Magnesium Deficiency Questionnaire: A New Non-Invasive Magnesium Deficiency Screening Tool Developed Using Real-World Data from Four Observational Studies

Abstract

Due to the high estimated prevalence of magnesium deficiency, there is a need for a rapid, non-invasive assessment tool that could be used by patients and clinicians to confirm suspected hypomagnesemia and substantiate laboratory testing. This study analyzed data from four large observational studies of hypomagnesemia in pregnant women and women with hormone-related conditions across Russia. Hypomagnesemia was assessed using a 62-item magnesium deficiency questionnaire (MDQ-62) and a serum test. The diagnostic utility (sensitivity/specificity) of MDQ-62 was analyzed using area under the receiver operating characteristic curve (AUROC). A logistic regression model was applied to develop a shorter, optimized version of MDQ-62. A total of 765 pregnant women and 8836 women with hormone-related conditions were included in the analysis. The diagnostic performance of MDQ-62 was "fair" (AUROC = 0.7-0.8) for women with hormone-related conditions and "poor" for pregnant women (AUROC = 0.6-0.7). The optimized MDQ-23 (23 questions) and MDQ-10 (10 questions) had similar AUROC values; for all versions of the questionnaire, there was a significant negative correlation between score and changes in total serum magnesium levels (p < 0.0001 for all comparisons; correlation coefficients ranged from -0.1667 to -0.2716). This analysis confirmed the value of MDQ in identifying women at risk of hypomagnesemia.

Keywords: hormone-related conditions; hypomagnesemia; magnesium deficiency questionnaire; pregnancy.

Figure 1

Study population: (a) Pregnant women cohort; (b) Women with hormone-related conditions cohort.

Figure 2

Prevalence and clinical management of magnesium deficiency: (a) Proportion of women with magnesium deficiency at Visit 1; (b) Proportion of women achieving the target level after four weeks of magnesium supplementation. ^a Includes women who had a magnesium serum level below the corresponding target at baseline.

Figure 3

AUROC curves showing the questionnaires′ ability to predict hypomagnesemia in women with hormone-related conditions for: (a) MDQ-62 using the cut-off <0.8 mmol/L; (b) MDQ-62 using the cut-off <0.66 mmol/L; (c) MDQ-23using the cut-off <0.8 mmol/L; (d) MDQ-10 using the cut-off <0.66 mmol/L. AUROC, area under the receiver operating characteristic; MDQ, magnesium deficiency questionnaire; The presented p values are related to ROC curves implying the H0 hypothesis: AUC = 0.5.