Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, 1161 21st Avenue South, Nashville, TN, 37232, USA.
College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
Eur J Nutr. 2020 Mar;59(2):671-683. doi: 10.1007/s00394-019-01934-5. Epub 2019 Mar 5.
We prospectively examined associations of lung cancer risk with food intake of B vitamins involved in one-carbon metabolism and the use of folic acid-containing supplements among a low-income population of black and white adults in the Southeastern US.
Within the Southern Community Cohort Study, we included 1064 incident lung cancer cases among 68,236 participants aged 40-79 years at study enrollment. Food intake and the use of folic acid-containing supplements were assessed using a validated food frequency questionnaire at study enrollment. Multivariate Cox regression was used to estimate hazards ratios (HRs) and the 95% confidence intervals (CIs).
Folate and/or folic acid intake from food were not associated with lung cancer risk; HRs (95% CI) for highest compared with lowest quartile were 1.08 (0.91-1.29) for total dietary folate, 1.00 (0.84-1.19) for food folate, and 1.09 (0.91-1.30) for food folic acid, respectively. Similarly, no associations were observed after stratifying by sex, race and smoking status, except for a positive association with total dietary folate intake among black women (HR 1.46, 95% CI 1.04-2.05 for the highest quartile compared with the lowest quartile, P trend = 0.02). Neither the use of folic acid-containing supplements nor food intake of vitamin B, vitamin B and riboflavin were associated with lung cancer risk.
Our findings do not support a protective effect of folate or folic acid for lung cancer prevention in a low-income population of black and white adults in the Southeastern US. Our finding of a positive association with total dietary folate intake among black women needs to be interpreted with caution and replicated in other studies.
我们前瞻性地研究了在美国东南部的黑人和白人低收入人群中,肺癌风险与参与一碳代谢的维生素 B 类食物摄入以及叶酸补充剂的使用之间的关系。
在南方社区队列研究中,我们纳入了 68236 名 40-79 岁参与者中的 1064 例肺癌新发病例。在研究开始时,使用经过验证的食物频率问卷评估食物摄入和叶酸补充剂的使用情况。使用多变量 Cox 回归估计风险比(HRs)和 95%置信区间(CIs)。
食物中叶酸和/或叶酸的摄入与肺癌风险无关;与最低四分位数相比,最高四分位数的 HRs(95%CI)分别为总膳食叶酸 1.08(0.91-1.29)、食物叶酸 1.00(0.84-1.19)和食物叶酸酸 1.09(0.91-1.30)。同样,在按性别、种族和吸烟状况分层后,也没有观察到关联,除了总膳食叶酸摄入量与黑人女性之间存在正相关(最高四分位数与最低四分位数相比,HR 为 1.46,95%CI 为 1.04-2.05,P 趋势=0.02)。叶酸补充剂的使用或维生素 B、维生素 B 和核黄素的食物摄入均与肺癌风险无关。
我们的研究结果不支持在美国东南部的黑人和白人低收入人群中,叶酸或叶酸补充剂对肺癌预防有保护作用。我们发现黑人女性总膳食叶酸摄入量与肺癌风险之间存在正相关,这一结果需要谨慎解释,并在其他研究中进行验证。