ABSTRACTBackgroundMagnesium supplementation may be effective for the prevention of cardiometabolic diseases, but mechanisms are unclear. Proteomic approaches can assist in identifying underlying mechanisms.MethodsWe collected repeated blood samples in 52 individuals enrolled in a double-blind trial which randomized participants 1:1 to oral magnesium supplementation (400 mg magnesium / day in the form of magnesium oxide) or matching placebo for 10 weeks. Plasma levels of 91 proteins were measured in baseline and follow-up samples using the Olink Cardiovascular Disease III proximity extension assay panel, and modeled as arbitrary units in log2 scale. We evaluated the effect of oral magnesium supplementation on changes in protein levels and the baseline association between serum magnesium and protein levels. The Holm procedure was used to adjust for multiple comparisons.ResultsParticipants were 73% women, 94% white, and had a mean age of 62. Changes in proteins did not significantly differ between the two intervention groups after correction for multiple comparisons. The most statistically significant effects were on myoglobin [difference −0.319 log2 units, 95% confidence interval (CI) (−0.550, −0.088), p = 0.008], tartrate-resistant acid phosphatase type 5 [−0.187, (−0.328, −0.045), p = 0.011], tumor necrosis factor ligand superfamily member 13B [−0.181, (−0.332, −0.031), p = 0.019], ST2 protein [−0.198, (−0.363, −0.032), p =0.020], and interleukin-1 receptor type 1 [−0.144, (−0.273, −0.015), p = 0.029]. Similarly, none of the associations of baseline serum magnesium with protein levels were significant after correction for multiple comparisons.ConclusionThough we did not identify statistically significant effects of oral magnesium supplementation in this relatively small study, this study demonstrates the value of proteomic approaches for the investigation of mechanisms underlying the beneficial effects of magnesium supplementation.Clinical Trials RegistrationClinicalTrials.govNCT02837328