Assessment of Serum Magnesium Level in Acute Exacerbation of COPD

Abstract

Background:Low serum magnesium is associated with airway hyper-reactivity and impaired pulmonary function.This study was carried out with an aim to compare serum Magnesium levels in patients with Acute Exacerbation of COPD and stable COPD.Methodology:This was an observational study done at a tertiary care centre in Central India over a period of one and a half years on 250 patients of COPD either presenting to the hospital in acute exacerbation or in a stable state. Patients were categorized into two groups: namely, AECOPD and stable COPD. Serum Magnesium was measured at the time of admission, discharge from hospital and also during follow up visit at the Out Patient Department. Stable COPD patients coming to the OPD were also included in the study and their serum magnesium was measured during their OPD visit. Mean and standard deviation were calculated for quantitative variables and appropriate statistical tests like students t test and ANOVA were applied.Results:Mean serum Magnesium level was lower in the AECOPD group as compared to the stable COPD group(1.60±0.49 vs 1.99 ± 0.09 mg/dl, respectively, p value=0.001). Mean serum Magnesiumlevel was low in the AECOPD group at the time of admission and normalized without magnesium supplementation at discharge. (1.60 ± 0.49 vs 1.78 ± 0.13mg/dl, p=0.0001). Serum Magnesium level decreased with increasing severity of COPD exacerbation. PPI and diuretic users in both AECOPD and stable COPD groups had lower serum magnesium than non users (1.29 ±0.46 vs 2.00, 1.21 ±0.42 vs 1.99 ±0.03 mg/dl respectively).Conclusion:During COPD exacerbation, serum Magnesium level decreased especially in those taking PPI and diuretics. This decrease was transient. The level returned to normal when the acute episode subsided. Patients with AECOPD had lower serum Magnesium level than stable COPD. More severe the COPD exacerbation, more frequent was the hypomagnesemia.