Suboptimal Biochemical Riboflavin Status Is Associated with Lower Hemoglobin and Higher Rates of Anemia in a Sample of Canadian and Malaysian Women of Reproductive Age

Aljaadi AM 1 , How RE 2 , Loh SP 2 , Hunt SE 3 , Karakochuk CD 1 , Barr SI 1 Show all authors , McAnena L 4 , Ward M 4 , McNulty H 4 , Khor GL 2 , Devlin AM 5 , Green TJ 1

Affiliations 

  • 1 Department of Food, Nutrition, and Health, University of British Columbia, Vancouver, British Columbia, Canada
  • 2 Department of Nutrition and Dietetics, Universiti Putra Malaysia, Selangor, Malaysia
  • 3 Healthy Mothers, Babies, and Children Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
  • 4 Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland
  • 5 Department of Pediatrics, University of British Columbia, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
J Nutr, 2019 Nov 01;149(11):1952-1959.
PMID: 31318024 DOI: 10.1093/jn/nxz151

Abstract

BACKGROUND: Riboflavin is required for several redox reactions. Clinical riboflavin deficiency occurs mainly in low-income countries, where it is associated with anemia. The functional significance of suboptimal riboflavin status in different populations and its role in anemia is not well understood.

OBJECTIVES: We assessed the biomarker status of riboflavin and its association with hemoglobin concentration and anemia in women living in Vancouver, Canada, and Kuala Lumpur, Malaysia.

METHODS: Healthy nonpregnant, nonbreastfeeding women (19-45 y) were recruited from Canada ( n = 206) and Malaysia (n = 210) via convenience sampling. Fasting blood was collected to assess riboflavin status [erythrocyte glutathione reductase activity coefficient (EGRac)], hematological indicators, soluble transferrin receptor (sTfR), ferritin, vitamin A, folate, and vitamin B-12 concentrations. Linear and logistic regression models were used to assess the association of riboflavin status with hemoglobin concentration and anemia.

RESULTS: EGRac (mean ± SD) values were higher, indicating poorer riboflavin status, in Malaysian compared with Canadian women (1.49 ± 0.17 compared with 1.38 ± 0.11). Likewise, riboflavin biomarker deficiency (EGRac ≥1.40) was significantly more prevalent among Malaysians than Canadians (71% compared with 40%). More Malaysian than Canadian women were anemic (hemoglobin <120 g/L; 18% compared with 7%). With use of linear regression (pooled sample; n = 416), EGRac values were negatively associated with hemoglobin concentration (r = -0.18; P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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