REVIEW ARTICLES   

Panminerva Medica 2001 September;43(3):177-209

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Hypomagnesemia. A review of pathophysiological, clinical and therapeutical aspects

Iannello S., Belfiore F.

From the Institute of Internal Medicine and Internal Specialties, Chair of Internal Medicine, University of Catania Medical School, Garibaldi Hospital, Catania, Italy

The aim of ­this ­paper is to dis­cuss, on the ­basis of an exten­sive lit­er­a­ture ­review, the ­role of mag­ne­sium (Mg) in ­health and dis­ease. Mg is an essen­tial ­cation ­playing a cru­cial ­role in ­many ­enzyme ­systems. Quantitative Mg ­body ­stores are reg­u­lated by meta­bolic and hor­monal ­effects on gas­troin­tes­tinal absorp­tion and ­renal excre­tion. Mg is a ­smooth ­muscle ­relaxant, ­dilates cor­o­nary ­arteries and periph­eral ves­sels, ­exerts anti­ar­rhythmic ­effects, may ­have a per­mis­sive ­effect on cat­e­chol­a­mine ­actions and can ­play a ­role in var­ious throm­bo­genic con­di­tions. Today, hypo­mag­ne­semia has ­become a rec­og­nized med­ical occur­rence ­which may be asso­ciated ­with ­many dif­ferent dis­eases, ­either ­genetic or ­acquired. Mg defi­ciency is one of the ­most fre­quent elec­tro­lyte abnor­mal­ities in clin­ical prac­tice, but it is prob­ably the ­most under­di­ag­nosed one. Clinical man­i­fes­ta­tions of hypo­mag­ne­semia may ­begin insid­i­ously or ­with dra­matic sud­dennes. A ­large ­part of the pop­u­la­tion (espe­cially ­aged sub­jects) may ­have an inad­e­quate Mg ­intake and a ­chronic ­latent Mg defi­ciency. Routine inclu­sion of ­serum Mg anal­ysis in the elec­tro­lyte ­panel rep­re­sents a con­tinued ­need to rec­og­nize hypo­mag­ne­semia and to ­treat Mg-­depleted ­patients. New clin­ical ­studies on Mg defi­ciency are nec­es­sary to ascer­tain the use­ful­ness and ­cost-effec­tive­ness of Mg replace­ment ­therapy.