Department of Urology, University of Pittsburgh, Pittsburgh, PA.
Urology. 2013 Dec;82(6):1197-203. doi: 10.1016/j.urology.2013.07.012. Epub 2013 Aug 28.
The US diet has been fortified with folic acid to prevent neural tube defects since 1998. The Physician Data Queries from the National Cancer Institute describe folate as protective against prostate cancer, whereas its synthetic analog, folic acid, is considered to increase prostate cancer risk when taken at levels easily achievable by eating fortified food or taking over-the-counter supplements. We review the present literature to examine the effects of folate and folic acid on prostate cancer, help interpret previous epidemiologic data, and provide clarification regarding the apparently opposing roles of folate for patients with prostate cancer. A literature search was conducted in Medline to identify studies investigating the effect of nutrition and specifically folate and folic acid on prostate carcinogenesis and progression. In addition, the National Health and Nutrition Examination Survey database was analyzed for trends in serum folate levels before and after mandatory fortification. Folate likely plays a dual role in prostate carcinogenesis. There remains conflicting epidemiologic evidence regarding folate and prostate cancer risk; however, there is growing experimental evidence that higher circulating folate levels can contribute to prostate cancer progression. Further research is needed to clarify these complex relationships.
自 1998 年以来，美国的饮食中已经添加了叶酸以预防神经管缺陷。国家癌症研究所的医生数据查询描述了叶酸可以预防前列腺癌，而其合成类似物叶酸酸，如果通过食用强化食品或服用非处方补充剂来达到容易达到的水平，被认为会增加前列腺癌的风险。我们回顾了目前的文献，以检查叶酸和叶酸酸对前列腺癌的影响，帮助解释以前的流行病学数据，并澄清叶酸对前列腺癌患者的明显相反作用。在 Medline 中进行了文献检索，以确定研究营养，特别是叶酸和叶酸酸对前列腺癌发生和发展影响的研究。此外，还分析了国家健康和营养检查调查数据库，以了解强制性强化前后血清叶酸水平的趋势。叶酸在前列腺癌发生中可能起双重作用。关于叶酸和前列腺癌风险的流行病学证据仍然存在矛盾；然而，越来越多的实验证据表明，较高的循环叶酸水平可能会导致前列腺癌的进展。需要进一步的研究来澄清这些复杂的关系。
