Serum Magnesium Concentrations and All-cause, Cardiovascular, and Cancer Mortality among U.S. Adults: Results from The NHANES I Epidemiologic Follow-up Study

Abstract

Background Few studies have examined the associations of serum magnesium (Mg) concentrations with total and cause-specific mortality in a nationally representative sample of US adults. We investigate the dose–response relationships of baseline serum Mg concentrations with risk of mortalities in a large, nationally representative sample of US adults. Methods We analyzed prospective data of 14,353 participants aged 25–74 years with measures of serum Mg concentrations at baseline (1971–1975) from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study (NHEFS). Mortality data was linked through December 31, 2011. We estimated the mortality hazard ratios (HRs), for participants within serum Mg categories of <0.7, 0.7–0.74, 0.75–0.79, 0.8–0.89 (referent), 0.9–0.94, 0.95–0.99, and ≥1.0 mmol/L using weighted multivariate-adjusted Cox proportional hazards models. Results During a median follow-up of 28.6 years, 9012 deaths occurred, including 3959 CVD deaths, 1923 cancer deaths, and 708 stroke deaths. The multivariate-adjusted HRs (95% CIs) of all-cause mortality across increasing categories of Mg were 1.34 (1.02, 1.77), 0.94 (0.75, 1.18), 1.08 (0.97, 1.19), 1.00 (referent), 1.05 (0.95, 1.16), 0.96 (0.79, 1.15), and 0.98 (0.76, 1.26). Similar trends were observed for cancer (HRs for serum Mg < 0.7: 1.39, 95% CI: 0.83, 2.32) and CVD mortality (HRs for serum Mg < 0.7: 1.28, 95% CI: 0.81, 2.02) but were not statistically significant. An elevated risk for stroke mortality was observed among participants with serum Mg < 0.70 mmol/L (HR: 2.55, 95% CI: 1.18, 5.48). Conclusions Very low serum Mg concentrations were significantly associated with an increased risk of all-cause mortality in US adults.