Transketolase Activity Research Articles

Critical role of arg433 in rat transketolase activity as probed by site-directed mutagenesis.

It has been shown that one arginine per monomer at an unknown position is essential for enzyme activity of the homodimeric transketolase (TK) [Kremer, Egan and Sable (1980) J. Biol. Chem. 255, 2405-2410]. To identify the critical arginine, four highly conserved arginine residues of rat TK (Arg102, Arg350, Arg433 and Arg506) were replaced with alanine by site-directed mutagenesis. Wild-type and mutant TK proteins were produced in Escherichia coli and characterized. The Arg102-->Ala mutant exhibited similar catalytic activity to the wild-type enzyme, whereas Arg350-->Ala, Arg506-->Ala and Arg433-->Ala mutants exhibited 36.7, 37.0 and 6.1% of the wild-type activity respectively. Three recombinant proteins (wild-type, Arg350-->Ala and Arg433-->Ala) were purified to apparent homogeneity using Ni2+-affinity chromatography and further characterized. All these proteins were able to form homodimers (148 kDa), as shown by immunoblot analysis subsequent to non-denaturing gel electrophoresis. The Arg433-->Ala mutant protein was less stable than the wild-type and Arg350-->Ala proteins at 55 degrees C. Kinetic analyses revealed that both Vmax and Km values were markedly affected in the Arg433-->Ala mutant. The Km values for two substrates xylulose 5-phosphate and ribose 5-phosphate were 11.5- and 24.3-fold higher respectively. The kcat/Km values of the Arg433-->Ala mutant for the two substrates were less than 1% of those of the wild-type protein. Molecular modelling of the rat TK revealed that Arg433 of one monomer has three potential hydrogen-bond interactions with the catalytically important highly conserved loop of the other monomer. Thus, our biochemical analyses and modelling data suggest the critical role of the previously uncharacterized Arg433 in TK activity.

Studies with oxythiamine to mimic reproduction disorders among fish early life stages

Newly fertilised eggs of sea trout ( Salmo trutta) were injected with the thiamine antagonist oxythiamine or with oxythiamine in combination with 3,3′,4,4′-tetrachlorobiphenyl (PCB #77). Rainbow trout ( Oncorhynchus mykiss) eggs were injected with PCB #77. A decrease in liver transketolase activity was used as a biomarker to indicate a physiological deficiency in thiamine. Exposure to oxythiamine caused deformities in the newly hatched larvae, as well as high mortality during the larval stages. Exposure to oxythiamine in combination with PCB #77 caused a synergistic higher frequency of disorders. Analysis of liver transketolase activity in the larvae injected with PCB #77 indicated that PCB #77 did not decrease the half-life of thiamine in the offspring. The data obtained indicate that oxythiamine increased the sensitivity to PCB #77 in the offspring, however through mechanisms other than those causing thiamine deficiency in feral fish.

Sialic acid, transketolase and Na+, K+, ATPase in patients with rheumatoid arthritis.

We studied transketolase activity of red blood cell hemolysates, and Na+, K+, ATPase activity and sialic acid concentration in red blood cell membranes from 52 patients with rheumatoid arthritis and 24 control subjects. Decreased red blood cell membrane Na+, K+, ATPase activity and sialic acid concentration and decreased transketolase in red blood cell hemolysates were observed in rheumatoid arthritis patients compared with control subjects (p < 0.001). Erythrocyte sedimentation rate and C-reactive protein values were increased in rheumatoid arthritis patients compared with control subjects (p < 0.0001). Significant correlations between sialic acid and Na+, K+, ATPase (r = 0.65, p < 0.001) and between sialic acid and transketolase (r = 0.58, p < 0.001) were observed. Erythrocyte sedimentation rate and C-reactive protein levels did not correlate with Na+, K+, ATPase activity or with sialic acid or transketolase in rheumatoid arthritis patients. These data show that decreases in Na+, K+, ATPase, and transketolase activities and sialic acid concentration are present in rheumatoid arthritis patients, and that the decrease in Na+, K+, ATPase and transketolase activities in rheumatoid arthritis might be due to decreased sialic acid.

