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Cited by 31Folate and B Vitamins ResearchIron Metabolism and DisordersNutrition and Health Studies

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

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Aljaadi, Abeer M, How, Ru En, Loh, Su Peng, Hunt, Shannon E, Karakochuk, Crystal D, Barr, Susan I, McAnena, Liadhan, Ward, Mary +4 more·2019·The Journal of Nutrition
DOI 10.1093/jn/nxz151
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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 < 0.001). This relation remained significant (P = 0.029) after adjusting for age, parity, ethnicity, vitamin B-12, folate, sTfR, ferritin, and vitamin A. Women with riboflavin deficiency (EGRac ≥1.40) were twice as likely to present with anemia (adjusted OR: 2.38; 95% CI: 1.08, 5.27) compared with women with EGRac <1.40.Conclusions Biochemical riboflavin deficiency was observed in Canadian and Malaysian women, with higher rates of deficiency among Malaysian women. Deficient biomarker status of riboflavin was a weak but significant predictor of hemoglobin and anemia, suggesting that the correction of riboflavin deficiency may potentially play a small protective role in anemia, but this requires further investigation.

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  1. [8]8. | Coomes MW. Heme biosynthesis. In: Devlin TM, editor. Textbook of | | 411 | | biochemistry: with clinical correlations. 7th ed. Hoboken, NJ: John Wiley & Sons; | | 412 | | 2011. p. 791. | | 413 |
  2. [41]41. | EFSA NDA Panel (EFSA Panel on Dietetic Products N and A, Turck D, Bresson | | 523 | | J, Burlingame B, Dean T, Fairweather-Tait S, Heinonen M, Hirsch-Ernst KI, | | 524 | | Mangelsdorf I, McArdle HJ, et al. Scientific opinion on Dietary Reference Values | | 525 | | for riboflavin. EFSA J. 2017;15:17-9. | | 526 |

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Authors
Aljaadi, A. M., How, R. E., Loh, S. P., Hunt, S. E., Karakochuk, C. D., Barr, S. I., McAnena, L., Ward, M., McNulty, H., Khor, G. L., Devlin, A. M., & Green, T. J.
Affiliations
  • University of British Columbia (CA)
  • Universiti Putra Malaysia (MY)
  • South Australian Health and Medical Research Institute (AU)
  • University of Ulster (GB)
Corresponding author
Green, Tim J
ORCID
Venue
The Journal of Nutrition
Publisher
Elsevier BV
Published
2019-11
Volume
149
Issue
11
Pages
1952-1959
ISSN
0022-3166 (ISSN-L)
DOI
10.1093/jn/nxz151
OpenAlex
W2963667266
Cited by
31
References
45
Citations by year
2026: 3 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 6 · 2021: 3 · 2020: 6
FWCI
2.83
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Universiti Putra Malaysia Institutional Repository (Universiti Putra Malaysia) (acceptedVersion)
  • Ulster University Research Portal (Ulster University) (acceptedVersion, other-oa)
Funders
  • Dairy Farmers of Canada
  • Natural Sciences and Engineering Research Council of Canada
  • Umm Al-Qura University
  • BC Children's Hospital Research Institute
Topics
  • Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
  • Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
Keywords
riboflavin deficiency, anemia, hemoglobin levels, women of reproductive age, soluble transferrin receptor, ferritin, vitamin B12, folic acid, vitamin A, micronutrient status, cross-national comparison, Canadian women, Malaysian women
MeSH terms
Adult, Anemia, Canada, Female, Ferritins, Hemoglobins, Humans, Malaysia, Middle Aged, Nutritional Status, Receptors, Transferrin, Riboflavin, Riboflavin Deficiency, Biomarkers, Prevalence, Young Adult

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