维生素 B3 缺乏症的全球总体患病率尚不清楚。糙皮病主要是一种成人病,通常影响 20~50 岁的成人。还会影响学龄儿童和青少年,然而很少影响婴幼儿。[13]World Health Organization. The management of nutrition in major emergencies. 2000. http://www.who.int/ (last accessed 1 September 2017).http://www.who.int/nutrition/publications/emergencies/9241545208/en/[14]Chawla J, Kvarnberg D. Hydrosoluble vitamins. Handb Clin Neurol. 2014;120:891-914.http://www.ncbi.nlm.nih.gov/pubmed/24365359?tool=bestpractice.com糙皮病与贫穷和营养不良有关,仍然是中国、印度及非洲贫穷地区的地方病。[3]WHO/FAO. Vitamin and mineral requirements in human nutrition. Report of a joint FAO/WHO expert consultation. Bangkok, Thailand. Rome. 2004.在美国,糙皮病在二十世纪早期在谷物为主食的南方诸州较常见,在 1928 年和 1929 年达到高峰。[15]Park YK, Sempos CT, Barton CN, et al. Effectiveness of food fortification in the United States: the case of pellagra. Am J Public Health. 2000;90:727-738.http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.90.5.727http://www.ncbi.nlm.nih.gov/pubmed/10800421?tool=bestpractice.com然而,到 1955 年,主要由于在食物中强化烟酸,才消除了因糙皮病所导致的死亡。自二十世纪八十年代起,全球范围内所报告的糙皮病主要发生于食物供给不足的难民和流离失所的人群中。[16]Mason JB. Lessons on nutrition of displaced people. J Nutr. 2002;132:2096S-2103S.http://jn.nutrition.org/content/132/7/2096S.fullhttp://www.ncbi.nlm.nih.gov/pubmed/12097702?tool=bestpractice.com该病还曾经再次出现于东非和南非,以及其他发生战争或动乱的地区。[17]Seal AJ, Creeke PI, Dibari F, et al. Low and deficient niacin status and pellagra are endemic in postwar Angola. Am J Clin Nutr. 2007;85:218-224.http://www.ajcn.org/content/85/1/218.fullhttp://www.ncbi.nlm.nih.gov/pubmed/17209199?tool=bestpractice.com[18]Lee BY, Thurmon TF. Nutritional disorders among workers in North China during national turmoil. Ann Nutr Metab. 2001;45:175-180.http://www.ncbi.nlm.nih.gov/pubmed/11464001?tool=bestpractice.com[19]Malfait P, Moren A, Dillon JC, et al. An outbreak of pellagra related to changes in dietary niacin among Mozambican refugees in Malawi. Int J Epidemiol. 1993;22:504-511.http://www.ncbi.nlm.nih.gov/pubmed/8359968?tool=bestpractice.com由于慢性酒精中毒、胃肠道吸收不良及异烟肼和抗抑郁药等药物的使用,最近在西欧、美国、澳大利亚及日本均报道过糙皮病病例。[20]Pipili C, Cholongitas E, Ioannidou D. The diagnostic importance of photosensitivity dermatoses in chronic alcoholism: report of two cases. Dermatol Online J. 2008;14:15.http://www.ncbi.nlm.nih.gov/pubmed/19094853?tool=bestpractice.com[21]Kertesz SG. Pellagra in 2 homeless men. Mayo Clin Proc. 2001;76:315-318.http://www.ncbi.nlm.nih.gov/pubmed/11243279?tool=bestpractice.com[22]Viljoen M, Swanepoel A, Bipath P. Antidepressants may lead to a decrease in niacin and NAD in patients with poor dietary intake. Med Hypotheses. 2015;84:178-182.http://www.ncbi.nlm.nih.gov/pubmed/25596911?tool=bestpractice.com