SHORT
COMMUNICATION
Does Magnesium Dysbalance Participate in the
Development of Insulin Resistance in Early Stages of Renal
Disease?
K. ŠEBEKOVÁ, K. ŠTEFÍKOVÁ, D. POLAKOVIČOVÁ1,
V. SPUSTOVÁ, R. DZÚRIK
Institute of Preventive and Clinical Medicine and 1Derer's
Hospital, Bratislava, Slovak Republic
Received
September 10, 2001
Accepted May 22, 2002
Summary
We investigated the potential role of magnesium (Mg) dysbalance
in the pathogenesis of insulin resistance (IR) in patients with
mildly-to-moderately decreased renal function (creatinine:
142.8±11.0 mmol/l). The data were compared to those of 8 age-
and sex-matched healthy controls (CTRL). The standard oral
glucose tolerance test (oGTT) was performed in 61 patients.
Twenty-two patients were classified as IR according to their
values on fasting and after-load immunoreactive insulin
concentrations. Serum and total erythrocyte Mg (tErMg) (atomic
absorption spectro-photometry) and free erythrocyte Mg (fErMg)
concentrations (31P NMR spectroscopy) were determined prior to
and two hours after the glucose load. Ten out of 39
insulin-sensitive (IS) patients, but only one out of 22
insulin-resistant (IR) patients, had a low basal fErMg
concentration (<162.2 mmol/l, c2, p<0.01). IR patients had
higher serum Mg, total erythrocyte Mg and bound erythrocyte Mg
(bErMg) concentrations (both before and after glucose load) when
compared with the IS group. Both groups responded to the glucose
load with a significant decrease in serum Mg concentration
(within the normal range), while the IR group also exhibited a
decline in tErMg and bErMg. The mean sum of insulin needed to
metabolize the same glucose load correlated positively with
tErMg (r=0.545, p<0.01) and bErMg (r=0.560, p<0.01) in the IR
patients. It is concluded that, at an early stage of renal
dysfunction, IR is not associated with the decline in free
erythrocyte Mg concentration, but the magnesium handling in red
blood cells is altered.
Key
words
31P NMR spectroscopy · Erythrocyte · Magnesium ·
Insulin resistance · Obesity · Kidney Disease
Reprint
requests
K. Šebeková, MD. PhD.; Institute of Preventive and Clinical
Medicine, Limbová 14, 833 01 Bratislava, Slovak Republic. Fax:
+421-2-59369170. E-mail:
sebekova@.upkm.sk
|