Bott C, Lembcke B, Stein J
Medizinische Klinik II, Universitätsklinikum Frankfurt am Main.
Z Gastroenterol. 2003 Mar;41(3):263-70. doi: 10.1055/s-2003-37904.
Nutritional factors are important contributors to colorectal cancer prevention. There is some evidence to suggest that a high dietary folate intake is associated with a reduced risk of colorectal cancer. Folate, which is found in green leafy vegetables, is involved in C1 group transfer and contributes to purin and thymi-dilate synthesis as well as to DNA methylation. Alterations in gene expression and DNA damage are discussed to result from low folate levels and might be associated with an elevated risk of colorectal malignancies. This hypothesis can be supported by the finding that a common polymorphism in the methylentetrahydrofolate reductase gene enhances the risk of colorectal cancer when folate status is low. Both retrospective and prospective epidemiologic studies confirm the observation that a high intake of folate correlates with a lower risk of colorectal cancer. There is also evidence from epidemiological studies that diets which are low in methyl donors, such as low contents of folate and/or methionine combined with relatively high alcohol consumption, even enhance the risk of colorectal cancer. A small number of intervention trials provide first evidence that folate intakes far above recommended dietary allowances might influence possible biomarkers of colorectal tumours.
营养因素是预防结直肠癌的重要因素。有证据表明,高膳食叶酸摄入量与降低结直肠癌风险有关。绿叶蔬菜中含有的叶酸参与C1基团转移,有助于嘌呤和胸腺嘧啶合成以及DNA甲基化。低叶酸水平会导致基因表达改变和DNA损伤,这可能与结直肠恶性肿瘤风险升高有关。亚甲基四氢叶酸还原酶基因的常见多态性在叶酸水平较低时会增加患结直肠癌的风险,这一发现支持了上述假设。回顾性和前瞻性流行病学研究均证实,高叶酸摄入量与较低的结直肠癌风险相关。流行病学研究还表明,甲基供体含量低的饮食,如叶酸和/或蛋氨酸含量低且酒精摄入量相对较高,会增加患结直肠癌的风险。少数干预试验首次证明,远远高于推荐膳食摄入量的叶酸摄入可能会影响结直肠肿瘤的潜在生物标志物。