Diabetes is a common health challenge. Previous studies have established that diabetes is often associated with low circulating magnesium status. As evidence from randomized controlled trials (RCTs) on the effect of magnesium supplementation on insulin resistance remains inconsistent, and the influence of baseline status is not fully understood, this systematic review and meta-analysis evaluated the effects of magnesium supplements, compared with placebo, on insulin resistance in individuals with diabetes and pre-diabetes. A comprehensive search based on the PRISMA 2020 guidelines was conducted in PubMed, Web of Science, and Scopus until 24 April 2026. Randomized controlled trials with a population of individuals with diabetes and pre-diabetes that received any magnesium supplements compared to a placebo group, evaluating insulin and the HOMA-IR index as the primary outcome, were included in our study. Secondary outcomes were serum magnesium level, HbA1c, and fasting blood glucose (FBG). We pooled data using a random-effects model to estimate changes in outcomes. Subgroup analyses were conducted based on dosage (> 250 and ≤ 250 mg/day) and follow-up duration (under or over 12 weeks). Meta-regression, publication bias, and sensitivity analysis were performed as well. Fifteen RCTs involving 1,085 participants met the criteria. Overall, the oral magnesium supplementation did not result in a statistically significant change in insulin levels (MD = - 1.73; 95% CI: -3.73 to 0.27; p-value = 0.09) and HOMA-IR (MD = - 0.74; 95% CI: -1.58 to 0.09; p-value = 0.08) in people with diabetes. Similar non-significant findings were observed in individuals with prediabetes (p > 0.05). However, meta-regression analysis demonstrated that baseline insulin level and HOMA-IR index significantly modified the intervention effect (p = 0.01), suggesting differential responsiveness across patient subgroups. No significant associations were observed for baseline HbA1c, fasting blood glucose, magnesium levels, age, or BMI. Subgroup analysis based on doses and duration of follow-up did not change the significance of the result. Magnesium supplementation does not appear to improve insulin resistance in individuals with diabetes or prediabetes significantly. However, its effects may depend on baseline insulin status, highlighting the need for targeted interventions in individuals with higher insulin resistance. Future well-designed trials with larger sample sizes are needed to clarify baseline insulin effects.
Alcoholic liver disease (ALD) involves progressive hepatic dysfunction and frequent electrolyte disturbances, but the relationship between serum magnesium and clinically staged ALD remains unclear. This study aimed to explore the relationship between the two with established markers of disease severity. In this hospital‑based cross‑sectional study, 80 adults with confirmed ALD were enrolled at a tertiary center in Karaikal, TN, IND, between January and December 2025. Patients were classified as non‑cirrhotic ALD, compensated cirrhosis, or decompensated cirrhosis. Clinical evaluation, laboratory tests (including serum magnesium), viral serology, ultrasonography, and the model for end-stage liver disease (MELD) and Maddrey's discriminant function (DF) scores were obtained. Prognostic assessment was performed using the MELD, Maddrey's DF, and the age-bilirubin-INR-creatinine (ABIC) scores. Most patients had non‑cirrhotic ALD (53.8%) or decompensated cirrhosis (40.0%); nearly all were male. With advancing stages, hemoglobin, platelets, sodium, albumin, and coagulation indices worsened, and MELD and DF scores increased significantly. Serum magnesium showed a progressive, borderline non‑significant decline (p=0.071). Conventional biochemical markers and prognostic scores robustly reflected ALD severity, while serum magnesium trended downward across stages, suggesting a potential adjunctive role rather than a standalone severity marker.
