Dhana Ashar, Yen Hsi, Li Tricia, Holmes Michelle D, Qureshi Abrar A, Cho Eunyoung
Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Dermatology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Cancer Epidemiol. 2018 Aug;55:176-183. doi: 10.1016/j.canep.2018.06.006. Epub 2018 Jul 7.
Nutrients involved in one-carbon metabolism - folate, vitamins B6 and B12, methionine, choline, and betaine - have been inversely associated with multiple cancer sites and may be related to skin cancer. However, there is a lack of research on the association between intake of these nutrients and cutaneous melanoma risk. The aim of this study was to examine the associations between intake of one-carbon metabolism nutrients and cutaneous melanoma risk in two large prospective cohorts.
The cohorts included 75,311 white women and 48,523 white men. Nutrient intake was assessed repeatedly by food frequency questionnaires and self-reported supplement use. We used Cox proportional hazards regression to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) and then pooled HRs using a random-effects model.
Over 24-26 years of follow-up, we documented 1328 melanoma cases (648 men and 680 women). Higher intake of folate from food only, but not total folate, was associated with increased melanoma risk (pooled HR for top versus bottom quintile: 1.36; 95% CI: 1.13-1.64; P for trend = 0.001). The association was significant in men, but attenuated in women. Higher intake of vitamins B6 and B12, choline, betaine, and methionine were not associated with melanoma risk, although there was modest increasing trend of risk for vitamin B6 from food only (pooled HR for top versus bottom quintile: 1.18; 95% CI: 0.99-1.41; P for trend = 0.03).
We found some evidence that higher intake of folate from food only was associated with a modest increased risk of cutaneous melanoma. However, since other factors related to dietary folate intake may account for the observed association, our findings warrant further investigation.
参与一碳代谢的营养素——叶酸、维生素B6、维生素B12、蛋氨酸、胆碱和甜菜碱——与多种癌症部位呈负相关,可能与皮肤癌有关。然而,关于这些营养素的摄入量与皮肤黑色素瘤风险之间的关联,目前缺乏相关研究。本研究的目的是在两个大型前瞻性队列中,检验一碳代谢营养素的摄入量与皮肤黑色素瘤风险之间的关联。
队列包括75311名白人女性和48523名白人男性。通过食物频率问卷和自我报告的补充剂使用情况,反复评估营养素摄入量。我们使用Cox比例风险回归来估计多变量调整后的风险比(HRs)和95%置信区间(CIs),然后使用随机效应模型汇总HRs。
在24至26年的随访中,我们记录了1328例黑色素瘤病例(648名男性和680名女性)。仅食物来源的叶酸摄入量较高,但总叶酸摄入量并非如此,与黑色素瘤风险增加相关(最高五分位数与最低五分位数的汇总HR:1.36;95%CI:1.13 - 1.64;趋势P值 = 0.001)。这种关联在男性中显著,但在女性中减弱。维生素B6、维生素B12、胆碱、甜菜碱和蛋氨酸的摄入量较高与黑色素瘤风险无关,尽管仅食物来源的维生素B6有适度的风险增加趋势(最高五分位数与最低五分位数的汇总HR:1.18;95%CI:0.99 - 1.41;趋势P值 = 0.03)。
我们发现一些证据表明,仅食物来源的叶酸摄入量较高与皮肤黑色素瘤风险适度增加有关。然而,由于与膳食叶酸摄入量相关的其他因素可能解释所观察到的关联,我们的发现值得进一步研究。