Author(s): Sonali Bhaumik, Arkadip Choudhury, Debaprasad Chakrabarti, Pradyut Kumar Dey
BACKGROUND The worldwide prevalence of chronic obstructive pulmonary disease (COPD) ranges from 4% to 10%. Acute exacerbation of COPD (AECOPD) adds to the burden of morbidity, mortality and hospital admissions, and increased healthcare utilization in modern medicine so much so, that it accounts for nearly 70% of COPD-related health expenditure. While several studies have already identified factors associated with frequent exacerbations including previous hospitalization for COPD, FEV1%, resting dyspnoea, altered blood gases, disease stage and duration, age etc, a few studies also show a potential role of magnesium as an etiological factor for chronic respiratory disease. Although the precise mechanism of this action is unknown, it has been suggested that Mg+2 plays a role in the maintenance of airway patency via relaxation of bronchial smooth muscle as well as certain other important functions of the respiratory system like mast cell stabilization and mucociliary clearance due to which, a decreased level of magnesium may increase COPD exacerbations. We wanted to confirm the possible associations between COPD acute exacerbation and serum magnesium levels, study serum magnesium levels in patients of stable as well as acute exacerbation of COPD attending a tertiary care hospital of Tripura. METHODS It is a comparative study conducted in Tripura Medical College & Dr BRAM Teaching Hospital, over a period of 3 months from November 2018 to January 2019 including all subjects with COPD confirmed after Pulmonary Function Testing with and without exacerbations attending the OPD and the Emergency Department during the study period. Serum Mg+2 was checked using ERBA CHEM 5 PLUS semi-automated analyser. Mann-Whitney test was used to assess the significance of difference between the serum Magnesium values between the two groups. RESULTS Of the 44 subjects with exacerbations, 13 (29.5%) subjects had hypomagnesaemia while only 12.5% (2/16) subjects without exacerbation had the same. However, the relationship was not statistically significant (p Value: 0.16). The median value of serum Magnesium of subjects with present or previous exacerbations was significantly lower than the median value of serum magnesium of subjects without any episode of exacerbation (1.50 mEq/dl; IQR: 0.40 mEq/dl vs. 1.75 mEq/dl; IQR: 0.30 mEq/dl, p Value: 0.017).