Potassium Magnesium Citrate Is Superior to Potassium Chloride in Reversing Metabolic Side Effects of Chlorthalidone.
Potassium Magnesium Citrate Is Superior to Potassium Chloride in Reversing Metabolic Side Effects of Chlorthalidone.
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柠檬酸钾镁在逆转氯噻酮的代谢副作用方面优于氯化钾。
DOI：
10.1161/hypertensionaha.123.21932
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Pak,CharlesCY
中科院分区：
文献类型：
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作者：
Vongpatanasin,Wanpen;Giacona,JohnM;Pittman,Danielle;Murillo,Ashley;Khan,Ghazi;Wang,Jijia;Johnson,Talon;Ren,Jimin;Moe,OrsonW;Pak,CharlesCY
噻嗪类利尿剂（TD）是高血压的一线治疗药物，因为它在降低血压和心血管风险方面具有一致的益处。TD也被认为会导致糖尿病的过度风险，这可能会限制长期使用。虽然钾（K）耗竭被认为是TD诱导的高血糖症的主要机制，但TD也引发镁（Mg）耗竭。然而，镁补充剂在调节TD的代谢副作用中的作用尚未研究。因此，我们的目的是确定钾镁柠檬酸盐（KMgCit）对空腹血糖和肝脏脂肪的影响，通过磁共振成像TD therapeutic. METHODS因此，我们进行了双盲随机对照试验，在60例非糖尿病高血压患者比较氯噻酮治疗期间氯化钾与KMgCit的影响。每例患者在随机化前接受氯噻酮单药治疗3周。主要终点是单独使用氯噻酮补充KCl或KMgCit 16周后空腹血糖的变化。受试者的平均年龄为59±11岁（30%的黑人参与者）。单用氯噻酮可使空腹血糖显著升高，血清钾、血清镁和24小时尿柠檬酸排泄量显著下降（均P <0.05）。与KCl相比，KMgCit使空腹血糖升高降低7.9 mg/dL（P<0.05），而KCl未观察到这一点。两组间肝脏脂肪含量无显著性差异。结论SKMgCit在预防TD诱导的高血糖方面上级优于临床常用的补钾剂KCl。该作用可改善接受该类药物治疗的高血压患者的耐受性和心血管安全性。
BACKGROUNDThiazide diuretics (TD) are the first-line treatment of hypertension because of its consistent benefit in lowering blood pressure and cardiovascular risk. TD is also known to cause an excess risk of diabetes, which may limit long-term use. Although potassium (K) depletion was thought to be the main mechanism of TD-induced hyperglycemia, TD also triggers magnesium (Mg) depletion. However, the role of Mg supplementation in modulating metabolic side effects of TD has not been investigated. Therefore, we aim to determine the effect of potassium magnesium citrate (KMgCit) on fasting plasma glucose and liver fat by magnetic resonance imaging during TD therapy.METHODSAccordingly, we conducted a double-blinded RCT in 60 nondiabetic hypertension patients to compare the effects of KCl versus KMgCit during chlorthalidone treatment. Each patient received chlorthalidone alone for 3 weeks before randomization. Primary end point was the change in fasting plasma glucose after 16 weeks of KCl or KMgCit supplementation from chlorthalidone alone.RESULTSThe mean age of subjects was 59±11 years (30% Black participants). Chlorthalidone alone induced a significant rise in fasting plasma glucose, and a significant fall in serum K, serum Mg, and 24-hour urinary citrate excretion (allP<0.05). KMgCit attenuated the rise in fasting plasma glucose by 7.9 mg/dL versus KCl (P<0.05), which was not observed with KCl. There were no significant differences in liver fat between the 2 groups.CONCLUSIONSKMgCit is superior to KCl, the common form of K supplement used in clinical practice, in preventing TD-induced hyperglycemia. This action may improve tolerability and cardiovascular safety in patients with hypertension treated with this drug class.