enerji için, glisinat sakinleşme ve uyku kalitesi için, malat kronik ağrılar için ve threonat beyin fonksiyonlarını desteklemek için tercih edilir. Genel sağlık üzerinde hayati öneme sahip olan bu mineralin doğru formda ve yeterli düzeyde alınması, metabolik dengenin korunması açısından temel bir gerekliliktir.
Magnesium is the second most abundant intracellular cation in the human body after potassium, playing critical roles in hundreds of metabolic processes such as energy production, protein synthesis, and muscle-nerve function. An average adult possesses 20-28 grams of magnesium, with 99% of this storage located in bones and muscles, while only 1% is measurable in the blood. Although daily requirements range from 300-400 mg depending on gender, needs increase during conditions like pregnancy and stress. The body's magnesium balance is delicately managed through the kidneys, intestines, and bones; however, routine blood tests do not always reflect the actual deficiency in tissues. Magnesium deficiency is associated with many chronic diseases, including insulin resistance, type 2 diabetes, hypertension, migraines, and fibromyalgia. The bioavailability of magnesium forms used in treatment varies; magnesium citrate is preferred for constipation and energy, glycinate for relaxation and sleep quality, malate for chronic pain, and threonate for supporting brain functions. Having vital importance for overall health, obtaining this mineral in the correct form and at adequate levels is a fundamental requirement for maintaining metabolic balance.
Referanslar
Barbagallo, M., Veronese, N., Dominguez, LJ. Magnesium in Aging, Health and Diseases. Nutrients, 2021;30;13(2):463. doi: 10.3390/nu13020463.
Shrimanker, I., Bhattarai, S. Electrolytes. 2021 Jul 26. In: StatPearls [Internet]. Treasure Island (FL). https://www.ncbi.nlm.nih.gov/books/NBK541123/
Jahnen-Dechent, W., Ketteler, M. Magnesium basics. Clin Kidney J, 2012;5(1):3–14.
De Baaij, J.H., Hoenderop, J.G., Bindels, RJ. Magnesium in man: implications for health and disease. Physiol Rev, 2015;95:1–46.
Schuchardt, J.P., Hahn, A. Intestinal absorption and factors influencing bioavailability of magnesium—an update. Curr Nutr Food Sci, 2017;13(4):260–278
Gragossian, A., Bashir, K., Friede, R. Hypomagnesemia. 2021 Nov 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29763179.
Mathew, A.A., Panonnummal, R. Magnesium'-the master cation-as a drug-possibilities and evidences. Biometals. 2021;34(5):955-986. doi: 10.1007/s10534-021-00328-7.
Banerjee, S., Jones, S. Magnesium as an Alternative or Adjunct to Opioids for Migraine and Chronic Pain: A Review of the Clinical Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017 Apr 20. PMID: 29334449.
Fiorentini, D., Cappadone, C., Farruggia, G. Magnesium: Biochemistry, Nutrition, Detection, and Social Impact of Diseases Linked to Its Deficiency. Nutrients, 2021;30;13(4):1136. doi: 10.3390/nu13041136.
Laires, MJ., Monteiro, C.P., Bicho, M. Role of cellular magnesium in health and human disease. Front Biosci, 2004;1;9:262-76. doi: 10.2741/1223.
Wallach, S. Availability of body magnesium during magnesium deficiency. Magnesium, 1988;7(5-6):262-270.
Mascarenhas, R., Vashistha, H., Kumbala, D. Magnesium Disorders. Hosp Med Clin, 2015; 549-564.
Meneely, R., Leeper, L., Ghishan, F.K. Intestinal maturation: in vivo magnesium transport. Pediatr Res, 1982;16(4 Pt 1):295-8. doi: 10.1203/00006450-198204000-00010.
Vanoni, F.O., Milani, G.P., Agostoni, C. Magnesium Metabolism in Chronic Alcohol-Use Disorder: Meta-Analysis and Systematic Review. Nutrients, 2021;7;13(6):1959. doi: 10.3390/nu13061959.
Maguire, D., Talwar, D., Shiels, P.G. The role of thiamine dependent enzymes in obesity and obesity related chronic disease states: A systematic review. Clin Nutr ESPEN, 2018;25:8-17. doi: 10.1016/j.clnesp.2018.02.007.
Makhsudov, J., Yilmaz, R. Çocuklarda D Vitamini Eksikliği: Çocuklarda D Vitamini Eksikliği. Chronicles of Precision Medical Researchers, 2020;1(1), 8-19.
