1
|
Ao M, Yamamoto K, Ohta J, Abe Y, Niki N, Inoue S, Tanaka S, Kuwabara A, Miyawaki T, Tanaka K. Possible involvement of thiamine insufficiency in heart failure in the institutionalized elderly. J Clin Biochem Nutr 2019; 64:239-242. [PMID: 31138958 PMCID: PMC6529701 DOI: 10.3164/jcbn.18-85] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 10/10/2018] [Indexed: 11/22/2022] Open
Abstract
Heart failure is a major manifestation of thiamine deficiency; beriberi. Even thiamine insufficiency, milder than deficiency, may be associated with increased heart failure risk. In this cross-sectional study, the relationship between thiamine insufficiency and heart failure was investigated in the Japanese institutionalized elderly from April to November 2017. Fifty-five subjects in four care facilities were evaluated for their whole blood thiamine and plasma brain natriuretic peptide concentrations. Mean whole blood thiamine concentration was 88.7 ± 22.3 nmol/L in men and 92.0 ± 16.5 nmol/L in women, and significantly and negatively correlated with plasma brain natriuretic peptide concentrations (r = −0.378, p = 0.007). In the multiple regression analysis adjusted by age, sex, body mass index, and eGFR, whole blood thiamine concentration was a significant negative contributor (standardized coefficient β = −0.488, p = 0.001) to plasma brain natriuretic peptide. In the logistic regression analysis adjusted by the same variables, whole blood thiamine concentration significantly contributed to plasma brain natriuretic peptide concentration higher than over 40 pg/ml (OR: 0.898, 95%CI: 0.838–0.962). Whole blood thiamine concentration in subjects with diuretics was significantly lower than those without it (p = 0.023). Thiamine insufficiency was related to increased plasma brain natriuretic peptide concentration and may increase the risk of heart failure.
Collapse
Affiliation(s)
- Misora Ao
- Department of Food and Nutrition, Kyoto Women's University, 35 Kitahiyoshi-cho, Imakumano, Higashiyama, Kyoto 605-8501, Japan
| | - Kanae Yamamoto
- Department of Food and Nutrition, Kyoto Women's University, 35 Kitahiyoshi-cho, Imakumano, Higashiyama, Kyoto 605-8501, Japan
| | - Junko Ohta
- Faculty of Nutrition, Kobe Gakuin University, 518 Arise, Ikawadani-cho, Nishi-ku, Kobe, Hyogo 651-2180, Japan
| | - Yasusei Abe
- Nursing Care Home, Airanomori Ujigokasho, 19-1 Gokasho-tonouchi, Uji, Kyoto 611-0011, Japan
| | - Naho Niki
- Nursing Care Center, Care House Ajisai, 4-1-3 Kamo-cho-ekihigashi, Kizugawa, Kyoto 619-1154, Japan
| | - Shino Inoue
- Nursing Care Center, Care House Yamabuki, 36-35 Ujisatojiri, Uji, Kyoto 611-0021, Japan
| | - Shinzo Tanaka
- Nursing Care Home, Villa Joyo, 1 Ichinobe-sasahara, Joyo, Kyoto 610-0114, Japan
| | - Akiko Kuwabara
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30 Habikino, Habikino, Osaka 583-8555, Japan
| | - Takashi Miyawaki
- Department of Food and Nutrition, Kyoto Women's University, 35 Kitahiyoshi-cho, Imakumano, Higashiyama, Kyoto 605-8501, Japan
| | - Kiyoshi Tanaka
- Department of Food and Nutrition, Kyoto Women's University, 35 Kitahiyoshi-cho, Imakumano, Higashiyama, Kyoto 605-8501, Japan.,Faculty of Nutrition, Kobe Gakuin University, 518 Arise, Ikawadani-cho, Nishi-ku, Kobe, Hyogo 651-2180, Japan
| |
Collapse
|
2
|
Katta N, Balla S, Alpert MA. Does Long-Term Furosemide Therapy Cause Thiamine Deficiency in Patients with Heart Failure? A Focused Review. Am J Med 2016; 129:753.e7-753.e11. [PMID: 26899752 DOI: 10.1016/j.amjmed.2016.01.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 01/19/2016] [Accepted: 01/20/2016] [Indexed: 10/22/2022]
Abstract
Diuretic therapy is a cornerstone in the management of heart failure. Most studies assessing body thiamine status have reported variable degrees of thiamine deficiency in patients with heart failure, particularly those treated chronically with high doses of furosemide. Thiamine deficiency in patients with heart failure seems predominantly to be due to increased urine volume and urinary flow rate. There is also evidence that furosemide may directly inhibit thiamine uptake at the cellular level. Limited data suggest that thiamine supplementation is capable of increasing left ventricular ejection fraction and improving functional capacity in patients with heart failure and a reduced left ventricular ejection fraction who were treated with diuretics (predominantly furosemide). Therefore, it may be reasonable to provide such patients with thiamine supplementation during heart failure exacerbations.
Collapse
Affiliation(s)
- Natraj Katta
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia
| | - Sudarshan Balla
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia
| | - Martin A Alpert
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia.
| |
Collapse
|