Post-operative sore throat (POST) frequently complicates general anesthesia involving endotracheal intubation, affecting roughly 60% of individuals and markedly hindering postoperative recovery. The current systematic review and meta-analysis assessed both the safety profile and prophylactic efficacy of preoperative magnesium sulfate administered via nebulization against POST. A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing preoperative nebulized magnesium sulfate with placebo or normal saline for POST prevention in adults undergoing elective surgery under general anesthesia was conducted. The primary outcome was POST incidence at 24 h. Secondary outcomes included POST at 2, 4, 8, and 12 h, hoarseness, cough, and hemodynamic adverse events. PROSPERO registration: CRD420261308633. Twelve RCTs comprising 1,023 patients were included. Nebulized Magnesium Sulfate significantly reduced POST at 24 h compared to control (RR = 0.25; 95% CI: 0.14-0.42; p < 0.00001; I² = 62%). Sensitivity analysis excluding an outlier reduced heterogeneity (I² = 7%) while maintaining significance. Significant reductions were also observed at 2 h (RR = 0.43; 95% CI: 0.32-0.58), 4 h (RR = 0.38; 95% CI: 0.19-0.77), and 12 h (RR = 0.34; 95% CI: 0.14-0.79). Subgroup analysis demonstrated comparable efficacy between the 225 mg dose and higher doses, with no statistically significant difference observed. No significant reduction was observed for hoarseness (RR = 0.44; 95% CI: 0.17-1.18) or cough (RR = 0.39; 95% CI: 0.15-1.04), and no increased hemodynamic risk was detected. Trial sequential analysis confirmed robust evidence for POST prevention. The administration of preoperative nebulized magnesium sulfate serves as an effective and safe measure to decrease POST incidence among adult patients, thereby justifying its inclusion in standard perioperative management protocols.
Magnesium-based implants hold great promise for orthopedic applications; however, their clinical translation is severely hindered by rapid corrosion and insufficient biological functionality. Herein, we report a multifunctional organic-inorganic hybrid coating constructed by integrating catechol-functionalized photo-crosslinkable polycarbonates with guanidine- and phenylboronic acid-modified hydroxyapatite nanoparticles on magnesium alloy substrates. The resulting hybrid coating forms a stable surface-eroding barrier, effectively suppressing rapid degradation while maintaining long-term interfacial integrity. Benefiting from the combined contribution of guanidyl functionalities and redox-active catechol/phenylboronic acid-containing structures, the coating exhibits potent antibacterial activity against Staphylococcus aureus and Escherichia coli and effectively reduces intracellular reactive oxygen species (ROS) levels. Meanwhile, the incorporation of bioactive hydroxyapatite promotes mineralized matrix deposition and osteogenic differentiation. This multifunctional coating establishes a favorable interfacial microenvironment integrating corrosion protection, antibacterial activity, oxidative stress regulation, and osteogenic stimulation, providing a versatile strategy for enhancing the biological performance of magnesium-based orthopedic implants.
Magnesium (Mg) deficiency is a major nutritional constraint in acidic orchard soils and can impair both vegetative growth and fruit quality in passion fruits (Passiflora edulis). However, the physiological and molecular mechanisms underlying Mg deficiency responses in passion fruit remain insufficiently understood. This study employed a comprehensive approach, integrating physiological assessments with metabolomic and transcriptomic profiling, to explore the responses to Mg deficiency in the leaves and fruits of purple passion fruit. Our findings revealed that Mg deficiency detrimentally affected chloroplast ultrastructure, significantly decreased SPAD values by an average of 16.1% and net photosynthetic rates by an average of 55.0% in leaves, and led to the accumulation of starch and soluble sugars (increased by approximately 26.4% and 11.9%, respectively) in source leaves. In fruit peels, Mg deficiency resulted in a significant reduction in anthocyanin content by approximately 46.3% and a 2.4-fold increase in chlorophyll content, leading to a 79.5% decrease in the anthocyanin-to-chlorophyll ratio and producing a commercially undesirable green coloration. Through integrative multi-omics analysis, we identified the specific alteration of the galactose metabolism pathway under Mg deficiency, which facilitated the synthesis of melibiose, fructose, and succinate as potential osmoprotectants. These results suggest that Mg deficiency compromises both the marketable appearance and nutritional quality of passion fruit, while simultaneously triggering carbon reallocation as an underlying potential mechanism. In conclusion, the metabolism of galactose may enhance plant adaptation to magnesium deficiency stress, thereby offering a physiological foundation for developing optimal magnesium fertilization strategies in passion fruit orchards cultivated in acidic soils.
