Magnesium deficiency and minimal hepatic encephalopathy among patients with compensated liver cirrhosis

Keren Cohen-Hagai, Dan Feldman, Tirza Turani-Feldman, Ruth Hadary, Shilo Lotan, Yona Kitay-Cohen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background: Magnesium is an essential intracellular cation. Magnesium deficiency is common in the general population and its prevalence among patients with cirrhosis is even higher. Correlation between serum levels and total body content is poor because most magnesium is intracellular. Minimal hepatic encephalopathy is a subclinical phase of hepatic encephalopathy with no overt symptoms. Cognitive exams can reveal minor changes in coordination, attention, and visuomotor function, whereas language and verbal intelligence are usually relatively spared. Objectives: To assess the correlation between intracellular and serum magnesium levels and minimal hepatic encephalopathy. Methods: Outpatients with a diagnosis of compensated liver cirrhosis were enrolled in this randomized, double-blinded study. Patients were recruited for the study from November 2013 to January 2014, and were randomly assigned to a control (placebo) or an interventional (treated with magnesium oxide) group. Serum and intracellular magnesium levels were measured at enrollment and at the end of the study. Cognitive function was assessed by a specialized occupational therapist. Results: Forty-two patients met the inclusion criteria, 29 of whom were included in this study. Among these, 83% had abnormal cognitive exam results compatible with minimal hepatic encephalopathy. While only 10% had hypomagnesemia, 33.3% had low levels of intracellular magnesium. Initial intracellular and serum magnesium levels positively correlated with cognitive performance. Conclusions: Magnesium deficiency is common among patients with compensated liver cirrhosis. We found an association between magnesium deficiency and impairment in several cognitive function tests. This finding suggests involvement of magnesium in the pathophysiology of minimal hepatic encephalopathy.

Original languageEnglish
Pages (from-to)533-538
Number of pages6
JournalIsrael Medical Association Journal
Volume20
Issue number9
StatePublished - Sep 2018

Keywords

  • Intracellular magnesium
  • Liver cirrhosis
  • Magnesium deficiency
  • Magnesium oxide
  • Minimal hepatic encephalopathy

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