Abstract：
Incidence of esophageal and gastric cancer has been linked to low B-vitamin status. We conducted matched nested case-control studies of incident esophageal squamous cell carcinoma (ESCC; 340 case-control pairs) and gastric cancer (GC; 352 case-control pairs) within the Golestan Cohort Study. The primary exposure was plasma biomarkers: riboflavin and flavin mononucleotide (FMN) (vitamin B2), pyridoxal phosphate (PLP) (B6), cobalamin (B12), para-aminobenzoylglutamate (pABG) (folate), and total homocysteine (tHcy); and indicators for deficiency: 3-hydroxykyurenine-ratio (HK-r for vitamin B6) and methylmalonic acid (MMA for B12). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression adjusting for matching factors and potential confounders. High proportions of participants had low B-vitamin and high tHcy levels. None of the measured vitamin B levels was associated with the risk of ESCC and GC, but elevated level of MMA was marginally associated with ESCC (OR = 1.42, 95% CI = 0.99-2.04) and associated with GC (OR = 1.53, 95% CI = 1.05-2.22). Risk of GC was higher for the highest versus lowest quartile of HK-r (OR = 1.95, 95%CI = 1.19-3.21) and for elevated versus non-elevated HK-r level (OR = 1.59, 95% CI = 1.13-2.25). Risk of ESCC (OR = 2.81, 95% CI = 1.54-5.13) and gastric cancer (OR = 2.09, 95%CI = 1.17-3.73) was higher for the highest versus lowest quartile of tHcy. In conclusion, insufficient vitamin B12 was associated with higher risk of ESCC and GC, and insufficient vitamin B6 status was associated with higher risk of GC in this population with prevalent low plasma B-vitamin status. Higher level of tHcy, a global indicator of OCM function, was associated with higher risk of ESCC and GC.
摘要：
食管癌和胃癌的发病率与维生素B水平低有关。我们在Golestan队列研究中对发生的食管鳞状细胞癌（ESCC；340例对照对）和胃癌（GC；352例对照对）进行了匹配的巢式病例对照研究。主要暴露于血浆生物标志物：核黄素和黄素单核苷酸（FMN）（维生素B2），磷酸吡哆醛（PLP）（B6），钴胺素(B12),对氨基苯甲酰基谷氨酸（pABG）（叶酸），和总同型半胱氨酸（tHcy）；和缺乏指标：3-羟基菊酯比率（HK-r代表维生素B6）和甲基丙二酸（MMA代表B12）。我们使用条件逻辑回归对匹配因素和潜在混杂因素进行调整来估计比值比（OR）和95％置信区间（CI）。高比例的参与者具有低B-维生素和高tHcy水平。没有测量的维生素B水平与ESCC和GC的风险相关，但MMA水平升高与ESCC(OR=1.42,95%CI=0.99-2.04)和GC(OR=1.53,95%CI=1.05-2.22)略有相关。最高四分位数与最低四分位数HK-r（OR=1.95，95CI=1.19-3.21）和升高与非升高HK-r水平（OR=1.59，95％CI=1.13-2.25）的GC风险较高。tHcy最高四分位数与最低四分位数相比，ESCC（OR=2.81，95％CI=1.54-5.13）和胃癌（OR=2.09，95CI=1.17-3.73）的风险更高。总之,维生素B12不足与ESCC和GC的高风险相关，在血浆B族维生素普遍水平较低的人群中，维生素B6水平不足与GC风险较高相关。更高水平的tHcy，OCM功能的全局指标，与ESCC和GC的高风险相关。
