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Serum Magnesium in Proton Pump Inhibitors Users and Non-Users Cover

Serum Magnesium in Proton Pump Inhibitors Users and Non-Users

Open Access
|Mar 2025

Figures & Tables

Table 1.

Characteristics and inpatient duration of proton pump inhibitor (PPI) use among cases (n = 185)

VariableValue (%)
Patients under active treatment with PPIs, n185/370 (50.0%)
Specific PPI used, n
– Pantoprazole112/185 (60.5%)
– Lansoprazole38/185 (20.5%)
– Omeprazole24/185 (13.0%)
– Esomeprazole11/185 (6.0%)
Treatment duration in hospital*
– Mean ± SD (days)19.03 ± 6.17
– Median (days)17
– Mode (days)14
– Range (days)14 – 49
Daily dose, mg† (mean ± SD)
– Pantoprazole40.2 ± 8.6
– Lansoprazole28.7 ± 6.4
– Omeprazole27.5 ± 7.9
– Esomeprazole22.0 ± 5.3
Route of administration, n†
– Oral166/185 (89.7%)
– Intravenous19/185 (10.3%)
Figure 1.

Mean serum magnesium values by PPI users

Table 2.

Association between timing of recent H2RA use and case–control status

Timing of Most Recent H2RA Prescription (a)Case Patients (n = 185)Control Patients (n = 185)Unadjusted Odds Ratio (95% CI)Adjusted Odds Ratio (95% CI) (b)
≤ 90 days (Current use)15 (8.1%)20 (10.8%)0.72 (0.35–1.49)0.84 (0.38–1.83)
91–180 days (Recent use)8 (4.3%)10 (5.4%)0.79 (0.31–1.99)0.91 (0.33–2.52)
181–365 days (Remote use)6 (3.2%)9 (4.9%)0.64 (0.23–1.80)0.76 (0.25–2.27)
No H2RA exposure156 (84.3%)146 (78.9%)--

[i] Hypomagnesemia was defined as serum magnesium < 1.8 mg/dL (institutional reference range 1.8–2.2 mg/dL). (a)Includes Pantoprazole, Lansoprazole, Omeprazole, Esomeprazole.

[ii] Adjusted model controlled for age, sex, diabetes mellitus, heart failure, systemic malignancy, and concomitant corticosteroid use. PPI use was defined as therapy for ≥ 5 days per week for ≥ 6 months prior to hospitalization.

Table 3.

Characteristics of patients enrolled as cases and controls

VariableCategory / StatisticCases (PPI+) (n = 185)Controls (PPI−) (n = 185)χ2 / t valuep-value
Demographics
Age (years), mean ± SD53.8 ± 13.452.6 ± 12.90.89 (t)0.37
Age group18–30 yr14 (7.6%)29 (15.7%)5.920.052
31–50 yr75 (40.5%)68 (36.8%)
≥51 yr96 (51.9%)88 (47.6%)
SexMale104 (56.2%)106 (57.3%)0.040.84
Female81 (43.8%)79 (42.7%)
Comorbidities
Diabetes mellitusYes68 (36.8%)61 (33.0%)0.500.47
HypertensionYes74 (40.0%)70 (37.8%)0.170.68
Cardiovascular diseaseYes28 (15.1%)23 (12.4%)0.520.47
Chronic liver diseaseYes11 (5.9%)9 (4.9%)0.140.71
Chronic kidney diseaseYes8 (4.3%)7 (3.8%)0.070.79
Systemic malignancyYes5 (2.7%)4 (2.2%)0.100.76
Clinical Characteristics
Type of admissionMedical121 (65.4%)118 (63.8%)0.080.78
Surgical36 (19.5%)41 (22.2%)0.350.55
ICU admissionYes14 (7.6%)10 (5.4%)0.640.42
QTc-prolonging drugsYes27 (14.6%)21 (11.4%)0.830.36
Systemic corticosteroid useYes19 (10.3%)14 (7.6%)0.670.41
Number of concomitant medications (median (IQR)) (a)7 (5–10)5 (3–8)3.45 (t)0.001*
Biochemical Parameters
Serum magnesium (mg/dL), mean ± SD1.77 ± 0.482.02 ± 0.435.63 (t)<0.001*
Serum magnesium category< 1.8 mg/dL101 (54.6%)48 (25.9%)32.00<0.001*
1.8–2.2 mg/dL52 (28.1%)91 (49.2%)
> 2.2 mg/dL32 (17.3%)46 (24.9%)

[i] (a)Number of distinct drugs is a surrogate marker for comorbidity.

[ii] Hypomagnesemia defined as serum magnesium < 1.8 mg/dL.

[iii] Significance threshold: p < 0.05; statistically significant results marked with *

[iv] Serum magnesium estimated by the modified methylthymol blue colorimetric method

Figure 2.

Serum Magnesium category in different groups

Table 4.

Regression analysis and distribution of serum magnesium levels in cases (PPI users) and controls.

VariableCategoryUnadjusted ORAdjusted OR95% CI (Lower–Upper)p-valueSerum Magnesium Levels (%)Total (%)
Age1.0021.0000.985–1.0150.986
GenderMale1 (ref)1 (ref)
Female1.821.940.773–1.8450.424
GroupControl1 (ref)1 (ref)<1.8 = 25.91.8–2.2 = 49.2>2.2 = 24.9100
Cases2.1452.4751.605–3.816<0.001*<1.8 = 54.61.8–2.2 = 28.1>2.2 = 17.3100
Overall Total<1.8 = 40.31.8–2.2 = 38.6>2.2 = 21.1100

[i] “Unadjusted OR” represents crude odds ratios before accounting for confounders.

[ii] “Adjusted OR” includes adjustments for variables like age, sex, comorbidities, and concurrent medication use.

[iii] The p-value marked with * (<0.001*) indicates statistical significance.

Figure 3.

Frequency Distribution (%) of ages in cases

DOI: https://doi.org/10.2478/eabr-2026-0004 | Journal eISSN: 2956-2090 (formerly 2335-075X, 2956-0454) | Journal ISSN: 2956-0454 (formerly 1820-8665)
Language: English
Page range: 29 - 38
Submitted on: Nov 12, 2025
Accepted on: Dec 15, 2025
Published on: Mar 5, 2025
Published by: University of Kragujevac, Faculty of Medical Sciences
In partnership with: Paradigm Publishing Services

© 2025 Sumana Sen, Jassica Katta, Mahender Kumar Medisetty, published by University of Kragujevac, Faculty of Medical Sciences
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.