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Association between folate intake, serum folate levels and the risk of lung cancer: a systematic review and meta-analysis
Authors:DAI Wei-min  YANG Bo  CHU Xiang-yang  WANG Yu-qi  ZHAO Ming  CHEN Li  ZHANG Guo-qing
Affiliation:DAI Wei-min (Department of General Thoracic Surgery,Chinese People's Liberation Army General Hospital, Beijing 100853,China);YANG Bo (Department of General Thoracic Surgery,Chinese People's Liberation Army General Hospital, Beijing 100853,China);CHU Xiang-yang (Department of General Thoracic Surgery,Chinese People's Liberation Army General Hospital, Beijing 100853,China);WANG Yu-qi (Department of General Thoracic Surgery,Chinese People's Liberation Army General Hospital, Beijing 100853,China);ZHAO Ming (Department of General Thoracic Surgery,Chinese People's Liberation Army General Hospital, Beijing 100853,China);CHEN Li (Department of Emergency,Chinese People's Liberation Army General Hospital, Beijing 100853,China);ZHANG Guo-qing (Department Clinic Oncology of Tumor Research Center,Chinese People's Liberation Army General Hospital, Beijing 100853,China);
Abstract:Background Folate plays a critical role in nucleotide synthesis and DNA methylation,and was considered to be associated with anti-carcinogenesis.Results from studies that concern the relationship between the folate intake or serum folate levels and lung cancer risk showed no consistency,which requires our further comprehensive metaanalysis.Methods Systematic literature search was conducted to identify the relevant studies (published prior to February 2013)according to standard protocol.Estimated effects were calculated under both random-effects and fixed-effects models.Heterogeneity between studies and publication bias were also evaluated.Results A total of 4390 cases and 6138 controls from 6 case-control studies revealed a significant overall inverse association between folate intake and lung cancer risk (OR =0.74,95% Cl =0.65-0.84,P< 0.001).Summary of 1438 cases and 2582 controls from 4 case-control studies and 44 cases out of a cohort of 1988 participants suggested a marginal association without significance (OR =0.78,95% Cl =0.60-1.02,P =0.075) between high serum folate levels and less lung cancer susceptibility; however,subgroup analysis about population-based case-control studies showed that high serum folate levels significantly associated with the reduced lung cancer risk (OR =0.76,95% Cl =0.58-1.00,P =0.048).Conclusion Higher folate intake can be a protective factor against lung cancer risk,and higher serum folate level is probably associated with reduced lung cancer risk in marginal manner,though more studies are warranted to confirm these associations.
Keywords:folate intake   serum folate lung cancer   meta-analysis
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