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Review
. 2013;8(3):e57720.
doi: 10.1371/journal.pone.0057720. Epub 2013 Mar 8.

Magnesium and the risk of cardiovascular events: a meta-analysis of prospective cohort studies

Xinhua Qu  1 , Fangchun Jin, Yongqiang Hao, Huiwu Li, Tingting Tang, Hao Wang, Weili Yan, Kerong Dai
Affiliations
Review

Magnesium and the risk of cardiovascular events: a meta-analysis of prospective cohort studies

Xinhua Qu et al. PLoS One. 2013.

Abstract

Background: Prospective studies that have examined the association between dietary magnesium intake and serum magnesium concentrations and the risk of cardiovascular disease (CVD) events have reported conflicting findings. We undertook a meta-analysis to evaluate the association between dietary magnesium intake and serum magnesium concentrations and the risk of total CVD events.

Methodology/principal findings: We performed systematic searches on MEDLINE, EMBASE, and OVID up to February 1, 2012 without limits. Categorical, linear, and nonlinear, dose-response, heterogeneity, publication bias, subgroup, and meta-regression analysis were performed. The analysis included 532,979 participants from 19 studies (11 studies on dietary magnesium intake, 6 studies on serum magnesium concentrations, and 2 studies on both) with 19,926 CVD events. The pooled relative risks of total CVD events for the highest vs. lowest category of dietary magnesium intake and serum magnesium concentrations were 0.85 (95% confidence interval 0.78 to 0.92) and 0.77 (0.66 to 0.87), respectively. In linear dose-response analysis, only serum magnesium concentrations ranging from 1.44 to 1.8 mEq/L were significantly associated with total CVD events risk (0.91, 0.85 to 0.97) per 0.1 mEq/L (P(nonlinearity)= 0.465). However, significant inverse associations emerged in nonlinear models for dietary magnesium intake (P(nonlinearity)= 0.024). The greatest risk reduction occurred when intake increased from 150 to 400 mg/d. There was no evidence of publication bias.

Conclusions/significance: There is a statistically significant nonlinear inverse association between dietary magnesium intake and total CVD events risk. Serum magnesium concentrations are linearly and inversely associated with the risk of total CVD events.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Dietary magnesium intake, serum magnesium concentrations, and the risk of total CVD events.
(A) Dietary magnesium intake; (B) Serum magnesium concentrations. Adjusted relative risks for the association between dietary magnesium intake and serum magnesium concentrations (highest vs. lowest categories) and the risk of total CVD events were sorted by statistical size, defined by the inverse of the variance of the relative risks. CI = confidence interval; RR = relative risk. *Male participants. †Female participants. ‡CVD death outcomes. §CHD outcomes.
Figure 2
Figure 2. Dose-response relationship between dietary magnesium intake and serum magnesium concentrations and the risk of total CVD events.
Relative risk (solid line) with 95% confidence interval (long dashed lines) for the association of dietary magnesium intake and serum magnesium concentrations with risk of total CVD events in a restricted cubic spline random-effects meta-analysis. The short dashed line represents the simpler linear model. The lowest values of 152 mg/d of dietary magnesium and 1.44 mEq/L of serum magnesium were used to re-estimate all relative risks.
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Grants and funding

This study was supported by Fund for National Basic Research Program of China (Grant No. 2012CB619101), Major Basic Research of Science and Technology Commission of Shanghai Municipality (Grant No. 11DJ1400303), and Key Disciplines of Shanghai Municipal Education Commission (Grant No. J50206). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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