[A magnézium és csonthatásai]


MAY 30, 2013

LAM KID - 2013;3(02)

[Since 1932, a number of animal studies have demonstrated the correlation of hypomagnesaemia and hypocalcaemia, and the variety of skeletal abnormalities resulting from low magnesium (Mg) intake. Several studies have shown that patients with osteoporosis have a decreased serum magnesium level, which is related to decreased bone mineral content and increased bone fragility. Mg has multiple physiological effects, thus it is not surprising that dozens of hypomagnesaemia-related diseases and symptoms have been reported. Adequate Mg concentration is necessary for the secretion of parathormone and its effect on target organs, activation of vitamin D in the kidney, the maintenance of calcium homeostasis, bone mineralisation and regeneration. Mild hypomagnesaemia is associated with general, atypical symptoms, whereas severe Mg deficiency is a life-threatening condition. Its concentration should be measured in serum and urine. Mg metabolism is determined by its absorption from the intestines and reabsorption in the kidneys. Recently revealed details of these processes give some insights into the mechanisms underlying a number of Mg deficient conditions related to genetic or medical reasons. Mg supplementation may be indicated for patient populations with the highest risk of hypomagnesaemia. For supplementation, the recommended total Mg dose is 350 mg, first in higher doses, several times per day for a longer period, complemented with Ca and K supplementation. Overdosing can only occur in patients with impaired renal function, which necessitates careful monitoring. Adequate Mg supplementation is an inexpensive, safe and effective preventive and therapeutic option for many diseases.]



Further articles in this publication


[Role of medicinal plants and natural products on osteoporotic fracture healing]

BALLA Bernadett


[The role of diet in the prevention of musculoskeletal diseases]

SPEER Gábor, SPEER Józsefné

[In the European Union, the lowest incidence of osteoporosis and rheumatoid arthritis has been reported in the Mediterranean area. However, for a long time only a few nutrients’ effects have been studied on BMD. Of these, the favourable effects of wine, fermented cheese and fruit and vegetable consumption have been demonstrated in the alleviation of both osteoporosis and rheumatoid arthritis. A number of promising studies are being conducted with analogues of antioxidant components of the mediterranean diet. Some of these components decrease the levels of pathological factors, such as interleukin-1, -6, -17, TNF-α, JAK2/STAT3, which are the targets of a number of efficient drugs. These findings demonstrate the significance of diet in the development of musculoskeletal diseases. In our review article, we present the above mentioned data, illustrated by some of our own recipes.]


[Radiological examinatons in multiple myeloma]

GYŐRI Gabriella, MAGYAR Péter, NAGY Zsolt


[Discontinuation of denosumab and associated fracture incidence: analysis from the FREEDOM trial]



[Potential antiosteoporotic agents from plants]

BALLA Bernadett

All articles in the issue

Related contents


[Once again on adherence - Is it just fashionable or indeed a timely issue?]

VALKUSZ Zsuzsanna

[Nonadherence to pharmacological treat-ment in osteoporosis is a well-recognised problem not only in Hungary but all over the world. As in other chronic diseases, adherence to osteoporosis treatment is poor, which results in serious problems affecting patients as well as health care resources. Low adherence rates consistent-ly result in increased rates of fractures. Some approaches aimed to improve com-plience and persistence, such as extension of dosing intervals, might improve patients’ adherence to therapy. International clinical studies have demonstrated that the number of fractures cannot be reduced without suf-ficient adherence. Improving patient edu-cation, enhancing interactions between health care providers and patients, taking into account patients’ preferences and involving them in treatment decisions may all improve adherence.]


[Practical questions regarding the use of teriparatide]


[Teriparatide has become one of the most important drug in the treatment of osteoporosis in Hungary. Although this is not a new drug, a number of questions arise regarding its use in everyday practice. When should we use it as first-line treatment? When should we change the used therapy to teriparatide? What kind of effect can we expect after the start of teriparatide therapy? What are the potential side effects? Financing rules limit, but do not fully control our therapeutic decisions, as these are mostly based on scientific data. In this review, we summarise new and older scientific data regarding teriparatide from practical aspects.]


[Osteoporotic patient’s use of prescription drugs - pilot study]


[BACKGROUND - In Hungary, the number of the highest mortality hip fractures is between 12 000-15 000 per year. The cost of treating hip fractures is several times higher than that of preventive medical therapy. Thus, the compliance of patients with osteoporosis is of great importance. METHODS - Using the informatical database of St. András Rheumatology Hospital at Héviz, we collected one year’s prescription drugs for osteoporosis and compared them with the number of drugs obtained by the patients, determined from National Health Insurance data. RESULTS - In general, the patients obtained 75% of prescription drugs. From the 4354 boxes of prescribed antiporotics, 3637 contained bisphosphonate (not considering vitamin D and calcium). Within this group, 88% of combination preparations were obtained, which is a greater ratio than that of non-combination bisphosphonates (84%). CONCLUSIONS - On the basis of our results, we posit that prescription of a combination preparation somewhat improves the patients’ compliance. The low concordance of vitamin D and calcium preparations is worrying.]


[Everyday decisions regarding osteoporosis treatment]


[Efficient, new medicines as well as recent scientific results have substantially changed the options and daily practice of osteoporosis treatment. Besides the indicated duration of therapies, their indication has also changed in several key points, and the range of possibilities for switching therapies have expanded. Despite the availability of a steadily increasing number of data, large-scale studies do not always help making therapeutic decisions, so we have to rely on professional protocols and our own experience, as well as on logical thinking. Moreover, we also have to observe financial regulations. This summary is intended to serve as a guideline for the most important decision situations from the initiation of therapy until its cessation.]


[The effect of sex hormone replacement on radial bone mineral content in boys with panhypopituitarism]


[INTRODUCTION - Children with pituitary insufficiency normally receive growth hormone and thyroid hormone substitution, but glucocorticoid treatment is rarely necessary. Sex hormone replacement is introduced in puberty, which, at the same time, promotes growth and bone maturation. In this study the effect of testosterone replacement on bone mineral content was examined. PATIENTS AND METHODS - Nine boys (16.3±1.3 years) with hypopituitarism were involved in the study who had been receiving growth hormone and thyroid hormone replacement for several years by the beginning of the study.Androgen was substituted by the intramuscular administration of 50 mg testosterone biweekly.The children's height,weight, the rate of pubescence, and bone age were checked, and bone mineral density was measured by single photon absorptiometry every six month. During the substitution treatment serum thyroxin and testosterone levels remained in the normal ranges. RESULTS - A significant increase in bone mineral density was observed during the testosterone treatment, with Z-scores -1.80, -0.91 and +0.14 at baseline, 12 and 24 months, respectively (p<0,001). Z-scores adjusted for bone age remained in the normal range throughout the study (-0.904 at baseline and -0.946 at one year). CONCLUSION - The increase rate of bone mineral density (0.16 g/cm/year) was significantly higher compared both to the normal reference in this age group (0.07 g/cm/yr, p=0.0015) and to the normal reference relative to their bone age (p<0.0006). The increase in bone mineral density suggests that testosterone replacement has an important role both in the quantitative and qualitative development of bones.]