• The results of using the magnesium and vitamin B6 in children with a combined course of chronic gastroduodenitis and primary arterial hypertension
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The results of using the magnesium and vitamin B6 in children with a combined course of chronic gastroduodenitis and primary arterial hypertension

HEALTH OF WOMAN. 2020.2(148): 70–74; doi 10.15574/HW.2020.148.70
Marushko Yu. V.1, Zlobynets A. S.1, Hyschak T. V.1, Komissarova О. S.2
1Bogomolets National Medical University, Kiev
2Shupyk National Medical Academy of Postgraduate Education, Kiev

The objective: to optimize the treatment of children with the combined course of chronic gastroduodenitis (CGD) and primary arterial hypertension (PH) against the backdrop of hypomagnesemia by including the combined preparation of magnesium and vitamin В6 in the treatment regimen.
Materials and methods. We examined 20 children aged 10 to 17 years with a combined course of CGD and PH and a serum magnesium content of ≤0.8 mmol/L. Children received non-drug treatment, treatment of CGD in accordance with the clinical protocol. PH treatment included an ACE inhibitor (enalapril) in an individual dose. Additionally preparation of magnesium and vitamin В6 was assigned.
Results. Against the background of combined treatment, after 1 month, complaints of abdominal pain, nausea, headache and a feeling of heaviness in the stomach were decreased most intense in patients. After 3 months, complaints of fatigue significantly decreased and normalized tests of self-assessment of the functional state and subjective assessment of the quality of night sleep. According to the ABPM data, the average daily SBP and SBP load (p<0.001) decreased most distinctly, and the SBP dipping increased (p=0.04). According to endoscopy results, the number of children with erythematous CHD after 3 months decreased from 40% to 10% (χ2=4.8; p=0.03), and erosive CHD was not diagnosed in any child (χ2=8.48; p=0.004 compared with the data before treatment).
Conclusions. Children with a combined course of CGD and PН need complex therapy using a combination of magnesium and vitamin В6. This approach contributes to the normalization of serum magnesium levels, the rapid reduction of complaints, the improvement of blood pressure, the quality of night sleep and the endoscopic picture of the gastric mucosa and duodenum.
Key words: chronic gastroduodenitis, primary arterial hypertension, children, treatment, magnesium preparations.

REFERENCES

1. Havkin AI, Gurova MM, Novikova VP. 2018. Primenenie indeksa komorbidnosti dlya otsenki vliyaniya sochetannoy patologii na harakter techeniya hronicheskogo gastroduodenita u podrostkov. Pediatriya 97(6):19-25.

2. Nakaz MOZ vid 29.01.2013 № 59 «Pro zatverdzhennia protokoliv diahnostyky ta likuvannia zakhvoriuvan orhaniv travlennia u ditei». Rezhym dostupu: http://www.moz.gov.ua/ua/portal/dn_20130129_0059.html.)

3. Truse R, Voß F, Herminghaus A, Schulz J, Weber APM, Mettler-Altmann T et al. 2019. Local gastric RAAS inhibition improves gastric microvascular perfusion in dogs. J Endocrinol. 241(3):235-47. https://doi.org/10.1530/JOE-19-0030; PMid:30978701

4. Zhivotova EYu, Timoshin SS. 2011. Uchastie renin-angiotenzinovoy sistemyi v podderzhanii tkanevogo gomeostaza v razlichnyih kletochnyih populyatsiyah. Sovremennyie tehnologii v meditsine 4:120-5.

5. Janett S, Bianchetti MG, Milani GP, Lava SA. 2016. Hypomagnesemia Following Prolonged Use of Proton-pump Inhibitors. Journal of Pediatric Gastroenterology and Nutrition. 62(4):e39. https://doi.org/10.1097/MPG.0000000000001087; PMid:27010402

6. Pisani LF, Filippi E, Vavassori S, Munizio N, Vecchi M, Pastorelli L. 2016. Effect of proton pump inhibitors on magnesium balance: is there a link to cardiovascular risk? MagnesRes. 29:1-10. https://doi.org/10.1684/mrh.2016.0397; PMid:27086964

7. Liao S, Gan L, Mei Z. 2019. Does the use of proton pump inhibitors increase the risk of hypomagnesemia: An updated systematic review and meta-analysis. Medicine (Baltimore). 98(13):e15011. https://doi.org/10.1097/MD.0000000000015011; PMid:30921222 PMCid:PMC6456119

8. Joan S. Di Palma, Suzanne C. Kenyon, Sheeja K. Abraham, Fernando del Rosario. 2013. Tu1835 Hypomagnesemia Is Not Associated With Chronic Proton Pump Inhibitor (PPI) Use in Pediatric Patients Gastroenterology 144(5):858-859. https://doi.org/10.1016/S0016-5085(13)63192-3

9. Kieboom BC, Kiefte-DeJong JC, Eijgelsheim M, Franco OH, Kuipers EJ, Hofman A et al. 2015. Proton Pump Inhibitors and Hypomagnesemia in the General Population: A Population-Based Cohort Study. Am J KidneyDis. 66:775-82. https://doi.org/10.1053/j.ajkd.2015.05.012; PMid:26123862

10. Baryishnikova GA, Chorbinskaya SA, Stepanova II, Blohina OE. 2019. Defitsit kaliya i magniya, ih rol v razvitii serdechno-sosudistyih zabolevaniy i vozmozhnost korrektsii. Consilium Medicum 21(1):67-73.

