Subclinical beriberi polyneuropathy in the low income group: an investigation with special tools on possible patients with suspected complaints.

OBJECTIVE

To determine the prevalence rate of subclinical beriberi polyneuropathy (PNP) in the low income group and to present new methods for early detection.

METHODS

We conducted a prospective, randomized observational study on all patients from family members of non-PNP patients presenting to the outpatient neurologic clinic of the Dr Soetomo Hospital in 1989 in Surabaya, Indonesia.

METHODS

The 53 group I patients belonged to the low income series, whereas the 56 group II patients were from the mid- and high-income groups. We analyzed their diets and determined their blood thiamine levels. Neurologic, internal, psychiatric as well as neurophysiologic examinations were performed on all patients.

RESULTS

The prevalence rate of subclinical beriberi PNP of the apparently healthy subjects of the low income group was 66% compared with 12.5% among the mid and high income groups. The exposure odds ratio was 13.6 (95% Cl, 2.78 to 8.04) indicating that the low income group ran a greater risk of developing beriberi PNP than the mid and high income groups.

CONCLUSIONS

Most of our low income group patients had an inadequate diet, especially concerning deficient thiamine intake. Analysis of the diets revealed, that they were usually rich in carbohydrate especially steamed milled rice, whereas intake of fat and thiamine was low, protein was just sufficient. The calorie intake was marginal. Carbohydrate rich and non fat calories in the diet with low thiamine intake may provoke beriberi.