ArticleFrontiers in immunology2026
Association of serum magnesium levels with the risk of spontaneous bacterial peritonitis and sepsis in hospitalized patients with cirrhosis: a retrospective cohort study.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Hypomagnesemia is common in patients with cirrhosis. This study aimed to examine the association between serum magnesium levels and the risks of hospital-acquired spontaneous bacterial peritonitis (HA-SBP) and sepsis. Methods: This retrospective study included patients with cirrhosis who were hospitalized at the First People's Hospital of Changde City, China, between May 2021 and June 2025. The exposure variable was the first serum magnesium measurement obtained within 48 hours of admission. The primary outcome was HA-SBP, and the secondary outcome was sepsis. Multivariable regression and restricted cubic spline (RCS) analyses were used to assess the associations. Results: A total of 1110 patients with cirrhosis were included. The incidences of HA-SBP and sepsis were 12.25% and 6.06%, respectively. Multivariable regression analysis showed that per 1-SD increase in serum magnesium, the risks of HA-SBP and sepsis decreased by 20.8% (odds ratio [OR] = 0.792, 95% confidence interval [CI]: 0.642-0.970, P = 0.026) and 35.5% (OR = 0.645, 95% CI: 0.464-0.883, P = 0.008), respectively. Compared with normomagnesemia, hypomagnesemia was associated with increased risks of HA-SBP (OR = 1.520, 95% CI: 1.009-2.286, P = 0.044) and sepsis (OR = 2.213, 95% CI: 1.189-4.177, P = 0.013). Sensitivity analyses yielded consistent results. RCS analysis showed a linear inverse association between serum magnesium levels and the risks of HA-SBP and sepsis (both P for nonlinearity > 0.05). In addition, the areas under the receiver operating characteristic curves for serum magnesium in predicting HA-SBP and sepsis were 0.635 (95% CI: 0.583-0.686) and 0.688 (95% CI: 0.617-0.758), respectively. Conclusions: Hypomagnesemia was associated with increased risks of HA-SBP and sepsis in patients with cirrhosis, and these findings should be further validated in prospective studies.
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