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ʻO ka sodium, potassium, calcium, bicarbonate, a me ke koena wai i loko o ke koko ke kumu no ka mālama ʻana i nā hana physiological i ke kino. Loaʻa ka nele o ka noiʻi e pili ana i ka maʻi magnesium ion. I ka hoʻomaka ʻana o ka makahiki 1980, ua ʻike ʻia ka magnesium ma ke ʻano he "electrolyte poina". Me ka loaʻa ʻana o nā kaila magnesium a me nā transporters, a me ka hoʻomaopopo ʻana i ka hoʻoponopono physiological a me ka hormonal o ka homeostasis magnesium, ʻike mau ka poʻe i ka hana o ka magnesium i ka lāʻau lapaʻau.

He mea koʻikoʻi ka Magnesium no ka hana kelepona a me ke olakino. Loaʻa maʻamau ka Magnesium ma ke ʻano o Mg2+, a aia i loko o nā pūnaewele a pau o nā mea ola a pau, mai nā mea kanu a hiki i nā mea momona kiʻekiʻe. He mea koʻikoʻi ka Magnesium no ke olakino a me ke ola, no ka mea he cofactor koʻikoʻi ia o ke kumu ikehu cellular ATP. Hoʻokomo nui ka Magnesium i nā kaʻina hana physiological o nā cell ma o ka hoʻopaʻa ʻana i nā nucleotides a me ka hoʻoponopono ʻana i ka hana enzyme. Pono nā hopena ATPase a pau i ka Mg2+- ATP, me nā hopena e pili ana i ka hana RNA a me DNA. ʻO ka Magnesium kahi cofactor o nā haneli o nā hopena enzymatic i nā cell. Eia kekahi, hoʻoponopono ka magnesium i ka glucose, lipid, a me ka metabolism protein. Hoʻopili ʻia ka Magnesium i ka hoʻoponopono ʻana i ka hana neuromuscular, hoʻoponopono i ka puʻuwai puʻuwai, ka leo vascular, ka huna ʻana o ka hormone, a me ka hoʻokuʻu ʻana o N-methyl-D-aspartate (NMDA) i loko o ka ʻōnaehana nerve waena. ʻO Magnesium ka lua o ka ʻelele i komo i ka hōʻailona intracellular a me ka mea hoʻoponopono o nā genes circadian rhythm e hoʻomalu i ka circadian rhythm o nā ʻōnaehana biological.

Aia ma kahi o 25 g o ka magnesium i loko o ke kino o ke kanaka, mālama nui ʻia i loko o nā iwi a me nā ʻiʻo palupalu. ʻO ka Magnesium kahi ion intracellular koʻikoʻi a ʻo ka lua o ka intracellular cation nui ma hope o ka potassium. I loko o nā pūnaewele, 90% a 95% o ka magnesium e hoʻopaʻa i nā ligands e like me ATP, ADP, citrate, proteins, a me nā waikawa nucleic, ʻoiai ʻo 1% a 5% wale nō o ka magnesium intracellular i loaʻa i ke ʻano manuahi. He 1.2-2.9 mg/dl (0.5-1.2 mmol/L) ka intracellular free magnesium concentration, e like me ka extracellular concentration. I loko o ka plasma, 30% o ka magnesium circulating e hoʻopaʻa ʻia i nā protein ma o nā ʻakika momona manuahi. ʻO nā poʻe maʻi me nā kiʻekiʻe kiʻekiʻe o nā ʻakika momona manuahi i ka maʻamau, he haʻahaʻa haʻahaʻa koʻikoʻi ka magnesium koko, ʻo ia hoʻi ke kūlike ʻole i ka pilikia o nā maʻi cardiovascular a me nā metabolic. Hiki ke hoʻololi i nā ʻakika momona manuahi, a me nā kiʻekiʻe o EGF, insulin, a me aldosterone, hiki ke hoʻopili i nā pae magnesium koko.

