1] Department of Community Nutrition, Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran [2] Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Sciences and Food Technology/National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Sciences and Food Technology/National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Eur J Clin Nutr. 2014 Mar;68(3):316-23. doi: 10.1038/ejcn.2013.209. Epub 2013 Oct 30.
BACKGROUND/OBJECTIVES: Folate, pyridoxine and cobalamin are coenzymatically essential in one-carbon methyl metabolism, and their deficiencies could explain some alterations during breast carcinogenesis. We aimed to evaluate the validity of folate, pyridoxine and cobalamin estimates from a food frequency questionnaire (FFQ) on the basis of their corresponding fasting plasma biomarkers, in breast cancer (BC) patients.
SUBJECTS/METHODS: In a prospective, consecutive case series, 149 women with primary BC aged between 30 and 69 years as a representative sample of Iranian women with BC were recruited. The 136-item FFQ was used for the validity assay. Fasting plasma folate and cobalamin were tested by automated electrochemiluminescence. The high-pressure liquid chromatography with fluorescence detection was used to determine the plasma levels of pyridoxal-5'-phosphate (PLP) and total homocysteine (tHcy).
Area under the curve (AUC) for assessing the diagnostic accuracy of folate-related data through an FFQ was 0.74 (P<0.01) in the reference model (folate plasma level<5.9 ng/ml), with sensitivity and specificity of 68% and 63%, respectively. The positive and negative predictive values (PPV and NPV) were 96.9% and 96.8%, respectively. The AUC for cobalamin intake in the reference model (plasma cobalamin<260 pmol/l) was 0.64 (P<0.01), with 60% sensitivity and 61% specificity. Although tHcy ≥10.0 μmol/l was used as reference indicator, the folate intake (AUC=0.71, P<0.01) and cobalamin intake status (AUC=0.67, P<0.05) were also determined appropriately by FFQ.
Dietary folate and cobalamin estimates from FFQ were significantly correlated with their fasting plasma concentrations. Our data supported the validity of new FFQ to rank individuals by dietary intake status of folate and cobalamin.
背景/目的：叶酸、吡哆醇和钴胺素在一碳甲基代谢中作为辅酶是必不可少的，它们的缺乏可能解释了乳腺癌发生过程中的一些改变。我们旨在评估基于相应的空腹血浆生物标志物的食物频率问卷（FFQ）对叶酸、吡哆醇和钴胺素估计值的有效性，该研究对象为 149 名年龄在 30 至 69 岁之间的原发性乳腺癌（BC）患者。
在一项前瞻性、连续病例系列研究中，招募了 149 名年龄在 30 至 69 岁之间的伊朗原发性 BC 女性患者作为研究对象。采用 136 项食物频率问卷进行有效性检测。使用自动化电化学发光法检测空腹血浆叶酸和钴胺素。采用高效液相色谱法-荧光检测法测定血浆吡哆醛-5'-磷酸（PLP）和总同型半胱氨酸（tHcy）水平。
在参考模型（叶酸血浆水平<5.9ng/ml）中，通过 FFQ 评估叶酸相关数据的诊断准确性的曲线下面积（AUC）为 0.74（P<0.01），其敏感性和特异性分别为 68%和 63%。阳性和阴性预测值（PPV 和 NPV）分别为 96.9%和 96.8%。参考模型中钴胺素摄入量的 AUC（血浆钴胺素<260pmol/l）为 0.64（P<0.01），敏感性为 60%，特异性为 61%。尽管 tHcy≥10.0μmol/l 被用作参考指标，但通过 FFQ 也可以适当确定叶酸摄入量（AUC=0.71，P<0.01）和钴胺素摄入量状态（AUC=0.67，P<0.05）。
FFQ 中膳食叶酸和钴胺素的估计值与它们的空腹血浆浓度显著相关。我们的数据支持了新的 FFQ 用于根据个体的饮食摄入状况对叶酸和钴胺素进行分类的有效性。
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