Can one really measure magnesium deficiency using the short-term magnesium loading test?

Objective: To compare a 1-h-version of a magnesium-loading-test (MLT) designed for outpatients in healthy controls with the 8-h standard; to establish the test in patients after renal transplantation prone to develop magnesium (Mg) deficiency; to correlate femur Mg-concentration and percentage retention of the given load.

Design: Comparison of mean values from healthy controls with respective from the literature; a prospective, randomized, controlled 4-month study; an intra-individual correlation of Mg-serum values and loading-test data with femur-Mg concentrations.

Setting: One centre study in a medical university; outpatients from the transplant unit; inpatients from the orthopedic unit.

Subjects: Twenty-four healthy controls aged 36.7 +/- 7.4 years; 34 patients after renal transplantation (46.5 +/- 14.3 years); 41 patients with hip replacement therapy (63.9 +/- 18.6 years).

Intervention: Baseline Mg values were measured by atomic absorption spectroscopy (AAS) in serum and urine. An intravenous Mg load with 0.1 mmol Mg-aspartate hydrochloride per kilogram bodyweight was given during 1 h. In 24 h-urine, the amount of excreted Mg was measured by AAS and the percentage retention of the given load calculated according to the formula: 1 - [Mg 24 h-urine/Mg test dose] x 100. Femur Mg was measured by AAS in a peace of the femur neck. Patients after renal transplantation were randomized after the first Mg load to either obtain daily 5 mmol Mg-aspartate hydrochloride per kilogram bodyweight, or placebo. Four months later a second loading-procedure was performed.

Main Outcome Measure: Serum Mg, percentage retention of the given Mg load (%Ret) and femur Mg concentration.

Results: Mean serum Mg values were within the normal range. In controls, %Ret was -18 +/- 21 and not different from the literature. In the first MLT after renal transplantation, %Ret was 47 +/- 43. In patients under Mg medication it decreased significantly to 16 +/- 26, but was 58 +/- 27 in the placebo group. Femur Mg concentration was 62.6 +/- 20.9 mmol kg-1 dry substance and the corresponding %Ret was 14 +/- 28 with r = - 0.7093.

Conclusion: The short-term version of the MLT is as good as the standard and was easily applied in outpatients. The indication from the good correlation between bone-Mg and %Ret and a marked decrease in %Ret in patients after Mg medication was that one can really measure magnesium deficiency.