Cazzola, R., Della Porta, M., Manoni, M. Going to the roots of reduced magnesium dietary intake: A tradeoff between climate changes and sources. Heliyon, 2020;3;6(11):e05390. doi: 10.1016/j.heliyon.2020.e05390.
Arnaud, M.J. Update on the assessment of magnesium status. Br J Nutr, 2008;99 Suppl 3:S24-36. doi: 10.1017/S000711450800682X.
Witkowski, M., Hubert, J., Mazur, A. Methods of assessment of magnesium status in humans: a systematic review. Magnesium Res, 2011;24:163-180.
Workinger, J.L., Doyle, R.P., Bortz, J. Challenges in the Diagnosis of Magnesium Status. Nutrients, 2018;10(9):1202. doi:10.3390/nu10091202
Saha, H., Harmoinen, A., Pietilä, K. Measurement of serum ionized versus total levels of magnesium and calcium in hemodialysis patients. Clin Nephrol, 1996;46(5):326-331.
Soliman, H.M., Mercan, D., Lobo, S.S. Development of ionized hypomagnesemia is associated with higher mortality rates. Crit Care Med, 2003;31(4):1082-1087.
Elin, R.J. Assessment of magnesium status for diagnosis and therapy. Magnes Res, 2010; 23(4):194–198.
Huijgen, H.J., Soesan, M., Sanders, R., Mairuhu, W. M., Kesecioglu, J., & Sanders, G. T. Magnesium levels in critically ill patients: What should we measure?. Am J Clin Pathol, 2000;114(5), 688-695.
Elin, R.J., Hosseini, J.M., Gill, J.R. Erythrocyte and mononuclear blood cell magnesium concentrations are normal in hypomagnesemic patients with chronic renal magnesium wasting. J Am Coll Nutr, 1994; 13: 463–466.
Mazur, A., Felgines, C., Feillet, C. Parenteral magnesium loading test in the assessment of magnesium status in healthy adult French subjects. Magnes Res, 1997;10(1):59-64.
Winarno, G.N.A., Pribadi, A., Maruli, H.J. Ratio of Serum Calcium to Magnesium Levels on Pregnancy with and without Preeclampsia. Med Sci Monit, 2021;12;27:e932032. doi: 10.12659/MSM.932032.
Córdova, A., Mielgo-Ayuso, J., Roche, E. Impact of Magnesium Supplementation in Muscle Damage of Professional Cyclists Competing in a Stage Race. Nutrients, 2019;16;11(8):1927. doi: 10.3390/nu11081927.
Al Alawi, A.M., Majoni, S.W., Falhammar, H. Magnesium and Human Health: Perspectives and Research Directions. Int J Endocrinol, 2018;16;2018:9041694. doi: 10.1155/2018/9041694.
Pilchova, I., Klacanova, K., Tatarkova, Z. The Involvement of Mg2+ in Regulation of Cellular and Mitochondrial Functions. Oxid Med Cell Longev, 2017;2017:6797460. doi: 10.1155/2017/6797460.
Uwitonze, A.M., Razzaque, M. S. Role of magnesium in vitamin D activation and function. J Am Osteopath Assoc, 2018;118.3: 181-189.
Maguire, D., Catchpole A., Sheerin, O. The relation between acute changes in the systemic inflammatory response and circulating thiamine and magnesium concentrations after elective knee arthroplasty. Sci Rep, 2021;28;11(1): 1-10.
Manialawy, Y., Khan, S.R., Bhattacharjee, A. The magnesium transporter NIPAL1 is a pancreatic islet-expressed protein that conditionally impacts insulin secretion. J Biol Chem, 2020;17;295(29):9879-9892. doi: 10.1074/jbc.RA120.013277.
Abdulkerim, K.B., Belviranlı, Muaz. Serum levels of calcium, selenium, magnesium, phosphorus, chromium, copper and iron–their relation to zinc in rats with induced hypothyroidism. Acta Clin Croat, 2013;52(2): 151-156.
Zhang, J., Berra-Romani, R., Sinnegger-Brauns, M.J. Role of Cav1.2 L-type Ca2+ channels in vascular tone: effects of nifedipine and Mg2+. Am J Physiol Heart Circ Physiol, 2007;292(1):415-425. doi: 10.1152/ajpheart.01214.2005.
Liotta, E.M., Prabhakaran, S., Sangha, R.S. Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage. Neurology, 2017;89(8), 813-819.
Houston, M. The role of magnesium in hypertension and cardiovascular disease. J Clin Hypertens (Greenwich), 2011;13(11): 843-847.
