Myocardial dysfunction in relation to serum thiamine levels in children with diabetic ketoacidosis
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Ragaa Abd-Elsalam Mohamed
und
Radwa Saeed Ibrahim
Abstract
Background
Thiamine deficiency is commonly reported in patients with diabetes especially during diabetic ketoacidosis (DKA) that could attribute to myocardial dysfunction in those patients. However, there is limited data regarding its relation to myocardial function among those patients. This study aimed to explore the association between myocardial function and serum thiamine levels in children with type 1 diabetes mellitus (DM).
Methods
This cross-sectional comparative study included 25 patients with DKA. Clinical data assessment, echocardiographic examination and measurement of serum high-sensitive troponin T (hs-cTnT) and thiamine levels were done. We also assessed the association between troponin levels, echocardiographic ventricular systolic and diastolic function and serum thiamine.
Results
Twenty-four percent of children with DKA had thiamine deficiency. DKA children with thiamine deficiency had significant acidosis and higher serum troponin levels and significant impairment of diastolic function than those without thiamine deficiency. The serum thiamine level had a significant positive correlation with the echocardiographic indices of diastolic function but negative correlation with troponin levels.
Conclusions
Thiamine deficiency is a common finding during the treatment of children with DKA, and this deficiency may be associated with myocardial dysfunction.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Lonsdale D. A review of the biochemistry, metabolism and clinical benefits of thiamine and its derivatives. Evid Based Complement Alternat Med 2006;3:49–59.10.1093/ecam/nek009Suche in Google Scholar PubMed PubMed Central
2. Costa NA, Gut AL, de Souza Dorna M, Pimentel JA, Cozzolino SM, et al. Serum thiamine concentration and oxidative stress as predictors of mortality in patients with septic shock. J Crit Care 2014;29:249–52.10.1016/j.jcrc.2013.12.004Suche in Google Scholar PubMed
3. Teigen LM, Twernbold DD, Miller WL. Prevalence of thiamine deficiency in a stable heart failure outpatient cohort on standard loop diuretic therapy. Clin Nutr 2016;35:1323–7.10.1016/j.clnu.2016.02.011Suche in Google Scholar PubMed
4. Wooley JA. Characteristics of thiamine and its relevance to the management of heart failure. Nutr Clin Pract 2008;23:487–93.10.1177/0884533608323430Suche in Google Scholar PubMed
5. Luong KV, Nguyen LT. The impact of thiamine treatment in the diabetes mellitus. J Clin Med Res 2012;4:153–60.10.4021/jocmr890wSuche in Google Scholar PubMed PubMed Central
6. Page GL, Laight D, Cummings MH. Thiamine deficiency in diabetes mellitus and the impact of thiamine replacement on glucose metabolism and vascular disease. Int J Clin Pract 2011;65:684–908.10.1111/j.1742-1241.2011.02680.xSuche in Google Scholar PubMed
7. Levin DL. Cerebral edema in diabetic ketoacidosis. Pediatr Crit Care Med 2008;9:320–9.10.1097/PCC.0b013e31816c7082Suche in Google Scholar PubMed
8. Thornalley PJ, Babaei-Jadidi R, Al Ali H, Rabbani N, Antonysunil A, et al. High prevalence of low plasma thiamine concentration in diabetes linked to a marker of vascular disease. Diabetologia 2007;50:2164–70.10.1007/s00125-007-0771-4Suche in Google Scholar PubMed PubMed Central
9. Woolum JA, Abner EL, Kelly A, Thompson Bastin ML, Morris PE, et al. Effect of thiamine administration on lactate clearance and mortality in patients with septic shock. Crit Care Med 2018;46:1747–52.10.1097/CCM.0000000000003311Suche in Google Scholar PubMed
10. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014;37:81–90.10.2337/dc14-S081Suche in Google Scholar PubMed
11. Koike H. Myopathy in thiamine deficiency: analysis of a case. J Neurol Sci 2006;18:195–202.10.1016/j.jns.2006.06.016Suche in Google Scholar PubMed
12. Hiffler L, Rakotoambinina B, Lafferty N, Garcia D. Thiamine deficiency in tropical pediatrics: new insights into a neglected but vital metabolic challenge. Front Nutr 2016;3:16.10.3389/fnut.2016.00016Suche in Google Scholar PubMed PubMed Central
13. Attaluri P, Castillo A, Edriss H, Nugent K. Thiamine deficiency: an important consideration in critically ill patients. Am J Med Sci 2018;356:382–90.10.1016/j.amjms.2018.06.015Suche in Google Scholar PubMed
14. McCann A, Midttun Ø, Whitfield KC, Kroeun H, Borath M, et al. Comparable performance characteristics of plasma thiamine and erythrocyte thiamine diphosphate in response to thiamine fortification in rural Cambodian women. Nutrients 2017;9:676.10.3390/nu9070676Suche in Google Scholar PubMed PubMed Central
15. Rosner EA, Strezlecki KD, Clark JA, Lieh-Lai M. Low thiamine levels in children with type 1 diabetes and diabetic ketoacidosis: a pilot study. Pediatr Crit Care Med 2015;16:114–8.10.1097/PCC.0000000000000302Suche in Google Scholar PubMed
