title: Normal riboflavin status in malaria patients in Gabon.
abstract: Previous publications reported commonly the occurrence of riboflavin deficiency and a positive correlation between riboflavin status and parasitemia in patients with Plasmodium falciparum malaria. In these studies, riboflavin status was determined by erythrocyte glutathione reductase activation coefficients (EGRACs). Inherited low erythrocyte glutathione reductase activity is highly prevalent in malarial regions, however. To rule out falsely diagnosed riboflavin deficiency in affected patients, we conducted an investigation using a high-performance liquid chromatography method (HPLC) instead of the EGRAC method. In 29 infants (age range, 1-5 years), 22 schoolchildren (age range, 6-12 years), and 33 adolescents and adults (age range, 13-74 years) from Lambaréné, Gabon, with acute P. falciparum malaria, plasma concentrations of riboflavin, flavin mononucleotide (FMN), and flavin adenine dinucleotide (FAD) were measured by HPLC. Results were correlated with parasite densities. Profiles of plasma concentrations of all 3 flavin compounds were within the normal range in all patients. Concentrations of free riboflavin were not different between the 3 age groups. In adolescents and adults, FMN and FAD concentrations were higher than in infants (P = 0.002 and P = 0.001) and schoolchildren (P = 0.003 and P = 0.002). Comparing children with hyperparasitemic and uncomplicated malaria, no difference in the concentrations of either flavin compound was found. Neither the concentrations of free riboflavin nor the concentrations of one of the flavin nucleotides correlated with parasitemia within subgroups of age or of children with uncomplicated and hyperparasitemic malaria. Our data indicate that nutritional riboflavin deficiency might have been overestimated in previous malaria studies and do not support a relationship between flavin concentrations and parasitemia in P. falciparum malaria.
authors.affiliation: Department of Internal Medicine I, Division of Infectious Diseases, University of Vienna, Vienna, Austria. ftraunmueller@netscape.net
authors.forename: Friederike
authors.initials: F
authors.lastname: Traunmüller
authors.forename: Michael
authors.initials: M
authors.lastname: Ramharter
authors.forename: Heimo
authors.initials: H
authors.lastname: Lagler
authors.forename: Florian
authors.initials: F
authors.lastname: Thalhammer
authors.forename: Peter G
authors.initials: PG
authors.lastname: Kremsner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Graninger
authors.forename: Stefan
authors.initials: S
authors.lastname: Winkler
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002851:Chromatography, High Pressure Liquid; D004912:Erythrocytes / Q000737:chemistry; D005260:Female; D005486:Flavin Mononucleotide / Q000097:blood; D005182:Flavin-Adenine Dinucleotide / Q000097:blood; D005681:Gabon / Q000453:epidemiology; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000150:complications / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D012256:Riboflavin / Q000097:blood*; D012257:Riboflavin Deficiency / Q000150:complications / Q000453:epidemiology* / Q000469:parasitology
chemical_list: D005182:Flavin-Adenine Dinucleotide; D005486:Flavin Mononucleotide; D012256:Riboflavin