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B-vitamin deficiency in hospitalized patients with heart failure.
J Am Diet Assoc. 2009 Aug; 109(8):1406-10.JA

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 > or = 1.2) and B-6 deficiency (plasma B-6 < or = 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 < or = 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.

Authors+Show Affiliations

Keenan Research Centre, Li Ka Shing Knowledge Institute, and Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada. keithm@smh.toronto.on.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19631047

Citation

Keith, Mary E., et al. "B-vitamin Deficiency in Hospitalized Patients With Heart Failure." Journal of the American Dietetic Association, vol. 109, no. 8, 2009, pp. 1406-10.
Keith ME, Walsh NA, Darling PB, et al. B-vitamin deficiency in hospitalized patients with heart failure. J Am Diet Assoc. 2009;109(8):1406-10.
Keith, M. E., Walsh, N. A., Darling, P. B., Hanninen, S. A., Thirugnanam, S., Leong-Poi, H., Barr, A., & Sole, M. J. (2009). B-vitamin deficiency in hospitalized patients with heart failure. Journal of the American Dietetic Association, 109(8), 1406-10. https://doi.org/10.1016/j.jada.2009.05.011
Keith ME, et al. B-vitamin Deficiency in Hospitalized Patients With Heart Failure. J Am Diet Assoc. 2009;109(8):1406-10. PubMed PMID: 19631047.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - B-vitamin deficiency in hospitalized patients with heart failure. AU - Keith,Mary E, AU - Walsh,Natalie A, AU - Darling,Pauline B, AU - Hanninen,Stacy A, AU - Thirugnanam,Subarna, AU - Leong-Poi,Howard, AU - Barr,Aiala, AU - Sole,Michael J, PY - 2008/10/01/received PY - 2009/01/26/accepted PY - 2009/7/28/entrez PY - 2009/7/28/pubmed PY - 2009/8/4/medline SP - 1406 EP - 10 JF - Journal of the American Dietetic Association JO - J Am Diet Assoc VL - 109 IS - 8 N2 - 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 > or = 1.2) and B-6 deficiency (plasma B-6 < or = 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 < or = 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. SN - 1878-3570 UR - https://www.unboundmedicine.com/medline/citation/19631047/B_vitamin_deficiency_in_hospitalized_patients_with_heart_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8223(09)00633-6 DB - PRIME DP - Unbound Medicine ER -