J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://jocmr.elmerjournals.com

Original Article

Volume 17, Number 9, October 2025, pages 490-498

Association of Sex Difference With Thiamine Responsive Disorders in Internal Medicine: A Pilot Case-Control Study

**Table 1.** Demographic and Clinical Characteristics (n = 35)
	Reference interval at our hospital	TRD group (n = 21)	Non-TRD group (n = 14)	P-value	Missing (%)
Significance: *P < 0.05; †P < 0.1. Data are presented as the number (percentage) using Pearson’s Chi-square test or Fisher’s exact test (two-sided), and median (interquartile range) using Wilcoxon rank-sum test as appropriate. Alb: albumin; ALT: alanine aminotransferase; AST: asparate aminotransferase; BMI: body mass index; BUN: blood urea nitrogen; CONUT: Controlling Nutritional Status; Cre: creatinine; eGFR: estimated glomerular filtration rate; F: female; γGT: gamma-glutamyl transpeptidase; Hb: hemoglobin; M: male; MCV: mean corpuscular volume; Plt: platelet count; PNI: Prognostic Nutritional Index; RBC: red blood cell count; TRD: thiamine responsive disorder; WBC: white blood cell count.
Sex (n, %)				0.023*	0
Male		10 (47.6)	1 (7.1)
Female		11 (52.4)	13 (92.9)
Age (years)		52 (33.5 - 70.5)	43 (24.8 - 76.3)	0.960	0
BMI (kg/m²)		19.8 (17.8 - 22.2)	21.9 (17.3 - 24.8)		51.4
Diet (n, %)					45.7
Normal amount		7 (50)	3 (60)
Unbalanced or small amount		7 (50)	2 (40)
Alcohol consumption (n, %)					48.6
Never		6 (37.5)	2 (100)
Monthly or less		1 (6.3)	0 (0)
2 - 4 times a month		1 (6.3)	0 (0)
2 - 3 times a week		0 (0)	0 (0)
4 or more times a week		8 (50)	0 (0)
Specific comorbidity					2.9
Gastrointestinal tract diseases (including surgery) (n, %)		3 (14.3)	0 (0)	0.251
Specific medication					0
Diuretics (n, %)		2 (9.5)	0 (0)	0.506
Whole blood total vitamin B1 concentration (nmol/L)	80 - 219	93.1 (74.8 - 106.4)	88.1 (82.3 - 111.4)	0.589	0
WBC (/µL)	3,300 - 8,600	5,300 (4,100 - 6,300)	6,400 (4,950 - 8,050)	0.035*	0
Neutrophils (%)	43.0 - 79.0	60.2 (55.3 - 69.6)	65.3 (55.8 - 74.4)	0.429
Lymphocytes (%)	15.0 - 47.0	28.7 (22.4 - 32.9)	27.1 (18.9 - 36.4)	0.840
Monocytes (%)	3.0 - 10.0	6.1 (4.9 - 8)	4.7 (3.7 - 5.8)	0.008*
Eosinophils (%)	1.0 - 5.0	1.6 (0.6 - 3.7)	1.3 (0.5 - 2.9)	0.489
Basophils (%)	0.0 - 1.0	0.5 (0.4 - 0.7)	0.5 (0.3 - 0.6)	0.721
RBC (×10⁴/µL)	435 - 555 (M), 386 - 492 (F)	434 (381.5 - 468)	462 (427 - 480.3)	0.089†	0
Hb (g/dL)	13.7 - 16.8 (M), 11.6 - 14.8 (F)	13 (11.4 - 14.5)	13.4 (11.8 - 14.2)	0.973	0
MCV (fL)	83.6 - 98.2	92.6 (88.0 - 97.8)	88.7 (85.7 - 91.1)	0.031*	0
Plt (×10³/µL)	158 - 348	263 (190.5 - 301)	253.5 (214.3 - 338.8)	0.480	0
AST (U/L)	13 - 30	19 (16.5 - 60.5)	16 (14.5 - 23)	0.028*	0
ALT (U/L)	10 - 42 (M), 7 - 23 (F)	15 (12 - 26)	12 (8.5 - 15.8)	0.098†	0
γGT (U/L)	13 - 64 (M), 9 - 32 (F)	17 (11.5 - 153.8)	16.5 (11.3 - 27.8)	0.533	8.6
Alb (g/dL)	4.1 - 5.1	4.1 (3.7 - 4.5)	4.2 (3.9 - 4.7)	0.417	0
BUN (mg/dL)	8 - 20	11 (8 - 15)	10 (7.5 - 16)	0.893	8.6
Cre (mg/dL)	0.65 - 1.07 (M), 0.46 - 0.79 (F)	0.7 (0.6 - 0.9)	0.7 (0.6 - 0.7)	0.711	0
eGFR (mL/min/1.73 m²)	60.0-	85.4 (60.7 - 107.5)	77.6 (69.7 - 98.0)	0.637	2.9
PNI	41-	47.0 (42.7 - 52.9)	52.0 (48.4 - 54.0)	0.077†	0
Modified CONUT score (n, %)					0
Normal (0 - 1)		11 (52.4)	11 (78.6)	0.162
Low risk (2 - 4)		9 (42.9)	3 (21.4)	0.282
Medium risk (5 - 8)		1 (4.8)	0 (0)	1.000
High risk (9 - 12)		0 (0)	0 (0)

