Can serum ionic magnesium disturbance increase the frequency of exacerbations in COPD? - A hospital based multi group case control study

Abstract

Objectives: Hypomagnesaemia has been cited as a predictor of acute exacerbations of Bronchial asthma due to increased frequency of bronco spasm, though it is under explored in COPD, therefore present study designed to find out the association of disturbance in free serum ionic Mg²⁺ levels in acute exacerbation of COPD. Methods: A case control hospital based multi-group study was designed. Total of 150 Study Subjects fit on inclusion criteria were included and comprises in three groups; G 1) Acute exacerbation of COPD (N=50); G 2) Healthy Controls (N=50); G 3) Known cases of COPD presenting to the OPD for follow up (N=50) to study the disturbance in serum ionic magnesium in patients of COPD with acute exacerbation. Data was analysed by using standard statistical software SPSS version 23. Chi Square, student t test and Pearson correlation and regression test were used as a tests of significance. p value 0.05 was considered significant. Results: Severe statistically significant diminution of serum ionic Mg²⁺ level was found in patients presented with an acute exacerbation of COPD (mean serum Mg²⁺=0.317mmol/l; SD0.06) compared to healthy (mean serum Mg²⁺=0.510mml/l; SD0.042) as well as stable COPD subjects (mean serum Mg²⁺=0.400 mmol/l; SD0.074; p=0.000). While mean serum ionic magnesium in type 2 Respiratory failure subjects was less than Non type 2 Respiratory failure (p=0.435). Serum ionic magnesium changes among subjects of COPD with acute exacerbation, was weakly associated with change in pH of blood (r = .057, p=0.697). Conclusions: Diminution of serum ionic magnesium (iMg²⁺) concentration was significantly associated with acute exacerbation of COPD, as well as enhances the frequency of hospital admission.