Luiz Erlon Rodrigues

The Effect of Magnesium Supplementation in Increasing Doses on the Control of Type 2 Diabetes

OBJECTIVE Hypomagnesemia occurs in 25–38% of patients with type 2 diabetes. Several studies have suggested an association between magnesium (Mg) depletion and insulin resistance and/or reduction of insulin secretion in these cases. Our purpose was to evaluate if Mg supplementation (as magnesium oxide [MgO]) would improve metabolic control in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS We studied 128 patients with type 2 diabetes (32 men, 96 women, aged 30–69 years), treated by diet or diet plus oral antidiabetic drugs, in the Bahia Federal University Hospital, Brazil. Patients at risk for hypomagnesemia or with reduced renal function were excluded. This study was a clinical randomized double-blind placebo-controlled trial. Patients received either placebo, 20.7 mmol MgO, or 41.4 mmol MgO daily(elementary Mg) for 30 days. Mg concentrations were measured in plasma, in mononuclear cells, and in 24-h urine samples. Fasting blood glucose, HbA1, and fructosamine were used as parameters of metabolic control. RESULTS Of the patients, 47.7% had low plasma Mg, and 31.1% had low intramononuclear Mg levels. Intracellular Mg in patients with diabetes was significantly lower than in the normal population (62 blood donors; 1.4 ± 0.6 vs. 1.7 ± 0.6 μg/mg of total proteins). No correlation was found between plasma and intracellular Mg concentrations (r = −0.179; P = 0.15) or between Mg concentrations and glycemic control (r = −0.165; P = 0.12). Intracellular Mg levels were lower in patients with peripheral neuropathy than in those without (1.2 ± 0.5 vs. 1.5 ± 0.6 μg/mg). Similar findings were observed in patients with coronary disease (1.0 ± 0.5 vs. 1.5 ± 0.6 μg/mg). In the placebo and in the 20.7 mmol Mg groups, neither a change in plasma and intracellular levels nor an improvement in glycemic control were observed. Replacement with 41.4 mmol Mg tended to increase plasma, cellular, and urine Mg and caused a significant fall (4.1 ± 0.8 to 3.8 ± 0.7 mmol/1) in fructosamine (normal, 1.87–2.87 mmol/1). CONCLUSIONS Mg depletion is common in poorly controlled patientswith type 2 diabetes, especially in those with neuropathy or coronary disease. More prolonged use of Mg in doses that are higher than usual is needed toestablish its routine or selective administration in patients with type 2 diabetes to improve control or prevent chronic complications.

Serum and intracellular magnesium deficiency in patients with metabolic syndrome—Evidences for its relation to insulin resistance

This cross sectional study evaluated serum (SMg) and intramononuclear (MMg) magnesium in patients with metabolic syndrome without diabetes and correlated them with cardiovascular risk factors. 72 patients and 57 controls (blood donors) were studied. Hypomagnesemia (SMg<1.7 mg/dL) was seen in 23.2% and intracellular depletion in 36.1% of the patients. SMg and MMg means were significantly lower in patients than in controls: 1.80+/-0.18 mg/dL vs. 2.43+/-0.43 mg/dL and 0.98+/-0.55 microg/mg vs. 1.67+/-0.64 microg/mg of protein (P<0.001). Inverse correlation was observed between, SMg and MMg with BMI; SMg with systolic blood pressure and waist circumference in women. Patients with acanthosis nigricans had lower SMg (1.75+/-0.18 mg/dL vs. 1.85+/- 0.18 mg/dL, P<0.05). Non-white people had lower SMg (1.78+/-0.16 mg/dL vs. 1.92+/-0.24 mg/dL, P=0.007) and MMg (0.95+/-0.59 microg/mg vs. 1.13+/-0.42 microg/mg, P=0.03). Patients with IR showed lower MgM means (0.84+/-0.33 microg/mg vs. 1.14+/-0.69 microg/mg, P<0.05). The same occurred in patients with low HDL-c levels (0.92+/-0.46 microg/mg vs. 1.20+/-0.70 microg/mg, P=0.03), and those with moderate and severe hepatic steatosis (0.77+/-0.29 microg/mg vs. 1.21+/-0.80 microg/mg, P<0.05). In conclusion, magnesium depletion in serum and mononuclear cells is common in obese people with metabolic syndrome, and it is more evident in non-white people with insulin resistance. This depletion may contribute to a post-receptor insulin resistance.

