Nutr. Metabol. 19: 153-157 (1975)
Biochemical Assessment of Thiamin Status in Patients with Neurosis lancu Gontzea, Viorica Gorcea ami Felicia Popescu Nutritional Research Center, Institute of Medicine and Pharmacy, Bucharest
Key Words. Neurosis • Thiamin status • Transketolase activity • Effect of refined foods Abstract. The thiamin status of 65 patients with neurosis was studied soon after their admission to the psychiatric department; 49 healthy persons were also studied. In compar ison with the control group, the patients with neurosis had a twice as low thiamin excretion and a 22 % lower erythrocyte transketolase (p < 0.001), while their blood pyruvate and pyruvate excretions were 31 -38 % higher (p < 0.001).
Introduction It is well established that the oxidation of glucose, which is the main source of energy in the nervous system, demands the presence of enzymes and co ferments, one of which is thiamin diphosphate. When the intake of thiamin is deficient, the glucose metabolism is disturbed and some normal intermediary metabolites (lactic acid, pyruvic acid) accumulate in the blood. The nervous system is highly sensitive not only towards hypoglycemia but also towards these metabolites, and when the amount of thiamin is reduced, mental symptoms appear resembling those of neurasthenia, i.e. intolerance to noise, inability to concentrate, memory defects, irritability, depression, insomnia, etc. (6, 9, 10). Contributing toward this deficiency are both a diminished intake of thiamin due to the increased consumption in the proportion of refined foods which are either practically lacking in thiamin (sugar, cereal products obtained from flours of low extraction) or very poor in it (sterilized canned food), as well as an intensified consumption of alcoholic beverages, which increases the requirement and diminishes the absorption of this vitamin. Taking into account the modifica tions which have occurred in food habits in advanced countries, the question arose whether the occurrence of neurosis can be due to the thiamin-glucose
Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 3/19/2018 1:32:51 AM
Received: August 23, 1974; accepted: September 26, 1975.
Gon tzea /Gorcea /Popescu
154
imbalance, which decreases the brain’s capacity of adapting itself to the multi tude of stimuli and stress of modern life. Materials and Methods A study was, therefore, made on 65 patients with neurosis soon after their admission to the psychiatric department where the diagnosis was established, and on 49 healthy per sons. On the one hand, we determined the concentration of the vitamin, as such, in the morning urine, as well as the quantity eliminated both in 60 min and per gram of creatinine (4). On the other hand, using an original loading test, the degree of saturation or the deficiency in thiamin was evaluated. At the same time, the activity of erythrocyte transketolase, which needs the presence of thiamin pyrophosphate, was measured (1-3, 8). For control, both the blood pyruvate level as well as the pyruvate excretion (mg%) and the quantity eliminated per gram of creatinine were determined (5, 11). In order to avoid or diminish the effect of the individual variations in the amount of active protoplasm, the quantity of vitamin administered by intramuscular injection in the loading test was the same per kg/body weight (50 Mg)- The injection was made in the morning before eating and. in order to keep the subjects under surveillance and to avoid the effect of food intake, the period of urine collection was reduced to 3 h. In order to find out indirectly the possibility of the existence of a thiamin hypovitaminosis, both the intake of products lacking this vitamin or having a poor content of it, and the intake of products which could compensate its deficiency were registered. In order to check the specificity of modifications noticed in the values of the studied indicators, the thiamin status before and after 10-15 days of vitamin B. treatment was determined in half the patients.
From the individual data, the average values with their standard error for each of the indicators and group of subjects were calculated. The results shown in table I and figure 1 were obtained by comparing the values of patients and healthy subjects. In patients with neurosis, the average values of thiamin elimination (concen tration and debit per hour and per gram of creatinine) were from 44 to 58 % lower in the control group (p < 0.001) and the activity of erythrocyte transketolase was 22% lower than in healthy persons ( p < 0.001). Proof of a thiamin deficiency in patients with neurosis is also the fact that the concentration of blood pyruvate was 31 % higher than in the healthy controls ( p < 0.001). A similar difference was also noticed in the renal excretion of pyruvic acid in pa tients with neurosis, the quantity eliminated per gram creatinine being 38 % higher than in the control group (p < 0.01). 3 h after the injection (i.m.) of the same quantity (50 /tg/kg body weight) of vitamin, the patients with neurosis eliminated only 27 % of the injected dose compared to 32 % in the healthy subjects. These differences show that patients with neurosis suffer from thiamin hypovitaminosis. Supporting this interpretation are the results obtained after the
Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 3/19/2018 1:32:51 AM
Results and Discussion
Biochemical Assessment of Thiamin Status in Patients with Neurosis
155
Table l. Thiamin status in patients with neurosis and in healthy (control) group Healthy
Number of persons Average age, years Average height, cm Average weight, kg
Patients
%
p
-5 8
< 0.001
17.50 ± 1.77 9.90 ± 1.89 298.10 ± 29.10 137.60 ± 18.20
-4 4 -5 4
Biochemical Assessment of Thiamin Status in Patients with Neurosis lancu Gontzea, Viorica Gorcea ami Felicia Popescu Nutritional Research Center, Institute of Medicine and Pharmacy, Bucharest
Key Words. Neurosis • Thiamin status • Transketolase activity • Effect of refined foods Abstract. The thiamin status of 65 patients with neurosis was studied soon after their admission to the psychiatric department; 49 healthy persons were also studied. In compar ison with the control group, the patients with neurosis had a twice as low thiamin excretion and a 22 % lower erythrocyte transketolase (p < 0.001), while their blood pyruvate and pyruvate excretions were 31 -38 % higher (p < 0.001).
