jsmc-10116

SERUM MAGNESIUM LEVEL IN CHILDREN WITH BRONCHIAL ASTHMA IN DUHOK CITY 

Azad A. Haleem Al.Mezori a and Akrem M. Atrushi b 

a Department of Pediatrics, College of Medicine, University of Duhok, Duhok-Iraq. 

b Department of Surgery, College of Medicine, University of Duhok, Duhok-Iraq. 

Submitted: 6/3/2017; Accepted: 1/8/2017; Published: 15/8/2017

DOI Link: https://doi.org/10.17656/jsmc.10116

ABSTRACT

Background

Asthma is an increasingly common disease over the last century. It is caused by chronic inflammation of lung airways with increased airway responsiveness and airflow obstruction. Magnesium is the fourth most common cation in the body and the major intracellular divalent cation. Mg+2 in extracellular fluid is crucial for normal neuromuscular activities. Magnesium deficiency is associated with increased contractility of smooth muscle cells including bronchiolar resulting in bronchospasm.

Objectives

To detect the prevalence of hypomagnesemia among asthmatic children and to find out any significant correlation of hypomagnesemia with asthma in children.

Patients and Methods

A case control study conducted in Duhok, North of Iraq in the period between January the 1st 2014 and January  the 1st 2015. One hundred asthmatic patients aged between 1 and 15 years were examined. All patients had acute asthmatic attacks with features of respiratory distress for which they were admitted to Heevi Pediatric Teaching Hospital. Those with fever, dehydration, localized wheezing, pneumonia, cardiac, renal, or hepatic dysfunction were excluded. They were all studied in terms of age, gender, duration of asthma, drugs used for treatment, severity of asthma and the patients’ growth as measured by Body Mass index. Control group included 100 children who were healthy non asthmatic and visited the hospital with their parents. Samples of blood were taken to measure serum magnesium level.Statistical analysis were performed by using the SPSS 19 where P<0.05 is significant.

Results

The mean serum magnesium in patients group was 1.91± 0.33 mg/dl while in the control group it was 2.03± 0.33 mg/dl. Serum magnesium levels were lower in the asthmatic patients than controls P= 0.01. Male gender predominated in both groups (68% , 61%) and the most common age among cases was 1- < 3 years and controls 5- <10 years. Serum magnesium level indirectly correlated with duration of asthma but not significantly (P=0.1). Serum magnesium level was not significantly related to body mass index P=0.3.Serum magnesium level decreased with increasing severity of asthma symptoms P= 0.05. Serum level is slightly lower in asthmatics on steroids and bronchodilators than those who were not P=0.7, P=0.9 respectively. 

Conclusion

Serum magnesium level is significantly lower in asthmatic children as compared to the control group. Serum Mg+2 level decreases as the duration of asthma is longer but not significantly. There is an inverse relation between serum Mg+2 and the severity of asthma. No significant change in serum Mg+2 develops when steroids and bronchodilators are used.

KEYWORDS

Serum magnesium, Childhood Asthma, Duhok City.

References 

1. Burney PGJ, Chinn S, Rhona RJ. Has the prevalence of asthma increased in children? Evidence from the national study of health and growth. BMJ. 1990; 300: 1306-10

2. Omran M, Russell G, Continuing increase in respiratory symptoms and atopy in Aberdeen schoolchildren. BMJ. 1996; 312: 334-36

3. Seaton A, Godden DJ, Brown K. Increase in asthma: a more toxic environment or a more susceptible population. Thorax. 1994; 49: 171-74.

4. Seaton A, Soutar A, Mullins J. The increase in hay fever: pollen, particulate matter and SO2 in ambient air. Q J Med. 1996;89: 279-84.

5. Das SK, Haldar AK, Ghosh I, Saha SK, Das A, Biswas S.Serum magnesium and stable asthma: Is there a link?.Lung India. 2010; 27(4): 205–208.

6. Dominguez LJ, Barbagallo M, Dilorenzo G, Drago A, Scola S,  Morici G et al.  Bronchial reactivity and intracellular magnesium: a possible mechanism for the bronchodilating effects of magnesium in asthma. Clinical Science. 1998; 95;137- 142.

7. deValk HW, Kok PT, Struyvenberg A.  Extracellular and intracellular magnesium concentrations in asthmatic patients. EurRespir J. 1993;61122- 1125.

8. Skobeloff EM, Spivey WH,McNamara RM, Greenspon L.  Intravenous magnesium sulfate for the treatment of acute asthma in the emergency department. JAMA. 1989;262:1210- 1213.