Owing to their vast crustal abundance and inherently dendrite-free electrodeposition, rechargeable magnesium batteries (RMBs) have emerged as a compelling next-generation alternative to conventional lithium-ion technologies. In this context, Prussian Blue Analogs (PBAs) demonstrate significant potential as intercalation cathode candidates, as their open framework and continuous 3D diffusion pathways facilitate efficient divalent ion transport. However, their practical implementation is currently hindered by limited specific capacity and insufficient cycling stability, primarily due to lattice distortion and sluggish intercalation kinetics. This study presents a novel magnesium storage mechanism involving vacancy-mediated ion insertion (4b sites) and the activation of adsorption-active sites (32f sites), thereby significantly boosting the electrochemical performance of PBA materials. Notably, the cation-deficient PBA (PBA□Fe), synthesized via slow coprecipitation and acid treatment, delivered a high energy density of 240 Wh kg-1, which is comparable to those of transition metal oxide materials, while maintaining 80.7% capacity retention over 1000 cycles at 200 mA g-1. The dual role of Fe vacancies-providing Mg2+ storage sites and activating additional adsorption active sites (32f sites)-highlights a strategic innovation for the deployment of high-capacity and long-cycle cathodes for RMBs. This work underscores the potential of defect engineering in optimizing high-performance Mg-ion battery materials.
Viscum album L. (European mistletoe) is a medicinally significant hemiparasitic plant with a rich bioactive phytochemical profile. Despite growing interest in its pharmacological properties, studies integrating nanoparticle biosynthesis, comprehensive biological evaluation, and computational analysis remain scarce for its austriacum subspecies. In this study, magnesium nanoparticles (VA-MgNPs) were green-synthesized using the ethanol extract of Viscum album subsp. austriacum as a bioreducing and capping agent, and their biological activities were comparatively assessed alongside the crude extract and Mg(NO3)2·6H2O precursor control. LC-HR/MS analysis identified quinic acid (10,027.49 μg/g) and chlorogenic acid (5294.12 μg/g) as the dominant phenolic constituents. The synthesized VA-MgNPs were characterized by FT-IR, UV-Vis, FE-SEM, TEM, and XRD analyses, confirming nanocrystalline formation with a mean crystallite size of approximately 66.47 nm. Antioxidant evaluation using DPPH, ABTS, and FRAP assays revealed that the crude extract retained superior radical scavenging capacity, which is attributed to the consumption of free phenolic hydroxyl groups during nanoparticle formation. In contrast, VA-MgNPs demonstrated markedly enhanced anticancer activity against breast (MCF-7: IC50 = 124 μg/mL; MDA-MB-231: IC50 = 96 μg/mL) and colorectal (HCT116: IC50 = 105 μg/mL; HT-29: IC50 = 135 μg/mL) cancer cell lines, with lower cytotoxicity toward non-tumorigenic cells, indicating selective antiproliferative action. Although antibacterial activity was limited across tested strains, VA-MgNPs exhibited significant antibiofilm activity, achieving up to 75% inhibition against Pseudomonas aeruginosa. Molecular docking simulations revealed that chlorogenic acid and its magnesium complex displayed strong binding affinities toward antioxidant- and antimicrobial-related protein targets, with binding energies reaching -8.5 kcal/mol, mechanistically supporting the observed biological activities. These findings demonstrate that VA-MgNPs are a promising nanotherapy platform, particularly for antibiofilm and anticancer applications.