ʻEkolu mau mea hoʻoponopono nui o ka magnesium: ʻo ka ʻōpū (hoʻoponopono i ka absorption magnesium dietary), iwi (hoʻopaʻa ʻana i ka magnesium ma ke ʻano o ka hydroxyapatite), a me nā puʻupaʻa (hoʻoponopono i ka urinary magnesium excretion). Hoʻohui ʻia kēia mau ʻōnaehana a hui pū ʻia, e hana pū ana i ka axis kidney iwi ʻōpū, kuleana no ka absorption, hoʻololi, a me ka excretion o ka magnesium. ʻO ke kūpono ʻole o ka metabolism magnesium hiki ke alakaʻi i nā hopena pathological a physiological

ʻO nā meaʻai momona i ka magnesium, ʻo ia ka ʻai, ka pī, nā nati, a me nā mea kanu ʻōmaʻomaʻo (ʻo ka magnesium ka mea nui o ka chlorophyll). Ma kahi o 30% a i ka 40% o ka lawe ʻana i ka magnesium meaʻai e komo ʻia e ka ʻōpū. Loaʻa ka hapa nui o ka absorption i loko o ka ʻōpū liʻiliʻi ma o ka halihali intercellular, kahi kaʻina passive e pili ana i nā junction paʻa ma waena o nā cell. Hiki i ka ʻōpū nui ke hoʻoponopono maikaʻi i ka absorption magnesium ma o ka transcellular TRPM6 a me TRPM7. Hiki i ka inactivation o ka intestinal TRPM7 gene ke alakaʻi i nā hemahema nui i ka magnesium, zinc, a me ka calcium, kahi e hōʻino ai i ka ulu mua a me ke ola ma hope o ka hānau ʻana. Hoʻopili ʻia ka absorption Magnesium e nā kumu like ʻole, me ka lawe ʻana i ka magnesium, ka waiwai pH intestinal, nā hormones (e like me ka estrogen, insulin, EGF, FGF23, a me ka hormone parathyroid [PTH]), a me ka microbiota gut.
I loko o nā puʻupaʻa, hoʻihoʻi hou nā tubules renal i ka magnesium ma o nā ala extracellular a me intracellular. ʻAʻole like me ka hapa nui o nā ion e like me ka sodium a me ka calcium, he liʻiliʻi wale nō (20%) o ka magnesium i hoʻihoʻi ʻia i nā tubules proximal, ʻoiai ʻo ka hapa nui (70%) o ka magnesium e hoʻihoʻi ʻia i ka loop Heinz. I loko o nā tubules proximal a me nā lālā koʻikoʻi o ka loop Heinz, hoʻoulu nui ʻia ka magnesium reabsorption e nā gradients concentrate a me ka hiki ke membrane. Hoʻokumu ʻo Claudin 16 a me Claudin 19 i nā kaila magnesium i nā lālā mānoanoa o ka loop Heinz, ʻoiai ʻo Claudin 10b e kōkua i ka hana ʻana i kahi voli intraluminal maikaʻi ma waena o nā cell epithelial, e hoʻokau i ka reabsorption magnesium ion. I nā tubules distal, hoʻoponopono maikaʻi ka magnesium i ka reabsorption intracellular (5% ~ 10%) ma o TRPM6 a me TRPM7 ma ka piko o ke kelepona, a laila e hoʻoholo ai i ka excretion magnesium urinary hope loa.
ʻO ka Magnesium kahi mea nui o nā iwi, a ʻo 60% o ka magnesium i loko o ke kino kanaka e mālama ʻia i loko o nā iwi. ʻO ka magnesium hiki ke hoʻololi ʻia i loko o nā iwi e hāʻawi i nā mālama ikaika no ka mālama ʻana i ka ʻike physiological plasma. Hoʻoikaika ka Magnesium i ka hoʻokumu ʻana o ka iwi ma o ka hoʻopili ʻana i ka hana o nā osteoblasts a me nā osteoclast. ʻO ka hoʻonui ʻana i ka ʻai magnesium hiki ke hoʻonui i ka ʻike o ka mineral iwi, a laila e hōʻemi i ka pilikia o ka haki a me ka osteoporosis i ka wā ʻelemakule. He ʻelua kuleana ko Magnesium i ka hoʻoponopono iwi. I ka wā o ka maʻi o ka mumū, hiki i ka magnesium ke hoʻoikaika i ka hōʻike ʻana o TRPM7 i nā macrophages, ka hana cytokine hilinaʻi magnesium, a hoʻoikaika i ka microenvironment immune o ka hoʻokumu ʻana i nā iwi. I ka wā o ka ho'ōla hou ʻana o ka iwi, hiki i ka magnesium ke hoʻopili i ka osteogenesis a keʻakeʻa i ka ua hydroxyapatite. Hoʻokomo pū ʻo TRPM7 a me ka magnesium i ke kaʻina o ka calcification vascular ma o ka hoʻololi ʻana o nā ʻiʻo ʻiʻo maʻemaʻe vascular i ka phenotype osteogenic.

