The role of thiamine dependent enzymes in obesity and obesity related chronic disease states: A systematic review

Abstract

The WHO 2016 report indicates that worldwide obesity is rising, with over 600 million people in the obese range (BMI>30). The recommended daily calorie intake for adults is 2000 kcal and 2500 kcal for women and men respectively. The average American consumes 3770 kcal/day and the average person in the UK consumes 3400 kcal/day. With such increased caloric intake, there is an increased load on metabolic pathways, in particular glucose metabolism. Such metabolism requires micronutrients as enzyme co-factors. The recommended daily allowance (RDA) for thiamine is 1.3 mg/day and 0.5 mg thiamine is required to process 1000 kilocalories (kcal). Therefore, despite the appearance of being overfed, there is now increasing evidence that the obese population may nutritionally depleted of essential micronutrients. Thiamine deficiency has been reported to be in the region of 16-47% among patients undergoing bariatric surgery for obesity. Thiamine, in turn, requires magnesium to be in its active form thiamine diphosphate, (TDP). TDP also requires magnesium to achieve activation of TDP dependent enzymes, including transketolase (TK), pyruvate dehydrogenase (PDH) and alpha-keto glutaric acid dehydrogenase (AKGDH), during metabolism of glucose. Thiamine and magnesium therefore play a critical role in glucose metabolism and their deficiency may result in the accumulation of anaerobic metabolites including lactate due to a mismatch between caloric burden and function of thiamine dependent enzymes. It may therefore be postulated that thiamine and magnesium deficiency are under-recognized in obesity and may be important in the progress of obesity and obesity related chronic disease states. The aim of the present systematic review was to examine the role of thiamine dependent enzymes in obesity and obesity related chronic disease states.

Integrative Analysis Revealing Human Adipose-Specific Genes and Consolidating Obesity Loci

“…To obtain insight into roles of unreported adipose-specific genes in adipose tissue, functional annotations of the genes and information from literature describing their potential functions in other tissues and results from analysis of GSE data were summarized (Table 1). Among these adipose-specific genes, CSN1S1 is involved in immune/inflammatory responses 30 , SLC19A3 is responsible for thiamine transport and subsequent energy production 31 , and LVRN ( AQPEP ) is a member of the aminopeptidase family that catalyzes peptide catabolic processes 32 . Of particular interest, GSE data (GSE9624 and GSE12050) showed that SLC19A3 and CSN1S1 genes were expressed significantly higher in omental and subcutaneous adipose tissue, respectively, of an obese population than a lean population (Table 1).…”

Association between Grain Intake, Nutrient Intake, and Diet Quality of Canadians: Evidence from the Canadian Community Health Survey–Nutrition 2015

“…Thiamin is known for its role in catalyzing glucose metabolism [44]. Studies have shown that the lower intakes of thiamin are associated with a higher frequency of obesity and overweight [44,45]. Therefore, the lower percentage of obese and overweight adults in the balanced intakes of grain might be explained by the balanced intake of carbohydrates, energy, and thiamin in this group.…”

“…Therefore, the lower percentage of obese and overweight adults in the balanced intakes of grain might be explained by the balanced intake of carbohydrates, energy, and thiamin in this group. The importance of thiamin in the metabolism of glucose, and consequently its association with obesity, is indicated in a systematic review [45]. However, a study indicated that the prevalence of diabetes and obesity in the U.S were associated with higher intakes from the vitamin B family, such as niacin and thiamin, during the last 50 years.…”

Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures – 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists

“…In general, thiamine deficiency occurs in 15.5 to 29% of patients with obesity . Thiamine testing may be considered pre‐operatively in light of reports describing relatively high prevalence rates of thiamine deficiency in patients awaiting bariatric surgery (16 to 47%, depending on ethnicity), early onset Wernicke encephalopathy (WE) 2 weeks after bariatric surgery instead of the more usual 3 months, and the potential prevention of WE with diligent pre‐operative thiamine replacement protocols . In a single institution, a retrospective observational study of 400 patients undergoing bariatric surgery showed that 16.5% had clinical thiamine deficiency preoperatively (consistent symptomatology and either low biochemical levels or significant improvement with thiamine supplementation) and 18% after RYGB .…”