INQUERITO SÔBRE O ESTADO DE NUTRIÇÃO DE UM GRUPO DA POPULAÇÃO DA CIDADE DE SÃO PAULO. III - Investigação sôbre a ocorrência de hipovitaminoses do Complexo B (tiamina, riboflavina e niacina)

Abstract

This paper deals with clinicai and biochemícal examinatíons in order to detect hypovitaminosis of the B complex group in 4208 individuais considered by themselves normal, who, have attended the Health Centers of São Paulo, accompanying patients. The relative importance of the signs and symptoms of the different hypovitaminosis B was discussed. Tlziamine Signs and symptoms related to the Central Nervous, Digestive and Cardiovascular Systems were investigated and are presented on Tables XXI and XXII. The results o f the perception o f vibration o f the tuning fork (256 C.P.S.) in 2336 individuais are presented on Table XX. Studies were undertaken to establish whether a greater incidence of signs and symptoms of hypothiaminosis would be found in individuais presenting already the main ones considered the most characteristic of this deficiency. Considering the relationship among the symptoms and signs of the Central Nervous System, a highly significant Coefficient of variability of Pearson anda positive Coeffícient of Yule were found (see pages 45, 46, 47). The probabilities of an individual with one or more manifestations of the Central Nervous System to have others manifestations were increasingly greater. Similar results were found in regard to the Digestive System In connection with the Cardiovascular System, our studies showed similar results in regarei to related symptoms; meanwhile the relationship among the sign aedema of lower limbs and the other symptoms of the Carddiovascular System was not statistically significant (see page 50 anel 5 I). The urinary excretion of thiamine was detected in I 65 individuais whose results are presenteei in Table XXIII; the average o f urinary elimination being 248, I 8 fLg o f thiamine per gram o f excretccl creatinin and the standard deviation 238,384 anel the standard erro r o f the a ver age I 8,623. The incidence of symptoms anel signs of thiamine deficiency in this group is presenteei on Table XXIV. A greater percentage of symptoms or signs was not found among individuais with a low rate of thiamine excretion. This finding enables us to think that the dosage of thiamine gives only an idea of the actual levei of the individual but does not translated the general nutritional status, as the clinicai examination does. Riboflavin Cutaneous. ocular, labial and lingual signs and symptoms due to Riboflavin deficiency in our group were studiecl, and the condensed results are presenteei, in percentage, on Table XXVI. The occurrence of facial seborrhea, its percentual distribution in accorclance with the location anel grade is founcl on Tahle XXV. More than 90% of facial seborrhea encountered was classified in the first grade, that is, very light.In regard to the incidence of angular stomatitis, 92,59% of the patients had it in the first grade. Greater incidence of signs anel symptoms of arriboflavinosis was found in individuais having already one of the typical signs of this cleficiency disease. See Tables XXVII, XXVIII, XXIX, XXX, and XXXI and corresponding graphs VI. VII, VIII, IX and X. See statistical studies on pages 8 I and 82, as well. The urinary excretion of riboflavin was measured in I 25 individuais, the results, separated in groups, are presenteei in Table XXXII. The average was I I9,46, the standard deviation I57,78, the standard error of the mean I4, I I I. The results of this study point out that 84,80 of the individuais examined had an excretion of rihoflavin considered as resulting from a deficient diet.Table XXXIII and graph XI show the clistribution of the inciclence of signs and symptoms of arriboflavinosis in the groups comprising those whose elimination of vitamin B2 was greater or lesser than 200 ug per gram of excretecl creatinin. We can see that the incidence of arriboflavinosis was higher among those. whose urinary excretion was lesser than 200 p.g of riboflavin per gram of excreted creatinin. Niacin. In the same group, similar studies were undertaken in regard to niacin deficiences. and the results are prescnted on Table XXXIV. The studies of the relationships between symptoms and signs of niacin deficiences are prescnted in condensed form on the Tablcs XXXV, XXXVI,XXXVII and corresponding graphs XII, XIII and XIV; this relationships were statistically low and the probabilities close to 50% c.mong the characteristic features of the niacin deficiency.