Division of Medical Oncology, The Ohio State University College of Medicine, Columbus, OH.
Women's Health Initiative, Fred Hutchinson Cancer Research Center, Seattle, WA.
Int J Cancer. 2020 Sep 1;147(5):1374-1384. doi: 10.1002/ijc.32913. Epub 2020 Feb 25.
We and others have reported associations between B vitamins principally involved in one-carbon metabolism and increased lung cancer risk; however, results for women have been inconsistent. Here we report on the association of supplemental vitamins B , folic acid and B intake and lung cancer risk using data from the Women's Health Initiative (WHI) study of postmenopausal women. Between 1993 and 1998, 161,808 women were recruited to participate in the WHI at 40 clinical centers in the US. After exclusions, 159,232 women were available for analysis and followed prospectively for an average of 18.3 years. Among them, 3,836 incident lung cancer cases were diagnosed. At baseline, supplemental B vitamins from multivitamins, vitamin mixtures and individual supplements were assessed. Adjusted Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations between supplemental B vitamin intake and lung cancer risk. Relative to no intake, women who took ≥50 mg/day of vitamin B had 16% (HR 0.84, 95% CI: 0.71-0.99) reduced lung cancer risk. Associations did not differ significantly by smoking status or lung cancer histology. Intakes of folic acid and vitamin B were not associated with risk. There is a need for replication of our findings from other large, prospective studies with similar high-quality measurement of supplement intakes before any recommendations can be made at present on B supplementation for lung cancer prevention in women.
我们和其他人已经报道了主要参与一碳代谢的 B 族维生素与肺癌风险增加之间的关联;然而,女性的结果一直不一致。在这里,我们报告了补充维生素 B、叶酸和 B 族维生素摄入与肺癌风险之间的关联,使用了来自美国妇女健康倡议(WHI)的绝经后妇女研究的数据。在 1993 年至 1998 年期间,有 161808 名妇女被招募参加 WHI 在美国的 40 个临床中心。经过排除后,有 159232 名妇女可用于分析,并前瞻性随访平均 18.3 年。其中,诊断出 3836 例肺癌病例。在基线时,评估了来自多种维生素、维生素混合物和单一补充剂的补充 B 族维生素。使用调整后的 Cox 回归模型来估计补充 B 族维生素摄入与肺癌风险之间的关联的危险比(HR)和 95%置信区间(CI)。与不摄入相比,每天摄入≥50mg 维生素 B 的妇女肺癌风险降低 16%(HR 0.84,95%CI:0.71-0.99)。关联与吸烟状况或肺癌组织学无显著差异。叶酸和维生素 B 的摄入量与风险无关。在目前可以提出任何关于女性肺癌预防中 B 族补充剂的建议之前,需要其他大型前瞻性研究对我们的发现进行复制,这些研究需要对补充剂摄入量进行类似的高质量测量。