Thiamine deficiency in cambodian infants with and without beriberi

Debra Coats, Kelsey Shelton-Dodge, Kevanna Ou, Vannara Khun, Sommon Seab, Kimsan Sok, Chiva Prou, Silvia Tortorelli, Thomas P. Moyer, Lisa E. Cooper, Tadhg P. Begley, Felicity T Enders, Philip R. Fischer, Mark Topazian

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objectives: To test the hypothesis that heavy metal toxicity and consumption of thiaminase-containing foods predispose to symptomatic thiamine deficiency. Study design: In a case-control study, thiamine diphosphate (TDP) blood concentrations were measured in 27 infants diagnosed with beriberi at a rural clinic, as well as their mothers and healthy Cambodian and American controls. Blood and urine levels of lead, arsenic, cadmium, mercury, and thallium were measured. Local food samples were analyzed for thiaminase activity. Results: Mean TDP level among cases and Cambodian controls was 48 and 56 nmol/L, respectively (P =.08) and was 132 nmol/L in American controls (P <.0001 compared with both Cambodian groups). Mean TDP level of mothers of cases and Cambodian controls was 57 and 57 nmol/L (P =.92), and was 126 nmol/L in American mothers (P <.0001 compared with both Cambodian groups). Cases (but not controls) had lower blood TDP levels than their mothers (P =.02). Infant TDP level decreased with infant age and was positively associated with maternal TDP level. Specific diagnostic criteria for beriberi did not correlate with TDP level. There was no correlation between heavy metal levels and either TDP level or case/control status. No thiaminase activity was observed in food samples. Conclusions: Thiamine deficiency is endemic among infants and nursing mothers in rural southeastern Cambodia and is often clinically inapparent. Neither heavy metal toxicity nor consumption of thiaminase-containing foods account for thiamine deficiency in this region.

Original languageEnglish (US)
Pages (from-to)843-847
Number of pages5
JournalJournal of Pediatrics
Volume161
Issue number5
DOIs
StatePublished - Nov 2012

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Beriberi
Thiamine Deficiency
Thiamine Pyrophosphate
thiaminase II
Mothers
Food
Cambodia
Asian Americans
Thallium
Arsenic
Heavy Metals
Mercury
Cadmium
Case-Control Studies
Nursing
Urine

Keywords

  • TDP
  • TDP/Hct
  • Thiamine diphosphate
  • Thiamine diphosphate divided by hematocrit

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Thiamine deficiency in cambodian infants with and without beriberi. / Coats, Debra; Shelton-Dodge, Kelsey; Ou, Kevanna; Khun, Vannara; Seab, Sommon; Sok, Kimsan; Prou, Chiva; Tortorelli, Silvia; Moyer, Thomas P.; Cooper, Lisa E.; Begley, Tadhg P.; Enders, Felicity T; Fischer, Philip R.; Topazian, Mark.

In: Journal of Pediatrics, Vol. 161, No. 5, 11.2012, p. 843-847.

Research output: Contribution to journalArticle

Coats, D, Shelton-Dodge, K, Ou, K, Khun, V, Seab, S, Sok, K, Prou, C, Tortorelli, S, Moyer, TP, Cooper, LE, Begley, TP, Enders, FT, Fischer, PR & Topazian, M 2012, 'Thiamine deficiency in cambodian infants with and without beriberi', Journal of Pediatrics, vol. 161, no. 5, pp. 843-847. https://doi.org/10.1016/j.jpeds.2012.05.006
Coats D, Shelton-Dodge K, Ou K, Khun V, Seab S, Sok K et al. Thiamine deficiency in cambodian infants with and without beriberi. Journal of Pediatrics. 2012 Nov;161(5):843-847. https://doi.org/10.1016/j.jpeds.2012.05.006
Coats, Debra ; Shelton-Dodge, Kelsey ; Ou, Kevanna ; Khun, Vannara ; Seab, Sommon ; Sok, Kimsan ; Prou, Chiva ; Tortorelli, Silvia ; Moyer, Thomas P. ; Cooper, Lisa E. ; Begley, Tadhg P. ; Enders, Felicity T ; Fischer, Philip R. ; Topazian, Mark. / Thiamine deficiency in cambodian infants with and without beriberi. In: Journal of Pediatrics. 2012 ; Vol. 161, No. 5. pp. 843-847.
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abstract = "Objectives: To test the hypothesis that heavy metal toxicity and consumption of thiaminase-containing foods predispose to symptomatic thiamine deficiency. Study design: In a case-control study, thiamine diphosphate (TDP) blood concentrations were measured in 27 infants diagnosed with beriberi at a rural clinic, as well as their mothers and healthy Cambodian and American controls. Blood and urine levels of lead, arsenic, cadmium, mercury, and thallium were measured. Local food samples were analyzed for thiaminase activity. Results: Mean TDP level among cases and Cambodian controls was 48 and 56 nmol/L, respectively (P =.08) and was 132 nmol/L in American controls (P <.0001 compared with both Cambodian groups). Mean TDP level of mothers of cases and Cambodian controls was 57 and 57 nmol/L (P =.92), and was 126 nmol/L in American mothers (P <.0001 compared with both Cambodian groups). Cases (but not controls) had lower blood TDP levels than their mothers (P =.02). Infant TDP level decreased with infant age and was positively associated with maternal TDP level. Specific diagnostic criteria for beriberi did not correlate with TDP level. There was no correlation between heavy metal levels and either TDP level or case/control status. No thiaminase activity was observed in food samples. Conclusions: Thiamine deficiency is endemic among infants and nursing mothers in rural southeastern Cambodia and is often clinically inapparent. Neither heavy metal toxicity nor consumption of thiaminase-containing foods account for thiamine deficiency in this region.",
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AU - Shelton-Dodge, Kelsey