16. Roman-Campos D, Cruz JS. Current aspects of thiamine deficiency on heart function. Life Sci 2014;98:1–5.10.1016/j.lfs.2013.12.029Suche in Google Scholar PubMed
17. Ozdemir O, Koksoy AY, Bulus AD, Andiran N, Yagli E. The effects of type 1 diabetes mellitus on cardiac functions in children: evaluation by conventional and tissue Doppler echocardiography. J Pediatr Endocrinol Metab 2016;29:1389–95.10.1515/jpem-2016-0222Suche in Google Scholar PubMed
18. Porter SG, Coats D, Fischer PR, Ou K, Frank EL, et al. Thiamine deficiency and cardiac dysfunction in Cambodian infants. J Pediatr 2014;164:1456–61.10.1016/j.jpeds.2014.01.049Suche in Google Scholar PubMed
19. Rao SN, Chandak GR. Cardiac beriberi: often a missed diagnosis. J Trop Pediatr 2010;56:284–5.10.1093/tropej/fmp108Suche in Google Scholar PubMed
20. Willeit P, Welsh P, Evans JD, Tschiderer L, Boachie C, et al. High-sensitivity cardiac troponin concentration and risk of first-ever cardiovascular outcomes in 154,052 participants. J Am Coll Cardiol 2017;70:558–68.10.1016/j.jacc.2017.05.062Suche in Google Scholar PubMed PubMed Central
21. Tran HA. Increased troponin I in “wet” beriberi. J Clin Pathol 2006;59:555.10.1136/jcp.2005.030163Suche in Google Scholar PubMed PubMed Central
22. Ahmed M, Azizi-Namini P, Yan AT, Keith M. Thiamine deficiency and heart failure: the current knowledge and gaps in literature. Heart Fail Rev 2015;20:1–11.10.1007/s10741-014-9432-0Suche in Google Scholar PubMed
23. Lee HS, Lee SA, Shin HS, Choi HM, Kim SJ, et al. A case of cardiac beriberi: a forgotten but memorable disease. Korean Circ J 2013;43:569–72.10.4070/kcj.2013.43.8.569Suche in Google Scholar PubMed PubMed Central
24. Moskowitz A, Graver A, Giberson T, Berg K, Liu X, et al. The relationship between lactate and thiamine levels in patients with diabetic ketoacidosis. J Crit Care 2014;29:10.10.1016/j.jcrc.2013.06.008Suche in Google Scholar PubMed PubMed Central
25. Xu RY, Zhu XF, Yang Y, Ye P. High-sensitive cardiac troponin T. J Geriatr Cardiol 2013;10:102–9.Suche in Google Scholar
26. deFilippi CR, de Lemos JA, Christenson RH, Gottdiener JS, Kop WJ, et al. Association of serial measures of cardiac troponin T using a sensitive assay with incident heart failure and cardiovascular mortality in older adults. J Am Med Assoc 2010;304:2494–502.10.1001/jama.2010.1708Suche in Google Scholar PubMed PubMed Central
27. Atabek ME, Pirgon O, Oran B, Erkul I, Kurtoglu S. Increased cardiac troponin I concentration in diabetic ketoacidosis. J Pediatr Endocrinol Metab 2004;17:1077–82.10.1515/JPEM.2004.17.8.1077Suche in Google Scholar PubMed
©2019 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
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- MYT1L mutation in a patient causes intellectual disability and early onset of obesity: a case report and review of the literature
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Artikel in diesem Heft
- Frontmatter
- Review
- The importance of anthropological methods in the diagnosis of rare diseases
- Original Articles
- PON1 arylesterase activity, HDL functionality and their correlation in malnourished children
- Prevalence of dyslipidemia and factors affecting dyslipidemia in young adults with type 1 diabetes: evaluation of statin prescribing
- Myocardial dysfunction in relation to serum thiamine levels in children with diabetic ketoacidosis
- Evaluation of long-term follow-up and methimazole therapy outcomes of pediatric Graves’ disease: a single-center experience
- Endocrine consequences of neuroblastoma treatment in children: 20 years’ experience of a single center
- Analysis of diabetes-associated autoantibodies in children and adolescents with autoimmune thyroid diseases
- Adrenal function of extremely premature infants in the first 5 days after birth
- Atypical presentation of Leydig cell tumour in three prepubertal patients: diagnosis, treatment and outcomes
- The diagnosis of cystinosis in patients reveals new CTNS gene mutations in the Chinese population
- Comparing the validity of continuous metabolic syndrome risk scores for predicting pediatric metabolic syndrome: the CASPIAN-V study
- Primary pigmented nodular adrenocortical disease (PPNAD): single centre experience
- Short Communication
- Classical galactosemia patients can achieve high IQ scores
- Case Reports
- Idiopathic gonadotropin-independent precocious puberty – is regular surveillance required?
- MYT1L mutation in a patient causes intellectual disability and early onset of obesity: a case report and review of the literature
- A case report and literature review of monoallelic mutation of GHR
- Pitfalls in the diagnosis of insulin autoimmune syndrome (Hirata’s disease) in a hypoglycemic child: a case report and review of the literature
