Blanck Heidi Michels, Bowman Barbara A, Serdula Mary K, Khan Laura Kettel, Kohn William, Woodruff Bradley A
Division of Nutrition, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Am J Clin Nutr. 2002 Aug;76(2):430-5. doi: 10.1093/ajcn/76.2.430.
Between 1990 and 1993, fear of ethnic persecution led 83,000 ethnic Nepalese to flee from Bhutan to refugee camps in Nepal, where they remained at the time of this study. Reported cases of angular stomatitis (AS), ie, thinning or fissuring at the mouth angles, increased 6-fold from December 1998 to March 1999, from 5.5 to 35.6 cases per 1000 per month. This increase came after the removal of a fortified cereal from rations.
The main objectives were to assess the prevalence of AS and of low concentrations of riboflavin, folate, vitamin B-12, and iron by using biochemical measures; to determine whether riboflavin status was associated with AS; and to assess the potential of AS as a screening measure for low riboflavin concentrations.
In October 1999, we performed a survey among a random sample of 463 adolescent refugees in which we conducted interviews and physical examinations and obtained blood specimens for riboflavin assessment. Riboflavin status was assessed with the erythrocyte glutathione reductase (EC 1.6.4.2) activity coefficient. After we excluded those adolescents who had taken vitamins during the past month, 369 were eligible for analyses.
AS was common (26.8%; 95% CI: 22.3, 31.3), the prevalence of low riboflavin concentrations was high (85.8%; 80.7, 90.9), and riboflavin status was associated with AS. Adolescents with AS had significantly lower riboflavin concentrations than did adolescents without AS (P = 0.02). The adjusted odds ratio for AS and low riboflavin concentrations was 5.1 (1.55, 16.5).
Globally, riboflavin deficiency is rare. Its emergence in food-dependent populations can be a harbinger of other B-vitamin deficiencies.
1990年至1993年间，因恐惧族裔迫害，8.3万尼泊尔族人从不丹逃至尼泊尔的难民营，在本研究开展时他们仍留在那里。据报告，患口角炎（即嘴角变薄或出现裂缝）的病例从1998年12月至1999年3月增加了6倍，从每月每1000人中有5.5例增至35.6例。这一增加是在口粮中取消了一种强化谷物之后出现的。
主要目的是通过生化检测评估口角炎以及核黄素、叶酸、维生素B-12和铁低浓度的患病率；确定核黄素状况是否与口角炎相关；评估口角炎作为核黄素低浓度筛查指标的潜力。
1999年10月，我们对463名青少年难民进行了随机抽样调查，进行了访谈和体格检查，并采集血样以评估核黄素水平。用红细胞谷胱甘肽还原酶（EC 1.6.4.2）活性系数评估核黄素状况。在排除过去一个月内服用过维生素的青少年后，369人符合分析条件。
口角炎很常见（26.8%；95%可信区间：22.3，31.3），核黄素低浓度的患病率很高（85.8%；80.7，90.9），且核黄素状况与口角炎相关。患口角炎的青少年的核黄素浓度显著低于未患口角炎的青少年（P = 0.02）。口角炎与核黄素低浓度的校正比值比为5.1（1.55，16.5）。
在全球范围内，核黄素缺乏很少见。在依赖食物的人群中出现核黄素缺乏可能是其他B族维生素缺乏的先兆。
