Nicola Veronese1,2, Jacopo Demurtas3, Gabriella Pesolillo4, Stefano Celotto5, Tommaso Barnini6, Giovanni Calusi7, Maria Gabriella Caruso8, Maria Notarnicola8, Rosa Reddavide8, Brendon Stubbs9,10,11, Marco Solmi12, Stefania Maggi13, Alberto Vaona14, Joseph Firth15,16, Lee Smith17, Ai Koyanagi18,19, Ligia Dominguez20, Mario Barbagallo20. 1. National Research Council, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128, Padova, Italy. ilmannato@gmail.com. 2. Research Hospital, National Institute of Gastroenterlogy, IRCCS De Bellis, Castellana Grotte, BA, Italy. ilmannato@gmail.com. 3. Primary Care Department, Azienda USL Toscana Sud Est, Grosseto, Italy. 4. Primary Care Service, ASL 02, Chieti, Italy. 5. Primary Care Department, Azienda per l'Assistenza Sanitaria 3 Alto Friuli -Collinare -Medio Friuli, Udine, Italy. 6. Primary Care Service, AUSL Toscana Centro, Firenze, Italy. 7. Primary Care Department, Azienda USL Toscana Centro, Prato, Italy. 8. Research Hospital, National Institute of Gastroenterlogy, IRCCS De Bellis, Castellana Grotte, BA, Italy. 9. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, SE5 8AZ, London, UK. 10. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box SE5 8AF, London, UK. 11. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK. 12. Neuroscience Department, University of Padova, Padova, Italy. 13. National Research Council, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128, Padova, Italy. 14. Primary Care Department, Azienda ULSS20 Verona, Verona, Italy. 15. NICM Health Research Institute, University of Western Sydney, Penrith, Australia. 16. Division of Psychology and Mental Health, University of Manchester, Manchester, UK. 17. The Cambridge Centre for Sport and Exercise Sciences, Department of Life Sciences, Anglia Ruskin University, Cambridge, UK. 18. Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, 28029, Madrid, Spain. 19. Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 0883, Barcelona, Spain. 20. Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
Abstract
PURPOSE: To map and grade all health outcomes associated with magnesium (Mg) intake and supplementation using an umbrella review. METHODS: Umbrella review of systematic reviews with meta-analyses of observational studies and randomized controlled trials (RCTs) using placebo/no intervention as control group. We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values, 95% prediction intervals, heterogeneity, small-study effects and excess significance. For meta-analyses of RCTs, outcomes with a random-effect p value < 0.005 and a high-GRADE assessment were classified as strong evidence. RESULTS: From 2048 abstracts, 16 meta-analyses and 55 independent outcomes were included (36 in RCTs and 19 in observational studies). In RCTs of Mg versus placebo/no active treatment, 12 over 36 outcomes reported significant results (p < 0.05). A strong evidence for decreased need for hospitalization in pregnancy and for decreased risk of frequency and intensity of migraine relapses in people with migraine was observed using the GRADE assessment. In observational studies, 9/19 outcomes were significant (p < 0.05). However, only one outcome presented highly suggestive evidence (lower incidence of type 2 diabetes in people with higher Mg intake at baseline) and one suggestive (lower incidence of stroke associated with higher Mg intake at baseline). CONCLUSION: Strong evidence according to the GRADE suggests that Mg supplementation can decrease the risk of hospitalization in pregnant women and reduce the intensity/frequency of migraine. Higher Mg intake is associated with a decreased risk of type 2 diabetes and stroke with highly suggestive and suggestive evidence, respectively, in observational studies.
PURPOSE: To map and grade all health outcomes associated with magnesium (Mg) intake and supplementation using an umbrella review. METHODS: Umbrella review of systematic reviews with meta-analyses of observational studies and randomized controlled trials (RCTs) using placebo/no intervention as control group. We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values, 95% prediction intervals, heterogeneity, small-study effects and excess significance. For meta-analyses of RCTs, outcomes with a random-effect p value < 0.005 and a high-GRADE assessment were classified as strong evidence. RESULTS: From 2048 abstracts, 16 meta-analyses and 55 independent outcomes were included (36 in RCTs and 19 in observational studies). In RCTs of Mg versus placebo/no active treatment, 12 over 36 outcomes reported significant results (p < 0.05). A strong evidence for decreased need for hospitalization in pregnancy and for decreased risk of frequency and intensity of migraine relapses in people with migraine was observed using the GRADE assessment. In observational studies, 9/19 outcomes were significant (p < 0.05). However, only one outcome presented highly suggestive evidence (lower incidence of type 2 diabetes in people with higher Mg intake at baseline) and one suggestive (lower incidence of stroke associated with higher Mg intake at baseline). CONCLUSION: Strong evidence according to the GRADE suggests that Mg supplementation can decrease the risk of hospitalization in pregnant women and reduce the intensity/frequency of migraine. Higher Mg intake is associated with a decreased risk of type 2 diabetes and stroke with highly suggestive and suggestive evidence, respectively, in observational studies.
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