Research Of Serum Magnesium On The Peripheral Nerve Function In Type 2 Diabetic Patients

Aims:This cross-sectional study aimed to evaluate the relationship between serum magnesium levels and peripheral nerve function in type 2 diabetes mellitus patients.Methods:In total,978 type 2 diabetes mellitus patients were recruited in our study.Nerve conduction studies were conducted in all participants.Composite z scores for nerve conduction parameters including conduction velocity,latency,and amplitude were calculated,respectively.F-wave of the peroneal,tibial,median and ulnar nerves were measured in type 2 diabetes mellitus patients.Variables analyzed contained F-wave minimum latency and persistence.Results:1.The patients with abnormal nerve conduction had lower serum magnesium levels than those with normal nerve conduction [0.87(0.82,0.92)vs.0.88(0.83,0.93)mmol/L,P = 0.048].2.Significant differences were observed in amplitude for motor tibial [6.10(3.90,8.13)vs.6.40(4.13,8.88)vs.6.60(4.63,9.38)mv,P = 0.046],sensory ulnar(P= 0.044)and sensory sural nerves(P = 0.012)among the three tertiles of serum magnesium.However,there was no significant difference in the conduction velocity and latency for all tested nerves.3.The post-hoc analysis using Bonferroni correction showed significant differences in the composite z score of amplitude between the medium and high tertile [(-0.48±0.03)vs.(-0.57±0.002),P = 0.047)] as well as between the low and high tertile [(-0.48±0.03)vs.(-0.60±0.002),P = 0.002)].Additionally,an increasing trend of composite z score of amplitude was accompanied by increased tertiles of magnesium(-0.60± 0.02 vs.-0.57± 0.02 vs.-0.48± 0.03,P for trend = 0.001).4.Multiple linear regression analysis showed that serum magnesium levels were still positively correlated with the composite z score of amplitude(? = 0.095,P = 0.014),after adjusting for all potential confounders(e.g.,age,sex,diabetes duration,HbA1 c,anti-hypertensive therapy,systolic blood pressure,diastolic blood pressure,urinary albumin excretion and estimated glomerular filtration rate).5.F-wave analysis demonstrated that F-wave minimum latency of the peroneal,tibial,median and ulnarnerves was significantly prolonged in the patients with abnormal nerve conduction(all P? 0.001).However,no difference was observed between the two groups in F-wave persistence(all P> 0.05).6.There were significant differences in F-wave minimum latency of the peroneal and tibial nerves among the three tertiles of serum magnesium(P = 0.015;P = 0.003).Spearman analysis indicated that F-wave minimum latency of the peroneal and tibial nerves were negatively correlated to serum magnesium levels(r=-0.099,P = 0.003;r=-0.068,P = 0.041).No difference was observed among the three tertiles in F-wave persistence(all P> 0.05).Conclusions:1.Decreased serum magnesium levels were significantly associated with lower composite z score of amplitude in type 2 diabetes mellitus patients,suggesting that serum magnesium might affect peripheral nerve function through axonal degeneration.2.In type 2 diabetes mellitus patients,the peripheral nerve function of the proximal segments in lower limbs was significantly associated with serum magnesium levels.The type 2 diabetes mellitus patients with higher serum magnesium could have better peripheral nerve function of the proximal segments in lower limbs.