Serum Magnesium Levels in Adults with Liver Cirrhosis and Its Association with Grade of Hepatic Encephalopathy

Background: Hepatic encephalopathy (HE) is a major neuropsychiatric complication of liver cirrhosis. Electrolyte and micronutrient abnormalities may contribute to its clinical manifestations. This study evaluated serum magnesium levels and their association with the severity of HE in adults with liver cirrhosis. Material and Methods: This hospital-based cross-sectional observational study included 154 adults with liver cirrhosis. Hepatic encephalopathy was graded according to the West Haven criteria. Serum magnesium was measured using the Xylidyl Blue I chromogenic method, and hypomagnesemia was defined as serum magnesium <1.6 mg/dL. Serum magnesium levels were compared according to the presence and grade of HE, and correlation analysis was performed. Results: The mean age was 50.81 ± 11.30 years, and 77.27% of participants were male. HE was present in 111 (72.08%) patients, while hypomagnesemia was observed in 62 (40.26%). Mean serum magnesium was significantly lower in patients with HE than in those without HE (1.56 ± 0.34 vs. 2.22 ± 0.28 mg/dL; p<0.0001). Hypomagnesemia was present in 54.95% of patients with HE compared with 2.33% without HE (p<0.0001). Mean serum magnesium progressively decreased from 2.22 ± 0.28 mg/dL in Grade 0 to 1.25 ± 0.19 mg/dL in Grade 4, while hypomagnesemia increased from 2.33% to 90.48%. Serum magnesium showed a strong negative correlation with HE grade (r = −0.792, p<0.0001). Conclusion: Lower serum magnesium levels were significantly associated with the presence and increasing severity of hepatic encephalopathy in patients with liver cirrhosis. Serum magnesium assessment may provide a simple adjunctive biochemical parameter in the evaluation of these patients.

Keywords: Liver cirrhosis; Hepatic encephalopathy; Hypomagnesemia; Serum magnesium; West Haven criteria.