Wheat is a globally significant cereal crop and constitutes a primary source of essential nutrients for human consumption. Comprehensive understanding of the mineral composition of wheat grains, including the distribution of minerals among the whole grain, bran, and germ, as well as the nutrient concentrations in various bread types, is essential for accurately evaluating its nutritional contributions. This study aimed to quantify the concentrations of three essential minerals-potassium (K), calcium (Ca), and magnesium (Mg)-in wheat grains cultivated across Iran under both irrigated and rainfed agricultural systems and mineral partitioning between the germ and bran fractions. A total of 1876 wheat samples, representing both irrigated and rainfed cultivation systems, were collected from diverse agroecological zones throughout Iran and their K, Ca, and Mg concentrations were measured. The mean concentrations of K, Ca, and Mg in the wheat grains were 4059 mg kg-1, 394 mg kg-1, and 1046 mg kg-1, respectively. Notably, all three minerals exhibited significantly higher concentrations in irrigated wheat compared to rainfed wheat. Spatial analysis indicated regional variability in mineral concentrations: potassium and calcium levels were lowest in northern provinces, which may be attributed to higher precipitation, intensified cultivation practices, and resultant soil nutrient depletion. Magnesium concentrations demonstrated a contrasting pattern, with reduced levels in northern and western provinces and increased concentrations in eastern and southern regions. A weak yet positive correlation was observed between mineral concentrations (K, Ca, Mg) and wheat grain yield. Furthermore, mineral concentrations were highest in the bran fraction, followed by whole grain and germ. Among different bread types analyzed, Baguette, Taftoon, and Sangak exhibited the highest concentrations of K, Ca, and Mg. These findings underscore considerable regional variability in the mineral content of wheat grains cultivated in Iran and suggest that irrigated agricultural practices generally enhance the accumulation of essential minerals in wheat.
Halogen-free electrolytes (HFEs) are promising for rechargeable magnesium batteries, but their application is limited by moderate ionic conductivity and interfacial instability. In this work, dimethyl sulfoxide (DMSO) was introduced as a functional additive to tailor the physicochemical and electrochemical properties of a Mg(NO3)2-based HFE system. FTIR and UV-vis analyses suggested that DMSO modifies the solvation structure through strong Mg2+-O coordination, leading to enhanced polarizability and reduced optical band gap. Electrochemical results showed improved ionic conductivity (up to 1.7 × 10-3 S cm-1), lower activation energy (∼0.10 eV), higher Mg2+ transference number (∼0.82), improved apparent oxidative stability (∼3.7 V), and improved Mg stripping/plating behavior with reduced overpotential. Mg-S full cells with sulfur/graphene/BaTiO3 cathodes exhibited enhanced discharge/charge capacities (1732/1176 mAh g-1) and improved cycling performance. XRD, SEM/EDS, impedance, and diffusion analyses further suggested enhanced Mg2+ transport and stabilization of the Mg/electrolyte interface. Overall, DMSO-induced solvation engineering provides an effective strategy for improving halogen-free electrolytes and magnesium battery performance.
In this study, rice husk generated from the rice milling industry, commonly used as boiler fuel and subsequently discarded as ash along with wood residue ash, has been valorised into a functional bio-nanocomposite. Unlike conventional approaches that rely on synthetic or purified precursors, the present work directly utilizes this industrial waste, thereby addressing both waste management and material development within a circular economy framework. In this context, rice husk ash and wood ash were employed for the synthesis of magnesium ferrite-based bio-nanocomposite beads (MgF/RHWA) using a gelatin matrix. The developed beads exhibited a uniform size distribution in the range of 1.7-2.2 mm, indicating good structural stability. Adsorption studies demonstrated high removal efficiencies of 99% for Cr(VI) and 97% for Ni(II), with maximum adsorption capacities of 7.25 mg/g and 6.125 mg/g, respectively. The enhanced performance is attributed to the synergistic interaction between gelatin functional groups (-NH₂, -OH, -COOH) and the MgF/RHWA composite. Kinetic studies followed a pseudo-second-order model with multi-stage intraparticle diffusion, while isotherm analysis confirmed Langmuir behaviour. Selectivity studies revealed favourable performance in the presence of competing anions (sulphate, chloride, phosphate, and nitrate), demonstrating effectiveness in multi-ionic systems. Thermogravimetric analysis (TGA) of the MgF/RHWA beads showed an overall mass loss of 87.90%, confirming the composite nature of the material. Regeneration studies indicated good reusability, with the adsorbent maintaining significant adsorption efficiency over five consecutive cycles. Overall, the results highlight the potential of this waste-derived bio-nanocomposite as a sustainable and cost-effective adsorbent for heavy metal removal in industrial wastewater.