Table 1. Demographic and Clinical Characteristics (n = 35)

Reference interval at our hospital

TRD group (n = 21)

Non-TRD group (n = 14)

P-value

Missing (%)

Significance: *P < 0.05; †P < 0.1. Data are presented as the number (percentage) using Pearson’s Chi-square test or Fisher’s exact test (two-sided), and median (interquartile range) using Wilcoxon rank-sum test as appropriate. Alb: albumin; ALT: alanine aminotransferase; AST: asparate aminotransferase; BMI: body mass index; BUN: blood urea nitrogen; CONUT: Controlling Nutritional Status; Cre: creatinine; eGFR: estimated glomerular filtration rate; F: female; γGT: gamma-glutamyl transpeptidase; Hb: hemoglobin; M: male; MCV: mean corpuscular volume; Plt: platelet count; PNI: Prognostic Nutritional Index; RBC: red blood cell count; TRD: thiamine responsive disorder; WBC: white blood cell count.

Sex (n, %)

0.023*

Male

10 (47.6)

1 (7.1)

Female

11 (52.4)

13 (92.9)

Age (years)

52 (33.5 - 70.5)

43 (24.8 - 76.3)

0.960

BMI (kg/m²)

19.8 (17.8 - 22.2)

21.9 (17.3 - 24.8)

51.4

Diet (n, %)

45.7

Normal amount

7 (50)

3 (60)

Unbalanced or small amount

7 (50)

2 (40)

Alcohol consumption (n, %)

48.6

Never

6 (37.5)

2 (100)

Monthly or less

1 (6.3)

0 (0)

2 - 4 times a month

1 (6.3)

0 (0)

2 - 3 times a week

0 (0)

4 or more times a week

8 (50)

0 (0)

Specific comorbidity

2.9

Gastrointestinal tract diseases (including surgery) (n, %)

3 (14.3)

0 (0)

0.251

Specific medication

Diuretics (n, %)

2 (9.5)

0 (0)

0.506

Whole blood total vitamin B1 concentration (nmol/L)

80 - 219

93.1 (74.8 - 106.4)

88.1 (82.3 - 111.4)

0.589

WBC (/µL)

3,300 - 8,600

5,300 (4,100 - 6,300)

6,400 (4,950 - 8,050)

0.035*

Neutrophils (%)

43.0 - 79.0

60.2 (55.3 - 69.6)

65.3 (55.8 - 74.4)

0.429

Lymphocytes (%)

15.0 - 47.0

28.7 (22.4 - 32.9)

27.1 (18.9 - 36.4)

0.840

Monocytes (%)

3.0 - 10.0

6.1 (4.9 - 8)

4.7 (3.7 - 5.8)

0.008*

Eosinophils (%)

1.0 - 5.0

1.6 (0.6 - 3.7)

1.3 (0.5 - 2.9)

0.489

Basophils (%)

0.0 - 1.0

0.5 (0.4 - 0.7)

0.5 (0.3 - 0.6)

0.721

RBC (×10⁴/µL)

435 - 555 (M), 386 - 492 (F)

434 (381.5 - 468)

462 (427 - 480.3)

0.089†

Hb (g/dL)