Sensitivity to Thiamine Deficiency in Cultured Human Cells is Dependent on Cell Type and is Enhanced in Cells From Thiamine-Responsive Megaloblastic Anemia Patients

To address tissue-specific variation in sensitivity to thiamine deficiency, three human cell types were grown in medium with various thiamine concentrations. The activity of a cytosolic and a mitochondrial thiamine diphosphate-dependent enzyme was examined. Each cell type displayed a unique response to thiamine depletion with respect to α-ketoglutarate dehydrogenase and transketolase activity and to inhibition of cell growth. Loss of α-ketoglutarate dehydrogenase activity was similar in lymphoblasts and fibroblasts, whereas loss of activity in neuroblastoma cells was significantly more resistant to thiamine depletion. Transketolase activity in neuroblastoma cells was only moderately resistant to thiamine depletion, with the activity in fibroblasts being the most and in lymphoblasts the least resistant. Total transketolase activity was 33% higher in fibroblasts than in lymphoblasts and neuroblastoma cells, indicating a differential requirement for production and maintenance of transketolase activity in this cell type. Compared with normal lymphoblasts, those derived from patients with thiamine-responsive megaloblastic anemia were 100 to 1000 times more sensitive to thiamine depletion. Although fibroblasts from these patients also demonstrated a 1000-fold increase in sensitivity with respect to transketolase activity, α-ketoglutarate dehydrogenase activity demonstrated no enhanced sensitivity. The results indicate a complex, cell-type dependent regulation of intracellular pools of thiamine and its phosphorylated derivatives in response to fluctuating extracellular thiamine levels.

Orally administered dehydroepiandrosterone-sulfate increases G6PD and transketolase activity in tumor tissue

Orally administered dehydroepiandrosterone-sulfate increases G6PD and transketolase activity in tumor tissue

Identification of catalytically important residues in yeast transketolase.

The possible roles of four histidine residues in the active site of yeast transketolase were examined by site-directed mutagenesis. Replacement of the invariant His69 with alanine yielded a mutant enzyme with 1.5% of the specific activity of the wild-type enzyme and with an increased KM for the donor. This residue is located at the bottom of the substrate cleft close to the C1 hydroxyl group of the donor substrate, and the side chain of His69 might be required for recognition of this hydroxyl group and possibly for maintenance of the proper orientation of the reaction intermediate, (alpha, beta-dihydroxyethyl)thiamin diphosphate. Amino acid replacements of His481 by alanine, serine, and glutamine resulted in mutant enzymes with significantly increased KM values for the donor substrate and specific activities of 4.4%, 1.9%, and 5.5% of the wild-type enzyme. The kinetic data suggest that this residue, although close to the C2 carbonyl oxygen of the substrate, is not absolutely required for stabilization of the negative charge that develops at this oxygen in the transition state. This points toward the 4'-NH2 group of the pyrimidine ring of thiamin diphosphate as the major source of charge stabilization. Mutations at positions His30 and His263 result in mutant enzymes severely impaired in catalytic activity (1.5% and less of the activity of wild-type transketolase). The KM value for the donor substrate was increased for the His30Ala mutant but remained unchanged in the His263Ala enzyme. The side chains of both residues interact with the C3 hydroxyl group of the donor substrate, and the results indicate that the two residues act in concert during proton abstraction of the C3 hydroxyl proton during catalysis.

The effect of acetaldehyde on human brain transketolase activity.

Chronic alcoholism and thiamine deficiency are well documented factors in the aetiology of Wernicke-Korsakoff Syndrome. More recently, acetaldehyde (ACH) has been implicated as a possible aetiological factor. In the present investigation the direct effect of ACH was studied on the activity of transketolase, a thiaminedependent enzyme, as well as two non-thiamine-dependent enzymes (aspartate aminotransferase and lactate dehydrogenase), isolated from five control human brains. The concentration of ACH required to inhibit 50% activity of holo- and apo-transketolase was 80 mM and 60 mM, respectively, whereas that for aspartate aminotransferase and lactate dehydrogenase was 14 mM and 10 mM, respectively. None of the enzymes were completely inhibited by the range of ACH concentrations used in the study. It was concluded that the thiamineindependent enzymes were markedly affected by the concentrations of ACH which did not affect the thiaminedependent enzyme, transketolase. In vitro studies with homogenates pre-treated with ACH in the presence of various concentrations of glutathione showed that the latter had a protective effect against loss of transketolase activity.

