Educational objective: Chronic thiamine (vitamin 6,) deficiency impairs glucose utilization in the central nervous system. This occurs due to decreased activity of the enzymes that use thiamine as a cofactor (eg, pyruvate dehydrogenase, a-ketoglutarate dehydrogenase, transketolase). Thiamine deficiency can be diagnosed if baseline erythrocyte transketolase activity is low but increases after addition of thiamine pyrophosphate.
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