Effect of Magnesium+Thiamine on red cell Transketolase Activity (ETKA)
Research type
Research Study
Full title
A prospective randomised controlled trial (PRCT) of the effect of Magnesium Sulphate administration on Red Cell (Erythrocyte) Transketolase Activity (ETKA) in Alcoholic patients at risk of Wernicke Korsakoff Syndrome treated with Thiamine
IRAS ID
201773
Contact name
Donogh Maguire
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Chronic alcoholics have a 30-80% incidence of thiamine deficiency causing Wernicke’s Encephalopathy (WE).
WE has a 20% mortality and 85% progress to irreversible brain damage. Intravenous (IV) thiamine replacement is standard practice in the treatment of alcoholic patients presenting to the A&E department, however routine co-supplementation with magnesium sulphate (MgSO4), a co-factor for thiamine in many energy producing metabolic processes, e. g. on the activity of the enzyme transketolase in red blood cells, is not routine practice in the treatment of these patients. Without correction of concomitant magnesium deficiency there may be impaired utilisation of thiamine resulting in a failure to treat WE.
In this study we would like to extend out previous work by randomising alcoholic patients to treatment with either thiamine alone, MgSO4 alone, or thiamine plus MgSO4, to determine whether treatment with MgSO4 has any effect on its own on red blood cell transketolase activity, or only acts to increase the effect of thiamine.
Transketolase activity reflects the activity of thiamine in the Pentose Phosphate Pathway, and suboptimal activity of this enzyme therefore indicates impaired energy producing potential, which in turn will more severely affect cells with a high energy requirement. Hence, the areas of the brain with highest metabolic demand are most vulnerable and affected first. These are the areas which control organised thought, and coordination.Patients therefore become confused and lose coordination of walking and balance. Samples would be taken at baseline and 2h after treatment. Standard treatment with IV Thiamine will then be administered to those patients randomised to the 'Magnesium sulphate alone' group.REC name
West of Scotland REC 3
REC reference
16/WS/0162
Date of REC Opinion
23 Sep 2016
REC opinion
Further Information Favourable Opinion