|REN, JIANSONG - Chinese Academy Of Medical Sciences|
|MURPHY, GWEN - National Institutes Of Health (NIH)|
|FAN, JINHU - Chinese Academy Of Medical Sciences|
|DAWSEY, SANFORD - National Institutes Of Health (NIH)|
|TAYLOR, PHILIP - National Institutes Of Health (NIH)|
|SELHUB, JACOB - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|QIAO, YOU-LIN - Chinese Academy Of Medical Sciences|
|ABNET, CHRISTIAN - National Institutes Of Health (NIH)|
Submitted to: Scientific Reports
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/8/2016
Publication Date: 10/17/2016
Citation: Ren, J., Murphy, G., Fan, J., Dawsey, S.M., Taylor, P.R., Selhub, J., Qiao, Y., Abnet, C.C. 2016. Prospective study of serum B vitamins levels and oesophageal and gastric cancers in China. Scientific Reports. 6:35281. https://doi.org/10.1038/srep35281.
Interpretive Summary: The function of B vitamins in health and disease is not always obvious, particularly in developed countries where nutritious foods and access to supplements are at easy reach. This study was conducted in rural China where such commodities are not always available. From a large set of stored blood samples, we measured the levels of B vitamins in a subset of subjects that developed cancer during 5 years of observation and a control group that remained cancer-free. We studied almost 500 patients who went on to develop esophageal cancer, 250 patients who went on to develop stomach cancers, and about 1,000 controls. The data obtained showed that people who went on to develop esophageal cancer had lower riboflavin (B2) concentrations in blood, whereas people who went on to develop esophageal cancer or stomach cancer had lower vitamin B12 plasma levels. In addition, higher serum flavin mononucleotide levels were significantly associated with increased risk of esophageal and gastric cardia cancer. These data suggest that proper B vitamin nutrition may be important for cancer prevention.
Technical Abstract: B vitamins play an essential role in DNA synthesis and methylation, and may protect against oesophageal and gastric cancers. In this case-cohort study, subjects were enrolled from the General Population Nutrition Intervention Trial in Linxian, China. Subjects included 498 oesophageal squamous cell carcinomas (OSCCs), 255 gastric cardia adenocarcinomas (GCAs), and an age- and sex-matched sub-cohort of 947 individuals. Baseline serum riboflavin, pyridoxal phosphate (PLP), folate, vitamin B12, and flavin mononucleotide (FMN) were measured for all subjects. We estimated the associations with Cox proportional hazard models, with adjustment for potential confounders. Compared to those in the lowest quartile of serum riboflavin, those in the highest had a 44% lower risk of OSCC (HR: 0.56, 95% CI: 0.41 to 0.75). Serum vitamin B12 as a continuous variable was observed to be significantly inversely associated with OSCC (HR: 0.95, 95% CI: 0.89 to 1.01, P for score test=0.041). Higher serum FMN levels were significantly associated with increased risk of OSCC (HR: 1.08, 95% CI: 1.01 to 1.16) and GCA (HR: 1.09, 95% CI: 1.00 to 1.20). Our study prompted that B vitamins have the potential role as chemopreventive agents for upper gastrointestinal cancers.