Poupon R E, Gervaise G, Riant P, Houin G, Tillement J P
INSERM, Unité 21/16, Villejuif, France.
Alcohol Alcohol. 1990;25(6):605-11. doi: 10.1093/oxfordjournals.alcalc.a045056.
The aim of our study was to answer the following questions: (1) is thiamine deficient in chronic excessive drinkers; and (2) is peripheral neuropathy associated with thiamine deficiency or with alcohol intake itself? We performed direct assays of blood concentrations of free thiamine and thiamine phosphate in excessive drinkers with or without peripheral neuropathy and in control subjects. We found no difference in free thiamine concentrations between excessive drinkers with and without neuropathy, and no difference in free thiamine concentrations between the two groups of excessive drinkers and the control group. By contrast, a deficiency in thiamine phosphate was observed in each group of excessive drinkers compared to the control group. This was reflected in blood concentrations of total thiamine which were also lower in excessive drinkers than in controls. Finally, the thiamine phosphate: free thiamine ratio was slightly but significantly lower in the two groups of excessive drinkers than in the control group. Both groups of excessive drinkers showed typical moderate liver disease of alcoholic origin. In conclusion, the free thiamine fraction was not diminished in this group of alcoholic hospital inpatients. Thiamine deficiency would not therefore appear to play a determining role in the onset of peripheral neuropathy. In contrast, the phosphorylated fraction was slightly reduced, probably owing to the liver disease in these subjects. Contrary to studies using indirect assay techniques, our results suggest that thiamine deficiency is either slight or absent in chronic drinkers.
（1）慢性酗酒者是否缺乏硫胺素；（2）周围神经病变是与硫胺素缺乏相关还是与酒精摄入本身相关？我们对有或无周围神经病变的酗酒者以及对照组受试者的血液中游离硫胺素和硫胺素磷酸盐浓度进行了直接测定。我们发现，有神经病变和无神经病变的酗酒者之间游离硫胺素浓度没有差异，两组酗酒者与对照组之间游离硫胺素浓度也没有差异。相比之下，与对照组相比，每组酗酒者均观察到硫胺素磷酸盐缺乏。这反映在总硫胺素的血液浓度上，酗酒者的总硫胺素血液浓度也低于对照组。最后，两组酗酒者的硫胺素磷酸盐：游离硫胺素比值略低于对照组，但差异有统计学意义。两组酗酒者均表现出典型的酒精性中度肝病。总之，在这组酒精性住院患者中，游离硫胺素部分并未减少。因此，硫胺素缺乏似乎在外周神经病变的发生中不起决定性作用。相比之下，磷酸化部分略有降低，可能是由于这些受试者患有肝病。与使用间接检测技术的研究相反，我们的结果表明，慢性饮酒者中硫胺素缺乏要么轻微要么不存在。
