Factors associated with thiamin deficiency in pediatric patients with heart disease and receiving diuretics: a...

Area of Science:

• Pediatric Cardiology
• Nutritional Biochemistry
• Clinical Medicine

Background:

• Thiamin deficiency (TD) can severely impact cardiac function, particularly in children with heart disease on diuretic therapy.
• Diuretic use in pediatric heart patients may increase the risk of severe thiamin deficiency manifestations.
• Wet beriberi, a clinical presentation of TD, highlights the critical link between thiamin and cardiovascular health.

Purpose of the Study:

• To determine the prevalence of thiamin deficiency (TD) in pediatric patients with heart disease on diuretic treatment.
• To evaluate factors associated with thiamin status in this vulnerable pediatric population.
• To assess the relationship between dietary intake, age, and thiamin status.

Main Methods:

• Recruited children (1 month-15 years) with heart disease, increased pulmonary blood flow, or congestive heart failure (CHF) on diuretics for ≥1 month.
• Collected data on cardiac condition, treatments, diet, anthropometry, and TD symptoms.
• Assessed thiamin status using erythrocyte transketolase activity assay and cardiac function via ejection fraction and N-terminal pro-brain natriuretic peptide.

Main Results:

• 15% (10 of 68) of participants presented with thiamin deficiency (TD).
• TD was not significantly associated with congestive heart failure (CHF) exacerbation.
• Adequate dietary thiamin intake correlated with better thiamin status (β: -0.37, P=0.003), while increasing age correlated with poorer status (β: +0.40, P=0.001).

Conclusions:

• Thiamin deficiency affects 15% of pediatric heart patients on diuretics.
• Sufficient dietary thiamin intake may offer protection against TD in this group.
• Older age is a risk factor for poorer thiamin status in pediatric heart patients on diuretics.