Prevalence of Thiamine Deficiency in Cirrhotic Patients Prevalence of Thiamine Deficiency in Cirrhotic Patients
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Abstract
OBJECTIVE: This study aimed to evaluate the prevalence of thiamine deficiency in outpatient cirrhosis and compare thiamine deficiency between alcoholic cirrhosis and non-alcoholic cirrhosis, whether there are any factors or clinical outcomes associated with thiamine deficiency, and short-term follow-up after vitamin B1 replacement.
METHODS: This cross-sectional study included patients who were diagnosed with cirrhosis at the Gastrointestinal and Hepatology Division of Vajira Hospital in outpatient settings. All patient data characteristics were collected and also baseline laboratory and erythrocyte transketolase activity (ETKA), which is a standard test for the diagnosis of thiamine deficiency. Patients who were diagnosed with thiamine deficiency were identified as ETKA ≥ 1.25. Thiamine deficiency patients were tested for clinical outcomes; ophthalmoplegia, nystagmus, ataxia, and Adult ADHD self-report scale v.1.1 and all of them underwent replacement with vitamin B1 for 3 months.
RESULTS: From January 2020 to December 2020, 121 eligible cirrhotic patients were enrolled. Alcoholic cirrhosis comprised 41/121 (33.9%), and non-alcoholic cirrhosis amounted to 80/121 (66.1%). The comparison of prevalence in alcoholic and non-alcoholic cases was 14.6% vs. 11.2% (P=0.59). Neither the severity of disease nor baseline nutritional status was related to thiamine deficiency. The prevalence of hepatocellular carcinoma (HCC) was higher in the thiamine deficiency group compared to the others (46.7% vs. 12.3%; p=0.003). In univariate analysis, HCC was the only factor related to thiamine deficiency. Almost all thiamine deficiency status cases did not have either neurologic abnormality or any attention deficit.
CONCLUSION: Thiamine deficiency was found in end-stage liver disease, irrespective of cirrhotic etiology. HCC was considered an associated factor of the thiamine deficiency. The occurrence of HCC may be emphasized as a proxy for the condition of thiamine deficiency.
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