Serum Electrolyte Profiles and Clinical Severity of Recurrent Nocturnal Leg Cramps in Adults: A Frequency-Matched Case-Control Study
Electrolyte Profiles in Recurrent Nocturnal Leg Cramps
DOI:
https://doi.org/10.69750/dmls.03.07.0222Keywords:
Muscle cramp, electrolytes, hypomagnesemia, hypocalcemia, hypokalemia, primary health careAbstract
Background: Nocturnal leg cramps are muscle contractions that disrupt sleep. Their relationship with biochemical abnormalities remains uncertain. This study compared electrolyte abnormalities in adults with recurrent nocturnal leg cramps and adults without cramps attending a primary healthcare clinic.
Methods: A single-center, frequency-matched case-control study was conducted at Continental Medical College, Lahore, Pakistan, from March 2025 to January 2026. It included 100 adults with recurrent nocturnal leg cramps and 100 controls without nocturnal or resting leg cramps during the preceding six months, frequency matched by sex and 10-year age group. Characteristics, medication exposure, fluid intake, standing duration, and cramp features were recorded. Sodium, potassium, corrected calcium, magnesium, phosphate, creatinine, albumin, and urea were measured. Multivariable logistic regression identified factors associated with cramp status.
Results: At least one electrolyte abnormality was present in 48.0% of cases and 19.0% of controls (odds ratio 3.94, 95% confidence interval 2.08–7.43; p<0.001). Hypomagnesemia was most frequent (25.0% vs 7.0%), followed by hypocalcemia (18.0% vs 6.0%) and hypokalemia (15.0% vs 5.0%). Among cases, abnormalities were more frequent across higher cramp-frequency categories and were associated with greater pain, longer episodes, sleep interruption, residual soreness, and fatigue. Any electrolyte abnormality remained associated with nocturnal leg cramps after adjustment (adjusted odds ratio 3.58, 95% confidence interval 1.84–6.98; p<0.001). Low fluid intake and prolonged standing were independently associated.
Conclusion: Adults with recurrent nocturnal leg cramps had more electrolyte abnormalities than frequency-matched controls. These findings demonstrate association but do not establish causality, temporality, or benefit from screening or correction.
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