Table_1_The interaction between estimated glomerular filtration rate and dietary magnesium intake and its effect on stroke prevalence: a cross-sectional study spanning 2003–2018.docx

BackgroundDespite the known associations of dietary magnesium intake and estimated glomerular filtration rate (eGFR) with cardiovascular diseases, their combined effects on stroke risk remain unclear. Therefore, this study aims to explore the associations of dietary magnesium intake and eGFR with stroke risk.
MethodsThe National Health and Nutrition Examination Survey (NHANES) data of 37,637 adult participants (≥18 years) from 2003 to 2018 was analyzed. Dietary magnesium intake was categorized as low (≤ 254 mg/day) and normal (> 254 mg/day) based on experimental data. Multiple logistic regression analyses and interaction tests were conducted to assess the associations of dietary magnesium intake and eGFR with stroke risk, with a focus on the interaction between different chronic kidney disease (CKD) stages based on eGFR levels and dietary magnesium intake. Additional analyses included multiplicative interaction analysis, restricted cubic spline analysis, and subgroup evaluations by age, sex, and ethnicity.
ResultsDietary magnesium intake and eGFR were inversely correlated with the risk of stroke. Participants with low dietary magnesium intake had a higher stroke risk than those with normal magnesium intake (odds ratio [OR] 1.09, 95% confidence interval [CI]: 1.03–1.42). Likewise, low eGFR was associated with an elevated stroke risk compared with normal eGFR (OR 1.56, 95% CI: 1.15–2.13). Furthermore, the two factors showed a multiplicative interaction effect on stroke risk (OR 1.05, 95% CI: 1.01–1.09). We observed a significant interaction between stage G3 CKD and low dietary magnesium intake (OR 1.05, 95% CI: 1.01–1.09), suggesting a potential association with stroke risk. However, similar associations were not observed for stages G4 and G5, possibly due to the smaller number of participants with G4 and G5 CKD. The restricted cubic spline analysis revealed a non-linear relationship between dietary magnesium intake, eGFR, and stroke risk. The interaction between magnesium deficiency and low eGFR persisted in participants aged >60 years, as well as in females, non-Hispanic Black people, and people of other races.
ConclusionDietary magnesium intake and eGFR correlate negatively with stroke prevalence. Moreover, there was an interaction between dietary magnesium intake and stroke prevalence across different CKD stages. Further large-scale prospective studies are needed to analyze the potential relationship between dietary magnesium intake, eGFR, and stroke.

研究背景 尽管已知膳食镁摄入与估算肾小球滤过率（estimated glomerular filtration rate, eGFR）均与心血管疾病存在关联，但二者对卒中风险的联合效应仍尚不明确。为此，本研究旨在探讨膳食镁摄入、eGFR与卒中风险之间的关联。研究方法 本研究分析了2003至2018年间共37,637名成年参与者（年龄≥18岁）的美国国家健康与营养检查调查（National Health and Nutrition Examination Survey, NHANES）数据。根据实验数据，将膳食镁摄入分为低摄入组（≤254mg/天）与正常摄入组（>254mg/天）。本研究采用多因素logistic回归分析与交互检验，评估膳食镁摄入、eGFR与卒中风险的关联，重点探讨基于eGFR水平划分的不同慢性肾脏病（chronic kidney disease, CKD）分期与膳食镁摄入之间的交互作用。额外分析包括相乘交互作用分析、限制性立方样条分析，以及按年龄、性别与种族进行的亚组评估。研究结果 膳食镁摄入与eGFR均与卒中风险呈负相关。与正常膳食镁摄入者相比，低膳食镁摄入参与者的卒中风险更高（比值比（odds ratio, OR）=1.09，95%置信区间（confidence interval, CI）：1.03~1.42）。同样，与正常eGFR者相比，低eGFR参与者的卒中风险升高（OR=1.56，95%CI：1.15~2.13）。此外，这两个因素对卒中风险存在相乘交互作用（OR=1.05，95%CI：1.01~1.09）。本研究观察到G3期CKD与低膳食镁摄入之间存在显著交互作用（OR=1.05，95%CI：1.01~1.09），提示其可能与卒中风险存在关联。但在G4、G5期CKD中未观察到类似关联，这可能与G4、G5期CKD的参与者人数较少有关。限制性立方样条分析显示，膳食镁摄入、eGFR与卒中风险之间存在非线性关系。在年龄>60岁的参与者、女性、非西班牙裔黑人和其他种族人群中，镁缺乏与低eGFR的交互作用依然存在。研究结论 膳食镁摄入与eGFR均与卒中患病率呈负相关。此外，不同CKD分期下，膳食镁摄入与卒中患病率之间存在交互作用。未来仍需开展大规模前瞻性研究，以分析膳食镁摄入、eGFR与卒中之间的潜在关联。