Dietary thiamin supply during lactation influences thiamin status in lactating rats and their offspring and the thiamin level in milk.

This study was conducted to examine the effect of dietary thiamin, ranging from deficient to excessive supplies, on thiamin status of lactating rats and their offspring, and the thiamin level in milk. Therefore, after parturition, rat dams were divided into eight groups of 10 each, and were fed diets with 0, 2, 4, 6, 7, 40, 350 and 3500 mg/kg thiamin over a total of 13 days during lactation. Milk for determining the thiamin concentration was obtained from day 6 and 13 of lactation. At day 14 of lactation rat dams and their offspring were used to ascertain the thiamin status including transketolase activity of blood, liver and brain, and thiamin concentration in body. Thiamin supplies ranging from deficient to excessive dietary concentrations influenced both the thiamin levels of the lactating dams and their offspring within 13 days. Lactating rat dams fed a thiamin-free diet and their offspring were classified as thiamin-deficient on the basis of growth retardation and a lower activity of transketolase in blood, liver and brain. Within these variables transketolase in blood has been shown to be most sensitive, and reached a plateau feeding 6 mg/kg thiamin. The concentration of thiamin in milk ranged between 0.1 and 19 mg/kg. The findings also show that dietary thiamin had the strongest effect on thiamin in milk obtained from day 6 and 13 of lactation, and a deficient or suboptimal supply with thiamin was therefore not compensated for an intensified transfer of reserved body thiamin into milk. Also thiamin levels in tissues and carcass, which did not show any clear-cut saturation characteristic, increased with increasing dietary thiamin, and this dose-dependence was more marked in blood and liver than in carcass.

Analysis of a transketolase gene from Kluyveromyces lactis reveals that the yeast enzymes are more related to transketolases of prokaryotic origins than to those of higher eukaryotes

The role of the pentose-phosphate pathway in carbohydrate metabolism of the yeast Kluyveromyces lactis, and the evolutionary relationships between the encoding genes, was investigated. For this purpose, we isolated the gene encoding transketolase (KlTKL1) and determined its nucleotide sequence. Surprisingly, comparisons of the deduced amino-acid sequence with those from other organisms revealed that the yeast enzymes are more related to those from prokaryotic sources than to those from higher eukaryotes. Functional analyses showed that KlTKL1 also complemented a Saccharomyces cerevisiae tkl1 tkl2 double mutant for growth in the absence of aromatic amino acids and restored transketolase activity in this mutant. A band detected in these transformants by Western-blot analysis corresponded to a band detected in K. lactis both in a wild-type strain and in a multicopy transformant with elevated transketolase activity.

Diagnostic significance of blood thiamine and transketolase activity in erythrocytes in metabolic acidosis during TPN : Hisao Nakasaki, Masatoshi Ohta, Tokitaka Katayama, Toshio Mitomi and Michio Tsuda From the Department of Surgery, Tokai University Oiso Hospital, 21-1, Gekyo, Oiso-city, Nakagun, Kanagawa, 259-01, Japan

Diagnostic significance of blood thiamine and transketolase activity in erythrocytes in metabolic acidosis during TPN : Hisao Nakasaki, Masatoshi Ohta, Tokitaka Katayama, Toshio Mitomi and Michio Tsuda From the Department of Surgery, Tokai University Oiso Hospital, 21-1, Gekyo, Oiso-city, Nakagun, Kanagawa, 259-01, Japan

Recurrent aphthous stomatitis and thiamine deficiency

Recurrent aphthous stomatitis is a disease of unknown cause. To examine whether thiamine (vitamin B1) deficiency is associated with recurrent aphthous stomatitis, we studied vitamin B1 levels in 70 patients with recurrent aphthous stomatitis and in 50 members of a control group. The vitamin B1 level was determined as thiamine pyrophosphate effect on transketolase activity in red blood cell lysates. Low levels of vitamin B1 were detected in 49 patients but in only two members of the control group (p < 0.0001). These low levels were not associated with patient age, sex, or underlying disease causing recurrent aphthous stomatitis. Our finding suggests an association between thiamine deficiency and recurrent aphthous stomatitis.

