Modulation of hepatic gene expression profiles by vitamin B1, vitamin B2, and niacin supplementation in mice exposed to acute hypoxia

This study was aimed to observe the effects of vitamin B₁, vitamin B₂, and niacin supplementation on hepatic gene expression profiles in mice exposed to acute hypoxia. Thirty mice were randomly divided into normal, acute hypoxia, and acute hypoxia plus vitamin B₁, vitamin B₂, and niacin supplementation groups and fed corresponding diets for 2 weeks and then exposed to a simulated altitude of 6000 m for 8 h. Hepatic gene expression profiles were analyzed using a microarray technique. Several biochemical markers were also assayed. The results showed that a total of 2476 genes were expressed differentially after acute hypoxia exposure (1508 upregulated genes and 968 downregulated genes). Compared with the acute hypoxia group, there were 1382 genes differentially expressed (626 upregulated genes and 756 downregulated genes) in the acute hypoxia plus vitamin B₁, vitamin B₂, and niacin supplementation group. Pathway analysis indicated that carbohydrate, lipid, and amino acid metabolism, as well as electron transfer chain, were improved to some extent after vitamin B₁, vitamin B₂, and niacin supplementation. Supportive results were obtained from biochemical assays. Our findings suggest that the supplementation of vitamin B₁, vitamin B₂, and niacin is beneficial in improving nutritional metabolism partly via gene expression under acute hypoxia condition.

Thiamine Prescribing Practices for Adult Patients Admitted to an Internal Medicine Service

BACKGROUND

Thiamine (vitamin B₁) is an essential cofactor responsible for the breakdown of glucose, and its deficiency is associated with Wernicke encephalopathy (WE). There is a lack of evidence from systematic studies on the optimal dosing of thiamine for WE. Objectives: The primary objective was to describe the prescribing patterns for IV thiamine in adult patients admitted to a large teaching hospital. The secondary objective was to evaluate the clinical resolution of WE symptoms (confusion, ataxia, and/or ocular motor abnormalities) in relation to the dose of IV thiamine prescribed.

METHODS

A retrospective design was used to review data for adult patients admitted to an internal medicine service from June 1, 2014, to June 30, 2015. All patients included in the study received IV thiamine: low-dose therapy was defined as 100 mg IV daily and high-dose therapy was defined as dosage greater than 100 mg IV daily.

RESULTS

A total of 141 patients were included; low-dose thiamine was prescribed for 115 (81.6%) and high-dose thiamine for 26 (18.4%). Patients for whom high-dose thiamine was prescribed were more likely to be those in whom a diagnosis of WE was being considered (12/26 [46.2%] versus 5/115 [4.3%], p < 0.001). Of the total 219 IV thiamine doses ordered, 180 (82.2%) were for 100 mg, and 143 (65.3%) were prescribed for once-daily administration. There was no statistically significant difference in the time to resolution of WE symptoms for patients receiving high-dose versus low-dose thiamine.

CONCLUSIONS

A wide variety of thiamine prescribing patterns were noted. This study did not show a difference in time to resolution of WE symptoms in relation to the dose of IV thiamine. Additional large-scale studies are required to determine the optimal dosing of thiamine for WE.

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Zusammenfassung. Erwachsene in der Schweiz trinken durchschnittlich zwei Gläser Wein pro Tag. Alkoholmissbrauch und kognitive Störungen sind eng verknüpft, vor allem bei älteren Personen. Die klinische Untersuchung muss nach Anzeichen von Unterernährung suchen und eine neuropsychologische Untersuchung einschliessen, wenn der Mini-Mental-Status pathologisch ist. Bei Anzeichen einer Gayet-Wernicke-Krankheit muss eine intravenöse B1-Vitamin-Therapie zur prophylaktischen oder therapeutischen Behandlung eingeleitet werden. Kognitive Beeinträchtigung ist eine schlechte Prognose für die Behandlung von Alkoholabhängigkeit, sollte aber nicht dazu führen, die Behandlungsbemühungen aufzugeben.