1. B-vitamin deficiency in hospitalized patients with heart failure
- Author
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Mary Keith, Pauline B. Darling, Stacy A. Hanninen, Howard Leong-Poi, Michael J. Sole, Aiala Barr, Subarna Thirugnanam, and Natalie A. Walsh
- Subjects
Vitamin ,Male ,medicine.medical_specialty ,Heart disease ,Riboflavin ,Physiology ,Nutritional Status ,Statistics, Nonparametric ,chemistry.chemical_compound ,Riboflavin Deficiency ,Risk Factors ,Internal medicine ,Odds Ratio ,Prevalence ,Medicine ,Humans ,Thiamine ,Aged ,Heart Failure ,Ontario ,Nutrition and Dietetics ,Chi-Square Distribution ,business.industry ,Nutritional Requirements ,Furosemide ,Thiamine Deficiency ,Middle Aged ,medicine.disease ,Pyridoxine ,Vitamin B 6 ,Hospitalization ,B vitamins ,Malnutrition ,Endocrinology ,Cross-Sectional Studies ,Logistic Models ,chemistry ,Heart failure ,Dietary Supplements ,Female ,business ,Vitamin B 6 Deficiency ,Food Science ,medicine.drug - Abstract
The impact of heart failure and its treatment on specific nutrient requirements is unknown. Furthermore, depletion of water-soluble B vitamins that play key roles in the production of cellular energy in patients with heart failure can contribute to depletion of energy reserves observed in the failing heart. A cross-sectional study recently reported that approximately one third of hospitalized patients with heart failure had tissue levels suggestive of thiamin deficiency (vitamin B-1). Riboflavin (vitamin B-2) and pyridoxine (vitamin B-6) are similar to thiamin in that they are water-soluble, subject to renal excretion, have limited tissue storage, and are dependent on intake. Therefore, it was hypothesized that the status of these B vitamins may also be adversely affected by heart failure. As a result, the prevalence of patients at risk of vitamin B-2 (erythrocyte glutathione reductase activity coefficient ≥1.2) and B-6 deficiency (plasma B-6 ≤20 nmol/L) was determined in a cross-section of 100 patients hospitalized with heart failure between April 2001 and June 2002 as well as in a group of volunteers without heart failure. Twenty-seven percent of patients with heart failure had biochemical evidence of vitamin B-2 deficiency, while 38% had evidence of B-6 deficiency. These prevalence rates were significantly higher than those observed in the volunteers without heart failure (2% and 19%, respectively; P ≤0.02). Use of common B-vitamin−containing supplements by patients with heart failure did not significantly reduce deficiency rates in comparison with those who did not use supplements (B-2 P =0.38 or B-6 P =0.18)). Finally, while 80% of patients with heart failure took diuretics, neither the dose nor the duration of furosemide use was related to the presence of either B-2 or B-6 deficiency. Given the physiologic importance of these vitamins, further investigations aimed at determining the effect of heart failure on specific nutrient requirements as well as the safety and efficacy of B-vitamin supplementation are warranted.
- Published
- 2008