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Abstract
A case control study was conducted to assess thiamine level in elderly patients with heart failure. The study included 126 subjects, divided into two groups heart failure cases 63 and their controls 63, recruited from outpatients clinics and inpatients of Geriatrics, Cardiology and Medicine departments of Ain Shams University Hospitals.
Both cases and controls were matched as regard age and gender distribution.
Subjects with diseases affecting thiamine level such as diabetes mellitus, sever liver disease, renal failure with dialysis, prolonged diarrhea and prolonged fever were excluded. Also subjects taking drugs affecting thiamine level such as total parental nutrition, vitamin supplementation within last three months, tetracycline, alcoholism, barbiturates chemotherapy and phynitoin were excluded.
Thiamine level was measured using high performance liquid chromatography in both cases and controls.
In addition serum albumin, total protein, random blood sugar, serum creatinine and blood urea nitrogen were done in both cases and controls.
Heart failure was diagnosed by The Framingham Criteria for Heart Failure (McKee et al., 1971) and Echocardiography was done to all cases.
On analysing the data collected the study revealed that there is lower levels of vitamin B1 among female and male cases compared to their controls with highly significant difference yet with no significant difference between female cases and female controls.
Also the study revealed that there is highly significant negative correlation between diuretics doses and vitamin B1 but there is no correlation between their duration and vitamin B1 level
The study revealed that there is negative correlation between duration of lanoxine intake and vitamin B1 level. In addition this study proved that there is highly significant negative correlation between HF duration and vitamin B1 level
Also the correlation between vitamin B1 and ejection fraction measured by Echo was studied in the cases and revealed that there is highly significant positive correlation.
In addition the relation between NYHA grading and vitamin B1 level were studied and revealed that there is highly statistically significant difference between NYHA grading and vitamin B1level, as decreased vitamin B1 level in high NYHA grading.
Also the effect of aging on thiamine B1 level was studied and revealed that there is no correlation between vitamin B1 level and age of both cases and controls.
On comparing nutritional state between cases and controls, the study revealed that there is no statistically significant difference between cases and controls as regard nutritional state.
On studying the relation between nutritional states of the studied groups (cases and controls) and vitamin B1 level, this present study revealed that patients with good nutritional states had higher level of vitamin B1 while patients with bad nutritional states had lower level of vitamin B1.
The study revealed that there is a significant positive correlation between vitamin B1 level and BMI of controls while there is no correlation between vitamin B1 level and BMI of cases.
The study proved that there is significant positive correlation between vitamin B1 level and serum albumin of cases and controls, also there is significant positive correlation between vitamin B1 level and total protein of controls, but there is no correlation between vitamin B1 level and total protein of cases.
Also the study revealed that that there is a significant difference between depressed and non depressed as regards vitamin B1. Also this study revealed that there is a highly statistically significant difference between patients suffering from peripheral neuropathy and patients not suffering as regard vitamin B1 level.