13.7 - 16.8 (M), 11.6 - 14.8 (F)

13 (11.4 - 14.5)

13.4 (11.8 - 14.2)

0.973

MCV (fL)

83.6 - 98.2

92.6 (88.0 - 97.8)

88.7 (85.7 - 91.1)

0.031*

Plt (×10³/µL)

158 - 348

263 (190.5 - 301)

253.5 (214.3 - 338.8)

0.480

AST (U/L)

13 - 30

19 (16.5 - 60.5)

16 (14.5 - 23)

0.028*

ALT (U/L)

10 - 42 (M), 7 - 23 (F)

15 (12 - 26)

12 (8.5 - 15.8)

0.098†

γGT (U/L)

13 - 64 (M), 9 - 32 (F)

17 (11.5 - 153.8)

16.5 (11.3 - 27.8)

0.533

8.6

Alb (g/dL)

4.1 - 5.1

4.1 (3.7 - 4.5)

4.2 (3.9 - 4.7)

0.417

BUN (mg/dL)

8 - 20

11 (8 - 15)

10 (7.5 - 16)

0.893

8.6

Cre (mg/dL)

0.65 - 1.07 (M), 0.46 - 0.79 (F)

0.7 (0.6 - 0.9)

0.7 (0.6 - 0.7)

0.711

eGFR (mL/min/1.73 m²)

60.0-

85.4 (60.7 - 107.5)

77.6 (69.7 - 98.0)

0.637

2.9

PNI

41-

47.0 (42.7 - 52.9)

52.0 (48.4 - 54.0)

0.077†

Modified CONUT score (n, %)

Normal (0 - 1)

11 (52.4)

11 (78.6)

0.162

Low risk (2 - 4)

9 (42.9)

3 (21.4)

0.282

Medium risk (5 - 8)

1 (4.8)

0 (0)

1.000

High risk (9 - 12)

0 (0)

**Table 2.** Signs and Symptoms Which Were Suspected to Be a Vitamin B1 Deficiency by the Treating Physicians
	TRD group (n = 21)	Non-TRD group (n = 14)	P-value
Data are presented as the number (percentage) using Pearson’s Chi-square test or Fisher’s exact test (two-sided). Significance: *P < 0.1. OD: orthostatic dysregulation; TRD: thiamine responsive disorder.
Malaise and unidentified complaint (n, %)	3 (30)	7 (70)	0 (0)	5 (100)	0.728
Early satiety, loss of appetite, nausea and dyspepsia (n, %)	4 (66.7)	2 (33.3)	0 (0)	5 (100)	0.721
OD (lightheadedness and syncope) (n, %)	1 (16.7)	5 (83.3)	1 (33.3)	2 (66.7)	0.712
Double and blurred vision (n, %)	2 (66.7)	1 (33.3)	0 (0)	0 (0)	0.259
Leg weakness (n, %)	3 (100)	0 (0)	0 (0)	0 (0)	0.259
Leg edema (n, %)	2 (100)	0 (0)	0 (0)	1 (100)	1.000
Forgetfulness (n, %)	1 (50)	1 (50)	0 (0)	1 (100)	1.000
Fatigability, palpitation, diaphoresis and shortness of breath on exertion (n, %)	0 (0)	0 (0)	0 (0)	3 (100)	0.056*
Palpitation (n, %)	0 (0)	2 (100)	0 (0)	0 (0)	0.506
Whole body pain (n, %)	0 (0)	0 (0)	0 (0)	2 (100)	0.153
Abdominal pain (n, %)	0 (0)	0 (0)	0 (0)	1 (100)	0.400
Feverish (n, %)	0 (0)	1 (100)	0 (0)	0 (0)	1.000
Vertigo (n, %)	1 (100)	0 (0)	0 (0)	0 (0)	1.000
Dizziness (n, %)	0 (0)	0 (0)	0 (0)	1 (100)	0.400
Ear fullness (n, %)	1 (100)	0 (0)	0 (0)	0 (0)	1.000
Irritability (n, %)	0 (0)	1 (100)	0 (0)	0 (0)	1.000

Table 2. Signs and Symptoms Which Were Suspected to Be a Vitamin B1 Deficiency by the Treating Physicians

TRD group (n = 21)

Non-TRD group (n = 14)

P-value

Male

Female

Male

Female

Data are presented as the number (percentage) using Pearson’s Chi-square test or Fisher’s exact test (two-sided). Significance: *P < 0.1. OD: orthostatic dysregulation; TRD: thiamine responsive disorder.