9. Noppen M, VanmaeleL, Impens N, Schandevyl W. Bronchodilating effect of intravenous magnesium sulfate in acute severe bronchial asthma. Chest. 1990; 97: 373- 376.

10. Clark  MC, Wright GD, Falk JL.  Aerosolized magnesium sulfate as acute therapy for pediatric asthma. Ann Emerg Med. 1991;20448.

11. Pabon H, Monem G, KissoonN. Safety and efficacy of magnesium sulfate infusion in children with status asthmaticus. PediatrEmerg Care. 1994;10: 200- 20.

12. Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008; 31:143 78.

13. Agin K, Darjani H. Blood serum magnesium values in chronic stable asthmatic patients: a case-control study. Tanaffos. 2005;4 (13):27–32.

14. Alamoudi OS. Electrolyte disturbances in patients with chronic, stable asthma: effect of therapy. Chest. 2001;120(2): 431–436.

15. Alamoudi OS. Hypomagnesaemia in chronic, stable asthmatics: prevalence, correlation with severity and hospitalization. EurRespir J.2000; 16 (3): 427- 31.

16. Rolla G, Bucca C, Burgiani M, Oliva A, Branciforte L. Hypomagnesemia in chronic obstructive lung disease: effect of therapy. Magnes. Trace Elem. 1990;9: 132–136.

17. Haffner CA, Kendall MJ. Metabolic effects of b2 agonists. J. Clin. Pharm. Ther. 1992;17:155–164.

18. Lia L.Macro-and microelements imbalance in etiology and progression of bronchial asthma in children.LikSprava. 2013; 4:33 38.

19. Sedighi M, Pourpak Z, Bavarian B, Alizadeh RS, ZareA ,Moin M.Low Magnesium Concentration in Erythrocytes of Children with Acute Asthma. Iran J Allergy Asthma Immunol. 2006; 5(4): 183-186.

20. Ermis B, Armutcu F, Gurel A, Kart L, Demircan N, Altin R et al . Trace elements statusin children with bronchial asthma.European Journal of General Medicine. 2004; 1:4-8.

21. Amin M, Abdel-Fattah M,Zaghloul SS. Magnesium concentration in acute asthmatic children.Iran J Pediatr. 2012; 22(4): 463-7.

22. Picado C, Deulofeu R, Lleonart R, Agustí M, Mullol J, Quintó L et al.Dietary micronutrients/antioxidants and their relationship with bronchial asthma severity. Allergy.2001;56(1):43-9.

23. Hill J, Micklewright A, Lewis S, Britton J. Investigation of the effect of short-term change in dietary magnesium intake in asthma. EurRespirJ.1997; 10 (10): 2225- 9.

24. Soutar A, Seaton A, Brown K. Bronchial reactivity and dietary antioxidant. Thorax.1997; 52 (2):160 –70.

25. Zervas E, Papatheodorou G, Psathakis K, Panagou P, Georgatou N, Loukides S. Reduced intracellular Mg concentrations in patients with acute asthma. Chest 2003;123 (1): 113- 8.

26. Kakish KS.Serum Magnesium Levels in Asthmatic Children During and Between Exacerbations .Arch PediatrAdolesc Med. 2001;155(2):181-183.

27. AliA, Bakr RM, Yousif M,Foad RE. Assessment of serum magnesium level in patients with bronchial asthma.Egyptian Journal of Chest Diseases and Tuberculosis.2015; 64: 535–539

28. Vittal BG, Rudresha BM, Aliya N, Priyadarshini KS. A study of magnesium and other serum electrolyte levels during nebulized salbutamol therapy, J. Clin.Diagn.2010;4:3460–3464.

29. Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R et al. Interpretative strategies for lung function tests, Eur. Respir. J. 2005;26(5):948–968.

30.  Mohammad HA, Abdulfttah MT , Abdulazez AO, Mahmoud AM ,Emam RM. A study of electrolyte disturbances in patients with chronic stable asthma and with asthma attacks. Egyptian Journal of Chest Diseases and Tuberculosis. 2014;63(3):529-534.

31. Durlach J. Editorial policy of Magnesium Research: General consideration the quality criteria for biomedical papers and some complementary guidelines for the contributors of Mag. Res. 1995;8:191-206.

32. Miller AL. The Etiologies, Pathophysiology, and Alternative / Complementary Treatment of Asthma. Alternate medicine review. 2001;6(1):20-47.

Full Text

 © The Authors, published by University of Sulaimani, College of Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.