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Serum magnesium concentration: time for a standardised and evidence-based reference range.

Heike Weisser1, Klaus Kisters2, Jürgen Vormann3

  • 1Institute of Laboratory Medicine, Klinikum Fulda gAG, University Medicine Marburg - Campus Fulda, Pacellialle 4, 360413 Fulda, Germany.

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Serum magnesium testing is uncommon, lacking a standard reference range. This study proposes raising the lower limit to 0.85 mmol/L to prevent diseases linked to low magnesium.

Keywords:
hypomagnesemialaboratory reportmagnesiumreference rangeserum magnesium

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Area of Science:

  • Clinical Chemistry
  • Biochemistry
  • Preventive Medicine

Background:

  • Total serum magnesium concentration is infrequently measured in clinical settings.
  • Current serum magnesium reference ranges lack standardization and an evidence-based foundation.
  • Variability exists among laboratories regarding the lower limit of serum magnesium.

Purpose of the Study:

  • To propose an evidence-based reference range for serum magnesium.
  • To highlight the preventive potential of optimal magnesium levels.
  • To advocate for standardization of serum magnesium testing.

Main Methods:

  • Literature search conducted in the PubMed database.
  • Keywords used: "serum magnesium", "reference interval", "reference range", "hypomagnesemia".
  • Citations from relevant studies were also reviewed.

Main Results:

  • Existing lower limits for serum magnesium vary significantly between laboratories.
  • Most current lower limits are below the 0.85 mmol/L (2.07 mg/dL) threshold recommended by expert groups.
  • Lower serum magnesium levels are associated with increased risks of type 2 diabetes and cardiovascular diseases.

Conclusions:

  • The lower limit of serum magnesium should be standardized at 0.85 mmol/L to mitigate health risks.
  • Laboratory reports should indicate the increased disease risk associated with levels below 0.85 mmol/L.
  • Serum magnesium determination should be prioritized in routine diagnostics, similar to other electrolytes.