Thiamine pyrophosphate effect and normalized erythrocyte transketolase activity ratio in Wernicke-Korsakoff patients and acute alcoholics undergoing detoxification.

Thiamine deficiency may be assessed clinically by an abnormally low specific erythrocyte transketolase activity and/or by abnormally large activation by thiamine diphosphate in vitro (or 'TPP effect'). In the present investigation, we report erythrocyte transketolase activation by TPP in acute alcoholics and Wernicke-Korsakoff patients undergoing detoxification. A new age-dependent parameter was used to improve the reliability of transketolase activity as an indicator of marginal thiamine deficiency. Thus normalized transketolase activity ratio (NTKZ), primary activation ratio (PAR) and further activation ratio (FAR) were measured in 29 acute alcoholics and 12 Wernicke-Korsakoff patients upon admission, and also on 47 control subjects. It was possible to follow up 14 of the 29 acute alcoholics after 7 days of treatment. Twenty-one per cent of the acute alcoholics and 33% of the Wernicke-Korsakoff patients, on admission to the detoxification Unit, had NTKZ values beyond the defined critical conditions for thiamine deficiency, whereas 7% of the former and 25% of the latter had PAR values beyond these critical conditions. Furthermore, all three parameters were significantly different in the Wernicke-Korsakoff patients compared to the other groups. The pattern of improvement of the different parameters on follow-up varied considerably and is difficult to explain, as only the NTKZ was statistically significant. Hence, only eight out of 14 acute alcoholics showed improvement in NTKZ, seven showed improvement of PAR and six showed improvement of FAR after treatment. Five patients showed improvement of both NTKZ and PAR and none of the patients showed improvement of all three parameters. We conclude that our findings confirm previous reports and that this modified transketolase activation test improves its reliability as an indicator of marginal thiamine deficiency.

Regional reductions of transketolase in thiamine-deficient rat brain.

Thiamine deficiency impairs oxidative metabolism and causes metabolic encephalopathy. An early reduction in transketolase (TK) activity may be an important pathogenic event. To assess the role of TK, we have delineated the regional/cellular distribution of TK protein and mRNA in adult rat brain in pyrithiamine-induced thiamine deficiency. TK activity declined in both vulnerable and spared regions. Immunoblots showed a parallel reduction of TK protein. With a few exceptions, immunocytochemistry indicated an overall decline of TK immunoreactivity and the decrease was not specific to vulnerable areas. In contrast to the pronounced, general decline of TK protein, in situ hybridization revealed a regional decrease of 0-25% of TK mRNA in thiamine deficiency. Northern blots indicated a similar level of TK mRNA in whole brain in thiamine deficiency. These results show that the decline of TK activity results from a proportional decrease of TK protein, and the deficiency may be due to an instability of TK protein or an inhibition of TK mRNA translation. The lack of correlation of the distribution, and the absence of specific alteration, of TK in affected regions suggest that the reduced TK may not be linked directly to selective vulnerability in thiamine deficiency.

Thiamine deficiency as predisposition to, and consequence of, increased alcohol consumption.

