Association Between Dietary Magnesium Intake and Low Muscle Mass: The Mediating Role of Inflammatory Indicators

Background: Magnesium is essential for mitochondrial function and muscle regeneration, potentially protecting against low muscle mass (LMM). We examined the association of dietary magnesium intake with LMM risk and skeletal muscle index (SMI), and whether inflammatory indicators mediate this relationship. Methods: A total of 5793 participants aged 20-59 years were included in this study from the National Health and Nutrition Examination Survey (NHANES) conducted from 2011 to 2018. To investigate the association of dietary magnesium intake with LMM and SMI, we applied weighted logistic regression model, linear regression model, restricted cubic spline analysis, subgroup analysis and sensitivity analysis. Inflammatory indicators were assessed using mediation analysis, including the C-reactive protein-albumin-lymphocyte (CALLY) index, neutrophil-platelet score (NP), platelet-to-albumin ratio (PAR) and red blood cell distribution width-to-albumin ratio (RAR) mediation. Results: In the fully adjusted model, participants in the highest magnesium quartile had a reduced risk of LMM, with OR of 0.33 (95% CI: 0.18, 0.60), and increased levels of SMI, with β values of 0.05 (95% CI: 0.04, 0.07). Mediation analysis showed that NP, PAR, and RAR mediated 18%, 13%, and 21% of the association between magnesium and LMM, respectively, and also acted as mediators of the relationship between magnesium and SMI, with mediation ratios of 32%, 24%, and 25%, respectively. Conclusion: Higher dietary magnesium intake was associated with lower LMM risk and higher SMI, partly mediated through inflammatory indicators involving NP, PAR, and RAR. This finding may provide a new perspective on the prevention and management of LMM.