Mucositis is a common debilitating complication of chemotherapy in cancer patients that limits enteral nutrition, causes diarrhea, dehydration and electrolyte wasting. 2'-fucosyllactose (2'-FL), a non-digestible oligosaccharide initially isolated from human milk, is critical in the development of gastrointestinal function and microbiome maturation in the newborn. Here, we demonstrate, that supplementation of 2'-FL in a medical food with magnesium (Humolyte®), protects Wistar rats from gastrointestinal mucosal injury from chemotherapeutic drugs doxorubicin, irinotecan, 5-flurouracil, and cisplatin. Supplementation with Humolyte® reduced weight loss and the severity of diarrhea from chemotherapy. Histopathology of ileal and colonic tissue showed preservation of overall mucosal anatomy including goblet cells and a markedly lesser inflammation. Humolyte® reduced hypertrophy and edema of oral mucosa caused by chemotherapy. In vitro, Humolyte® improved goblet cell survival and mucin secretion while reducing monolayer permeability. Thus, Humolyte® can be a useful adjunctive therapy for patients with cancer suffering from chemotherapy-induced mucositis.
Postoperative pain following spinal and neurological surgeries is often severe and can hinder recovery, mobilization, and increase risk of chronic pain. While opioids are the traditional standard for pain management, associated risks and the ongoing opioid crisis necessitate alternative therapies. Magnesium sulfate, an NMDA receptor antagonist and calcium channel blocker, has shown promise in reducing postoperative pain and opioid consumption. The present investigation utilized a systematic search for studies from PubMed, Embase, and Web of Science. Sources were eligible for inclusion in this review if published from 2010 to present, if patients received a spinal or neurological surgery regardless of patient age, country, race, and gender, and if the source was a randomized control trial, case report, or case series. Sources in non-English, without full-text access, and systematic reviews/meta-analyses were excluded, as well as studies focused on non-human subjects or studies with adjuvant therapies. Nine randomized controlled trials met our criteria. Pain scores (VAS/NRS) and opioid consumption were the primary outcomes. Meta-analysis was conducted using Cochrane Review Manager with fixed or random-effects models depending on heterogeneity. Magnesium sulfate significantly reduced pain scores at rest at multiple postoperative time points, including 0 h (MD=- 0.79; p = 0.004), 4 h (MD= -1.03, p < 0.00001), 24 h (MD= -0.78: p = 0.005), and 48 h (MD= -0.67: p = 0.0006). Opioid consumption was also significantly reduced at various intervals. No major adverse events were reported. Perioperative magnesium sulfate infusion is a safe and effective adjunct for reducing postoperative pain and opioid use in spinal surgery patients, with potential applications in neurological procedures pending further research.
Acoustoelectric (AE) devices enable coupling between acoustic waves and mobile charge carriers, offering a route toward RF-to-DC conversion, RF power sensing, energy harvesting, and responsive sensing applications. The efficiency of this coupling depends on both the electromechanical properties of the piezoelectric substrate and the transport properties of the conductive film interacting with the surface acoustic wave (SAW). Here an AE SAW delay line platform is presented for generating large AE currents using graphene on lead magnesium niobate-lead titanate (PMN-PT). Leveraging graphene's high carrier mobility and the strong electromechanical coupling of (111)-cut PMN-PT, this platform achieves giant AE current generation. Additionally, AE responsivity (RAE) is introduced here as a figure of merit for comparing AE platforms. The platform comprises interdigitated transducers (IDTs) deposited and patterned on the bulk PMN-PT surface for launching SAW and a monolayer graphene film positioned within the SAW propagation region. Experimental measurements confirm generation of AE current and voltage within the SAW passband, with the AE current reaching up to 90.39 µA at an RF input power of 20 dBm, corresponding to an RAE of 7.66 µA/(W·MHz). The reported AE current and AE responsivity outperform most of the previously reported platforms, validating the effectiveness of the proposed approach.