It was found that the activity of the marker thiamine-dependent enzyme, transketolase (TK), was decreased (down to 61-79% of control) in blood, liver and brain of inbred rats following a 6-month consumption of 15% ethanol as their only source of drinking fluid. After ethanol withdrawal, the enzyme activity was gradually restored, but did not reach the control values until 1 month following cessation of alcohol consumption. Moreover, in rats preferring ethanol, the decrease of TK activity was more pronounced than in water-preferring rats. Another experiment showed that thiamine deficiency induced by the thiamine antagonist, oxythiamine (200 mg/kg), led to a prolonged increase of the preferential intake of ethanol solutions in inbred rats. Significantly lower liver TK activities and thiamine pyrophosphate content were found in Finnish AA line rats as opposed to ANA line rats which had been obtained by selective outbreeding for high and low voluntary alcohol intake, respectively. Significantly lower TK activity was also found in the whole brain (89%), cerebellum (79%) and pons-medulla oblongata (87%) of AA rats as compared to ANA animals. Our own findings and the literature data confirm the hypothesis that thiamine deficiency can be both predisposing to and a consequence of, increased alcohol consumption.

Thiamine, Riboflavin, Folate, and Vitamin B12 Status of Infants with Low Birth Weights Receiving Enteral Nutrition

The purpose of the present study was to monitor the vitamin status of 14 low-birth-weight (LBW) infants (< 1,750 g birth weight) at 2 weeks and an additional four infants at 3 weeks who were receiving an enteral formula providing 247 micrograms/100 kcal thiamine, 617 micrograms/100 kcal riboflavin, 37 micrograms/100 kcal folate, and 0.55 micrograms/100 kcal vitamin B12. The mean birth weight of the 18 infants was 1,100 +/- 259 g, and mean gestational age was 29 +/- 2 weeks. Weekly blood, 24-h urine collections, and dietary intake data were obtained. For thiamine, red blood cell (RBC) transketolase activity was within the normal range for all infants. For riboflavin, RBC glutathione reductase activity was normal for all infants except one. We calculated from intake and urinary excretion data that these infants require 225 micrograms/100 kcal thiamine and 370 micrograms/100 kcal riboflavin, respectively. Mean plasma folate levels were 21 +/- 11 ng/ml at 2 weeks and 18 +/- 5 ng/ml at 3 weeks. RBC folate levels were 455 +/- 280 ng/ml at 2 weeks and 391 +/- 168 ng/ml at 3 weeks. All folate blood values were normal, except for one subject with an elevated level (59 ng/ml). Vitamin B12 plasma values were 737 +/- 394 pg/ml at 2 weeks and 768 +/- 350 pg/ml at 3 weeks, and all values were normal except for three infants with elevated values. In conclusion, appropriate vitamin status was maintained during this short observational period, during administration of this enteral formula; however, riboflavin concentrations in the enteral feed may be excessive.

Reduced activities of thiamine-dependent enzymes in brains of alcoholics in the absence of Wernicke's encephalopathy.

The relative roles of alcohol per se, thiamine deficiency, and liver disease in the pathogenesis of alcohol-related brain damage have not been fully elucidated. In particular, the extent to which alterations of brain thiamine metabolism contribute to cognitive dysfunction in alcoholism in the absence of Wernicke's encephalopathy has not been established. In the present study, thiamine diphosphate-dependent enzymes were measured using standard spectrophotometric techniques in homogenates of brain tissue obtained at autopsy from eight alcoholic patients, all of whom died in hepatic coma without clinical or neuropathological evidence of Wernicke's encephalopathy and six nonalcoholic, age-matched controls, matched for autopsy delay time and free, at the time of death, from gross malnutrition or other neurological or psychiatric disorders. Transketolase activities were reduced in cerebellum (by 35%, p < 0.01), thalamus (by 35%, p < 0.01), frontal cortex (by 22%, p < 0.01), temporal cortex (by 20%, p < 0.01), and prefrontal cortex (by 19%, p < 0.01). Activities of the pyruvate dehydrogenase complex were selectively reduced in prefrontal cortex by 25% (p < 0.01). Activities of alpha-ketoglutarate dehydrogenase were within normal limits in all brain regions of alcoholic patients. The generalized reductions of transketolase activity undoubtedly result from thiamine deficiency. Previous studies suggest that the presence of liver disease may exacerbate thiamine deficiency in alcoholics. A sustained loss of transketolase activity in brain could result in disruption of pentose shunt activity and concomitant reductions in reducing equivalents and lipid metabolism within the cell. The selective loss of pyruvate dehydrogenase activity in prefrontal cortex of alcoholic cirrhotics could relate to the phenomenon of hepatic coma.(ABSTRACT TRUNCATED AT 250 WORDS)

Transketolase A of Escherichia coli K12. Purification and properties of the enzyme from recombinant strains.

