Firdevs Ulutaş, Veli Çobankara
Van Medical Journal - 2026;33(2):149-157
Introduction: Interstitial lung disease (ILD) is one of the most clinically significant extra-articular manifestations of rheumatoid arthritis (RA), yet the contribution of micronutrient imbalances -particularly magnesium deficiency -to pulmonary involvement remains largely unexplored. This study aimed to characterize serum magnesium levels in patients with RA and to investigate their potential relationship with ILD. Materials & Methods: In this cross-sectional analysis, 425 patients with RA were comprehensively assessed for clinical features, comorbidities, disease activity, and bone health. Serum magnesium levels were classified as normal or reduced using a 2.0 mg/dL threshold, while ILD was determined by high-resolution computed tomography. Multiple logistic regression assessed whether magnesium deficiency independently predicted ILD. Results: Most patients demonstrated serum magnesium values below 2 mg/dL. Although low magnesium levels clustered with diabetes and poorer bone-health categories, low serum magnesium did not emerge as an independent predictor of ILD after adjustment for demographic factors, metabolic comorbidities, and treatment modalities (OR = 1.15). Increasing age (OR = 1.10) and male sex (OR = 6.6) remained strong independent predictors of ILD. Biologic therapy use was independently associated with the presence of ILD (OR = 9.97). Age and disease duration emerged as the principal determinants of impaired bone status, with older age (OR = 1.04) and longer disease duration (OR = 1.03) independently predicting poorer bone health. Conclusion: Serum magnesium levels were not independently associated with ILD risk or pattern in RA. Although hypomagnesemia correlated with metabolic and skeletal comorbidities, it lost significance in multivariate analyses. Pulmonary and bone outcomes were mainly driven by demographic factors and cumulative disease burden.
