非酒精性脂肪性肝病（NAFLD）是肝细胞癌（HCC）不断上升发病率的主要原因之一。镁是细胞活动中的主要阳离子。有关镁水平及其与HCC的关系的流行病学数据很少。本研究旨在探讨血清镁水平与NAFLD患者患HCC风险之间的关系。从2004年到2018年，从匹兹堡大学医疗中心电子病历中确定了26,053名NAFLD患者。在平均5.15年的随访期后，有395名患者在第一次血清镁的测量后发展为HCC。使用Cox比例风险回归模型，根据年龄，性别，种族，体重指数，利尿剂使用，2型糖尿病病史，高血压病史，高血脂症史和吸烟史进行调整，计算了血清镁四分位水平与HCC发病率的风险比（HR）和95%置信区间（CI）。发展HCC的NAFLD患者与未发展HCC的患者相比，其平均（±标准偏差）血清镁水平较低（0.769±0.131 mmol/L vs. 0.789±0.125 mmol/L；p=0.003）。在多种潜在混杂因素的调整后（Ptrend=0.02），与最低四分位相比，血清镁的第二、三和第四四分位的HCC HR值（95% CI）分别为0.87（0.67-1.12）、0.77（0.57-1.04）和0.73（0.56-0.96）。这一发现表明，血清镁水平较高与NAFLD患者患HCC的风险显著降低有关。© 2023美国癌症协会。

Nonalcoholic fatty liver disease (NAFLD) is a major contributor to the rising incidence of hepatocellular carcinoma (HCC). Magnesium is a major cation in cellular activities. Epidemiological data on magnesium level and its relation to HCC are sparse. This study aimed to examine the associations between serum levels of magnesium and the risk of HCC among patients with NAFLD.A total of 26,053 patients with NAFLD were identified in the University of Pittsburgh Medical Center Electronic Health Records from 2004 through 2018. After an average of 5.15 years of follow-up, 395 patients developed HCC after the first measurement of serum magnesium. Cox proportional hazards regression model was used to calculate hazard ratios (HRs) and 95% CIs of HCC incidence associated with quartile levels of serum magnesium after adjustment for age, sex, race, body mass index, diuretics use, history of type 2 diabetes, history of hypertension, history of hyperlipidemia, and tobacco smoking.Patients with NAFLD who developed HCC had a significantly lower mean (± standard deviation) serum magnesium (0.769 ± 0.131 mmol/L) than those who remained free of HCC (0.789 ± 0.125 mmol/L; p = .003). Compared with the lowest quartile, the HRs (95% CIs) of HCC second, third, and fourth quartiles of serum magnesium were 0.87 (0.67-1.12), 0.77 (0.57-1.04), and 0.73 (0.56-0.96), respectively, after adjustment for multiple potential confounders (Ptrend  = .02).This finding suggests higher levels of serum magnesium were significantly associated with decreased risk of HCC among patients with NAFLD.© 2023 American Cancer Society.