Digestive Diseases and Sciences

, Volume 47, Issue 3, pp 543–548 | Cite as

Thiamine Deficiency in Hepatitis C Virus and Alcohol-Related Liver Diseases

  • Stéphane Lévy
  • Christian Hervé
  • Edouard Delacoux
  • Serge Erlinger
Article

Abstract

Thiamine deficiency is a common feature in chronic alcoholic patients, and its pathophysiology remains poorly understood. Until now, thiamine deficiency has been considered to be mainly the result of alcoholism irrespective of the underlying liver disease. The aims of the study were to compare the prevalence of thiamine deficiency in alcohol- and hepatitis C virus- (HCV-) related cirrhosis and in patients with chronic hepatitis C without cirrhosis. Forty patients with alcoholic cirrhosis (group A), 48 patients with HCV-related cirrhosis (group B), and 59 patients with chronic hepatitis C without cirrhosis (group C) were included prospectively. Thiamine status was evaluated by concomitant determination of erythrocyte transketolase activity, thiamine diphosphate (TDP) effect, and direct measurement of erythrocyte thiamine and its phosphate esters by HPLC. Thiamine was mainly present in erythrocytes in its diphosphorylated form. Prevalence of thiamine deficiency and levels of TDP in thiamine-deficient patients were similar in patients of group A (alcoholic cirrhosis) and of group B (viral C cirrhosis). None of the patients with chronic hepatitis (group C) was deficient. Thiamine deficiency was not correlated with the severity of the liver disease or disease activity. No impairment of thiamine phosphorylation was found in the three groups. conclusion, alcoholic or HCV-related cirrhotics have the same range of thiamine deficiency, while no patient without cirrhosis has thiamine deficiency, and impaired phosphorylation does not account for the deficiency observed in cirrhotics. We suggest that thiamine should be given to patients with cirrhosis irrespective of its cause.