ʻO ka nui o ka magnesium serum maʻamau i nā pākeke he 1.7 ~ 2.4 mg / dl (0.7 ~ 1.0 mmol / L). ʻO ka hypomagnesemia e pili ana i ka neʻe ʻana o ka magnesium serum ma lalo o 1.7 mg / dl. ʻO ka hapa nui o nā maʻi me ka palena palena hypomagnesemia ʻaʻohe hōʻailona maopopo. Ma muli o ka hiki ke loaʻa ka hemahema o ka magnesium no ka manawa lōʻihi i nā poʻe maʻi me nā pae serum magnesium i ʻoi aku ma mua o 1.5 mg/dl (0.6 mmol/L), manaʻo kekahi e hoʻonui i ka paepae haʻahaʻa no ka hypomagnesemia. Eia nō naʻe, hoʻopaʻapaʻa mau kēia pae a koi hou i ka hōʻoia lapaʻau. ʻO 3% ~ 10% o ka heluna kanaka he hypomagnesemia, ʻoiai ʻo ka nui o nā maʻi maʻi diabetes type 2 (10% ~ 30%) a me nā maʻi maʻi maʻi (10% ~ 60%) ʻoi aku ka kiʻekiʻe, ʻoi aku ka nui o nā mea maʻi maʻi maʻi (ICU), nona ka nui o ka maʻi ma mua o 65%. Ua hōʻike ʻia nā haʻawina cohort he nui e pili ana ka hypomagnesemia me ka piʻi nui ʻana o ka make a me ka maʻi maʻi cardiovascular.

ʻO nā hōʻike lapaʻau o ka hypomagnesemia e pili ana i nā hōʻailona kikoʻī ʻole e like me ka hiamoe, ka ʻiʻo spasms, a i ʻole nāwaliwali o ka ʻiʻo ma muli o ka lawa ʻole o ka ʻai ʻana i ka meaʻai, hoʻonui ʻia ka poho o ka ʻōpū, hoʻemi i ka renal reabsorption, a i ʻole ka hāʻawi hou ʻana o ka magnesium mai waho a i loko o nā cell (Figure 3B). ʻO ka hypomagnesemia maʻamau e noho pū me nā maʻi electrolyte ʻē aʻe, e like me hypocalcemia, hypokalemia, a me metabolic alkalosis. No laila, hiki ʻole ke nānā ʻia ka hypomagnesemia, ʻoi aku ka nui o nā wahi lapaʻau kahi i ana mau ʻole ʻia nā pae magnesium koko. I loko wale nō o ka hypomagnesemia koʻikoʻi (serum magnesium<1.2 mg/dL [0.5 mmol/L]), ʻike ʻia nā hōʻailona e like me ka neuromuscular excitability (ka wāwae wāwae wāwae, ka epilepsy, a me ka haʻalulu), nā maʻi maʻi cardiovascular (arrhythmias and vasoconstriction), a me nā maʻi metabolic (ke kū'ē i ka insulin a me ka calcification cartilage). Hoʻopili ʻia ʻo Hypomagnesemia me ka hoʻonui ʻana i ka haukapila a me ka nui o ka make, ʻoiai ke hele pū ʻia me ka hypokalemia, e hōʻike ana i ka koʻikoʻi o ka magnesium.
ʻO ka maʻi magnesium i loko o ke koko e emi iho ma lalo o 1%, no laila ʻaʻole hiki i ke koko magnesium ke hoʻohālikelike pono i ka nui o ka magnesium i loko o ke kino. Ua hōʻike ʻia ka noiʻi ʻoiai inā he maʻamau ka neʻe ʻana o ka magnesium serum, hiki ke hoʻopau ʻia ka ʻike intracellular magnesium. No laila, ʻo ka noʻonoʻo ʻana i ka maʻi magnesium wale nō i loko o ke koko me ka noʻonoʻo ʻole i ka ʻai ʻana i ka magnesium meaʻai a me ka lilo ʻana o ka mimi e hoʻohaʻahaʻa i ka hemahema o ka magnesium clinical.

