Low serum magnesium levels are associated with increased risk of fractures: a long-term prospective cohort study

Setor Kwadzo Kunutsor*, Michael Richard Whitehouse, Ashley William Blom, Jari Antero Laukkanen

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Magnesium, which is an essential trace element that plays a key role in several cellular processes, is a major component of bone; however, its relationship with risk of major bone fractures is uncertain. We aimed to investigate the association of baseline serum magnesium concentrations with risk of incident fractures. We analyzed data on 2,245 men aged 42-61 years in the Kuopio Ischemic Heart Disease prospective cohort study, with the assessment of serum magnesium measurements and dietary intakes made at baseline. Hazard ratios (95% confidence intervals [CI]) for incident total (femoral, humeral, and forearm) and femoral fractures were assessed. During a median follow-up of 25.6 years, 123 total fractures were recorded. Serum magnesium was non-linearly associated with risk of total fractures. In age-adjusted Cox regression analysis, the hazard ratio (HR) (95% CIs) for total fractures in a comparison of the bottom quartile versus top quartile of magnesium concentrations was 2.10 (1.30-3.41), which persisted on adjustment for several established risk factors 1.99 (1.23-3.24). The association remained consistent on further adjustment for renal function, socioeconomic status, total energy intake, and several trace elements 1.80 (1.10-2.94). The corresponding adjusted HRs for femoral fractures were 2.56 (1.38-4.76), 2.43 (1.30-4.53), and 2.13 (1.13-3.99) respectively. There was no evidence of an association of dietary magnesium intake with risk of any fractures. In middle-aged Caucasian men, low serum magnesium is strongly and independently associated with an increased risk of fractures. Further research is needed to assess the potential relevance of serum magnesium in the prevention of fractures.
Original languageEnglish
Pages (from-to)593-603
Number of pages11
JournalEuropean Journal of Epidemiology
Issue number7
Early online date12 Apr 2017
Publication statusPublished - Jul 2017

Structured keywords

  • Centre for Surgical Research


  • Magnesium
  • Cohort study
  • Fracture
  • Risk factor


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