thiamine hepatitis C virus alcohol cirrhosis deficiency 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. 1.
    Stryer L: Biochemistry, 2nd ed. San Francisco, WH Freeman, 1981, pp 331–355Google Scholar
  2. 2.
    McLaren D: Metabolic disorders. In Conn HF, (ed). Current Therapy. Philadelphia, WB saunders, 1978, pp 409–410Google Scholar
  3. 3.
    Hoyumpa AM: Mechanisms of thiamin deficiency in chronic alcoholism. Am J Clin Nutr 33:2750–2761, 1980Google Scholar
  4. 4.
    Leevy CM: Thiamin deficiency and alcoholism. Ann New York Acad Sci 378:316–326, 1982Google Scholar
  5. 5.
    Morgan MY: Nutritional aspects of liver and biliary disease. In Oxford Textbook of Clinical Hepatology. Bircher J, Benhamou JP, McIntyre N, Rizzetto M, Rodès J (eds). Oxford Medical Publication, pp 1923–1981, Oxford, 1999Google Scholar
  6. 6.
    Alter MJ: Epidemiology of hepatitis C in the West. Semin Liver Dis 15:5–14, 1995Google Scholar
  7. 7.
    Hervé C, Beyne P, Delacoux E: Determination of thiamine and its phosphate esters in human erythrocytes by high-performance liquid chromatography with isocratic elution. J Chromatogr B 653:217–220, 1994Google Scholar
  8. 8.
    Seligmann H, Halkin H, Rauchfleisch S, Kaufmann N, Tal R, Motro M, Vered Z, Ezra D: Thiamine deficiency in patients with congestive heart failure receiving long term furosemide therapy—a pilot study. Am J Med 91:151–155, 1991Google Scholar
  9. 9.
    Nixon PF, Diefenbach RJ, Duggleby RG: Inhibition of transketolase and pyruvate decarboxylase by omeprazole. Biochem Pharmacol 44:177–179, 1992Google Scholar
  10. 10.
    Delacoux E, Sancho J, Evstigneeff T, Coulombier L, Langin S: Détermination de l'activité de la transcétolase érythrocytaire. Clin Chim Acta 108:483–486, 1980Google Scholar
  11. 11.
    Hervé C, Beyne P, Letteron P, Delacoux E: Comparison of erythrocyte transketolase activity with thiamine and thiamine phosphate ester levels in chronic alcoholic patients. Clin Chim Acta 234:91–100, 1995Google Scholar
  12. 12.
    Tallaksen CME, Bohmer T, Bell H, Karlsen J: Concomitant determination of thiamin and its phosphate esters in human blood and serum by high-performance liquid chromatography. J Chromatogr 564:127–136, 1991Google Scholar
  13. 13.
    Knodell RG, Ishak KG, Black WC, Chen TS, Craig R, Kaplowitz N, Kiernan TW, Wollman J: Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1:431–435, 1981Google Scholar
  14. 14.
    Majumdar SK, Shaw GK, O'Gorman P, Aps EJ, Efferman EL, Thomson AD: Blood vitamin status (B1, B2, B6, folic acid, and B12) in patients with alcoholic liver disease. Int J Vitam Nutr Res 52:266–271, 1982Google Scholar
  15. 15.
    Graudal N, Torp-Pedersen K, Bonde J, Hanel HK, Kristensen M, Milman N, Thomsen AC: The influence of hepatic insufficiency due to alcoholic cirrhosis on the erythrocyte tranketolase activity (ETKA). Liver 7:91–95, 1987Google Scholar
  16. 16.
    Baines M, Davies G: The evaluation of erythrocyte thiamine diphosphate as an indicator of thiamin status in man, and its comparison with erythrocyte transketolase activity measurements. Ann Clin Biochem 25:698–705, 1988Google Scholar
  17. 17.
    Takeuchi T, Jung EH, Nishino K, Itokawa Y: The relationship between the thiamin pyrophosphate effect and the saturation status of the transketolase with its coenzyme in human erythrocyte. Int J Vitam Nutr Res 60:112–120, 1990Google Scholar
  18. 18.
    Blansjaar BA, Zwang R, Blijenberg BG: No transketolase abnormalities in Wernicke Korsakoff patients. J Neurol Sci 106:88–90, 1991Google Scholar
  19. 19.
    Mc Cool BA, Plonk ST, Martin PR, Singleton CK: Cloning of human transketolase cDNAs and comparison of the nucleotide sequence of the coding region in Wernicke-Korsakoff and non-Wernicke-Korsakoff individuals. J Biol Chem 268:1397–1404, 1993Google Scholar
  20. 20.
    Fennelly J, Frank O, Baker H, Leevy CM: Red blood cell transketolase activity in malnourished alcoholics with cirrhosis. Am J Clin Nutr 20:946–949, 1967Google Scholar
  21. 21.
    Abe T, Itokawa Y: Effect of ethanol administration on thiamine metabolism and transketolase activity in rats. Int J Vitam Nutr Res 47:307–314, 1977Google Scholar
  22. 22.
    Atukorala TMS, Duggleby RG, Nixon PF: Effects of acetaldehyde upon catalysis by human erythrocyte transketolase. Biochem Pharmacol 37:2100–2101, 1988Google Scholar
  23. 23.
    Baines M: Detection and incidence of B and C vitamin deficiency in alcohol related illness. Ann Clin Biochem 15:307–312, 1978Google Scholar
  24. 24.
    Camilo ME, Morgan MY, Sherlock S: Erythrocyte transketolase activity in alcoholic liver disease. Scand J Gastroenterol 16:273–279, 1981Google Scholar
  25. 25.
    Tallaksen CME, Bohmer T, Bell H: Blood and serum thiamin phosphate esters concentrations in patients with alcohol dependance syndrome before and after thiamin treatment. Alcohol Clin Exp Res 16:320–325, 1992Google Scholar
  26. 26.
    Rindi G, Reggiani C, Patrini C, Laforenza U: Effect of ethanol administration on the in vivo kinetics of thiamine phosphorylation and dephosphorylation in different organs. I—Chronic effects. Alcohol Alcoholism 26:285–301, 1991Google Scholar
  27. 27.
    Rindi G, Reggiani C, Patrini C, Gastaldi G, Laforenza U: Effect of ethanol on the in vivo kinetics of thiamine phosphorylation and dephosphorylation in different organs of rat. II— Acute effects. Alcohol Alcoholism 27:505–522, 1992Google Scholar
  28. 28.
    Hoyumpa AM, Middleton HM, Wilson FA, Shenker S: Thiamine transport across the rat intestine. I. Normal characteristics. Gastroenterology 68:1218–1227, 1975Google Scholar
  29. 29.
    Rindi G, Casirola D, Poggi V, De Vizia B, Patrini C, Laforenza U: Thiamine transport by erythrocytes and ghosts in thiamineresponsive megaloblastic anaemia. J Inher Metab Dis 15:231–242, 1992Google Scholar
  30. 30.
    Breen KJ, Buttigieg R, Iossifidis S, Lourensz C, Wood B: Jejunal uptake of thiamin hydrochloride in man: Influence of alcoholism and alcohol. Am J Clin Nutr 42:121–126, 1985Google Scholar
  31. 31.
    Gauvin DV, Briscoe RJ, Goulden KL, Wojnicki FH, Russin R, Martin PR, Holloway FA: Influence of thiamine on the behavioral sensitivity to ethanol. Alcohol Clin Exp Res 18:1398–1405, 1994Google Scholar
  32. 32.
    Martin PR, Impeduglia G, Giri PR, Karanian J: Acceleration of ethanol metabolism by past thiamine deficiency. Alcohol Clin Exp Res 13:457–460, 1989Google Scholar
  33. 33.
    Tallaksen CME, Bell H, Bohmer T: The concentration of thiamin and thiamin phosphate esters in patients with alcoholic liver cirrhosis. Alcohol Alcoholism 27:523–530, 1992Google Scholar
  34. 34.
    Butterworth RF, Gaudreau C, Vincelette J, Bourgault AM, Lamothe F, Nutini AM: Thiamine deficiency in AIDS. Lancet 338:1086, 1991Google Scholar

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Stéphane Lévy
    • 1
  • Christian Hervé
    • 2
  • Edouard Delacoux
    • 2
  • Serge Erlinger
    • 1
  1. 1.Department of Hepatology andINSERM U-481, Hôpital BeaujonClichyFrance
  2. 2.Department of Clinical BiochemistryHôpital BeaujonClichyFrance

Personalised recommendations