Low levels of serum magnesium are associated with poststroke cognitive impairment in ischemic stroke patients

Figures & data

Figure 1 Study recruitment profile.

Abbreviation: PSCI, poststroke cognitive impairment.

Table 1 Baseline clinical characteristics in non-PSCI and PSCI patients at 1 month

	Non-PSCI (n=222)	PSCI (n=105)	P-value
Demographic characteristics
Age (years), mean ± SD	61.14±9.97	65.39±10.08	<0.001
Male/female	153/69	54/51	0.003
Married status, n (%)	202 (91.0)	90 (85.7)	0.180
Education levels, n (%)			0.029
Illiterate	55 (24.8)	41 (39)
Primary school	103 (46.4)	38 (36.2)
Postsecondary school	64 (28.8)	26 (24.8)
TOAST classification, n (%)			0.741
LA	180 (81.1)	84 (80)
CE	12 (5.4)	6 (5.7)
SA	23 (10.8)	11 (10.5)
SOE	4 (1.8)	1 (1.0)
SUE	2 (0.9)	3 (2.9)
Lesion location, n (%)			0.840
Left hemisphere	69 (31.1)	37 (35.2)
Right hemisphere	79 (35.6)	31 (29.5)
Brainstem	36 (16.2)	18 (17.1)
Cerebellum	10 (4.5)	4 (3.8)
Others	28 (12.6)	15 (14.3)
Multiple infarcts, n (%)	85 (38.3)	52 (49.5)	0.056
Vascular risk factors, n (%)
Hypertension	157 (70.7)	73 (69.5)	0.897
Diabetes mellitus	63 (28.4)	37 (35.2)	0.247
Hyperlipidemia	21 (9.5)	10 (9.5)	1.000
Coronary artery disease	14 (6.3)	8 (7.6)	0.814
History of stroke	17 (7.7)	12 (11.4)	0.299
Current smoking	73 (32.9)	20 (19.0)	0.012
Current drinking	89 (40.1)	38 (36.2)	0.544
NIHSS score, median (IQR)	2.5 (1–4)	3 (1.5–5)	0.210
HAMA score, median (IQR)	4 (1–7)	4 (1–8)	0.800
HAMD score, median (IQR)	4 (2–7)	5 (1–9)	0.616
Poor outcome, n (%)	31 (14.2)	22 (21.0)	0.148
BI score, median (IQR)	100 (98–100)	100 (91–100)
Laboratory data
Mg^2+ (mmol/L), mean ± SD	0.86±0.07	0.83±0.09	0.003
HbA1c (mmol/L), mean ± SD	6.36±1.59	6.28±1.26	0.707
FBG (mmol/L), mean ± SD	5 (4.4–5.9)	4 (4.6–6.4)	0.257
PBG (mmol/L), mean ± SD	7.6 (6.0–10.6)	8.1 (6.0–12.4)	0.391

Abbreviations: BI, Barthel Index; CE, cardioembolism; FBG, fasting blood glucose; HAMA, Hamilton Anxiety Rating Scale; HAMD, Hamilton Depression Rating Scale; HbA1c, hemoglobin A1c; LA, large-artery atherosclerosis; Mg²⁺, magnesium; MMSE, Mini–Mental State Examination; NIHSS, National Institutes of Health Stroke Scale; PBG, postprandial blood glucose; PSCI, poststroke cognitive impairment; SA, small-artery occlusion lacunar; SOE, stroke of other determined etiology; SUE, stroke of other undetermined etiology; TOAST, Trial of Org 10172 in Acute Stroke Treatment.

Figure 2 Comparisons of serum Mg²⁺ levels in patients with PSCI and non-PSCI.

Notes: In the box-and-whisker plots, the horizontal line in the middle of each box indicates the median value; the lower and upper ends of the box represent the 25th and 75th percentiles, and the peripheral lines extending to the outer fences represent 10th and 90th percentiles, respectively. ^**P<0.01 compared with the non-PSCI group via the Mann–Whitney U-test.
Abbreviations: Mg²⁺, magnesium; PSCI, poststroke cognitive impairment.

Table 2 Magnesium levels across tertiles of patients

	Non-PSCI patients (n=222)	PSCI patients (n=105)	P-value
Magnesium, n (% of total population)			<0.001
Tertile 1 (≤0.82 mmol/L)	65 (29.3)	54 (51.4)	<0.001
Tertile 2 (0.83–0.88 mmol/L)	81 (36.5)	23 (21.9)	0.011
Tertile 3 (≥0.89 mmol/L)	76 (34.2)	28 (26.7)	0.204

Abbreviation: PSCI, poststroke cognitive impairment.

Table 3 Multivariate logistic model of the clinical determinants of PSCI

Variables	OR (95% CI)	P-value
Magnesium		0.001
Tertile 1	2.236 (1.232–4.058)	0.008
Tertile 2	0.765 (0.395–1.480)	0.426
Age	1.043 (1.014–1.073)	0.003
Sex	1.614 (0.885–2.943)	0.118
Education levels		0.527
Illiterate	0.776 (0.412–1.460)	0.431
Primary school	1.083 (0.515–2.276)	0.833
Current smoking	0.747 (0.385–1.449)	0.389
NIHSS score	1.094 (0.994–1.205)	0.066
History of stroke	1.648 (0.709–3.827)	0.246

Abbreviations: NIHSS, National Institutes of Health Stroke Scale; PSCI, poststroke cognitive impairment.