The prevalence of thiamin deficiency in hospitalized patients with congestive heart failure
The prevalence of thiamin deficiency in hospitalized patients with congestive heart failure
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DOI：
10.1016/j.jacc.2005.08.060
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发表时间：
2006-01-17
影响因子：
24
通讯作者：
Keith, ME
中科院分区：
文献类型：
--
作者：
Hanninen, SA;Darling, PB;Keith, ME
本研究的目的是确定硫胺素缺乏症（TD）的患病率在一个横截面的住院充血性心力衰竭（CHF）患者，并调查因素，有助于其development.Background硫胺素缺乏症表现为CHF的症状，因此，可能会恶化现有的心力衰竭。充血性心力衰竭患者可能会增加TD的风险，作为一个结果，利尿剂引起的尿硫胺素排泄，疾病的严重程度，营养不良，和先进的age.METHODS红细胞焦磷酸硫胺素浓度，使用高效液相色谱法，测定在100 CHF患者和50名对照组。变量包括利尿剂（类型和剂量）、左心室功能障碍、纽约心脏协会功能分级、肌酐清除率、硫胺素摄入量（饮食和补充剂），营养不良，食欲评级，结果CHF患者硫胺素缺乏的发生率（33%）高于对照组（12%），（p = 0.007）。硫胺素缺乏与尿硫胺素丢失（p = 0.03）、不使用含硫胺素的补充剂（p = 0.06）和保留的肾功能（p = 0.05）有关。增加尿硫胺素损失（微克/克肌酐）被认为是唯一显着的积极预测硫胺素状态的多元Logistic回归分析（p = 0.03）。结论三分之一的住院CHF患者TD。与以前的研究相反，尿中硫胺素损失的增加预示着硫胺素状态的改善。补充硫胺素在临床环境中可能对TD有保护作用。未来的研究是必要的，以确定是否补充硫胺素改善硫胺素状态和疾病的严重程度在CHF患者。
OBJECTIVES The purpose of this study was to determine the prevalence of thiamin deficiency (TD) in a cross section of hospitalized congestive heart failure (CHF) patients and to investigate factors that contribute to its development.BACKGROUND Thiamin deficiency manifests as symptoms of CHF and, therefore, may worsen existing heart failure. Congestive heart failure patients may be at increased risk for TD as a result of diuretic-induced urine thiamin excretion, disease severity, malnutrition, and advanced age.METHODS Erythrocyte thiamin pyrophosphate concentrations, using high-performance liquid chromatography, were measured in 100 CHF patients and compared to 50 control subjects. Variables including diuretics (type and dose), left ventricle dysfunction, New York Heart Association functional classification, creatinine clearance, thiamin intake (diet and supplements), malnutrition, appetite ratings, and age were related to TD using univariate statistics and multiple logistic regression analysis.RESULTS Thiamin deficiency was more prevalent in CHF patients (33%) compared to control subjects (12%) (p = 0.007). Thiamin deficiency was related to urine thiamin loss (p = 0.03), non-use of thiamin-containing supplements (p = 0.06), and preserved renal function (p = 0.05). Increased urinary thiamin loss (mu g/g creatinine) was found to be the only significant positive predictor of thiamin status on multiple logistic regression analysis (p = 0.03).CONCLUSIONS One-third of hospitalized CHF patients were TD. In contrast to previous studies, increased urinary losses of thiamin were predictive of improved thiamin status. Thiamin supplementation may be protective against TD in the clinical setting. Future studies are warranted to determine if thiamin supplementation improves thiamin status and disease severity in CHF patients.