Magnesium deficiency in the students of the Republic of Bashkortostan: prevalence, impact on reproductive health, and effectiveness of correction

Rationale. Magnesium is known as a cofactor for over 600 enzymatic reactions and plays a key role in maintaining women's reproductive health. Magnesium deficiency is associated with dysmenorrhea, premenstrual syndrome (PMS), menstrual irregularities, and, in the long run, with pregnancy complications (preeclampsia, premature birth, fetal growth restriction). Despite its clinical significance, there is a lack of studies on the prevalence of magnesium deficiency among youth in the Republic of Bashkortostan. Given that pregravid preparation is a key period for preventing reproductive losses, timely detection and correction of magnesium deficiency in girls of early reproductive age are of primary importance.

Objective. To assess the prevalence of magnesium deficiency among students of the Republic of Bashkortostan, analyze its link with nutritional status and reproductive health indicators in girls (menstrual cycle regularity, severity of dysmenorrhea and premenstrual syndrome), and show the laboratory and clinical trends during three months of magnesium citrate therapy in patients with verified magnesium deficiency.

Materials and methods. A total of 606 students (480 girls, 126 boys) aged 15–19 were examined. Serum magnesium levels were identified (reference values 0.77–1.03 mmol/L). Menstrual cycle regularity, dysmenorrhea intensity using a visual analog scale (VAS, 0–10 points), and PMS severity using a total score (10 symptoms, 0–30 points) were assessed. Magnesium citrate (Solgar) at a dose of 400 mg of elemental magnesium per day per os was prescribed to 135 girls with hypomagnesemia (< 0.77 mmol/L) for 3 months.

Results. Magnesium deficiency (< 0.77 mmol/L) was detected in 240/480 (50.0%) girls and 55/126 (43.7%) boys aged 15–19. The frequency of deficiency did not differ between the age subgroups of 15–17 and 18–19 years. The median magnesium level in girls with deficiency was significantly lower than in boys: 0.64 [0.50; 0.71] versus 0.70 [0.58; 0.75] mmol/L (p< 0.05). The highest frequency of magnesium deficiency was associated with regular fast food consumption (35.9%) and low intake of fruits and vegetables (27.6%).

During three months of therapy with magnesium citrate (400 mg/day) in 135 girls with hypomagnesemia, normalization of magnesium levels was achieved in 129 (95.5%) patients. The median magnesium level increased from 0.65 [0.52; 0.70] to 0.85 [0.78; 0.93] mmol/l. The intensity of dysmenorrhea according to VAS scale decreased from 7 [5; 8] to 3 [2; 5] points. The total score of PMS symptoms decreased from 18 [15; 22] to 8 [5; 12]. The proportion of girls with a regular menstrual cycle increased from 68.8% (93/135) to 95.5% (129/135)

Conclusion. Magnesium deficiency is common situation among students of the Republic of Bashkortostan and is associated with menstrual irregularities, dysmenorrhea, and PMS. Three months of magnesium citrate therapy (400 mg/day) effectively corrects the deficiency and improves indicators of reproductive health in girls aged 15–19, justifying the need for magnesium status screening as part of preconception care.