Lower risk of cervical intraepithelial neoplasia in women with high plasma folate and sufficient vitamin B12 in the post-folic acid fortification era.
Lower risk of cervical intraepithelial neoplasia in women with high plasma folate and sufficient vitamin B12 in the post-folic acid fortification era.
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DOI：
10.1158/1940-6207.capr-08-0175
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发表时间：
2009-07
期刊：
影响因子：
--
通讯作者：
Partridge EE
中科院分区：
文献类型：
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作者：
Piyathilake CJ;Macaluso M;Alvarez RD;Bell WC;Heimburger DC;Partridge EE
本研究的目的是确定叶酸强化时代后美国血浆叶酸和维生素 B12 浓度对宫颈癌风险的影响。该研究纳入了 376 名绝经前育龄妇女，她们的高危 (HR) 人乳头瘤病毒 (HPV) 感染检测呈阳性，并被诊断为宫颈上皮内瘤变 (CIN) 2 级或以上（CIN 2+，病例）或≤CIN 1（非病例）。 CIN 2+（是/否）是逻辑回归模型中的因变量，该模型指定血浆叶酸浓度与血浆 B12 浓度结合作为主要关注的独立预测因子，调整年龄、种族、教育、吸烟、奇偶数、终生男性性伴侣数量、避孕药具的使用、腰围、体力活动、健康饮食指数以及维生素 A、C、生育酚和总维生素的循环浓度 胡萝卜素。与血浆叶酸≤19.8 ng/mL和血浆维生素 B12 <200.6的女性相比，血浆叶酸超生理浓度（>19.8 ng/mL）且血浆维生素 B12 (≥200.6 pg/mL)充足的女性被诊断为 CIN 2+ 的几率降低 70% (P = 0.04) 皮克/毫升。我们的结果并没有证实美国后的超生理血浆叶酸浓度的担忧。叶酸强化时代会增加绝经前育龄妇女患 CIN 的风险。事实上，较高的叶酸含量与显着降低的 CIN 风险相关，尤其是当维生素 B12 充足时，这证明了维生素 B12 在叶酸强化计划所创造的高叶酸环境中的重要性。
The purpose of this study was to determine the influence of plasma folate and vitamin B12 concentrations on cervical cancer risk in the U.S. after the folic acid fortification era. The study included 376 premenopausal women of childbearing age who tested positive for infections with high-risk (HR) human papillomaviruses (HPVs) and were diagnosed with cervical intraepithelial neoplasia (CIN) grade 2 or higher (CIN 2+, cases) or ≤CIN 1 (noncases). CIN 2+ (yes/no) was the dependent variable in logistic regression models that specified plasma folate concentrations combined with plasma B12 concentrations as the independent predictors of primary interest, adjusting for age, race, education, smoking, parity, number of lifetime male sexual partners, use of contraceptives, waist circumference, physical activity, healthy eating index, and circulating concentrations of vitamins A, C, tocopherol, and total carotene. Women with supraphysiologic concentrations of plasma folate (>19.8 ng/mL) who also had sufficient plasma vitamin B12 (≥200.6 pg/mL) had 70% lower odds of being diagnosed with CIN 2+ (P = 0.04) when compared with women with plasma folate of ≤19.8 ng/mL and plasma vitamin B12 of <200.6 pg/mL. Our results do not corroborate the concern that supraphysiologic plasma folate concentrations seen in the post-U.S. folic acid fortification era increase the risk of CIN in premenopausal women of childbearing age. In fact, higher folate is associated with significantly lower risk of CIN, especially when vitamin B12 is sufficient, demonstrating the importance of vitamin B12 in the high-folate environment created by the folic acid fortification program.