Factors associated with thiamin deficiency in pediatric patients with heart disease and receiving diuretics: a single-center study

Background: Thiamin deficiency (TD) manifesting clini-cally as wet beriberi can significantly impair a patient's cardiac function. Children with heart disease who are receiving diuretic treatment may be at increased risk for severe clinical manifestations of TD. Purpose: This study aimed to determine the prevalence of TD and evaluate the association between various factors with thiamin status in pediatric patients with heart disease undergoing diuretic treatment. Methods: Children with heart disease aged 1 month to 15 years who exhibited increased pulmonary blood flow or congestive heart failure (CHF) and had been taking diuretics for at least 1 month were recruited. Data regard-ing their heart condition, treatment, dietary intake, anth-ropometry, and symptoms and signs of TD were collected. An erythrocyte transketolase activity assay after the addition of exogenous thiamin pyrophosphate was used to assess thiamin status. Left ventricular ejection fraction and N-terminal pro-brain natriuretic peptide levels were indicators of cardiac function and laboratory evidence of CHF, respectively. Results: A total of 68 participants were recruited, of whom 10 (15%) had TD. TD was not associated with a CHF exacerbation. An adequate dietary thiamin intake was associated with a better thiamin status (β=-0.37, P=0.003), while increasing age was linked to a poorer thiamin status (β=+0.40, P=0.001). Conclusion: TD was present in 15% of pediatric patients with heart disease who were receiving diuretic treatment. An adequate dietary thiamin intake appeared to have a protective effect against TD, while increasing age was associated with a poorer thiamin status.