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Serum total folate, 5-methyltetrahydrofolate and vitamin B12 concentrations on incident risk of lung cancer |
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| Authors: | Yaping Wei Benjamin Xu Qiangqiang He Ping Chen Qi Zhang Xi Zhang Hui Yuan Yong Duan Zhuo Wang Ziyi Zhou Lishun Liu Yun Song Guangyun Mao Xianhui Qin Genfu Tang Binyan Wang Hao Zhang Huiyuan Guo Hanping Shi |
| Affiliation: | 1. College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China;2. Departments of Epidemiology and Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA;3. Graduate School at Shenzhen, Tsinghua University, Shenzhen, China Shenzhen Evergreen Medical Institute, Shenzhen, China;4. College of Pharmacy, Jinan University, Guangzhou, China;5. Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China;6. Beijing Anzhen Hospital, Capital Medical University, Beijing, China;7. Yunnan Key Laboratory of Laboratory Medicine, Kunming, China Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming, China;8. College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China;9. Shenzhen Evergreen Medical Institute, Shenzhen, China Institute for Biomedicine, Anhui Medical University, Hefei, China;10. Department of Preventive Medicine, School of Public Health & Management, Wenzhou Medical University, Wenzhou, China;11. Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangzhou, China;12. Institute for Biomedicine, Anhui Medical University, Hefei, China;13. Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China |
| Abstract: | Tobacco smoking is a major known risk factor for lung cancer. While micronutrients, especially those involved in maintaining DNA integrity and regulating gene expression, may be protective, research on this association is limited. This report aimed to investigate associations of total folate, 5-methyltetrahydrofolate (5-mTHF) and vitamin B12 with incident risk of lung cancer, and whether the associations vary by smoking status. A nested case-control study with 490 incident lung cancer cases and 490 controls matched by age (±1 year), sex, residence, and center, drawn from a community-based prospective study in China, was conducted from 2016 to 2019. 5-mTHF accounted for the majority of total folate. Only 4.4% had detectable unmetabolized folic acid. Lung cancer cases had lower levels of 5-mTHF compared to controls. There was an inverse, nonlinear association between 5-mTHF and lung cancer, which persisted after adjustment for covariables (P for trend = .001). Compared to the lowest 5-mTHF quartile, those in higher quartiles had lower risks of lung cancer: second quartile OR = 0.65; 95% CI: 0.45-0.93; third quartile OR = 0.50; 95% CI: 0.34-0.74; fourth quartile OR = 0.56; 95% CI: 0.38-0.83. This inverse association was more pronounced among ever smokers; consistently, the highest risk of lung cancer (OR = 3.21, 95% CI: 1.97-5.24) was observed among ever smokers with low 5-mTHF levels compared to participants who never smoked and had higher 5-mTHF levels. Vitamin B12 was not associated with lung cancer risk. In this sample of Chinese adults without confounding by unmetabolized folic acid, higher levels of 5-mTHF were associated with lower risk of incident lung cancer. |
| Keywords: | 5-methyltetrahydro folate lung cancer smoking status vitamin B12 |