11. Costello RB, Elin RJ, Rosanoff A, Wallace TC, Guerrero-Romero F, Hruby A et al. 2016. Perspective: the case for an evidence-based reference interval for serum magnesium: The time has come. AdvNutr. 7:977–93. https://doi.org/10.3945/an.116.012765; PMid:28140318 PMCid:PMC5105038

12. Beketova GV, Soldatova OV. 2015. Asteniya – «seli batareyki»? Fiziologcheskie podhodyi k korrektsii astenicheskih i psihovegetativnyih narusheniy u detey s hronicheskim gastroduodenitom. Pediatriya. Vostochnaya Evropa. 2(10):62-74.

13. Zhang X, Li Y, Del Gobbol C, Rosanoff A, Wang J, Zhang W et al. 2016. Effects of magnesium supplementation on blood pressure: A meta-analysis of randomized double-blind placebo-controlled trials. Hypertension 68:324–33. https://doi.org/10.1161/HYPERTENSIONAHA.116.07664; PMid:27402922

14. Rosanoff A, Plesset MR. 2013. Oral magnesium supplements decrease high blood pressure (SBP>155 mmHg) in hypertensive subjects on anti-hypertensive medications: a targeted meta-analysis. MagnesRes. 26:93–9. https://doi.org/10.1684/mrh.2013.0343; PMid:24134861

15. Hyshchak TV. 2017. Pervynna arterialna hipertenziia u ditei: systemni mekhanizmy adaptatsii, dyferentsiiovana terapiia. Avtoref. dys. d-ra med. nauk: 14.01.10. Hyshchak Tetiana Vitaliivna, Nats. med. un-t im. O.O. Bohomoltsia. K:36.

16. Marushko YuV, Hyshchak TV. 2013. Vplyv kombinovanoho preparatu mahniiu na astenichni proiavy ta yakist nichnoho snu u ditei z pervynnoiu arterialnoiu hipertenziieiu. Sovrem. pedyatryia 3:94-9.

17. Cao Y, Zhen S, Taylor AW, Appleton S, Atlantis E, Shi Z. 2018. Magnesium Intake and Sleep Disorder Symptoms: Findings from the Jiangsu Nutrition Study of Chinese Adults at Five-Year Follow-Up. Nutrients. 10(10):1354. https://doi.org/10.3390/nu10101354; PMid:30248967 PMCid:PMC6212970

18. Abbasi B. 2012. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo controlled clinical trial. J. Res. Med. Sci. 17(12):1161–9.

19. Li Q, Wang N, Hu F, Li C, Li J, Yang G. 2016. Study of compound bismuth and magnesium granules on clearance of helicobacter pylori infection in KM mice. Int J ClinExp Med. 9(7):12888-12895.

20. Lurbe E, Agabiti-Rosei E, Cruickshank JK, Dominiczak  A, Erdine S, Hirth A et al. 2016. European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 34(10):1887-920. https://doi.org/10.1097/HJH.0000000000001039; PMid:27467768

21. Rekomendatsii Ukrainskoi asotsiatsii kardiolohiv iz profilaktyky ta likuvannia arterialnoi hipertenzii: Posibnyk do Natsionalnoi prohramy profilaktyky i likuvannia arterialnoi hipertenzii. 2011. 5-te vydannia, vypr. i dop. K, PPVMB:80.

22. Rekomendatsii Ukrainskoi asotsiatsii kardiolohiv, Ukrainskoi asotsiatsii endokrynnyh hirurhiv, asotsiatsii nefrolohiv Ukrainy z dyferentsiinoi diahnostyky arterialnykh hipertenzii. 2014. Arteryalnaia hypertenzyia 3:64-93.

23. Onovlena ta adaptovana klinichna nastanova, zasnovana na dokazakh «Arterialna hipertenziia» Nakaz MOZ Ukrainy vid 24.05.2012 № 384.

24. Baza FE, AlShahawi HA, Zahra S, Abdel Hakim RA. 2016. Magnesium supplementation in children with attention deficit hyperactivity disorder. Egypt J Med Hum Genet 17:63–70. https://doi.org/10.1016/j.ejmhg.2015.05.008

25. Djokic G, Vojvodić P, Korcok D, Agic A, Rankovic A, Djordjevic V et al. 2019. The Effects of Magnesium – Melatonin – Vit B Complex Supplementation in Treatment of Insomnia. Open Access Maced J Med Sci. 7(18):3101–3105. https://doi.org/10.3889/oamjms.2019.771; PMid:31850132 PMCid:PMC6910806

26. Dibaba DT, Xun P, Song Y, Rosanoff A, Shechter M, He K. 2017. The effect of magnesium supplementation on blood pressure in individuals with insulin resistance, prediabetes, or noncommunicable chronic diseases: a meta-analysis of randomized controlled trials. Am J ClinNutr. 106:921–9. https://doi.org/10.3945/ajcn.117.155291; PMid:28724644 PMCid:PMC5573024

27. Cao S, Hodges JK, McCabe LD, Weaver CM. 2019. Magnesium Requirements in Children: Recommendations for revaluation and Comparison With Current Evidence for Adults. Nutrition Today 54(5):195–206. https://doi.org/10.1097/NT.0000000000000363

28. Fedoseenko MV, Shilyaev RR, Gromova OA, Petrova OA, Kopilova EB, Knyazeva IV. 2003. Biologicheskaya rol magniya, kaltsiya i tsinka v regulyatsii funktsiy i razvitii zabolevaniy pischevaritelnoy sistemy u detey. Voprosy sovremennoy pediatrii 2(6):67-72.