Dietary magnesium intake and metabolic syndrome in the adult population: dose-response meta-analysis and meta-regression

Sang-Yhun Ju, Whan-Seok Choi, Sun-Myeong Ock, Chul-Min Kim, Do-Hoon Kim, Sang-Yhun Ju, Whan-Seok Choi, Sun-Myeong Ock, Chul-Min Kim, Do-Hoon Kim

Abstract

ncreasing evidence has suggested an association between dietary magnesium intake and metabolic syndrome. However, previous research examining dietary magnesium intake and metabolic syndrome has produced mixed results. Our objective was to determine the relationship between dietary magnesium intake and metabolic syndrome in the adult population using a dose-response meta-analysis. We searched the PubMed, Embase and the Cochrane Library databases from August, 1965, to May, 2014. Observational studies reporting risk ratios with 95% confidence intervals (CIs) for metabolic syndrome in ≥ 3 categories of dietary magnesium intake levels were selected. The data extraction was performed independently by two authors, and the quality of the studies was evaluated using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). Based on eight cross-sectional studies and two prospective cohort studies, the pooled relative risks of metabolic syndrome per 150 mg/day increment in magnesium intake was 0.88 (95% CI, 0.84-0.93; I(2) = 36.3%). The meta-regression model showed a generally linear, inverse relationship between magnesium intake (mg/day) and metabolic syndrome. This dose-response meta-analysis indicates that dietary magnesium intake is significantly and inversely associated with the risk of metabolic syndrome. However, randomized clinical trials will be necessary to address the issue of causality and to determine whether magnesium supplementation is effective for the prevention of metabolic syndrome.

Figures

Figure 1
Figure 1
Study-specific risks ratios (RRs) and 95% CIs of metabolic syndrome risk according to study-specific levels of dietary magnesium intake. Depending on available information, the median, midpoints or means of the categories were used for defining study-specific levels of magnesium intake categories (mg/day). The vertical axis is on a log scale.
Figure 2
Figure 2
(a) Association between the risk of metabolic syndrome and dietary magnesium intake: dose-response meta-regression. The levels of magnesium intake (mg/day) were modeled using a linear trend with random-effects meta-regression models. The solid black line represents the weighted regression line based on variance-weighted least squares. The gray line shows the 95% CI around the regression line. The circles indicate RRs in each study. The circle size is proportional to the precision of the RR. The vertical axis is on a log scale. (b) Forest plots of the risks ratios (RRs) of metabolic syndrome per 150 mg/day increment in dietary magnesium intake (n = 30,092) using a random-effects analysis. The squares represent study-specific RR (the square sizes are proportional to the weight of each study in the overall estimate); the horizontal lines represent 95% confidence intervals (CIs); and the diamond represents the overall RR estimate with the 95% CI.
Figure 3
Figure 3
Relative risk for metabolic syndrome per 150 mg/day increment in dietary magnesium intake according to different study-level characteristics. * p > 0.05 from meta-regression analyses on each of the covariates; FFQ, food frequency questionnaires; NCEP-ATP III, National Cholesterol Education Program and Adult Treatment Panel III; the key sets of covariates indicate age, sex, obesity, smoking, alcohol intake, exercise and calorie intake: ++, the key sets of covariates were adequately confirmed and adjusted for during the analysis phase; +, although the existence of major confounding variables were confirmed, the key sets of covariates were not adequately considered during the design and analytic phases.

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