Magnesium Replacement Does Not Improve Insulin Resistance in Patients With Metabolic Syndrome: A 12-Week Randomized Double-Blind Study

Background To evaluate the effect of magnesium (Mg) replacement on insulin resistance and cardiovascular risk factors in women with metabolic syndrome (MS) without diabetes. Methods This 12-week clinical randomized double-blind study compared the effects of 400 mg/day of Mg with those of a placebo (n = 72) on fasting glucose, insulin, HOMA-IR, lipid profile and CRP. Mg was measured in serum (SMg) and in mononuclear cells (MMg). Results Hypomagnesemia (SMg < 1.7 mg/dL) was seen in 23.2% of patients and intracellular depletion in 36.1% of patients. The MMg means were lower in patients with obesity (0.94 ± 0.54 μg/mg vs. 1.19 ± 0.6 μg/mg, P = 0.04), and insulin resistance (0.84 ± 0.33 μg/mg vs. 1.14 ± 0.69 µg/mg, P < 0.05). Mg replacement did not alter SMg (1.82 ± 0.14 mg/dL vs. 1.81 ± 0.16 mg/dL, P = 0.877) and tended to increment MMg (0.90 ± 0.40 μg/mg vs. 1.21 ± 0.73 μg/mg, P = 0.089). HOMA-IR did not alter in interventions nor in placebo group (3.2 ± 2.0 to 2.8 ± 1.9, P = 0.368; 3.6 ± 1.9 to 3.2 ± 1.8, respectively), neither did other metabolic parameters. Conclusion Serum and intracellular Mg depletion is common in patients with MS; however, Mg replacement in recommended dosage did not increase significantly Mg levels, neither reduced insulin resistance or metabolic control.

Opioid peptides and gastrointestinal symptoms in autism spectrum disorders

Autism spectrum disorders (ASDs) are characterized by deficits in the individual’s ability to socialize, communicate, and use the imagination, in addition to stereotyped behaviors. These disorders have a heterogenous phenotype, both in relation to symptoms and regarding severity. Organic problems related to the gastrointestinal tract are often associated with ASD, including dysbiosis, inflammatory bowel disease, exocrine pancreatic insufficiency, celiac disease, indigestion, malabsorption, food intolerance, and food allergies, leading to vitamin deficiencies and malnutrition. In an attempt to explain the pathophysiology involved in autism, a theory founded on opioid excess has been the focus of various investigations, since it partially explains the symptomatology of the disorder. Another hypothesis has been put forward whereby the probable triggers of ASDs would be related to the presence of bacteria in the bowel, oxidative stress, and intestinal permeability. The present update reviews these hypotheses.

Dieta afro-bahiana, estrés oxidativo y ejercício físico

OBJECTIVE: The aim of this study was to observe the protective role of a diet based on the culinary culture of Bahia State against an oxidative stress induced by strenuous exercise in 17 young and healthy individuals. METHODS: Meat, palm oil, fruit juices, roots, manioc flour and cereals are the main constituents of this diet. Dietary control had a span of four months. Before the dietetic regime started blood samples were collected from each individual both at rest and also five minutes after a bout of strenuous exercise. Samples were collected again both at rest and after the bout of strenuous exercise at the end of the dietary intervention. RESULTS: The oxidative status was assessed measuring catalase and superoxide dismutase activities in erythrocytes, and lipid peroxidation in membranes of these cells. These parameters were not affected by the diet when at rest. The strenuous exercise did not interfere with superoxide dismutase activities and lipid peroxidation before and after the dietary intervention. However, strenuous exercise induced an increase in catalase activities before and after the dietary regime (19.49 and 11.74% respectively). Moreover, this effect was significantly (p<0,05) less pronounced (26.11%) as a result of the diet. CONCLUSION: These data suggest that antioxidants present in the Bahia State diet can down-regulate the increase in catalase activity induced by strenuous exercise.

Relações da dieta ovo-lácteo-vegetariana com o exercício físico e as enzimas antioxidantes superóxido dismutase e catalase

OBJETIVO: O objetivo deste trabalho foi estudar a influencia da dieta ovo-lacteo-vegetariana e do exercicio fisico extenuante sobre as atividades das enzimas catalase e superoxido dismutase em dez individuos masculinos, jovens e saudaveis. METODOS: O controle alimentar aplicou-se por quatro meses. Antes disso, foram recolhidas amostras de sangue em estado basal e cinco minutos apos o exercicio fisico extenuante efetuado em esteira rolante. O mesmo procedimento foi aplicado apos o controle alimentar. RESULTADOS: Os resultados mostraram que a dieta ovo-lacteo-vegetariana, em condicoes de repouso, reduziu de forma significativa a atividade da enzima catalase em 18,98% (p<0,05) e aumentou, tambem de forma significativa, a atividade da enzima superoxido dismutase em 77,84% (p<0,001). Depois do exercicio fisico extenuante, a dieta ovo-lacteo-vegetariana reduziu a atividade da enzima catalase de forma significativa em 26,11% (p<0,05) e nao alterou a atividade da enzima superoxido dismutase. CONCLUSAO: Os resultados indicam que tanto as atividades da catalase como da superoxido dismutase sao sensiveis a uma dieta ovo-lacteo-vegetariana adequada.