Transketolase A was purified to apparent homogeneity from recombinant Escherichia coli K12 cells carrying the homologous cloned tktA gene on a pUC19-derived plasmid. These recombinant cells exhibited a transketolase activity in crude extracts of up to 9.7 U/mg compared to < or = 0.1 U/mg in wild-type cells. Transketolase A was purified from crude extracts of a recombinant strain by successive ammonium sulfate precipitations and two anion-exchange chromatography steps (Q-Sepharose FF, Fractogel EMD-DEAE column) and afforded an apparently homogeneous protein band on SDS/PAGE. The enzyme, both in its active and apoform, had a molecular mass of 145,000 Da (+/- 10,000 Da), judged by gel-filtration chromatography. Subunits of 73,000 Da (+/- 2000 Da) were determined on SDS/PAGE, thus, transketolase A most likely forms a homodimer. N-terminal amino acid sequencing of the protein verified the identity with the cloned gene tktA. The specific activity of the purified enzyme, determined at 30 degrees C with the substrates xylulose 5-phosphate (donor of C2 compound) and ribose 5-phosphate (acceptor) at an optimal pH (50 mM glycylglycine, pH 8.5), was 50.4 U/mg. Km values for the substrates xylulose 5-phosphate and ribose 5-phosphate were 160 microM and 1.4 mM, respectively. Km values for the other physiological substrates of transketolase A were 90 microM for erythrose 4-phosphate (best acceptor substrate), 2.1 mM for D,L-glyceraldehyde 3-phosphate, 1.1 mM for fructose 6-phosphate, and 4 mM for sedoheptulose 7-phosphate. Hydroxypyruvate served as alternative donor (Km = 18 mM). Unphosphorylated acceptor compounds were formaldehyde (Km = 31 mM), glycolaldehyde (14 mM), D,L-glyceraldehyde (10 mM) and D-erythrose (150 mM). The enzyme was competitively inhibited by D-arabinose 5-phosphate (K = 6 mM at a concentration of 2.5 mM D-arabinose 5-phosphate) or by the chelating agent EDTA. The inactive apoform of transketolase A was yielded by dialysis against buffer containing 10 mM EDTA, thus removing the cofactors thiamine diphosphate and divalent cations. The reconstitution of the apoenzyme proceded faster in the presence of manganese ions (Kd = 7 microM at 10 microM thiamine diphosphate) than with other divalent cations.

Transketolase a of Escherichia coli K12. Purification and Properties of the Enzyme from Recombinant Strains

Transketolase A was purified to apparent homogeneity from recombinant Escherichia coli K12 cells carrying the homologous cloned tktA gene on a pUC19-derived plasmid. These recombinant cells exhibited a transketolase activity in crude extracts of up to 9.7 U/mg compared to ≤0.1 U/mg in wild-type cells. Transketolase A was purified from crude extracts of a recombinant strain by successive ammonium sulfate precipitations and two anion-exchange chromatography steps (Q-Sepharose FF, Fractogel EMD-DEAE column) and afforded an apparently homogeneous protein band on SDS/PAGE. The enzyme, both in its active and apoform, had a molecular mass of 145000 Da (±10000 Da), judged by gel-filtration chromatography. Subunits of 73000 Da (±2000 Da) were determined on SDS/PAGE, thus, transketolase A most likely forms a homodimer. N-terminal amino acid sequencing of the protein verified the identity with the cloned gene tktA. The specific activity of the purified enzyme, determined at 30°C with the substrates xylulose 5-phosphate (donor of C2 compound) and ribose 5-phosphate (acceptor) at an optimal pH (50 mM glycylglycine, pH 8.5), was 50.4 U/mg. Km values for the substrates xylulose 5-phosphate and ribose 5-phosphate were 160μM and 1.4mM, respectively. Km values for the other physiological substrates of transketolase A were 90 μM for erythrose 4-phosphate (best acceptor substrate), 2.1 mM for D,L-glyceraldehyde 3-phosphate, 1.1 mM for fructose 6-phosphate, and 4 mM for sedoheptulose 7-phos-phate. Hydroxypyruvate served as alternative donor (Km=18 mM). Unphosphorylated acceptor compounds were formaldehyde (Km= 31 mM), glycolaldehyde (14 mM), D,L-glyceraldehyde (10 mM) and d-erythrose (150 mM). The enzyme was competitively inhibited by d-arabinose 5-phosphate (Ki= 6 mM at a concentration of 2.5 mM d-arabinose 5-phosphate) or by the chelating agent EDTA. The inactive apoform of transketolase A was yielded by dialysis against buffer containing 10 mM EDTA, thus removing the cofactors thiamine diphosphate and divalent cations. The reconstitution of the apoenzyme pro-ceded faster in the presence of manganese ions (Kd= 7 μM at 10 μM thiamine diphosphate) than with other divalent cations.