Despite the potential of biochar to enhance crop nutrient uptake, the complex, feedstock-dependent interactions among biochar properties, soil biological processes, and plant root traits remain poorly understood. Hence, this study employed machine learning algorithms (Linear regression and Random Forest) with advanced feature selection methods (Correlation-based Feature Subset Selection Evaluator, Correlation-Based Attribute Evaluator, Principal Components Attribute Transformer, and Stepwise Regression) to predict potassium (K+) and magnesium (Mg2+) uptake by wheat (Triticum aestivum L.) roots. A greenhouse experiment was conducted for 42 days, utilizing soils amended with four biochar treatments derived from wheat stubble, wood residues, rice husk, and corn residues (25 g biochar kg⁻¹ soil). The models were trained using a comprehensive dataset of over 40 parameters from the experiment (including variables such as soil basal respiration, root cation exchange capacity, and biochar specific surface area). The results indicated that Random Forest models achieved excellent predictive performance and outperformed Linear Regression, demonstrating superior ability to capture nonlinear relationships and feature interactions. Feature selection revealed distinct mechanisms: K+ uptake was primarily driven by soil basal respiration, root adenosine triphosphate (ATP) content, and biochar surface properties (zeta potential and Brunauer-Emmett-Teller (BET) surface area), highlighting microbial mobilization and energy-dependent active transport. In contrast, Mg2+ uptake was driven predominately by biochar oxygenation, biochar Mg2+ content, root cation exchange capacity, and carboxyl groups on root cell walls (yielding a predictive CC of 0.89 and MAE of 0.71). The significance of biochar's intrinsic Mg2+ content suggests a direct nutritional contribution from the amendment itself, which is a fundamentally different pathway than the indirect mechanisms highlighted for K+. Biochar efficacy was highly feedstock-dependent, with wheat stubble and wood residue biochars outperforming rice husk and corn residue biochars. These quantitative results provide specific mechanistic insights into biochar-mediated variation of cationic nutrition and demonstrate the power of machine learning for unraveling complex rhizosphere dynamics.
Modulating the cation distribution of magnesium spinel ferrites (MgFe2O4) offers a strategic pathway to optimize their functional properties. This study reports the synthesis of novel, mesoporous binary mixed ferrites (Mn0.5Mg0.5Fe2O4 and Cu0.5Mg0.5Fe2O4) via a rapid sol-gel auto-combustion method to achieve selective separation of target metal ions from complex aqueous matrices. Structural and morphological characterizations confirmed the formation of phase-pure, cubic spinel structures (average crystallite sizes of 24-35 nm) featuring interconnected, sponge-like mesoporous architectures. Surface analyses identified abundant oxygen vacancies and hydroxyl groups, which act as critical active sites for inner-sphere metal complexation. Both nano-ferrites exhibited super-paramagnetic behavior; however, the Mn-doped variant demonstrated a higher saturation magnetization (56.33 emu g-1) compared to the Cu-doped ferrite (37.97 emu g-1), enabling highly efficient post-treatment magnetic separation. In competitive multi-metal sorption assays, the transition-metal dopants dictated distinct, pH-dependent selectivity profiles. Mn0.5Mg0.5Fe2O4 exhibited high affinity for Zn2+ separation at pH 6, while Cu0.5Mg0.5Fe2O4 acted as a precision sorbent, achieving exceptional (∼95%) targeted selectivity for Ag+ recovery. These findings demonstrate that targeted metal doping effectively tailors the interfacial chemistry of spinel ferrites, establishing them as robust, magnetically retrievable platforms for both toxic metal remediation and high-value resource recovery.
Soft tissue calcification, a common cause of cardiovascular mortality in conditions like chronic kidney disease (CKD), is influenced by magnesium (Mg). However, the exact mechanism, whether extracellular chemistry-mediated or cell-mediated, remains unclear. Here we focused on the extracellular milieu. Using fluorescence-labelled fetuin-A and a live imaging platform, we found that Mg reduced spontaneous mineral precipitation by stabilizing calcium and phosphate as colloidal protein-mineral particles (CPP) in calcification media containing up to 10 mM calcium and phosphate. Addition of 1.25-5 mM Mg progressively stabilized the protein-mineral particles in the fluid phase, increasing calcification. Dynamic light scattering revealed smaller and more numerous CPP at up to 4 mM Mg. At 10 mM Mg, no calcification occurred even with 10 mM added calcium and phosphate. This suggested a critical Mg concentration range in supersaturated calcification media, where Mg paradoxically enhanced calcification by stabilizing mineral precursors and increasing their availability. These findings demonstrate Mg's dual role: an inhibitor of protein-mineral complex aggregation at high concentrations and a facilitator of mineral availability from colloidal protein-mineral phases at concentrations up to about 5 mM Mg. This highlights the role of Mg in providing highly dynamic, mineral-rich, stable protein-mineral complexes driving matrix calcification, yet preventing mineral precipitation.
