Carmichael Suzan L, Yang Wei, Correa Adolfo, Olney Richard S, Shaw Gary M
California Research Division, March of Dimes Foundation, Oakland, California, USA.
J Urol. 2009 Jan;181(1):315-21; discussion 321. doi: 10.1016/j.juro.2008.09.041. Epub 2008 Nov 14.
We examined whether hypospadias is associated with maternal intake of folic acid containing vitamin/mineral supplements or dietary intake of nutrients related to one-carbon metabolism (folate, choline, vitamins B12 and B6, thiamine, riboflavin, methionine and zinc).
The study included births from October 1997 to December 2003 that were part of the National Birth Defects Prevention Study. Diet was assessed by food frequency questionnaire during maternal telephone interviews. Analyses included 915 cases with second or third degree hypospadias (urethra opened at the penile shaft, scrotum or perineum) and 2,266 male, liveborn, nonmalformed controls. All ORs and 95% CIs were estimated from logistic regression models that included several potential confounders. Nutrient based analyses also included energy intake.
Hypospadias risk was not associated with supplement use (adjusted ORs were 1.2, 95% CI 0.9-1.6 for intake beginning in the month before or the first month of pregnancy and 1.1, 95% CI 0.8-1.4 for intake beginning in the second or third month, relative to no intake). Among women who took supplements reduced hypospadias risk was associated with higher dietary intakes of choline, methionine and vitamin B12. The respective ORs (CIs) for the highest vs lowest quartiles were 0.7 (0.5-1.1), 0.6 (0.4-0.9) and 0.7 (0.5-1.0). Among women who did not take supplements increased risk of hypospadias was associated with higher vitamin B12 intake. The OR (CI) for the highest vs lowest quartile was 3.1 (1.1-9.0).
This study suggests an association of hypospadias with intake of certain nutrients related to one-carbon metabolism.
我们研究了尿道下裂是否与母亲摄入含叶酸的维生素/矿物质补充剂或与一碳代谢相关营养素（叶酸、胆碱、维生素B12和B6、硫胺素、核黄素、蛋氨酸和锌）的饮食摄入有关。
该研究纳入了1997年10月至2003年12月出生的婴儿，这些婴儿是国家出生缺陷预防研究的一部分。在母亲电话访谈期间，通过食物频率问卷评估饮食情况。分析包括915例二度或三度尿道下裂（尿道开口于阴茎干、阴囊或会阴）病例以及2266例存活、非畸形的男性活产对照。所有比值比（OR）和95%可信区间（CI）均通过包含多个潜在混杂因素的逻辑回归模型进行估计。基于营养素的分析还包括能量摄入。
尿道下裂风险与补充剂使用无关（相对于未摄入，妊娠前一个月或妊娠第一个月开始摄入的调整后OR为1.2，95%CI为0.9 - 1.6；妊娠第二个月或第三个月开始摄入的调整后OR为1.1，95%CI为0.8 - 1.4）。在服用补充剂的女性中，尿道下裂风险降低与胆碱、蛋氨酸和维生素B12的饮食摄入量较高有关。最高四分位数与最低四分位数相比的相应OR（CI）分别为0.7（0.5 - 1.1）、0.6（0.4 - 0.9）和0.7（0.5 - 1.0）。在未服用补充剂的女性中，尿道下裂风险增加与维生素B12摄入量较高有关。最高四分位数与最低四分位数相比的OR（CI）为3.1（1.1 - 9.0）。
本研究表明尿道下裂与某些与一碳代谢相关营养素的摄入有关。
