Brock A Williams1,2, Kelsey M Cochrane1,2, Jordie A J Fischer1,2, Abeer M Aljaadi1,2, Liadhan McAnena3, Mary Ward3, Helene McNulty3, Hou Kroeun4, Tim J Green5, Kyly C Whitfield6, Crystal D Karakochuk1,2. 1. Department of Food, Nutrition and Health, the University of British Columbia, Vancouver, Canada. 2. British Columbia Children's Hospital Research Institute, Vancouver, Canada. 3. Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, United Kingdom. 4. Helen Keller International, Phnom Penh, Cambodia. 5. South Australian Health and Medical Research Institute, Adelaide, Australia. 6. Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
Abstract
BACKGROUND: Riboflavin is required for erythropoiesis, which is increased in people with hemoglobinopathies due to increased hemolysis and erythrocyte turnover. Dietary intake and status of riboflavin is poor in Cambodia, where hemoglobinopathies are common. OBJECTIVE: We assessed the association between genetic hemoglobin disorders and riboflavin status in women of reproductive age in Cambodia. METHODS: Venous blood samples from 515 Cambodian women of reproductive age, 18-45 y, were analyzed for biomarker status of riboflavin [erythrocyte glutathione reductase activation coefficient (EGRac)], genetic hemoglobin (Hb) disorders, and hematological indices. Linear regression analysis was used to estimate the association between EGRac with Hb, ferritin, and Hb genotypes. EGRac was log transformed in the analyses, and the regression coefficients represent the geometric mean differences. RESULTS: Genetic Hb disorders were present in 57% of the population, with the homozygous hemoglobin E variant (Hb EE) occurring in ∼10% of women (n = 53). Deficient (EGRac ≥1.40) or marginal riboflavin status (EGRac ≥1.30 and <1.40) was observed in 92% (n = 475) of women. The variant Hb EE genotype was associated with 18% (95% CI: 9%, 28%) higher geometric mean EGRac values than the normal Hb AA genotype (P < 0.001). CONCLUSIONS: Although riboflavin biomarker deficiency or marginal status is widely prevalent in Cambodian women, lower riboflavin status was observed more frequently in women with the Hb EE genotype than in women with normal Hb AA. The relation between genetic Hb disorders and riboflavin warrants further investigation. This trial was registered at clinicaltrials.gov as NCT01593423 and NCT02481375.
BACKGROUND:Riboflavin is required for erythropoiesis, which is increased in people with hemoglobinopathies due to increased hemolysis and erythrocyte turnover. Dietary intake and status of riboflavin is poor in Cambodia, where hemoglobinopathies are common. OBJECTIVE: We assessed the association between genetic hemoglobin disorders and riboflavin status in women of reproductive age in Cambodia. METHODS: Venous blood samples from 515 Cambodian women of reproductive age, 18-45 y, were analyzed for biomarker status of riboflavin [erythrocyte glutathione reductase activation coefficient (EGRac)], genetic hemoglobin (Hb) disorders, and hematological indices. Linear regression analysis was used to estimate the association between EGRac with Hb, ferritin, and Hb genotypes. EGRac was log transformed in the analyses, and the regression coefficients represent the geometric mean differences. RESULTS: Genetic Hb disorders were present in 57% of the population, with the homozygous hemoglobin E variant (Hb EE) occurring in ∼10% of women (n = 53). Deficient (EGRac ≥1.40) or marginal riboflavin status (EGRac ≥1.30 and <1.40) was observed in 92% (n = 475) of women. The variant Hb EE genotype was associated with 18% (95% CI: 9%, 28%) higher geometric mean EGRac values than the normal Hb AA genotype (P < 0.001). CONCLUSIONS: Although riboflavin biomarker deficiency or marginal status is widely prevalent in Cambodian women, lower riboflavin status was observed more frequently in women with the Hb EE genotype than in women with normal Hb AA. The relation between genetic Hb disorders and riboflavin warrants further investigation. This trial was registered at clinicaltrials.gov as NCT01593423 and NCT02481375.
Authors: B Wilcken; F Bamforth; Z Li; H Zhu; A Ritvanen; M Renlund; C Stoll; Y Alembik; B Dott; A E Czeizel; Z Gelman-Kohan; G Scarano; S Bianca; G Ettore; R Tenconi; S Bellato; I Scala; O M Mutchinick; M A López; H de Walle; R Hofstra; L Joutchenko; L Kavteladze; E Bermejo; M L Martínez-Frías; M Gallagher; J D Erickson; S E Vollset; P Mastroiacovo; G Andria; L D Botto; M Redlund Journal: J Med Genet Date: 2003-08 Impact factor: 6.318
Authors: Vashti Verbowski; Zaman Talukder; Kroeun Hou; Ly Sok Hoing; Kristina Michaux; Victoria Anderson; Rosalind Gibson; Kathy H Li; Larry D Lynd; Judy McLean; Tim J Green; Susan I Barr Journal: Matern Child Nutr Date: 2018-01-05 Impact factor: 3.092
Authors: Kyly C Whitfield; Crystal D Karakochuk; Yazheng Liu; Adrian McCann; Aminuzzaman Talukder; Hou Kroeun; Mary Ward; Helene McNulty; Larry D Lynd; David D Kitts; Eunice C Y Li-Chan; Judy McLean; Timothy J Green Journal: J Nutr Date: 2015-01-07 Impact factor: 4.798
Authors: Heidi Michels Blanck; Barbara A Bowman; Mary K Serdula; Laura Kettel Khan; William Kohn; Bradley A Woodruff Journal: Am J Clin Nutr Date: 2002-08 Impact factor: 7.045
Authors: Lisa A Houghton; Winsome R Parnell; Christine D Thomson; Timothy J Green; Rosalind S Gibson Journal: J Nutr Date: 2016-07-27 Impact factor: 4.798