Introduction It is well established that the oxidation of glucose, which is the main source of energy in the nervous system, demands the presence of enzymes and co ferments, one of which is thiamin diphosphate. When the intake of thiamin is deficient, the glucose metabolism is disturbed and some normal intermediary metabolites (lactic acid, pyruvic acid) accumulate in the blood. The nervous system is highly sensitive not only towards hypoglycemia but also towards these metabolites, and when the amount of thiamin is reduced, mental symptoms appear resembling those of neurasthenia, i.e. intolerance to noise, inability to concentrate, memory defects, irritability, depression, insomnia, etc. (6, 9, 10). Contributing toward this deficiency are both a diminished intake of thiamin due to the increased consumption in the proportion of refined foods which are either practically lacking in thiamin (sugar, cereal products obtained from flours of low extraction) or very poor in it (sterilized canned food), as well as an intensified consumption of alcoholic beverages, which increases the requirement and diminishes the absorption of this vitamin. Taking into account the modifica tions which have occurred in food habits in advanced countries, the question arose whether the occurrence of neurosis can be due to the thiamin-glucose
Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 3/19/2018 1:32:51 AM
Received: August 23, 1974; accepted: September 26, 1975.
Gon tzea /Gorcea /Popescu
154
imbalance, which decreases the brain’s capacity of adapting itself to the multi tude of stimuli and stress of modern life. Materials and Methods A study was, therefore, made on 65 patients with neurosis soon after their admission to the psychiatric department where the diagnosis was established, and on 49 healthy per sons. On the one hand, we determined the concentration of the vitamin, as such, in the morning urine, as well as the quantity eliminated both in 60 min and per gram of creatinine (4). On the other hand, using an original loading test, the degree of saturation or the deficiency in thiamin was evaluated. At the same time, the activity of erythrocyte transketolase, which needs the presence of thiamin pyrophosphate, was measured (1-3, 8). For control, both the blood pyruvate level as well as the pyruvate excretion (mg%) and the quantity eliminated per gram of creatinine were determined (5, 11). In order to avoid or diminish the effect of the individual variations in the amount of active protoplasm, the quantity of vitamin administered by intramuscular injection in the loading test was the same per kg/body weight (50 Mg)- The injection was made in the morning before eating and. in order to keep the subjects under surveillance and to avoid the effect of food intake, the period of urine collection was reduced to 3 h. In order to find out indirectly the possibility of the existence of a thiamin hypovitaminosis, both the intake of products lacking this vitamin or having a poor content of it, and the intake of products which could compensate its deficiency were registered. In order to check the specificity of modifications noticed in the values of the studied indicators, the thiamin status before and after 10-15 days of vitamin B. treatment was determined in half the patients.
From the individual data, the average values with their standard error for each of the indicators and group of subjects were calculated. The results shown in table I and figure 1 were obtained by comparing the values of patients and healthy subjects. In patients with neurosis, the average values of thiamin elimination (concen tration and debit per hour and per gram of creatinine) were from 44 to 58 % lower in the control group (p < 0.001) and the activity of erythrocyte transketolase was 22% lower than in healthy persons ( p < 0.001). Proof of a thiamin deficiency in patients with neurosis is also the fact that the concentration of blood pyruvate was 31 % higher than in the healthy controls ( p < 0.001). A similar difference was also noticed in the renal excretion of pyruvic acid in pa tients with neurosis, the quantity eliminated per gram creatinine being 38 % higher than in the control group (p < 0.01). 3 h after the injection (i.m.) of the same quantity (50 /tg/kg body weight) of vitamin, the patients with neurosis eliminated only 27 % of the injected dose compared to 32 % in the healthy subjects. These differences show that patients with neurosis suffer from thiamin hypovitaminosis. Supporting this interpretation are the results obtained after the
Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 3/19/2018 1:32:51 AM
Results and Discussion
Biochemical Assessment of Thiamin Status in Patients with Neurosis
155
Table l. Thiamin status in patients with neurosis and in healthy (control) group Healthy
Number of persons Average age, years Average height, cm Average weight, kg
Patients
%
p
-5 8
< 0.001
17.50 ± 1.77 9.90 ± 1.89 298.10 ± 29.10 137.60 ± 18.20
-4 4 -5 4