Malaise and unidentified complaint (n, %)

3 (30)

7 (70)

0 (0)

5 (100)

0.728

Early satiety, loss of appetite, nausea and dyspepsia (n, %)

4 (66.7)

2 (33.3)

0 (0)

5 (100)

0.721

OD (lightheadedness and syncope) (n, %)

1 (16.7)

5 (83.3)

1 (33.3)

2 (66.7)

0.712

Double and blurred vision (n, %)

2 (66.7)

1 (33.3)

0 (0)

0.259

Leg weakness (n, %)

3 (100)

0 (0)

0.259

Leg edema (n, %)

2 (100)

0 (0)

1 (100)

1.000

Forgetfulness (n, %)

1 (50)

0 (0)

1 (100)

1.000

Fatigability, palpitation, diaphoresis and shortness of breath on exertion (n, %)

0 (0)

3 (100)

0.056*

Palpitation (n, %)

0 (0)

2 (100)

0 (0)

0.506

Whole body pain (n, %)

0 (0)

2 (100)

0.153

Abdominal pain (n, %)

0 (0)

1 (100)

0.400

Feverish (n, %)

0 (0)

1 (100)

0 (0)

1.000

Vertigo (n, %)

1 (100)

0 (0)

1.000

Dizziness (n, %)

0 (0)

1 (100)

0.400

Ear fullness (n, %)

1 (100)

0 (0)

1.000

Irritability (n, %)

0 (0)

1 (100)

0 (0)

1.000

**Table 3.** Risk Factors for TRDs
Variable	Univariate logistic regression analysis	Multivariate logistic regression analysis (forced entry method)
Significance: *P < 0.05; ^†P < 0.1. An odds ratio (confidence interval) and a P-value were calculated based on likelihood ratio. ALT: alanine aminotransferase; AST: asparate aminotransferase; CI: confidence interval; CONUT: Controlling Nutritional Status; γGT: gamma-glutamyl transpeptidase; MCV: mean corpuscular volume; OR: odds ratio; PNI: Prognostic Nutritional Index.
Sex
Male	1.00 (reference)		1.00 (reference)
Female	0.08 (0.0043 - 0.55)	0.007*	0.03 (0.0009 - 0.32)	0.002*
Age (1-year increments)	1.00 (0.97 - 1.03)	0.955	0.96 (0.91 - 1.00)	0.066^†
AST, ALT, γGT, and MCV
All normal	1.00 (reference)		1.00 (reference)
Any abnormal	2.26 (0.51 - 12.27)	0.291	0.80 (0.08 - 6.54)	0.829
PNI and modified CONUT score
All normal	1.00 (reference)		1.00 (reference)
Any abnormal	3.33 (0.77 - 18.0)	0.109	5.75 (0.87 - 65.6)	0.070†

Table 3. Risk Factors for TRDs

Variable

Univariate logistic regression analysis

Multivariate logistic regression analysis (forced entry method)

OR (95% CI)

P-value

Adjusted OR (95% CI)

P-value

Significance: *P < 0.05; ^†P < 0.1. An odds ratio (confidence interval) and a P-value were calculated based on likelihood ratio. ALT: alanine aminotransferase; AST: asparate aminotransferase; CI: confidence interval; CONUT: Controlling Nutritional Status; γGT: gamma-glutamyl transpeptidase; MCV: mean corpuscular volume; OR: odds ratio; PNI: Prognostic Nutritional Index.

Sex

Male

1.00 (reference)

Female

0.08 (0.0043 - 0.55)

0.007*

0.03 (0.0009 - 0.32)

0.002*

Age (1-year increments)

1.00 (0.97 - 1.03)

0.955

0.96 (0.91 - 1.00)

0.066^†

AST, ALT, γGT, and MCV

All normal

1.00 (reference)

Any abnormal

2.26 (0.51 - 12.27)

0.291

0.80 (0.08 - 6.54)

0.829

PNI and modified CONUT score

All normal

1.00 (reference)

Any abnormal

3.33 (0.77 - 18.0)

0.109

5.75 (0.87 - 65.6)

0.070†