ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition Methodology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1674062
This article is part of the Research TopicNutritional Indicators and Implications for Human Health Volume IIView all 3 articles
Magnesium depletion score is a risk factor for all-cause, cancer and cardiovascular disease mortality in cancer survivors: evidence from two prospective cohort studies
Provisionally accepted
- 1Shaanxi Provincial People's Hospital, Xi'An, China
- 2Shaanxi Provincial People's Hospital Department of Urology, Xi'an, China
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Background: Cancer survivors face significant mortality risks, including from cardiovascular disease (CVD) and cancer. Magnesium depletion score (MDS) is a prognostic biomarker, but its prognostic value in cancer survivors is unknown. Methods: This prospective study utilizes data from two distinct cohorts: the National Health and Nutrition Examination Survey (NHANES) and the Shaanxi Provincial People’s Hospital. We analyzed 3,528 cancer survivors from NHANES (1999-2018) and 473 patients from the hospital cohort. Associations between MDS (0, 1, 2, ≥3) and all-cause, cancer-specific, and CVD mortality were assessed using weighted multivariate Cox regression, Kaplan-Meier analysis and Fine-Gray competing risk model. Predictive accuracy was evaluated using time-dependent ROC curves. Results: During follow-up (median 165 months for NHANES), higher MDS (≥3) was significantly associated with increased mortality risk after full adjustment: all-cause (HR=2.48, 95% CI:1.86-3.29), cancer (HR=2.17, 95% CI:1.44-3.26), and CVD (HR=3.89, 95% CI:1.91-7.91) compared to MDS=0 (all p for trend<0.001). Kaplan-Meier curves and competing risk model confirmed worse survival with higher MDS. Time-dependent ROC demonstrated good predictive accuracy for all mortality risk. Results remained robust in sensitivity analyses and the single-centre cohort. Conclusions: Higher MDS is a strong, independent predictor of increased all-cause, cancer-specific, and CVD mortality risk among cancer survivors. MDS provides valuable prognostic information and could aid in risk stratification for personalized survivorship care.
Keywords: cancer survivors, Magnesium Deficiency, magnesium depletion score, Cause-specific mortality, prognosis
Received: 27 Jul 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Ma, Li and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xing Liu, 524633141@qq.com
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