Thiamine and Micronutrient Deficiencies in Hospitalized Veterans Without Alcohol Use Disorder

Micronutrient deficiencies (MiDs) can increase medical complexity in hospitalized adults, but the prevalence in those without alcohol use disorder (AUD) is unknown. Our objectives were to prospectively determine the prevalence of thiamine, cobalamin, folate, magnesium, and cholecalciferol deficiencies in hospitalized veterans without AUD.

Newly hospitalized veterans without AUD were recruited. Plasma thiamine, cholecalciferol, cyanocobalamin, folate, magnesium, C-reactive protein, albumin, and prealbumin were obtained. Interviews, physical exams, and medical record reviews were completed to assess clinical signs of MiDs, food insecurity, malnutrition, and hospitalization metrics. Pearson chi-square, Fisher's exact, and logistic regression evaluated relationships among MiDs, malnutrition, food insecurity, demographics, and hospitalization metrics.

A total of 206 participants were enrolled, and 183 had partial results while 155 had complete results. The prevalences of deficiencies were 31.32% for magnesium, 27.07% for thiamine, 25.27% for cholecalciferol, 4.40% for cyanocobalamin, and 0.55% for folate. Malnutrition was reported by 50.60% of participants, and 56.00% reported food insecurity. Of those with biomarker MiDs, signs and symptoms were found in 97.92% with thiamine, 85.96% with magnesium, 67.39% with cholecalciferol, and 37.5% with cyanocobalamin deficiency. Cholecalciferol deficiency was associated with thiamine deficiency (p = 0.011, OR 3.180, CI 1.556-6.529), food insecurity (p = 0.0073, OR 2.690, CI 1.289-5.662), and longer length of hospital stay (p = 0.0401, IRR 1.295). All other associations were not statistically significant.

In this exploratory pilot study, MiDs affected more than half of hospitalized veterans without AUD and were frequently associated with clinical signs and symptoms. TD affected one quarter of participants. Cholecalciferol deficiency was associated with longer hospital stays.