Thiamin Status, Diuretic Medications, and the Management of Congestive Heart Failure

Objective To assess the prevalence of thiamin deficiency in patients with congestive heart failure who are treated with diuretics that inhibit sodium and chloride reabsorption in the thick ascending limb of the loop of Henle (loop diuretic therapy). Design A cross-sectional investigation of thiamin status of consecutive patients with congestive heart failure being treated with loop diuretic therapy. Setting Cardiology clinic of a midwestern tertiary-care medical center. Subjects Thirty-eight patients were recruited (mean age±standard deviation=55±14 years). Validation of methodology was conducted with nine age-matched control subjects. Main outcome measures Thiamin status was assessed biochemically by in vitro erythrocyte transketolase activity assay. Assessment of dietary intake of thiamin was accomplished with a semiquantitative food frequency questionnaire. Statistical analyses performed Fisher's exact test and logistic regression were used to evaluate relationships between thiamin status and variables of interest. Results Biochemical evidence of thiamin deficiency was found in 8 of 38 (21%) patients. Evidence of risk for dietary thiamin inadequacy was found in 10 of 38 patients (25%). Seven of the 8 patients with biochemical evidence of thiamin deficiency met study criteria for dietary adequacy, although quantified data suggested that only 4 of the patients achieved two thirds of the Recommended Dietary Allowance. Biochemical evidence of thiamin deficiency tended to be more common among patients with poor left ventricular ejection fractions ( P=.07). Conclusions Thiamin deficiency may occur in a substantial proportion of patients with congestive heart failure, and dietary inadequacy may contribute to increased risk. J Am DietAssoc. 1995; 95:541-544.

Comparison of erythrocyte transketolase activity with thiamine and thiamine phosphate ester levels in chronic alcoholic patients

The effect of chronic alcoholism on biochemical evaluation of thiamine status was studied by the concomitant determination of erythrocyte transketolase (ETK) activity, its relative increase by in vitro addition of thiamine diphosphate (TDP effect) and the direct measurement of thiamine and its phosphate esters by high performance liquid chromatography. Thirty-eight percent of alcoholic subjects showed a thiamine deficiency with decreased thiamine diphosphate concentrations compared with healthy subjects (90.8 ± 25.7 nmol/l vs. 176 ± 28.0 nmol/l, respectively, mean ± S.D., P < 0.001). Thiamine diphosphate concentrations were highly correlated with total thiamine concentrations and TDP effect (respectively r = 0.99 and 0.79, n = 85, P < 0.001). No abnormality in thiamine phosphorylation related to chronic alcoholism was noted. Finally, 47% of these deficient alcoholic patients had normal ETK activity. We concluded that, if indirect evaluation of thiamine status is to be chosen, the determination of ETK activity should be associated with TDP effect since the latter has been shown to be highly linked to total thiamine and thiamine diphosphate in erythrocytes. Furthermore, the direct measurement of thiamine and its phosphate esters was a more sensitive and specific index of thiamine nutrition.