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      Serum magnesium and stable asthma: Is there a link?

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          Abstract

          Background:

          Although magnesium is used through intravenous and inhalation route in the management of asthma, actual prevalence of hypomagnesemia in asthma is not known. We conducted this study: 1) to detect the prevalence of hypomagnesemia in stable asthma and 2) to assess the significance of hypomagnesemia in these patients.

          Design:

          Prospective clinical study.

          Setting:

          Department of Respiratory Medicine, Calcutta National Medical College, Kolkata.

          Period of Study:

          Four months from January, 2007, to April, 2007.

          Materials and Methods:

          Fifty patients attending outpatients department of respiratory medicine with stable asthma were randomly selected. They were assessed clinically and their serum magnesium levels were measured. This was compared with the serum magnesium values of 45 nonasthmatic healthy controls.

          Results:

          Out of 50 patients, 14 had hypomagnesemia. Possible relationship of hypomagnesemia with tachycardia, tachypnoea, severity of asthma, medication use, and previous and future exacerbations were analyzed.

          Conclusion:

          There was statistically significant association of hypomagnesemia with tachypnoea, severe asthma, use of long-acting β-agonist, inhaled corticosteroids, theophylline, use of ≥ 3 medications, previous and future exacerbations but not with tachycardia or use of short-acting β 2 -agonist or montelukast.

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          Most cited references24

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          The nature of the neuromuscular block produced by magnesium.

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            Magnesium: its proven and potential clinical significance.

            Magnesium is the fourth most abundant cation in the body and is present in more than 300 enzymatic systems, where it is crucial for adenosine triphosphate (ATP) metabolism. Deficiency states result in increased insulin resistance, as well as increased smooth muscle and platelet reactivity. Magnesium deficiency has been shown to correlate with a number of chronic cardiovascular diseases, including hypertension, diabetes mellitus, and hyperlipidemia. Intravenous magnesium has been used therapeutically in critical situations such as status asthmaticus, torsades de pointes, and preeclampsia. Few controlled studies exist regarding the therapeutic uses of oral magnesium supplementation in chronic cardiovascular diseases. Randomized clinical trials are urgently needed to determine whether magnesium supplementation will alter the natural history of these disease states.
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              Effect of magnesium chloride on rabbit bronchial smooth muscle.

              The objective of this study was to determine the extent to which magnesium relaxes bronchial smooth muscle during induced contraction. An in-vitro model using bronchial rings from New Zealand White rabbits stimulated to contract by electrical stimulation, histamine, or bethanechol. Magnesium chloride 1, 6, 16, 36, and 86 mM was added to each tissue bath and resting tension was measured. Electrical stimulation 100 V/100 ms, histamine 10 mM, or bethanechol 6.25 mM was added to washed tissues to induce contraction. This was followed with magnesium chloride 5, 10, and 50 mM, and the response of bronchial smooth muscle was measured. Magnesium chloride 1, 6, 16, 36, and 86 mM decreased the mean +/- SEM resting tension of bronchial rings by 40 +/- 16, 100 +/- 11, 110 +/- 10, 170 +/- 9, and 275 +/- 22 mg, respectively. Electrical stimulation (4) of 100 V/100 ms increased the mean +/- SEM resting tension by 168 +/- 52 mg. Magnesium chloride 5, 15, and 50 mM added to the tissue bath decreased the response to 100 V/100 ms to 65 +/- 27, 40 +/- 23, and 1 +/- 0 mg, respectively. Histamine 10 mM (4) increased mean +/- SEM resting tension by 490 +/- 121 mg. Magnesium chloride 5, 15, and 50 mM decreased the histamine response by 80 +/- 56, 250 +/- 74, and 475 +/- 131 mg, respectively. Bethanechol 6.25 mM (14) increased the mean +/- SEM resting tension by 495 +/- 74 mg. Magnesium chloride (5, 15, 50 mM) decreased bethanechol-induced tension by 52 +/- 18, 184 +/- 26, and 506 +/- 64 mg, respectively. Magnesium chloride produced dose-dependent relaxation of bronchial smooth muscle at rest and when stimulated by histamine, bethanechol, or electrical impulse. Calcium chloride was unable to significantly reverse magnesium-induced relaxation. These data support the hypothesis that magnesium relaxes smooth muscle and dilates bronchial rings.
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                Author and article information

                Journal
                Lung India
                LI
                Lung India : Official Organ of Indian Chest Society
                Medknow Publications (India )
                0970-2113
                0974-598X
                Oct-Dec 2010
                : 27
                : 4
                : 205-208
                Affiliations
                Department of Respiratory Medicine, North Bengal Medical College, Susruta Nagar, Darjeeling, India
                [1 ] Department of Critical Care Medicine, Columbia Asia Hospital, Kolkata, India
                [2 ] Department of Respiratory Medicine, Calcutta National Medical College, Kolkata, India
                [3 ] Department of Respiratory Medicine, Calcutta National Medical College, Kolkata, India
                Author notes
                Address for correspondence: Dr. Sibes Kumar Das, Souhardya Appartment, 1 st Floor, Flat – A, West Bankimpally, Madhyamgram, Kolkata - 129, India. E-mail: sibesdas67@ 123456gmail.com
                Article
                LI-27-205
                10.4103/0970-2113.71944
                2988169
                21139715
                8fcdc1e0-53c3-43e8-aa53-1761771aceae
                © Lung India

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Original Article

                Respiratory medicine
                link,serum magnesium,stable asthma
                Respiratory medicine
                link, serum magnesium, stable asthma

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