A Proposed Scale to Assess Magnesium Status Using Serum Calcium and Magnesium Ratios.

Area of Science:

• Biochemistry
• Clinical Diagnostics
• Nutritional Science

Background:

• Accurate assessment of human magnesium (Mg) status is crucial for clinical practice.
• Current methods using serum Mg and calcium (Ca) ratios lack standardization, employing four interchangeable expressions.
• A unified approach is needed to reliably evaluate Mg status through serum ratios.

Purpose of the Study:

• To propose and validate a unified scale for assessing human magnesium status using serum Mg and Ca ratios.
• To explore the diagnostic utility of this proposed scale in various clinical scenarios and published research.
• To determine if the proposed scale offers superior diagnostic value compared to serum Mg alone.

Main Methods:

• Development of a unified scale for serum Mg/Ca and Ca/Mg ratios, applicable to both weight and molar calculations.
• Application of the proposed scale to four case studies.
• Analysis of published research data, including COVID-19 mortality, healthy adults, periodontal disease, and acute coronary syndrome patients.

Main Results:

• The proposed serum Mg/Ca scale demonstrated superior Mg diagnostic value over serum Mg alone in case studies.
• In hospitalized COVID-19 patients, the scale's "depleted Mg" status predicted mortality.
• Analysis of healthy adults revealed a wide range of Mg status (from "seriously depleted" to "adequate") even with "normal" serum Mg.
• The scale showed prognostic value in periodontal disease and identified appropriate diagnostic utility in acute coronary syndrome when "corrected Ca" was excluded.

Conclusions:

• The proposed Mg/Ca ratio scale requires consistent reporting of total serum Ca and Mg in identical units (weight or molar).
• Standardization in reporting units and methodology for serum Mg and Ca ratios is essential for clarity.
• The proposed scale warrants further investigation as a potentially more precise marker of Mg deficit than serum Mg alone.