Antineoplastic agents significantly contribute to drug-induced liver injury (DILI). This study evaluates magnesium isoglycyrrhizinate (MgIG) for preventing DILI in hematological malignancy patients receiving novel antitumor therapies. This multicenter retrospective analysis included hematological malignancy patients treated with hepatoprotective agents across 13 Chinese centers (December 2023-February 2024). Primary outcomes assessed liver injury incidence and severity at 21, 30, and 60 days; secondary outcomes evaluated safety. Propensity score-matched cohorts (MgIG = 324, control = 182) showed balanced baselines. MgIG recipients had higher chemotherapy (91.4 vs. 64.3%, P < 0.001) and Venetoclax exposure (26.2 vs. 2.2%, P < 0.001). Baseline AE incidence was higher with MgIG (4.6 vs. 0.5%, P = 0.014), but subsequent follow-ups showed comparable AE rates. Hepatic injury incidence was similar (4.2 vs. 4.0%, P > 0.05). Controls exhibited greater ALT, AST and γ-GGT elevations at day 30 and γ-GGT elevation at day 60 (all P < 0.05). MgIG reduced overall hepatic AEs (48.0 vs. 66.7%, P < 0.001), driven by fewer grade 1-2 abnormalities (43.5 vs. 60.3%, P < 0.001), though grade ≥2 events remained comparable. Interim assessments revealed higher hepatic AE rates in controls at day 21 (54.5 vs. 37.1%) and day 30 (55.7 vs. 34.1%; P < 0.001), with elevated grade ≥2 AEs by day 60 (18.6 vs. 8.6%, P = 0.022). Prophylactic MgIG attenuates antineoplastic therapy-induced ALT/AST/TBiL elevations in hematological malignancies, demonstrating hepatoprotective efficacy. While its impact on overall DILI incidence remains unclear, longitudinal data suggest clinically meaningful mitigation of hepatotoxicity severity in high-risk subgroups during critical phases.
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[This corrects the article DOI: 10.3389/fpls.2026.1739257.].
Gitelman syndrome is an autosomal recessive salt-wasting tubulopathy characterized by hypokalemia, metabolic alkalosis, hypomagnesaemia and hypocalciuria. It may present in adulthood with nonspecific symptoms including cramps, fatigue and musculoskeletal complaints. We report the case of a 34-year-old male electrical engineer with a three-year history of low back pain, neck and shoulder pain, and radiculopathy. His spinal history is briefly noted as contextual. He was found to have persistent hypokalemia (serum K⁺ ~2.9-3.4 mmol/L), hypomagnesaemia (serum Mg²⁺ ~0.97-1.16 mmol/L), metabolic alkalosis (serum HCO₃⁻ ~28-31 mmol/L, arterial blood gas pH ~7.49) and low urinary fractional excretion of calcium (FECa ~0.002). Work-up excluded other causes of potassium and magnesium wasting; normal blood pressure was noted. A clinical diagnosis of Gitelman syndrome was made. Management included counselling regarding a high-sodium diet together with potassium-rich and magnesium-rich foods, supplementation of potassium and magnesium, and planned initiation of eplerenone and sodium chloride supplementation. We discuss the pathophysiology of Gitelman syndrome, its typical biochemical profile, differential diagnosis (including Bartter syndrome), the relevance of the patient's musculoskeletal pain in the setting of electrolyte imbalance, and therapeutic considerations. This case underscores the importance of considering Gitelman syndrome in adults presenting with persistent hypokalemia, hypomagnesaemia and metabolic alkalosis, even when musculoskeletal symptoms dominate the presentation. Early recognition allows targeted therapy, potentially improving quality of life.