Lower plasma magnesium, measured by nuclear magnetic resonance spectroscopy, is associated with increased risk of developing type 2 diabetes mellitus in women: Results from a Dutch prospective cohort study 29 2 smoker 22. Blood pressure was measured with an automatic Dinamap XL Model 9300 series device (Johnson-Johnson Medical, Tampa, FL, USA). Hypertension was defined as a systolic blood pressure (SBP) >140mmHg or a diastolic blood pressure (DPB) >90mmHg, and/or the use of anti-hypertensive drugs. Information on medication use was combined with information on drug use from the IADB.nl database, containing pharmacy-dispensing data from community pharmacies in the Netherlands 23. Estimated glomerular filtration rate (eGFR) based on serum creatinine and serum cystatin C was calculated from the Chronic Kidney Disease Epidemiology Collaboration equation 24. Urinary albumin, sodium, urea, and creatinine excretion and circulating albumin, sodium, potassium, calcium and creatinine, total cholesterol, high-density lipoprotein cholesterol, triglycerides, high sensitivity C-reactive protein (hsCRP) and glucose were determined as previously described 25–28. Assessment of T2D risk Incident T2D was ascertained if one or more of the following criteria were met: 1) fasting plasma glucose >7.0 mmol/L; 2) random sample plasma glucose >11.1 mmol/L; 3) self-reporting of a physician diagnosis; 4) initiation of glucose-lowering medication use retrieved from a central pharmacy registry 29. Incident T2D was defined as T2D that occurred after the second screening. Statistical analysis Analytic validation data was calculated using Analyze-it (Analyze-it Software, Ltd. Leeds, UK). Passing-Bablok regression analysis was used to test agreement between NMRmeasured Mg in EDTA plasma and heparin plasma Mg measured on the Roche Modular Analyzer. Bland-Altman plots were used to visualize bias. Baseline characteristics are reported in terms of means (SD) when normally distributed or medians (interquartile range) in the case of non-normally distributed data. Categorical data are presented as frequencies (percentages). We prospectively examined the association between chelated Mg and risk of developing T2D using Cox proportional hazards regression models.We used chelated Mg as a continuous variable in these models and additionally, we examined the association in tertiles of chelated Mg. Person-time of follow-up was calculated for each participant from the first visit (baseline) until the last visit, the incidence of T2D, death, or relocation to an unknown destination, whichever came first. Multivariable Cox models were adjusted for age, sex, BMI, smoking (2 categories), alcohol intake (2 categories), triglyceride to high-density lipoprotein cholesterol ratio, hypertensive treatment, parental history of T2D, plasma levels of albumin, potassium
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