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Related Experiment Videos

Relationship between ionized and total magnesium in serum

W R Külpmann1, M Gerlach

  • 1Medical University of Hanover, Institute of Clinical Chemistry, Germany.

Scandinavian Journal of Clinical and Laboratory Investigation. Supplementum
|January 1, 1996
PubMed
Summary

Magnesium levels are closely related only in severe hypermagnesaemia. Protein concentration significantly impacts total magnesium measurements, affecting accuracy in hypoproteinaemia and potentially masking low ionized magnesium.

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Area of Science:

  • Clinical Chemistry
  • Biochemistry
  • Analytical Chemistry

Background:

  • Accurate assessment of magnesium status is crucial for patient health.
  • Ionized magnesium is the biologically active form, but total magnesium is often measured.
  • Factors influencing the relationship between total and ionized magnesium require clarification.

Purpose of the Study:

  • To investigate the relationship between ionized and total magnesium concentrations.
  • To determine the influence of protein concentration on magnesium measurements.
  • To assess the reliability of total magnesium in various clinical conditions.

Main Methods:

  • Ionized magnesium measured using an ion-selective electrode (Microlyte 6, KONE) at pH 7.4.
  • Total magnesium concentration determined by flame atomic absorption spectrometry.

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  • Analysis included samples with varying magnesium and protein levels, including paraproteinaemic sera.

    • Main Results:

    • Close correlation between total and ionized magnesium observed only in marked hypermagnesaemia (> 1.2 mmol/L).
    • Poor correlation in samples with slightly elevated total magnesium or hypomagnesaemia (< 0.65 mmol/L).
    • Protein concentration critically affects the relationship; agreement is acceptable in normoproteinaemia but poor in hypoproteinaemia (< 40 g/L).

    Conclusions:

    • Total magnesium concentration is unreliable for assessing magnesium status in hypoproteinaemia.
    • Albumin concentration is the primary determinant of the protein-bound magnesium fraction.
    • Clinical interpretation of total magnesium requires consideration of protein levels and overall magnesium status.