Srebro, D., Vuckovic, S., Milovanovic, A. Magnesium in Pain Research: State of the Art. Curr Med Chem, 2017;24(4):424-434. doi: 10.2174/0929867323666161213101744.
https://tr.wikipedia.org/wiki/Na%2B/K%2B-ATPaz
Apell, H.J., Hitzler, T., Schreiber, G. Modulation of the Na,K-ATPase by Magnesium Ions. Biochemistry, 2017;21;56(7):1005-1016. doi: 10.1021/acs.biochem.6b01243.
Dalton, L.M., Ní Fhloinn, D.M., Gaydadzhieva, G.T. Magnesium in pregnancy. Nutr Rev, 2016;74(9):549-57. doi: 10.1093/nutrit/nuw018.
Cascella, M., Vaqar, S. Hypermagnesemia. 2021 Nov 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 31747218.
Bayramoğlu, E., Keskin, M., Aycan, Z. Long-term Clinical Follow-up of Patients with Familial Hypomagnesemia with Secondary Hypocalcemia. J Clin Res Pediatr Endocrinol, 2021;23;13(3):300-307. doi: 10.4274/jcrpe.galenos.2021.2020.0192.
Iwasaki, Y., Asai, M., Yoshida, M. Impaired parathyroid hormone response to hypocalcemic stimuli in a patient with hypomagnesemic hypocalcemia. J Endocrinol Invest, 2007;30(6):513-6. doi: 10.1007/BF03346336.
Manuel, y K.B., Moorkens, G., Vertommen, J. Magnesium status and parameters of the oxidant-antioxidant balance in patients with chronic fatigue: effects of supplementation with magnesium. J Am Coll Nutr, 2000;19(3):374-82.
Ozcaliskan, I. H., Sahin, H., Tanriverdi, F. Association Between Magnesium Status, Dietary Magnesium Intake, and Metabolic Control in Patients with Type 2 Diabetes Mellitus. J Am Coll Nutr, 2019;38(1):31-39. doi: 10.1080/07315724.2018.1476194.
Kirii, K., Iso, H., Date, C. JACC Study Group. Magnesium intake and risk of self-reported type 2 diabetes among Japanese. J Am Coll Nutr, 2010;29(2):99-106. doi: 10.1080/07315724.2010.10719822. PMID: 20679144.
Hopping, B.N., Erber, E., Grandinetti, A. Dietary fiber, magnesium, and glycemic load alter risk of type 2 diabetes in a multiethnic cohort in Hawaii. J Nutr, 2010;140(1):68-74. doi: 10.3945/jn.109.112441. Epub 2009 Nov 4.
Blancquaert, L., Vervaet, C., Derave, W. Predicting and Testing Bioavailability of Magnesium Supplements. Nutrients, 2019;20;11(7):1663. doi: 10.3390/nu11071663.
Uysal, N., Kizildag, S., Yuce, Z. Timeline (Bioavailability) of Magnesium Compounds in Hours: Which Magnesium Compound Works Best? Biol Trace Elem Res, 2019;187(1):128-136. doi: 10.1007/s12011-018-1351-9.
Lindberg, J.S., Zobitz, M.M., Poindexter, J.R. Magnesium bioavaila¬bility from magnesium citrate and magnesium oxide. J Am Coll Nutr, 1990;9:48-55.
Boyle, N.B., Lawton, C., Dye, L. The effects of magnesium supplementation on subjective anxiety and stress—a systematic review. Nutrients, 2017;26;9(5):429. doi: 10.3390/nu9050429.
Abraham, G.E., Flechas, J.D. Management of fibromyalgia: rationale for the use of magnesium and malic acid. J Nutr Med, 1992; 3(1):49–59.
Zhao, L., Lou, J.S., Kang, Y. Taurine-magnesium coordination compound at¬tenuates hypoxia/reoxygenation induced Ion channel dysfunction in rat ventricular myocytes. Drug Res (Stuttg), 2013 63(4):185-91. doi: 10.1055/s-0033-1334881.
Eby, G.A., Eby, K.L. Rapid recovery from major depression using magnesium treatment. Med Hypotheses, 2006;67(2):362-370.
Slutsky, I., Abumaria, N., Wu, L.J. Enhancement of learning and me¬mory by elevating brain magnesium. Neuron, 2010;28;65(2):165-77.
Özata, M. Magnezyumun iyileştirici gücü (1). İstanbul: Efe Akademi; 2021.1-117.