ʻO nā maʻi me ka hypomagnesemia e ʻike pinepine i ka hypokalemia. Hoʻopili pinepine ʻia ka hypokalemia paʻakikī me ka hemahema o ka magnesium, a hiki ke hoʻoponopono pono ʻia ma hope o ka hoʻi ʻana o nā pae magnesium i ka maʻamau. Hiki i ka hemahema o ka Magnesium ke hoʻoikaika i ka huna ʻana o ka pāhare pāpaʻa mai nā awāwa ohi, e hoʻonui hou ana i ka nalowale o ka pālolo. ʻO ka emi ʻana o nā kiʻekiʻe o ka magnesium intracellular e kāohi ai i ka hana Na + - K + - ATPase a hoʻonui i ka wehe ʻana o nā kahawai medullary potassium (ROMK) extrarenal, e alakaʻi ana i ka lilo o ka potassium mai nā puʻupaʻa. ʻO ka pilina ma waena o ka magnesium a me ka potassium e pili pū ana i ka hoʻoulu ʻana i ka sodium chloride co transporter (NCC), ma laila e hoʻoikaika ai i ka sodium reabsorption. ʻO ka hemahema o ka Magnesium e hōʻemi ana i ka nui o ka NCC ma o ka ligase protein ubiquitin E3 i kapa ʻia ʻo NEDD4-2, ka mea e hoʻohaʻahaʻa i ka hoʻomohala ʻana o ka cell neuronal precursor, a pale i ka hoʻoulu ʻana o NCC ma o hypokalemia. Hiki i ka hoʻohaʻahaʻa mau ʻana o ka NCC ke hoʻonui i ka lawe ʻana o Na + i loko o ka hypomagnesemia, e alakaʻi ana i ka hoʻonui ʻana i ka pāpaʻi mimi a me ka hypokalemia.

He mea maʻamau ka hypocalcemia i nā poʻe maʻi me ka hypomagnesemia. Hiki i ka hemahema o ka Magnesium ke pale i ka hoʻokuʻu ʻana o ka hormone parathyroid (PTH) a hoʻemi i ka naʻau o nā puʻupaʻa i ka PTH. ʻO ka emi ʻana o nā pae PTH hiki ke hōʻemi i ka reabsorption calcium renal, hoʻonui i ka excretion calcium urinary, a hopena i ka hypocalcemia. Ma muli o ka hypocalcemia i hoʻokumu ʻia e ka hypomagnesemia, paʻakikī pinepine ka hypoparathyroidism ke hoʻoponopono ke ʻole ka hoʻihoʻi ʻana o ke koko magnesium i ka maʻamau.

ʻO ke ana ʻana o ka serum magnesium ke ʻano maʻamau no ka hoʻoholo ʻana i ka ʻike magnesium ma ka hana lapaʻau. Hiki iā ia ke loiloi koke i nā loli pōkole i ka ʻike magnesium, akā hiki ke hoʻohaʻahaʻa i ka nui o ka magnesium ma ke kino. Hiki ke hoʻopili i nā kumu hopena (e like me hypoalbuminemia) a me nā mea exogenous (e like me ka hemolysis specimen a me nā anticoagulants, e like me EDTA) i ke ana o ka magnesium, a pono e noʻonoʻo ʻia kēia mau mea i ka unuhi ʻana i nā hopena hoʻokolohua koko. Hiki ke ana ʻia ka serum ionized magnesium, akā ʻaʻole maopopo ka hoʻohana ʻana i ka lāʻau lapaʻau.
I ka wā e ʻike ai i ka hypomagnesemia, hiki ke hoʻoholo ʻia ke kumu ma muli o ka mōʻaukala olakino o ka mea maʻi. Eia nō naʻe, inā ʻaʻohe kumu kumu, pono e hoʻohana ʻia nā ʻano diagnostic kūikawā no ka ʻike ʻana i ke kumu o ka pau ʻana o ka magnesium ma muli o ke kīpē a i ʻole ka ʻōpū o ka ʻōpū, e like me 24-hour magnesium excretion, magnesium excretion fraction, a me ka hoʻāʻo hoʻoili magnesium.