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AU - Seab, Sommon

AU - Sok, Kimsan

AU - Prou, Chiva

AU - Tortorelli, Silvia

AU - Moyer, Thomas P.

AU - Cooper, Lisa E.

AU - Begley, Tadhg P.

AU - Enders, Felicity T

AU - Fischer, Philip R.

AU - Topazian, Mark

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N2 - Objectives: To test the hypothesis that heavy metal toxicity and consumption of thiaminase-containing foods predispose to symptomatic thiamine deficiency. Study design: In a case-control study, thiamine diphosphate (TDP) blood concentrations were measured in 27 infants diagnosed with beriberi at a rural clinic, as well as their mothers and healthy Cambodian and American controls. Blood and urine levels of lead, arsenic, cadmium, mercury, and thallium were measured. Local food samples were analyzed for thiaminase activity. Results: Mean TDP level among cases and Cambodian controls was 48 and 56 nmol/L, respectively (P =.08) and was 132 nmol/L in American controls (P <.0001 compared with both Cambodian groups). Mean TDP level of mothers of cases and Cambodian controls was 57 and 57 nmol/L (P =.92), and was 126 nmol/L in American mothers (P <.0001 compared with both Cambodian groups). Cases (but not controls) had lower blood TDP levels than their mothers (P =.02). Infant TDP level decreased with infant age and was positively associated with maternal TDP level. Specific diagnostic criteria for beriberi did not correlate with TDP level. There was no correlation between heavy metal levels and either TDP level or case/control status. No thiaminase activity was observed in food samples. Conclusions: Thiamine deficiency is endemic among infants and nursing mothers in rural southeastern Cambodia and is often clinically inapparent. Neither heavy metal toxicity nor consumption of thiaminase-containing foods account for thiamine deficiency in this region.

AB - Objectives: To test the hypothesis that heavy metal toxicity and consumption of thiaminase-containing foods predispose to symptomatic thiamine deficiency. Study design: In a case-control study, thiamine diphosphate (TDP) blood concentrations were measured in 27 infants diagnosed with beriberi at a rural clinic, as well as their mothers and healthy Cambodian and American controls. Blood and urine levels of lead, arsenic, cadmium, mercury, and thallium were measured. Local food samples were analyzed for thiaminase activity. Results: Mean TDP level among cases and Cambodian controls was 48 and 56 nmol/L, respectively (P =.08) and was 132 nmol/L in American controls (P <.0001 compared with both Cambodian groups). Mean TDP level of mothers of cases and Cambodian controls was 57 and 57 nmol/L (P =.92), and was 126 nmol/L in American mothers (P <.0001 compared with both Cambodian groups). Cases (but not controls) had lower blood TDP levels than their mothers (P =.02). Infant TDP level decreased with infant age and was positively associated with maternal TDP level. Specific diagnostic criteria for beriberi did not correlate with TDP level. There was no correlation between heavy metal levels and either TDP level or case/control status. No thiaminase activity was observed in food samples. Conclusions: Thiamine deficiency is endemic among infants and nursing mothers in rural southeastern Cambodia and is often clinically inapparent. Neither heavy metal toxicity nor consumption of thiaminase-containing foods account for thiamine deficiency in this region.

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