Jebmh.com Original Research Article J. Evid. Based Med. Healthc., pISSN- 2349-2562, eISSN- 2349-2570/ Vol. 5/Issue 3/Jan. 15, 2018 Page 276 A STUDY OF SERUM MAGNESIUM LEVELS IN PATIENTS WITH ACUTE EXACERBATION OF COPD AND ITS COMPARISON WITH STABLE COPD PATIENTS- A PROSPECTIVE STUDY Saswat Subhankar 1 , Geetanjali Panda 2 , Jyoti Patnaik 3 1 Senior Resident, Department of Pulmonary Medicine, KIMS, Bhubaneswar, Odisha. 2 Associate Professor, Department of Pulmonary Medicine, SCBMCH, Cuttack, Odisha. 3 Professor and HOD, Department of Pulmonary Medicine, MKCG Medical College, Berhampur, Odisha. ABSTRACT BACKGROUND Chronic obstructive pulmonary disease is a collection of conditions characterised by persistent airflow limitation. It is recognised as an important cause of global burden of Non-Communicable Diseases (NCDs). Being a multicomponent disease characterised by abnormal inflammatory response of the lungs with systemic muscle dysfunction, a growing body of evidence has suggested a role of magnesium in exacerbations of COPD. Magnesium, owing to its ability to alleviate bronchospasm may have a role in maintaining disease stability in COPD patients. In the current study, we hypothesised that basal serum magnesium level must have some role in airway homeostasis and that a dysregulation results in decompensation. MATERIALS AND METHODS The study was conducted in the Department of Pulmonary Medicine, S.C.B. Medical College and Hospital, Cuttack, during the period of October 2012 to September 2014 and was designed on a case-control model with 40 patients in each group. RESULTS Patients with acute exacerbation of COPD had a mean serum magnesium level of 1.88 ± 0.19 mg/dL (95%, CI). Among the stable COPD patients, the mean serum magnesium level was 2.0625 ± 0.18 mg/dL (95%, CI) (p<0.0001). Magnesium deficiency was more common among smokers as compared to nonsmokers (OR=2.83). CONCLUSION We consider that observed association between serum magnesium and acute exacerbation of COPD to be substantial both in terms of the statistical power of the study and clarity of our findings. This is a modifiable risk factor and we recommend that serum magnesium be determined in all patients admitted for acute exacerbation. KEYWORDS Airflow, Exacerbations, Magnesium, Bronchospasm. HOW TO CITE THIS ARTICLE: Subhankar S, Panda G, Patnaik J. A study of serum magnesium levels in patients with acute exacerbation of COPD and its comparison with stable COPD patients- A prospective study. J. Evid. Based Med. Healthc. 2018; 5(3), 276-279. DOI: 10.18410/jebmh/2018/56 BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality all over the world. It poses a huge burden from healthcare costs on patients as well as on the healthcare infrastructure. Furthermore, the magnitude of burden is almost similar in the developed and the developing countries of the world. 1,2,3 COPD characterised by “airflow limitation, which is not fully reversible” is now recognised as “a preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterised by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles/gases.” 4 Magnesium is one of the most important factors for regulation of inflammatory response as well as muscle function and COPD is a multicomponent disease characterised by abnormal inflammatory response of the lungs with systemic muscle dysfunction. A growing body of evidence suggests that magnesium deficiency contributes to exacerbations of asthma, and as a corollary, that magnesium is useful in alleviating bronchospasm in these patients. 5-7 Although, the precise mechanism of this action is unknown. It has been suggested that magnesium plays a role in the maintenance of airway patency via relaxation of bronchial smooth muscle. 8 Chronic Obstructive Pulmonary Disease (COPD) represents an overlap of chronic bronchitis and emphysema and patients with COPD have an element of asthmatic bronchitis. 9 Bronchospasm is a contributing factor in their inability to clear secretions. This may result in reduced pulmonary gas exchange with consequences such Financial or Other, Competing Interest: None. Submission 25-12-2017, Peer Review 30-12-2017, Acceptance 11-01-2018, Published 13-01-2018. Corresponding Author: Dr. Geetanjali Panda, Associate Professor, Department of Pulmonary Medicine, SCB Medical College and Hospital, Cuttack, Odisha. E-mail: drgeetanjalipanda@gmail.com DOI: 10.18410/jebmh/2018/56