ʻO nā mea hoʻohui Magnesium ke kumu no ka mālama ʻana i ka hypomagnesemia. Eia naʻe, i kēia manawa ʻaʻohe alakaʻi lapaʻau akaka no ka hypomagnesemia; No laila, ʻo ke ʻano o ka mālama ʻana e hilinaʻi nui ʻia i ka paʻakikī o nā hōʻailona maʻi. Hiki ke mālama ʻia ka hypomagnesemia māmā me nā mea hoʻohui waha. Nui nā hoʻomākaukau magnesium ma ka mākeke, kēlā me kēia me nā helu absorption like ʻole. ʻO nā paʻakai organik (e like me ka magnesium citrate, magnesium aspartate, magnesium glycine, magnesium gluconate, a me ka magnesium lactate) ʻoi aku ka maʻalahi o ke kino o ke kanaka ma mua o nā paʻakai inorganic (e like me ka magnesium chloride, magnesium carbonate, a me ka magnesium oxide). ʻO ka hopena ʻaoʻao maʻamau o nā mea hoʻohui o ka magnesium waha he maʻi maʻi, kahi mea paʻakikī no ka hoʻohui ʻana i ka magnesium waha.
No nā hihia refractory, pono paha ka lāʻau lapaʻau adjuvant. No nā poʻe maʻi me ka hana maʻamau maʻamau, hiki ke hoʻonui i ka nui o ka magnesium epithelial me ka aminophenidate a i ʻole triaminophenidate. ʻO nā hoʻolālā ʻē aʻe e pili ana i ka hoʻohana ʻana i ka SGLT2 inhibitors e hoʻonui i ka pae serum magnesium, ʻoi aku hoʻi i nā maʻi me ka maʻi diabetes. ʻAʻole maopopo nā hana ma hope o kēia mau hopena, akā pili paha lākou i ka emi ʻana o ka filtration rate glomerular a me ka piʻi ʻana o ka renal tubular reabsorption. No nā poʻe maʻi me ka hypomagnesemia i kūpono ʻole i ka lāʻau lapaʻau magnesium supplementation waha, e like me ka poʻe me ka pōkole bowel syndrome, ka hopu lima a me ka wāwae, a i ʻole epilepsy, a me ka poʻe me ka hemodynamic instability i hoʻokumu ʻia e arrhythmia, hypokalemia, a me hypocalcemia, pono e hoʻohana i ka lāʻau intravenous. Hiki ke hoʻomaikaʻi ʻia ka hypomagnesemia i hoʻokumu ʻia e PPI e ka hoʻokele waha o ka inulin, a pili paha kāna hana i nā loli i ka microbiota gut.

ʻO ka Magnesium kahi mea electrolyte koʻikoʻi akā ʻike pinepine ʻia i ka maʻi maʻi a me ka mālama ʻana. Hoʻāʻo pinepine ʻia e like me ka electrolyte maʻamau. ʻAʻohe hōʻailona maʻamau ka hypomagnesemia. ʻOiai ʻaʻole maopopo ke ʻano pololei o ka hoʻoponopono ʻana i ke koena magnesium i loko o ke kino, ua holomua ka holomua ma ke aʻo ʻana i ke ʻano hana e hana ai nā puʻupaʻa i ka magnesium. Hiki i nā lāʻau he nui ke hoʻoulu i ka hypomagnesemia. He mea maʻamau ka hypomagnesemia ma waena o nā maʻi maʻi maʻi a me kahi kumu pilikia no ka noho lōʻihi o ka ICU. Pono e hoʻoponopono ʻia ka hypomagnesemia ma ke ʻano o ka hoʻomākaukau paʻakai organik. ʻOiai he nui nā mea pohihihi e hoʻoholo ʻia e pili ana i ke kuleana o ka magnesium i ke olakino a me nā maʻi, ua nui nā holomua ma kēia kahua, a pono e nānā pono nā kauka lapaʻau i ke koʻikoʻi o ka magnesium i ka lāʻau lapaʻau.