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Original Article

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

Phakwan Laohathai¹  , Rathaporn Sumboonnanonda¹, Puthita Saengpanit¹, Chodchanok Vijarnsorn², Chatchawan Srisawat³, Kwanjai Chotipanang¹, Sarawut Junnu³, Supawan Kunnangja¹, Hathaichanok Rukprayoon¹, Phakkanan Phuangphan¹, Sompong Liammongkolkul³, Arthima Phaokong⁴, Narumon Densupsoontorn¹ 

¹Division of Nutrition, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
²Division of Cardiology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
³Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
⁴Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Correspondence Narumon Densupsoontorn ,Tel: +6624195674, Email: narumon.den@mahidol.edu

Received: December 11, 2024; Revised: March 14, 2025   Accepted: March 14, 2025.

Abstract

Background
Thiamin deficiency (TD) manifesting clinically 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 and had been taking diuretics for at least 1 month were recruited. Data regarding their heart condition, treatment, dietary intake, anthropometry, 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 congestive heart failure (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
Thiamin deficiency 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 thiamin deficiency, while increasing age was associated with a poorer thiamin status.

Keywords :Thiamin deficiency, Erythrocyte transketolase activity assay, Pediatric patients, Heart failure