高收入国家与酒精摄入无关的硫胺素缺乏:文献综述。
Thiamine deficiency unrelated to alcohol consumption in high-income countries: a literature review.
机构信息
The New York Academy of Sciences, New York, New York.
Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
出版信息
Ann N Y Acad Sci. 2021 Aug;1498(1):46-56. doi: 10.1111/nyas.14569. Epub 2021 Feb 11.
Thiamine deficiency has been typically associated with alcoholism or as a prevalent problem in low- and middle-income countries (LMICs) whose populations rely on staple foods with a low content of thiamine. We conducted a literature review of published and unpublished data to identify relevant adult cases with confirmed thiamine deficiency of nonalcoholic cause in developed countries. We selected 17 reports with 81 adult cases of confirmed thiamine deficiency affecting adult patients with a wide range of ages and underlying conditions (e.g., cancer, gastrointestinal diseases, heart failure, and obesity). Thiamine deficiency may have been caused by disease-related malnutrition, bariatric surgery, chronic use of diuretics, repeated vomiting, lack of thiamine in parenteral nutrition formulas, food insecurity, and reliance on monotonous or restrictive diets. Treatment with intravenous thiamine resulted in partial or complete recovery from the symptoms (cardiac, neurologic, and metabolic disorders) for most patients. The number and variety of symptomatic thiamine-deficient adults identified in this review demonstrates that thiamine deficiency is not exclusive to LMICs and, in high-income settings, is not exclusive to alcoholic patients. In developed countries, this serious but treatable condition can be expected in patients suffering from various medical conditions or following certain dietary patterns.
维生素 B1 缺乏症通常与酗酒有关,或在依赖低维生素 B1 主食的低收入和中等收入国家(LMICs)普遍存在。我们对已发表和未发表的数据进行了文献回顾,以确定发达国家中由非酒精原因引起的确诊维生素 B1 缺乏的相关成年病例。我们选择了 17 份报告,其中包括 81 例确诊的维生素 B1 缺乏成年病例,这些病例影响了年龄和基础疾病范围广泛的成年患者(例如癌症、胃肠道疾病、心力衰竭和肥胖症)。维生素 B1 缺乏可能是由与疾病相关的营养不良、减重手术、长期使用利尿剂、反复呕吐、肠外营养配方中缺乏维生素 B1、食物不安全以及依赖单调或限制饮食引起的。大多数患者经静脉注射维生素 B1 治疗后,症状(心脏、神经和代谢紊乱)部分或完全缓解。本综述中确定的有症状的维生素 B1 缺乏症成年患者的数量和种类表明,维生素 B1 缺乏症不仅限于 LMICs,在高收入环境中,也不仅限于酗酒患者。在发达国家,患有各种疾病或遵循某些饮食模式的患者可能会出现这种严重但可治疗的病症。