The effects of nutritional support and inflammation on plasma thiamine and erythrocyte thiamine pyrophosphate concentrations in the acute phase of critical illness: A pioneer study

• Published in: Journal of critical care 2024-06, Vol.81, p.154605, Article 154605
• Main Authors: Ozer, Nurhayat Tugra, Sahin, Gulşah Gunes, Ergul, Serap Sahin, Yuksel, Recep Civan, Temel, Sahin, Sungur, Murat, Ziegler, Thomas
• Format: Article
• Language: English
• Subjects: Critical care; Enteral nutrition; Erythrocyte; eTPP; ICU; Inflammation; Micronutrient; Plasma; Plasma thiamine; Vitamin B
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2024.154605

Thiamine (vitamin B1) is a vitamin that plays a cofactor role in energy metabolism which provide energy from macronutrients in the human body. Plasma thiamine values indicate recent intake while erythrocyte thiamine pyrophosphate (eTPP) level shows actual thiamine status. To determine thiamine level, while the analysis of plasma thiamine is affected by inflammation, eTPP is not. This study aimed to determine effect of nutrition and inflammation on plasma thiamine and eTPP in acute phase of critical illness. This prospective observational study performed in medical intensive care unit (ICU). Acute phase determined first 7 days after ICU admission. The study period consisted of two study time points that first is within 24 h in ICU and second is discharge day in participants with ICU stay 7 days. Plasma thiamine and eTPP values analyzed using high pressure liquid chromatography (HPLC). Fifty patients were enrolled. The mean age of study sample was 68.0 (range: 52.5–75.5). The mean APACHE II score was 14.7±7.4. The mean plasma thiamine concentrations were 13.6 ± 5.22 nmol/L at 1st study time point and 15.2 ± 5.06 nmol/L at 2nd study time point. The median eTPP value was 621.0 (range: 406.9–921.9) and 587.8 (range: 338.2–889.4) at 1st and 2nd study time point, respectively. The median CRP concentrations were 135.4 (IQR: 87.9–172.1) mg/L at 1st study time point and 103.5 (IQR: 38.1–199.9) mg/L at 2nd study time point. A total of 26% of participants demonstrated thiamine deficiency (reflected by eTPP). Plasma thiamine and eTPP values were significantly higher in patients receiving enteral tube feeding compared to participants receiving regular diet with/without oral nutritional supplement (p  0.05). Our results showed that patients receiving enteral tube feeding had higher plasma thiamine and eTPP concentrations than orally fed patients. While CRP value decreased, plasma thiamine levels increased, not statistically significant.